Ebola virus disease: a zoonotic disease with an extremely high fatality rate / 中国热带医学

@# Ebola virus disease (EVD) is a severe infectious disease caused by Ebola virus in humans and primates. The main clinical features are fever and bleeding. The disease was first identified in Zaire and Sudan in Africa in 1976. Since then, it has caused many large-scale epidemics in Africa. One of the largest and most complex Ebola outbreaks in history was the 2014-2016 outbreak in West Africa, which caused more cases and deaths than all previous outbreaks combined. As of 2022, about 35 000 EVD cases and 15 000 deaths have been reported. During the African pandemic, EVD also spread to other regions outside the African continent, such as the Americas and Europe, and became a public health issue of worldwide concern. In Africa, the re-emergence of the disease in Uganda and the Republic of Congo in 2022 has attracted much attention from the world. This article systematically summarizes the history, epidemiological distribution, route of infection, clinical symptoms, diagnosis, treatment, prevention and control of Ebola virus disease, so as to provide reference for relevant workers in China.

Global Epidemic of Ebola Virus Disease and the Importation Risk into China: An Assessment Based on the Risk Matrix Method / 生物医学与环境科学（英文）

OBJECTIVE@#To analyze the global epidemic status of the Ebola virus disease (EVD) and assess the importation risk into China.@*METHODS@#Data from World Health Organization reports were used. We described the global epidemic status of EVD from 1976-2021, and assessed and ranked the importation risk of EVD from the disease-outbreaking countries into China using the risk matrix and Borda count methods, respectively.@*RESULTS@#From 1976-2021, EVD mainly occurred in western and central Africa, with the highest cumulative number of cases (14,124 cases) in Sierra Leone, and the highest cumulative fatality rate (85%) in the Congo. Outbreaks of EVD have occurred in the Democratic Republic of the Congo and Guinea since 2018. The importation risk into China varies across countries with outbreaks of disease. The Democratic Republic of the Congo had an extremely high risk (23 Borda points), followed by Guinea and Liberia. Countries with a moderate importation risk were Nigeria, Uganda, Congo, Sierra Leone, Mali, and Gabon, while countries with a low importation risk included Sudan, Senegal, and Co

Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease

Background: Experience from the Zaire Ebolavirus epidemic in the eastern Democratic Republic of the Congo (2018­2020) demonstrates that early initiation of essential critical care and administration of Zaire Ebolavirus specific monoclonal antibodies may be associated with improved outcomes among patients with Ebola virus disease (EVD). Objectives: This series describes 13 EVD patients and 276 patients with suspected EVD treated during a Zaire Ebolavirus outbreak in Guinea in 2021. Method: Patients with confirmed or suspected EVD were treated in two Ebola treatment centres (ETC) in the region of N'zérékoré. Data were reviewed from all patients with suspected or confirmed EVD hospitalised in these two ETCs during the outbreak (14 February 2021 ­ 19 June 2021). Ebola-specific monoclonal antibodies, were available 2 weeks after onset of the outbreak. Results: Nine of the 13 EVD patients (age range: 22­70 years) survived. The four EVD patients who died, including one pregnant woman, presented with multi-organ dysfunction and died within 48 h of admission. All eight patients who received Ebola-specific monoclonal antibodies survived. Four of the 13 EVD patients were health workers. Improvement of ETC design facilitated implementation of WHO-recommended 'optimized supportive care for EVD'. In this context, pragmatic clinical training was integrated in routine ETC activities. Initial clinical manifestations of 13 confirmed EVD patients were similar to those of 276 patients with suspected, but subsequently non confirmed EVD. These patients suffered from other acute infections (e.g. malaria in 183 of 276 patients; 66%). Five of the 276 patients with suspected EVD died. One of these five patients had Lassa virus disease and a coronavirus disease 2019 (COVID-19) co-infection. Conclusion: Multidisciplinary outbreak response teams can rapidly optimise ETC design. Trained clinical teams can provide WHO-recommended optimised supportive care, including safe administration of Ebola-specific monoclonal antibodies. Pragmatic training in essential critical care can be integrated in routine ETC activities. Contribution: This article describes clinical realities associated with implementation of WHO-recommended standards of 'optimized supportive care' and administration of Ebola virus specific treatments. In this context, the importance of essential design principles of ETCs is underlined, which allow continuous visual contact and verbal interaction of health workers and families with their patients. Elements that may contribute to further quality of care improvements for patients with confirmed or suspected EVD are discussed.

