Science & Technology Review >

2014 , Vol. 32 >Issue 24: 15 - 24

DOI: https://doi.org/10.3981/j.issn.1000-7857.2014.24.001

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Ebola Virus Disease: Epidemiology, Ecology, Diagnosis, Treatment, and Control

  • LI Yu ,
  • REN Xiang ,
  • LIU Di ,
  • CHENG Ying ,
  • GAO George Fu ,
  • YU Hongjie
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  • 1. Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
    2. CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China;
    3. Chinese Center for Disease Control and Prevention, Beijing 102206, China

Received date: 2014-08-20

  Online published: 2014-08-27

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Abstract

Ebolavirus is the causative agent of Ebola Virus Disease (EVD) and was first found in 1976 in Africa. The genus of Ebolavirus includes 5 species, of which the 4 species, i.e., Sudan ebolavirus, Zaire ebolavirus, Taï Forest ebolavirus and Bundibugyo ebolavirus caused human cases of EVD in the history. The additional species, Reston ebolavirus, was associated with several outbreaks among monkeys and was once isolated from domestic pigs of Philippines. EVD has a fatality rate between 25% and 90%, with its outbreaks in humans limited to Africa and mainly happened in central Africa between 10°N and 10°S so far. The ongoing outbreak in West Africa has been the biggest one, with 2615 cases reported as of August 20, 2014. EVD is widely considered to be a zoonosis and its most likely natural reservoirs are fruit bats based on the current evidence. Ebolavirus can spread within human, mainly through contact of blood and secretions of patients presenting symptoms and the contaminated objects as well. So the health care staff, home care person and individuals with contact of corpse of EVD cases are the high risk population for infection. EVD has an abrupt onset of early symptoms such as fever, anorexia and weakness, which are nonspecific. But the disease can be diagnosed through testing RNA, antigen, or antibody. There have been no licensed drugs or vaccine in the market, while the treatment is still limited to treating the symptoms as they appear and supportive care. The current strategy for prevention and control includes early detection of cases, rapid investigation and response, tracing and close observation of high risk contact, and effective infection control in the health care facilities and the community.

Key words： Ebola virus disease; Ebolavirus; epidemiology

Cite this article

LI Yu , REN Xiang , LIU Di , CHENG Ying , GAO George Fu , YU Hongjie . Ebola Virus Disease: Epidemiology, Ecology, Diagnosis, Treatment, and Control[J]. Science & Technology Review, 2014 , 32(24) : 15 -24 . DOI: 10.3981/j.issn.1000-7857.2014.24.001

