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Out of Nowhere
Published in Rae-Ellen W. Kavey, Allison B. Kavey, Viral Pandemics, 2020
Rae-Ellen W. Kavey, Allison B. Kavey
In 1990, there was a dramatic development when a terrifying disease struck monkeys imported from the Philippines to the United States for research, while they were in quarantine in Virginia. Symptoms were similar to the clinical picture of Ebola hemorrhagic fever with 100% fatality, but despite extensive contact between caretakers and monkeys, no humans developed any signs of illness and only four handlers even showed antibody evidence of infection. The virus was subsequently found to have originated in captive macaques in the Philippines and was identified as a new Ebola virus, named Ebola Reston.111 There have still been no human illnesses attributed to Ebola Reston but in 2008, the Reston virus was identified as the cause of an epidemic of hemorrhagic fever in pigs; again, animal caretakers had antibody evidence of infection but no humans developed disease.112,113 This is important because it suggests that pigs – known to also be infected with EBOV Zaire – could potentially serve as the site for development of a new recombinant virus capable of infecting humans with an extremely high fatality disease.
Diagnostic Approach to Fulminant Hepatitis in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Ebola, also called Ebola hemorrhagic fever, is a viral hemorrhagic fever of humans caused by the Ebola virus, a member of the Filoviridae family. It is spread by direct contact with body fluids, such as blood, stool, and vomitus of an infected human. Ebola is characterized by fever, fatigue, vomiting, diarrhea, rash, kidney, liver failure, and occasionally bleeding. It is associated with a high case fatality rate of 54.7%, with fatality rates reported to increase with age and high viral load [28]. Patients with Ebola virus disease were found to have AST/ALT levels of more than five times the upper limit of normal and, in severe cases, levels of more than 15 times the upper limit of normal [29]. Diagnosis of Ebola can be made by serum PCR on blood drawn within 3 days of the onset of symptoms. A rapid chromatographic immunoassay (ReEBOV) that detects Ebola virus antigen can provide results within 15 minutes; however, this has been associated with false-positive results in 10% of patients who tested negative by PCR [30]. On postmortem liver biopsy, hepatocellular necrosis with minimal inflammation is the primary histological finding. There is no specific therapy for Ebola, and treatment includes fluids and supportive care.
The Pathogenesis and Pathology of the Hemorrhagic State in Viral and Rickettsial Infections
Published in James H. S. Gear, CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
Ebola hemorrhagic fever manifested similar clinical features in the outbreaks in both Zaire and Sudan.108-111 Prominent early symptoms included fever, headache, myalgia, diarrhea, and vomiting with later appearance of hemorrhage and pharyngitis. Other clinical observations were prostration, abdominal pain, nausea, anorexia, cough, conjunctivitis, arthralgia, CNS involvement, including neurologic signs and psychosis, and spontaneous abortion. Sudan cases were described as having, in addition, chest pain and a morbilliform rash that underwent desquamation. Hemorrhagic diathesis was observed in 70% of cases and included hematemesis, bloody diarrhea, melena, ecchymoses, epistaxis, and bleeding from the gums and vagina. Laboratory evaluations were incomplete, but have shown thrombocytopenia, prolonged prothrombin time, serum fibrin degradation products, leukopenia, and elevated serum alanine aminotransferase and aspartate aminotransferase in selected cases.
Acute inhalation toxicity of aerosolized electrochemically generated solution of sodium hypochlorite
Published in Inhalation Toxicology, 2022
Bohdan Murashevych, Dmitry Girenko, Hanna Maslak, Dmytro Stepanskyi, Olha Abraimova, Olha Netronina, Petro Zhminko
In recent decades, the fight against infections has again become one of the most important goals of mankind. This is due to several factors. Firstly, the trend toward an increase in population density obviously leads to an increase in the concentration of people in public places, which, in turn, significantly increases the risk of epidemics of infectious diseases, especially those transmitted by the aerogenic mechanism (Tarwater and Martin 2001; Li et al. 2018; Amoo et al. 2020). Secondly, the processes of globalization, new transport technologies, and the development of tourism have significantly changed the patterns of migration, involving more and more people in interstate and intercontinental passenger flows (Vignier and Bouchaud 2018; Gossling et al. 2021). Because of this, the spread of infections, including endemic ones such as Ebola hemorrhagic fever or Zika fever, can become rampant in a very short time (Chakhtoura et al. 2018; Hasan et al. 2019). The third important factor is the increase in the number of multi-resistant microorganisms – superbugs – that are resistant to the antibiotic drugs and some traditional antiseptics, including alcohols, can actively form biofilms and have long ceased to be exclusively hospital infectious agents (Adegoke et al. 2016; Aslam et al. 2018; Pidot et al. 2018). And the latest events related to the COVID-19 pandemic have emphasized once again the vital need for the development and ubiquitous use of new means and systems of disinfection as the most effective way to prevent infectious diseases (Shimabukuro et al. 2020; Dhama et al. 2021).
Nanovaccine: an emerging strategy
Published in Expert Review of Vaccines, 2021
The precise design of immunogenic epitopes of entrapped or surface displayed antigens, along with sophistication of biocompatible nanoparticles form an attractive alternative to conventional vaccines. By a tunable size, shape and attached functional groups, targeted delivery of various bioactive compounds via intravenous, intramuscular and mucosal routes can be assured by NPs. Emerging preclinical evidences suggest PLGA, cationic liposomes and SLNs to be promising NP platforms for new generation vaccines that address the short-comings of various live-attenuated and subunit vaccines. However, research should advance in terms of safety, commercial feasibility and cost-effectiveness for successful clinical translations of potent nanovaccines against fatal infectious diseases like Ebola hemorrhagic fever, influenza, Nipah virus infection, dengue, visceral leishmaniasis, HIV, Lassa hemorrhagic fever, trypanosomiasis etc. and cancer. Additionally, cationic mucoadhesive polymers may find extensive use in case of orally, vaginally and respiratory transmitted diseases like influenza, TB, HIV and Herpes where mucosal immunity plays a vital role.
Targeting Ebola virus replication through pharmaceutical intervention
Published in Expert Opinion on Investigational Drugs, 2021
Frederick Hansen, Heinz Feldmann, Michael A Jarvis
Due to a lack of consistent association of hemorrhagic symptomology with infection, Ebola hemorrhagic fever (EHF) was renamed EVD during the 2013–2015 West Africa epidemic. Due to its relatively higher association with human outbreaks (as well as wild ape disease), most is known about EBOV compared to other ebolaviruses, and therefore EBOV will serve as the primary focus of this review. Characteristics of disease associated with EBOV infection result both from direct as well as indirect mechanisms. EVD is characterized by an initial viral prodrome and febrile illness (headache, myalgia, nausea and vomiting), followed by capillary leakage and hemorrhage, which progresses in severe cases to a septic-shock like syndrome with disseminated intravascular coagulation (DIC) and multiorgan failure [20]. EBOV replicates in a wide variety of different cell types (macrophages, dendritic cells (DCs), endothelial cells, hepatocytes and fibroblasts) during infection [21], and the biology of EBOV within these different cells accounts, in large part, for characteristics of EVD.