Points of entry dynamics: understanding the cross-border threats for Ebola virus disease and COVID-19 in Ghana using a logic model approach

Background. The influx of people across the national borders of Ghana has been of interest and concern in the public health and national security community in recent times due to the low capacity for the prevention and management of epidemics and other public health risks. Although the International Health Regulations (IHR) stipulate core public health capacities for designated border facilities such as international airports, seaports, and ground crossings, contextual factors that influence the attainment of effective public health measures and response capabilities remain understudied. Objective. To assess the relationship between contextual factors and COVID-19 procurement to help strengthen infrastructure resources for points of entry (PoE) public health surveillance functions, thereby eliminating gaps in the design, implementation, monitoring, and evaluation of pandemicrelated interventions in Ghana. Materials and Methods. This study employed a mixed-methods design, where quantitative variables were examined for relationships and effect size interactions using multiple linear regression techniques and the wild bootstrap technique. Country-level data was sourced from multiple publicly available sources using the social-ecological framework, logic model, and IHR capacity monitoring framework. The qualitative portion included triangulation with an expert panel to determine areas of convergence and divergence. Results. The most general findings were that laboratory capacity and KIA testing center positively predicted COVID-19 procurement, and public health response and airline boarding rule negatively predicted COVID-19 procurement. Conclusion. Contextual understanding of the COVID-19 pandemic and Ebola epidemic is vital for strengthening PoE mitigation measures and preventing disease importation.

Mathematical modelling approach of the study of Ebola virus disease transmission dynamics in a developing country

Background: Ebola Virus causes disease both in human and non-human primatesespecially in developing countries. In 2014 during its outbreak, it led to majority of deaths especially in some impoverished area of West Africa and its effect is still witnessed up till date. Materials and Methods:We studied the spread of Ebola virus and obtained a system of equations comprising of eighteen equations which completely described the transmission of Ebola Virus ina population where control measures were incorporated and a major source of contacting the disease which is the traditional washing of dead bodies was also incorporated. We investigated the local stability of the disease-free equilibrium using the Jacobian Matrix approach and the disease-endemic stability using the center manifold theorem. We also investigated the global stability of the equilibrium points using the LaSalle's Invariant principle.Results: The result showed that the disease-free and endemic equilibrium where both local and globally stable and that the system exhibits a forward bifurcation.Conclusions: Numerical simulations were carried out and our graphs show that vaccine and condom use is best for susceptible population, quarantine is best for exposed population, isolation is best for infectious population and proper burial of the diseased dead is the best to avoid further disease spread in the population and have quicker and better recovery.

The two-stage interaction of Ebola virus VP40 with nucleoprotein results in a switch from viral RNA synthesis to virion assembly/budding

Ebola virus (EBOV) is an enveloped negative-sense RNA virus and a member of the filovirus family. Nucleoprotein (NP) expression alone leads to the formation of inclusion bodies (IBs), which are critical for viral RNA synthesis. The matrix protein, VP40, not only plays a critical role in virus assembly/budding, but also can regulate transcription and replication of the viral genome. However, the molecular mechanism by which VP40 regulates viral RNA synthesis and virion assembly/budding is unknown. Here, we show that within IBs the N-terminus of NP recruits VP40 and is required for VLP-containing NP release. Furthermore, we find four point mutations (L692A, P697A, P698A and W699A) within the C-terminal hydrophobic core of NP result in a stronger VP40-NP interaction within IBs, sequestering VP40 within IBs, reducing VP40-VLP egress, abolishing the incorporation of NC-like structures into VP40-VLP, and inhibiting viral RNA synthesis, suggesting that the interaction of N-terminus of NP with VP40 induces a conformational change in the C-terminus of NP. Consequently, the C-terminal hydrophobic core of NP is exposed and binds VP40, thereby inhibiting RNA synthesis and initiating virion assembly/budding.