References

[1] World Health Organization. Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation (Interim version 1.1) [M/OL].[2014-08-10]. http://www.who.int/csr/disease/ebola/manual_EVD/en.
[2] WorldHealthOrganization.WHOstatementonthemeetingoftheInternational Health Regulations Emergency Committee regarding the 2014 Ebola outbreak in West Africa [EB/OL]. (2014-08-08) [2014-08-10]. http:// www.who.int/mediacentre/news/statements/2014/polio-20140505/en.
[3] Centres for Disease Prevention and Control. Ebola hemorrhagic fever- 2014 Ebola outbreak in West Africa [EB/OL]. [2014-08-24]. http://www. cdc.gov/vhf/ebola/outbreaks/guinea/index.html.
[4] Cheng Y, Liu J, Li Y, et al. Ebloa viral disease: Update research of etiology, pathogenic mechanism, treatment and vaccine[J]. Chinese Science Bulletin, (under review).
[5] World Health Organization. Ebola haemorrhagic fever in Sudan, 1976 [J]. Bull World Health Organ, 1978, 56: 247-270.
[6] World Health Organization. Ebola haemorrhagic fever in Zaire, 1976 [J]. Bull World Health Organ, 1978, 56: 271-293.
[7] Cox N J, McCormick J B, Johnson K M, et al. Evidence for two subtypes of Ebola virus based on oligonucleotide mapping of RNA [J]. J Infect Dis, 1983, 147: 272-275.
[8] Jahrling P B, Geisbert T W, Johnson E D, et al. Preliminary report: Isolation of Ebola virus from monkeys imported to USA[J]. The Lancet, 1990, 335: 502-505.
[9] Le Guenno B, Formenty P, Wyers M, et al. Isolation and partial characterisation of a new strain of Ebola virus [J]. The Lancet, 1995, 345: 1271-1274.
[10] Wamala J F, Lukwago L, Malimbo M, et al. Ebola hemorrhagic fever associated with novel virus strain, Uganda, 2007—2008 [J]. Emerg Infect Dis, 2010, 16(7): 1087-1092.
[11] Emond R T, Evans B, Bowen E T, et al. A case of Ebola virus infection[J]. British Medical Journal. 1977, 2(6086): 541-544.
[12] Borisevich I V, Markin V A, Firsova I V, et al. Hemorrhagic (Marburg, Ebola, Lassa, and Bolivian) fevers: Epidemiology, clinical pictures, and treatment [J]. Voprosy Virusologii-Problems of Virology, 2006, 51(5): 8- 16.
[13] Akinfeyeva L A, Aksyonova O I, Vasilyevich I V, et al. A case of Ebola hemorrhagic fever[J]. Infektsionnye Bolezni, 2005, 3(1): 85-88.
[14] Barrette R W, Metwally S A, Rowland J M, et al. Discovery of swine as a host for the Reston ebolavirus [J]. Science, 2009, 325: 204-206.
[15] Jahrling P B, Geisbert T W, Johnson E D, et al. Preliminary report: Isolation of Ebola virus from monkeys imported to USA[J]. The Lancet, 1990, 335: 502-505.
[16] Hayes C G, Burans J P, Ksiazek T G. Outbreak of fatal illness among captive macaques in the Philippines caused by an Ebola-related filovirus[J]. The American Journal Tropical Medicine and Hygiene, 1992, 46: 664-671.
[17] World Health Organization. Viral haemorrhagic fever in imported monkeys[R]. Weekly Epidemiological Record, Ceneva: WHO, 1992, 67 (24): 183.
[18] Rollin P E, Williams J, Bressler D, et al. Isolated cases of Ebola (subtype Reston) virus among quarantined non-hman primates recently imported from the Philippines to the United States[J]. Journal of Infectious Diseases, 1999, 179 (Suppl 1): 108-114.
[19] Miranda M E, Ksiazek T G, Retuya T J, et al. Epidemiology of Ebola (subtype Reston) virus in the Philippines, 1996[J]. Journal of Infectious Diseases, 1999, 179 (Suppl 1): 115-119.
[20] Miranda M E, White M E, Dayrit M M, et al. Seroepidemiological study of filovirus related to Ebola in the Philippines [J]. The Lancet, 1991, 337: 425-426.