Dixième épidémie d'Ebola en République Démocratique du Congo: défis majeurs relevés dans la prise en charge médicale / Tenth Ebola outbreak in Democratic Republic of the Congo: major challenges in health care management

Identifié depuis 1976, le filovirus Ebola est la cause d´une maladie caractérisée principalement par un syndrome grippale inaugural avec une fièvre quasi permanente suivi des signes digestifs: diarrhée, vomissement à la base de la déshydratation. La mort survient souvent dans un tableau de défaillance multi-viscérale (insuffisance hépatorénale, encéphalopathie voire, trouble de coagulation). Le taux de mortalité est compris entre 50 et 90%. Traditionnellement, les malades suspects et confirmés à Ebola étaient isolés dans des tentes pour un traitement essentiellement symptomatique avec utilisation fort limitée des actes invasifs. Les mesures de prévention n´étaient faites que de respect des mesures d´hygiène. Chez les personnels soignants, le taux de contamination était de 76% lors de la première épidémie de Yambuku. Au fil du temps, des mesures de prise en charge se sont améliorées par l´utilisation du vaccin, une réanimation appropriée, traitement spécifique au filovirus et l´utilisation des CUBE (chambre d´urgence biosécurisée pour epidémie).

Identified in 1976, Ebola virus, a member of the Filoviridae family (filovirus), can cause a disease mainly characterized by inaugural influenza-like syndrome with almost permanent fever followed by gastrointestinal symptoms, such as diarrhea, vomiting causing dehydration. Death often occurs as a result of multi-system organ failure (hepatorenal failure, encephalopathy or even blood clotting disorders). Mortality rate is between 50 and 90%. Traditionally, patients with suspected and diagnosed Ebola were isolated in tents for essentially symptomatic treatment with very limited use of invasive procedures. Prevention consisted of measures aimed at respecting hygiene. Among caregivers,infection rate was 76% during the first Yambuku outbreak. Over time, management measures have been improved by the use of the vaccine, appropriate resuscitation techniques, specific treatment for filovirus and the use of BECUO (Biosecure Emergency Care Unit for Outbreaks).

Support for the response to COVID-19 in Uganda: contribution of the global health security program at Makerere University's Infectious Diseases Institute

Background: Outbreaks are occurring at increasing frequency and they require multisectoral and multi-stakeholder involvement for optimal response. The Global Health Security Agenda is a framework that governments and other stakeholders can use to strengthen countries' capacities to prevent, detect and respond to outbreaks but there are few examples of academic programs using this approach. Methods: This is a narrative review of contributions of Makerere University through the Global Health Security Program at the Infectious Diseases Institute (IDI). Information was sourced from peer-reviewed publications and grey literature highlighting work done between 2017 - 2021. Results: Aligned to GHSA, IDI made contributions to strengthen national and subnational capacities for biosafety and biosecurity, sample collection and transportation, electronic disease surveillance, infection prevention and control, case management prior to COVID-19 that were subsequently used to support response efforts for COVID-19 in Uganda. Conclusion: The IDI Global Health Security program provides a model that can be used by institutions to deliberately develop capacities relevant to outbreak preparedness and response.

Factores pronósticos clínicos determinantes en la supervivencia de pacientes con el virus Ébola / Clinical prognostic factors determining the survival of patients with the Ebola virus

Introducción: La enfermedad por el virus del Ébola presenta una elevada letalidad, por lo cual resulta de gran interés la realización de investigaciones que aborden las manifestaciones clínicas que pudieran ser factores pronósticos de supervivencia. Objetivo: Evaluar factores pronósticos de los pacientes enfermos de ébola. Métodos: El universo lo constituyó la totalidad (n = 350) de pacientes ingresados. Se emplearon medidas de resumen para variables cualitativas, estimaciones puntuales y por intervalos para las cuantitativas, así como las pruebas de significación Kaplan-Meier, regresión de Cox y Odds Ratio. Se trabajó con un nivel de confiabilidad del 95 por ciento. Resultados: La supervivencia global fue del 42,5 por ciento. La media de supervivencia, de aproximadamente 10 días (IC: 9 - 11 días). Los pacientes que ingresaron en estado grave (OR = 3,76), que tuvieron dolor lumbar (OR = 2,24), que refirieron cefalea (OR = 2,22), que presentaron fiebre (OR=2,16), que aquejaron de dolor abdominal (OR=1,95) y a quienes se les constató inyección conjuntival (OR = 1,86), tuvieron mayor probabilidad de fallecer, que quienes ingresaron sin estos síntomas y signos. Conclusiones: La supervivencia fue elevada, pese a las complicaciones presentadas. Los síntomas y signos predictores de muerte en los pacientes fueron: la gravedad del paciente al momento del ingreso, la presencia de dolor lumbar, cefalea, fiebre, dolor abdominal e inyección conjuntival(AU)

Introduction: Ebola virus disease has a high lethality, which is why it is of great interest to carry out research that addresses clinical manifestations that could be prognostic factors for survival. Objective: To evaluate prognostic factors of Ebola patients. Methods: the universe was constituted by the totality (n = 350) of admitted patients. Summary measures were used for qualitative variables, point and interval estimates for quantitative variables, as well as Kaplan-Meier significance tests, Cox regression and Odds Ratio. We worked with a 95% level of reliability. Results: The overall survival was 42.5 por ciento. The average survival, approximately 10 days (CI: 9-11 days). Patients who were admitted in serious condition (OR = 3.76), who had low back pain (OR = 2.24), who reported headache (OR = 2.22), who presented fever (OR = 2.16), who they suffered from abdominal pain (OR = 1.95) and who were found to have conjunctival injection (OR = 1.86), were more likely to die than those who entered without these symptoms and signs. Conclusions: Survival was high, despite the complications presented. The symptoms and predictive signs of death in the patients were: the severity of the patient at admission, the presence of low back pain, headache, fever, abdominal pain and conjunctival injection(AU)

Recent advances in the discovery and development of Ebola virus inhibitors / 药学学报

Ebola virus is extremely virulent and highly contagious. Ebola virus causes outbreaks of severe hemorrhagic fever, with human mortality rates of up to 90%. There is currently no preventive or therapeutic treatment in the form of vaccines, biological or small molecular agents. Currently, a lot of anti-Ebola virus agents have been reported. Here, we review the latest advances in this field.

El contenido visual publicado en prensa durante una crisis sanitaria: El caso del Ébola, España 2014 / Visual content published by the press during a health crisis: The case of Ebola, Spain, 2014 / O conteúdo visual publicado na imprensa durante uma crise sanitária: o caso do Ebola, Espanha 2014

Ante el escaso número de estudios en este ámbito, el objetivo es analizar el contenido visual en la prensa durante la crisis sanitaria del Ébola en España que ocasionó gran alarma en la sociedad en 2014. En una muestra nacional de diarios, se identifica contenido visual en el 92% (n=160) de artículos sobre el Ébola y en el 87,5% (n=14) de portadas. La fotografía es el recurso más usado (69,2%), seguido de gráficos (9,2%) e infografías (8,8%), mientras que 'conflicto' es el encuadre más frecuente (42%). Se detecta un aumento rápido del contenido visual en los primeros dos días de la crisis que disminuye paulatinamente a partir del quinto día (p<.001). Este estudio puede abrir nuevas vías de investigación para profundizar en la investigación del contenido visual, especialmente durante la crisis sanitaria dada la gran importancia que adquiere la comunicación.(AU)

Considering the scarce number of studies in this sphere, the objective is to analyze the visual content published by the press during the health crisis of Ebola in Spain, which caused great alarm in that society in 2014. In a sample of Spanish newspapers, visual content was identified in 92% (n=160) of the articles about Ebola and in 87.5% (n=14) of front pages. Photography was the most used resource (69.2%), followed by graphs (9.2%) and infographics (8.8%), while 'conflict' was the most frequent framing (42%). A rapid increase in the use of visual content was detected in the first two days of the crisis, followed by a gradual decrease from the fifth day onwards (p <0.001). This study can open new research paths for further investigation of visual content, especially during a health crisis, due to the great importance communication acquires in this situation.(AU)