[21] Centers for Disease Control and Prevention. Update: Filovirus infection in animal handlers [J]. Morbidity Mortality Weekly Report, 1990, 39 (13): 221.
[22] World Health Organization. Ebola virus disease in Guinea—23 March 2014 [EB/OL]. [2014- 03- 25]. http://www.who.int/csr/don/2014_03_ 23_ebola/en.
[23] Baize S, Pannetier D, Oestereich L, et al. Emergence of Zaire Ebola virus disease in Guinea- Preliminary Report[J]. N Engl J Med, [2014- 08-14] http://www.nejm.org/doi/full/10.1056/NEJMoa1404505.
[24] European Centre for Disease Prevention and Control. Outbreak of Ebola virus disease in West Africa [R/OL]. (2014-08-01)[2014-08-14]. http:// www.ecdc.europa.eu/en/publications/_layouts/forms/Publication_DispForm. aspx?List=4f55ad51-4aed-4d32-b960-af70113dbb90&ID=1141.
[25] Pourrut X, Délicat A, Rollin P E, et al. Spatial and temporal patterns of Zaire ebolavirus antibody prevalence in the possible reservoir bat species [J]. J Infect Dis, 2007, 196 Suppl 2): 176-183.
[26] Towner J S, Amman B R, Sealy T K, et al. Isolation of genetically diverse Marburg viruses from Egyptian fruit bats [J]. PLoS Pathogens, 2009, 5.[2014-08-14] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2713404.
[27] Leroy E M, Epelboin A, Mondonge V, et al. Human Ebola outbreak resulting from direct exposure to fruit bats in Luebo, Democratic Republic of Congo, 2007[J]. Vector-Borne and Zoonotic Diseases, 2009, 9: 723-728.
[28] Bausch D G, Nichol S T, Muyembe- Tamfum J J, et al. Marburg haemorrhagic fever associated with multiple genetic lineages of virus [J]. N Engl J Med, 2006, 355: 909-919.
[29] Bausch D G, Borchert M, Grein T, et al. Risk factors for Marburg hemorrhagic fever, Democratic Republic of the Congo[J]. Emerg Infect Dis, 2003, 9: 1531-1537.
[30] Leroy E M, Kumulungui B, Pourrut X, et al. Fruit bats as reservoirs of Ebola virus[J]. Nature，2005, 438 (7068): 575-576.
[31] Swanepoel R, Leman P A, Burt F J, et al. Experimental inoculation of plants and animals with Ebola virus[J]. Emerg Infect Dis, 1996, 2(4): 321-325.
[32] Morvan J M, Deubel V, Gounon P, et al. Identification of Ebola virus sequences present as RNA or DNA in organs of terrestrial small mammals of the Central African Republic [J]. Microbes and Infection, 1999, 1: 1193-1201.
[33] Leroy E M, Rouquet P, Formenty P, et al. Multiple Ebola virus transmission events and rapid decline of central African wildlife [J]. Science, 2004, 303(5656): 387-390.
[34] Formenty P, Boesch C, Wyers M, et al. Ebola virus outbreak among wild chimpanzees living in a rain forest of Cote d'Ivoire [J]. J Infect Dis, 1999, 179(Suppl 1): 120-126.
[35] Bermejo M, Rodríguez-Teijeiro J D, Illera G, et al. Ebola outbreak killed 5000 gorillas[J]. Science, 2006, 314 (5805): 1564.
[36] Nkoghe D, Formenty P, Leroy E M, et al. Multiple Ebola virus haemorrhagic fever outbreaks in Gabon, from October 2001 to April 2002[J]. Bull Soc Pathol Exot. 2005, 98 (3): 224-229.
[37] Formenty P, Libama F, Epelboin A, et al. Outbreak of Ebola hemorrhagic fever in the Republic of the Congo, 2003: a new strategy[J]. Med Trop (Mars). 2003, 63(3): 291-295.
[38] Feldmann H, Jones S, Klenk H D, et al. Ebola virus: From discovery to vaccine [J]. Nature Reviews Immunology, 2003, 3(8): 677-685.
[39] Heinz F, Thomas W G. Ebola haemorrhagic fever [J]. The Lancet, 2011, 377: 849-862.