Considerando o número escasso de estudos neste âmbito, o objetivo é analisar o conteúdo visual na imprensa durante a crise sanitária do Ebola na Espanha, que causou um grande alarme na sociedade em 2014. Em uma amostra de diários nacionais, identifica-se conteúdo visual em 92% (n = 160) dos artigos sobre o Ébola e em 87,5% (n = 14) das capas. A fotografia é o recurso mais utilizado (69,2%), seguido por gráficos (9,2%) e inforgráficos (8,8%), enquanto 'conflito' é o enquadramento mais frequente (42%). Detecta-se um rápido aumento no conteúdo visual nos dois primeiros dias da crise, que diminui gradativamente a partir do quinto dia (p <0,001). Este estudo pode abrir novas vias de pesquisas que aprofundem na investigação do conteúdo visual, especialmente durante uma crise sanitaria devido à grande importância que a comunicação adquire.(AU)

¿La información sobre salud está condicionada por la nacionalidad de los enfermos? El ébola como estudio de caso / Does health news depend on patients' nationality? An Ebola case study

Resumen La salud cada vez tiene más presencia en la prensa generalista, especialmente cuando los temas que se abordan afectan a países desarrollados. Esta investigación expone las diferencias que se generan en la cobertura periodista cuando ocurre un hecho relevante como pueda ser una epidemia y que afecta tanto a países occidentales como a países africanos subdesarrollados. El trabajo que presentamos evidencia que en la epidemia de Ébola, reconocida como tal por la Organización Mundial de la Salud en el año 2014, el volumen de las noticias sobre la epidemia solo aumentó la información relativa a esta enfermedad cuando hubo occidentales afectados directamente por la misma. Así se observa en los resultados que ofrece el análisis de contenido realizado en tres diarios de diferentes nacionalidades como son el español El País, el francés Le Figaro y el mexicano Reforma durante las fechas de marzo de 2014 a enero de 2015.

Abstract It is increasingly common to see the issue of health included in the general press, particularly when the topic being discussed affects developed nations. This research project shows the differences that appear in press coverage when there is a relevant event, such as an epidemic, which affects both developed, western nations and underdeveloped African ones. This work shows that, in the case of the Ebola epidemic - which was recognised as such by the World Health Organisation in 2014 -, the press only gave the problem greater coverage when there were cases of westerners being directly affected by it. That can be observed in the results of the content analysis in three daily newspapers from different countries: El País (Spain), Le Figaro (France) and Reforma (Mexico), between March 2014 and January 2015.

Intervención educativa sobre el Ébola para estudiantes de Medicina de. 5to año. Septiembre - noviembre 2018 / Educational intervention about Ébola for 5th year medicine students. September- november 2018

RESUMEN Introducción: el virus del Ébola es el causante de la enfermedad vírica febril hemorrágica del Ébola: infecciosa, altamente contagiosa, muy severa, afecta tanto a animales como a seres humanos, presenta alta mortalidad y constituye un problema de salud que, sin un control adecuado, puede llegar a convertirse en epidemia de alcance mundial. Objetivo: evaluar el nivel de conocimientos acerca de la enfermedad del Ébola en los estudiantes de 5to año de Medicina, de la Universidad de Ciencias Médicas de Holguín, Cuba. Métodos: se realizó un estudio de intervención educativa sobre la enfermedad del Ébola, mediante un programa educativo a partir de la identificación de las necesidades de aprendizaje de los estudiantes de 5to año de Medicina, a través de un cuestionario para medir el nivel de conocimientos sobre aspectos de esta dolencia Resultados: el grupo de edades con mayores conocimientos sobre el tema fue el de 21 a 24 años (60,52%). El sexo femenino predominó sobre el masculino en cuanto a conocimientos de la enfermedad (82,85%). Al presenciar un largometraje como parte del programa educativo confeccionado, los estudiantes de 21 a 24 años mostraron mayor dominio (65,51%). Conclusiones: previo a nuestra intervención, el nivel de conocimiento de los estudiantes sobre la enfermedad del Ébola eran incorrectos. Se aplicó el método de intervención educativa de forma satisfactoria. Al culminar, se modificó el nivel de conocimientos incorrectos y los suficientes y correctos se incrementaron.