[40] Groseth A, Feldmann H, Strong J E. The ecology of Ebola virus [J]. Trends in Microbiology, 2007, 15(9): 408-416.
[41] Pan Y, Zhang W, Cui L, et al. Reston virus in domestic pigs in China [J]. Arch Virol, 2014, 159(5): 1129-1132.
[42] Georges A J, Leroy E M, Renaud A A, et al. Ebola hemorrhagic fever outbreaks in Gabon, 1994—1997: Epidemiologic and health control issues[J]. J Infect Dis, 1999, 179(Suppl 1): 65-75.
[43] Geisbert T W, Hensley L E, Larsen T, et al. Pathogenesis of Ebola haemorrhagic fever in cynomolgus macaques: evidence that dendritic cells are early and sustained targets of infection [J]. Am J Pathol, 2003, 163(6): 2347-2370.
[44] Kuniholm M H. Bat exposure is a risk factor for Ebola virus infection[C]// Filoviruses: Recent advance and future challenges: An ICID Global Symposium, Winnipeg, Manitoba, Canada, 2006.
[45] Peters C J, LeDuc L W. Ebola: The virus and the disease [J]. J Infect Dis, 1999, 179 (Suppl 1): 1-288.
[46] Khan A S, Tshioko F K, Heymann D L, et al. The reemergence of Ebola haemorrhagic fever, Democratic Republic of the Congo, 1995 [J]. J Infect Dis, 1999, 179 (Suppl 1): 76-86.
[47] Ksiazek T G, West C P, Rollin P E, et al. ELISA for the detection of antibodies to Ebola virus [J]. J Infect Dis, 1999, 179 (Suppl 1): 192-198.
[48] Rodriguez L L, De Roo A, Guimard Y, et al. Persistence and genetic stability of Ebola virus during the outbreak in Kikwit, Democratic Republic of the Congo, 1995 [J]. J Infect Dis, 1999, 179 (Suppl 1): 170- 176.
[49] Zaki S R, Shieh W J, Greer P W, et al. A novel immunohistochemical assay for the detection of Ebola virus in skin: Implications for diagnosis, spread, and surveillance of Ebola haemorrhagic fever [J]. J Infect Dis, 1999, 179(Suppl 1): 36-47.
[50] Jahrling P B, Geisbert T W, Jaax N K, et al. Experimental infection of cynomolgus macaques with Ebola-Reston filoviruses from the 1989— 1990 U.S. epizootic [J]. Arch Virol, 1996, 11 (Suppl 1): 115-134.
[51] Piercy T J, Smither S J, Steward J A, et al. The survival of filoviruses in liquids, on solid substrates and in a dynamic aerosol [J]. J Appl Microbiol. 2010, 109 (5): 1531-1539.
[52] Geisbert T W, Daddario-Dicaprio K M, Geisbert J B, et al. Vesicular stomatitis virus- based vaccines protect nonhuman primates against aerosol challenge with Ebola and Marburg viruses [J]. Vaccine, 2008, 26 (52): 6894-6900.
[53] Bertherat E, Renaut A, Nabias R, et al. Leptospirosis and ebola virus infection in five gold-panning villages in northeastern Gabon[J]. Am J Trop Med Hyg, 1999, 60(4): 610-615.
[54] Rowe A K, Bertolli J, Khan A S, et al. Clinical, virologic, and immunologic follow- up of convalescent Ebola haemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo [J]. J Infect Dis, 1999, 179 (Suppl 1): 28-35.
[55] Colebunders R, Borchert M. Ebola haemorrhagic fever—A review [J]. J Infect, 2000, 40(1): 16-20.
[56] Centres for Disease Control and Prevention. Interim guidance for monitoring and movement of persons with Ebola virus disease exposure[R/OL]. [2014- 08- 15]. http://www.cdc.gov/vhf/ebola/hcp/monitoringand- movement-of-persons-with-exposure.html.
[57] Centres for Disease Control and Prevention. Ebola hemorrhagic feversigns and symptoms [EB/OL]. [2014- 08- 15]. http://www.cdc.gov/vhf/ ebola/symptoms/index.html.
[58] Okware S I, Omaswa F G, Zaramba S, et al. An outbreak of Ebola in Uganda[J]. Tropical Medicine and International Health. 2002, 7(12): 1068-1075.