ABSTRACT Introduction: Èbola virus causes hemorrhagic febrile viral disease of Èbola, a severe infectious disease, highly contagious, with a high mortality level, which affects animals and humans; a health problem which may become epidemic worldwide without a suitable control. Objective: evaluate knowledge about Èbola disease of 5th year medicine students from September to November 2018. Methods: an educational intervention study about Èbola disease for 5th year medicine students, through an educational program from the identification of their needs, with one summary to measure their knowledge level about fundamental aspects of this disease, was carried out. Results: the age group with suitable knowledge about the subject was between 21 and 24 (60, 52%). Females predominated with (82, 85%). When they all watch the film included in the educational program, the same age group predominated (65, 51%). Conclusions: before the intervention, 5th year medicine student's knowledge level about Èbola disease was inadequate. Educational intervention method was successfully applied. As the conclusion of the educational intervention, adequate and sufficient knowledge increased and those incorrect were modified.

Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional (VIII) / Ebola epidemic in Africa: Cuban medical experience in this international health emergency (VIII)

RESUMEN La misión de la brigada médica perteneciente al Contingente Internacional Especializado en Situaciones de Desastres y Graves Epidemias "Henry Reeve", que laboró en Sierra Leona, terminó el 1ro de abril de 2015, con sus objetivos cumplidos. Fueron atendidos 1589 pacientes y confirmados 619 con el ébola (38,9 %), se disminuyó el índice de mortalidad de 92 % a 43,3 % y se salvaron 351 vidas entre el 5 de noviembre de 2014 y el 10 de marzo de 2015. En total se trabajaron 377 días, con 6024 horas de estancia en el Centro de Tratamiento del Ébola y 2217 horas vistiendo el equipo de protección individual. Sus integrantes recibieron reconocimientos nacionales e internacionales y numerosas distinciones que avalaron el desempeño de tan exitosa encomienda.

ABSTRACT The mission of the medical brigade belonging to the "Henry Reeve "International Contingent Specialized in Situations of Disasters and Serious Epidemics, which worked in Sierra Leone, ended on April 1, 2015, with its objectives fulfilled. 1589 patients were treated and 619 confirmed with Ebola (38.9%), the death rate was reduced from 92% to 43.3% and 351 lives were saved from November 5, 2014 to March 10, 2015. they worked 377 days in all, with 6024 hours of stay in the Ebola Treatment Center and 2217 hours wearing the personal protection equipment. Its members received national and international recognition and numerous distinctions that endorsed the performance of such a successful mission.

Influencia de los procederes de enfermería en la sobrevivencia de los pacientes afectados por el Ébola / Influence of Nursing Procedures in the Survival of Patients Affected by Ebola

Introducción: El virus del Ébola causa una enfermedad grave sumamente infecciosa, que lleva rápidamente a la muerte, con una tasa de letalidad de hasta 90 por ciento, pero puede prevenirse. Objetivo: Describir relevancia de los procederes de enfermería en la sobrevivencia de los pacientes afectados por el Ébola Métodos: Estudio descriptivo, de corte transversal en Liberia, África Occidental, en el periodo de noviembre 2014 a febrero 2015. El universo estuvo constituido por 203 pacientes a quienes se les aplicó procederes de enfermería por enfermeros que integraron la brigada médica cubana. La información se obtuvo de la observación directa y la revisión de la base de datos estadística de la misión cubana en Liberia, se procesó mediante el Sistema SPSSS versión 11,5 a través de técnicas de estadística descriptiva. Resultados: Predominó el sexo masculino (55,66 por ciento), diciembre fue el mes de mayor ingreso (36,45 por ciento), la mayoría de los pacientes fueron ingresados en la salas de sospechosos (60,09 por ciento), predominó la administración de medicamentos por vía oral, con 820 procederes (52,59 por ciento), se logró que 51,25 por ciento de los pacientes atendidos egresaran vivos, siendo el mes de enero el de mayor letalidad (66,70 por ciento). Conclusiones: La labor realizada por los enfermeros cubanos en la lucha contra el Ébola en Liberia, África Occidental, y el cumplimiento estricto de los protocolos según procederes de enfermería contribuyó al control hemodinámico de los pacientes atendidos y a la disminución paulatina de la epidemia, así como la letalidad por dicho evento(AU)

Introduction: Ebola virus causes a highly infectious and serious disease, which quickly leads to death, with a death rate of up to 90 percent, but it can be prevented. Objective: To describe the relevance of nursing procedures in the survival of patients affected by Ebola. Methods: Descriptive, cross-sectional study carried out in West Africa, Liberia in the period from November 2014 to February 2015. The study population consisted of 203 patients who were applied nursing procedures by personnel who were part of the Cuban medical brigade. The information was obtained by direct observation and review of the statistical database of the Cuban mission in Liberia; and processed through the system SPSSS version 11.5, through descriptive statistics techniques. Results: The male sex predominated (55.66 percent). December was the month with highest admittance (36.45 percent); the majority of patients were admitted to the ward of suspects (60.09 percent). The administration of oral medications predominated, with 820 procedures (52.59 percent). It was achieved for 51.25 percent of the patients attended to be discharged alive, the month of January accounting for the highest mortality (66.70 percent). Conclusions: The work carried out by the Cuban nurses in the fight against Ebola in West Africa, Liberia and the strict compliance with the protocols according to nursing procedures contributed to the hemodynamic control of the patients attended and the gradual reduction of the epidemic, as well as the mortality for the event(AU)

Caracterización clínico epidemiológica de pacientes con ébola en un centro de tratamiento de Sierra Leona / Clinical-epidemiological characterization of Ebola disease in patients at a treatment center in Sierra Leone

Introducción: La enfermedad del ébola se dio a conocer por primera vez en 1976, con una letalidad muy elevada en todos los brotes detectados. Objetivo: Caracterizar clínica y epidemiológicamente a los pacientes portadores de la enfermedad por el virus del Ébola. Métodos: Se realizó un estudio observacional, descriptivo y transversal en 424 pacientes ingresados en un centro de tratamiento de ébola en la República de Sierra Leona, África occidental, con el diagnóstico confirmado mediante la técnica de reacción en cadena de la polimerasa para virus Ébola, durante el período de noviembre de 2014 hasta marzo de 2015. Resultados: Se muestra que el grupo etario más afectado fue el de 25 a 34 con un 25,9 por ciento. La mayor letalidad se presentó en los pacientes con más de 65 años de edad con un 44,4 por ciento. El síntoma que prevaleció fue la fiebre para un 61,8 por ciento, y el hipo se presentó en el 88,8 por ciento de los fallecidos. Conclusión: Se concluye que la enfermedad no tuvo distinción significativa con el sexo. La mayor letalidad se presentó en las edades geriátricas. Los síntomas más frecuentes fueron la fiebre, diarrea y el decaimiento. El hipo fue el signo que más se presentó en los pacientes que fallecieron(AU)

Introduction: Ebola disease was first reported in 1976 with a very high lethality in all outbreaks. Objective: To clinically and epidemiologically characterize the patients carriers of Ebola virus disease. Methods: we conducted an observational, descriptive and cross-sectional study in 424 patients admitted to an Ebola Treatment Center in the Republic of Sierra Leone, West Africa from November 2014 to March 2015. The polymerase chain reaction technique for Ebola virus confirmed the diagnosis. Medical records provided all data. Results: The age group most affected was 25 to 34 (25.9 percent). The highest lethality occurred in those over 65 years of age (44.4 percent ). Fever was the prevailing symptom (61.8 percent) and hiccups occurred in 88.8 percent of the deceased. Conclusion: Clinical manifestations were variable, although fever was the main symptom. Hiccup was a sign of poor prognosis when associated with a higher percentage of mortality. Lethality was high(AU)

Misinformation on salt water use among Nigerians during 2014 Ebola outbreak and the role of social media