[59] Kortepeter M G, Bausch D G, Bray M. Basic clinical and laboratory features of filoviral hemorrhagic fever [J]. J Infect Dis, 2011, 204 (Suppl 3): 810-816.
[60] Bwaka M A, Bonnet M J, Calain P. Ebola hemorrhagic fever in Kikwit, Democratic Republic of Congo: Clinical observations in 103 patients [J]. J Infect Dis, 1999, 179(Suppl 1): 1-7.
[61] Strong J E, Grolla A, Jahrling P B, et al. Filoviruses and arenaviruses[C]// Detrick B, Hamilton R G, Folds J D. Manual of molecular and clinical laboratory immunology. 7th ed. Herndo, Virginia: ASM Press, 2006: 774-790.
[62] US Food and Drug Administration. Emergency use authorizations-2014 Ebola virus emergency use authorization [EB/OL]. [2014-08-17]. http:// www.fda.gov/medicaldevices/safety/emergencysituations/ucm161496. htm.
[63] Centres for Disease Control and Prevention. Ebola hemorrhagic feverdiagnosis[ EB/OL].[2014-08-15].http://www.cdc.gov/vhf/ebola/diagnosis/ index.html.
[64] Fauci A S. Ebola—Underscoring the global disparities in health care resources[EB/OL]. [2014-08-17]. http://www.nejm.org/doi/full/10.1056/ NEJMp1409494.
[65] Centre for Infectious Disease Research and Ppolicy. Experimental Ebola drug may have helped 2 US patients [EB/OL]. [2014-08-11]. http://www.cidrap.umn.edu/news-perspective/2014/08/experimental-ebola- drug-may-have-helped-2-us-patients.
[66] Mupapa K, Massamba M, Kibadi K, et al. Treatment of Ebola haemorrhagic fever with blood transfusions from convalescent patients. International Scientific and Technical Committee [J]. J Infect Dis, 1999, 179 (Suppl 1): 18-23.
[67] Feldmann H, Jones S M, Schnittler H J, et al. Therapy and prophylaxis of Ebola virus infections [J]. Curr Opin Investig Drugs, 2005, 6(8): 823-830
[68] Bray M, Paragas J. Experimental therapy of filovirus infections [J]. Antiviral Res, 2002, 54 (1): 1-17.
[69] Centres for Disease Prevention and Control. Ebola hemorrhagic fever-treatment [EB/OL]. [2014-08-16]. http://www.cdc.gov/vhf/ebola/ treatment/index.html.
[70] Huggins J W. Prospects for treatment of viral haemorrhagic fevers with ribavirin, a broad-spectrum antiviral drug [J]. Rev Infect Dis, 1989, 11 (Suppl 4): 750-761.
[71] Ignatyev G, Steinkasserer A, Streltsova M, et al. Experimental study on the possibility of treatment of some haemorrhagic fevers [J]. J Biotechnol, 2000, 83(1/2): 67-76.
[72] MacNeil A, Farnon E C, Morgan O W, et al. Filovirus outbreak detection and surveillance: Lessons from Bundibugyo[J]. J Infect Dis, 2011, 204 (Suppl 3): 761-767.
[73] Borchert M, Mutyaba I, van Kerkhove M D, et al. Ebola haemorrhagic fever outbreak in Masindi District, Uganda: Outbreak description and lessons learned [J]. BMC Infect Dis, 2011, 11: 357.
[74] World Health Organization, Centres for Disease Control and Prevention. Infection Control for Viral Haemorrhagic Fevers [R/OL]. [2014-08-15]. http://www.cdc.gov/vhf/abroad/pdf/african-healthcare-setting-vhf.pdf.
[75] Dowell S F, Mukunu R, Ksiazek T G, et al. Transmission of Ebola haemorrhagic fever: A study of risk factors in family members, Kikwit, Democratic Republic of the Congo, 1995 [J]. J Infect Dis, 1999, 179 (Suppl 1): 87-91.
[76] Lloyd E S, Zaki S R, Rollin P E, et al. Long-term disease surveillance in Bandundu region, Democratic Republic of the Congo: A model for early detection and prevention of Ebola haemorrhagic fever [J]. J Infect Dis, 1999, 179 (Suppl 1): 274-280.
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