Objective: To determine the spread of misinformation on salt water among Nigerians, salt water use for Ebola prophylaxis, and the role played by the social media during the 2014 Ebola outbreak. Methods: Information was collected from the general Nigerian population through online Google forms which were majorly disseminated via Facebook and WhatsApp platforms. The data retrieved was analysed using descriptive statistics, Chi-square test and multivariate logistic regression. Results: A total of 703 questionnaires were included in the final analysis. The respondents' mean age was (30.2±6.7) years, predominantly male (73.2%). Almost all of them (95.0%) had received some message to use salt water, 37.4% of whom received such message on social media. Around a half of them ever made an attempt to verify the health information they received on social media (50.9%), and about a quarter (24.0%) of them had used salt water during the outbreak. Many of them had used salt water because they believed it would not harm them (52.0%). Salt water was less likely to be used by those who had received such message on social media, as well as by those who had received some contrary information to salt use. Conclusions: Social media could serve as an effective tool in propagating health information and should be actively engaged by health agencies, to spread accurate information.

Ebola virus disease: Recent advancs in diagnostics and therapeutics

Ebola virus disease (EVD) is associated with haemorrhagic fever in humans and nonhuman primates, with a high rate of fatality (up to 90%). Some outbreaks in human history have proven the lethality of EVD. The recent epidemic of 2014 and 2015 in West Africa was the deadliest of all time (11 284 deaths). To understand the transmission dynamics, we have reviewed the epidemiology of EVD to date. The absence of any licensed vaccines or approved drugs against Ebola virus (EBOV) further highlights the severity and crisis level of EVD. Some organizations (public and private) are making considerable efforts to develop novel therapeutic approaches or vaccines to contain the outbreak of EBOV shortly. Here, we summarized the various potential drugs and vaccines (undergoing multiple phases of clinical trials) that have arisen as an alternative against EBOV, and we highlighted the numerous issues and limitations hindering this process. Alternatively, an increasing focus on strengthening the medical and civic health structure could provide speedy benefits in containing the spread of EVD, as well as offer a resilient foundation for the deployment of novel drugs and vaccines to the affected countries, once such drugs and vaccines become available.

Misinformation on salt water use among Nigerians during 2014 Ebola outbreak and the role of social media

Objective: To determine the spread of misinformation on salt water among Nigerians, salt water use for Ebola prophylaxis, and the role played by the social media during the 2014 Ebola outbreak. Methods: Information was collected from the general Nigerian population through online Google forms which were majorly disseminated via Facebook and WhatsApp platforms. The data retrieved was analysed using descriptive statistics, Chi-square test and multivariate logistic regression. Results: A total of 703 questionnaires were included in the final analysis. The respondents' mean age was (30.2±6.7) years, predominantly male (73.2%). Almost all of them (95.0%) had received some message to use salt water, 37.4% of whom received such message on social media. Around a half of them ever made an attempt to verify the health information they received on social media (50.9%), and about a quarter (24.0%) of them had used salt water during the outbreak. Many of them had used salt water because they believed it would not harm them (52.0%). Salt water was less likely to be used by those who had received such message on social media, as well as by those who had received some contrary information to salt use. Conclusions: Social media could serve as an effective tool in propagating health information and should be actively engaged by health agencies, to spread accurate information.

Ebola virus disease: Recent advancs in diagnostics and therapeutics

Ebola virus disease (EVD) is associated with haemorrhagic fever in humans and nonhuman primates, with a high rate of fatality (up to 90%). Some outbreaks in human history have proven the lethality of EVD. The recent epidemic of 2014 and 2015 in West Africa was the deadliest of all time (11 284 deaths). To understand the transmission dynamics, we have reviewed the epidemiology of EVD to date. The absence of any licensed vaccines or approved drugs against Ebola virus (EBOV) further highlights the severity and crisis level of EVD. Some organizations (public and private) are making considerable efforts to develop novel therapeutic approaches or vaccines to contain the outbreak of EBOV shortly. Here, we summarized the various potential drugs and vaccines (undergoing multiple phases of clinical trials) that have arisen as an alternative against EBOV, and we highlighted the numerous issues and limitations hindering this process. Alternatively, an increasing focus on strengthening the medical and civic health structure could provide speedy benefits in containing the spread of EVD, as well as offer a resilient foundation for the deployment of novel drugs and vaccines to the affected countries, once such drugs and vaccines become available.