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.

Investigation of rodent reservoirs of emerging pathogens in Côte d'Ivoire, West Africa

Background: One of the main health problems in West Africa remains upsurge of emerging pathogens. Ebola virus disease outbreak occurred in 2014 in Liberia, Guinea and Sierra Leone, Monkeypox virus in Nigeria in 2017 and most recently Lassa virus in Nigeria, Togo and Benin in 2018. These pathogens have animal reservoirs as vectors for transmission. Proper investigation of the pathogens in their rodent vectors could help reduce and manage their emergence and spread. Methodology: This study was conducted with an approval from the Côte d'Ivoire Bioethics Community. Small mammal trappings were carried out in 9 sites within three zones namely, peri-urban, peri-rural and protected areas. Liver, lung and kidney tissues from trapped small mammals were sampled in accordance with the recommended conditions of biosafety and bioethics. The organs were transported in liquid nitrogen to the laboratory. Molecular tests were used to detect pathogens. Orthopoxviruses and Monkeypox virus were detected in the organs by PCR using consensus primers targeting the virus surface membrane haemagglutinin (HA) genes, while Leptospira species were detected by PCR using primers targeting the rrs and lfb1 genes. Results: Out of 4930 night-traps, 256 (5.19%) small mammals were trapped including Crocidura, Rattus, Lophuromys, Praomys, Mus and Mastomys. Leptospira species were detected in 6 genera from 7 study sites and the infected small mammals accounted for 13.3%. Leptospira sp was detected mainly in the rodent vector genera Rattus (32.3%), Lophuromys (29.0%), and Praomys (16.1%). Three species of Leptospira were detected and Leptospira interrogans was the most common frequent species (74.2%). Monkeypox virus was not detected from studied small mammals. Conclusion: The initial data from our investigation indicates the presence of Leptospira sp in rodent vectors, Rattus, Lophuromys and Praomys, which are the potential small mammalian reservoirs of this pathogen in Cote d'Ivoire.

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).

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.

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)

A comprehensive district-level laboratory intervention after the ebola epidemic in Sierra Leone

Background: The 2014­2016 Ebola outbreak exposed the poor laboratory systems in Sierra Leone. Immense needs were recognised across all areas, from facilities, diagnostic capacity, supplies, trained personnel to quality assurance mechanisms.Objective: We aimed to describe the first year of a comprehensive intervention, which started in 2015, in a public hospital's general laboratory serving a population of over 500 000 in a rural district.Methods: The intervention focused on (1)supporting local authorities and healthcare workers in policy implementation and developing procedures to enhance access to services, (2) addressing gaps by investing in infrastructure, supplies, and equipment, (3) development of quality assurance mechanisms via mentorship, bench-side training, and the introduction of quality control and information systems. All work was performed alongside counterparts from the Ministry of Health and Sanitation.Results: We observed a strong increase in patient visits and inpatient and outpatient testing volumes. Novel techniques and procedures were taken up well by staff, leading to improved and expanded service and safety, laying foundations for further improvements.Conclusion: This comprehensive approach was successful and the results suggest an increase in trust from patients and healthcare workers

Insights of window-bsed mechanism approach to visualize composite bioData point in feature spaces

In this paper, we propose a window-based mechanism visualization approach as an alternative way to measure the seriousness of the difference among data-insights extracted from a composite biodata point. The approach is based on two components: undirected graph and Mosaab-metric space. The significant application of this approach is to visualize the segmented genome of a virus. We use Influenza and Ebola viruses as examples to demonstrate the robustness of this approach and to conduct comparisons. This approach can provide researchers with deep insights about information structures extracted from a segmented genome as a composite biodata point, and consequently, to capture the segmented genetic variations and diversity (variants) in composite data points.

Data Fitting and Scenario Analysis of Vaccination in the 2014 Ebola Outbreak in Liberia

OBJECTIVES: This study aimed to extend an epidemiological model (SEIHFR) to analyze epidemic trends, and evaluate intervention efficacy. METHODS: SEIHFR was modified to examine disease transmission dynamics after vaccination for the Ebola outbreak. Using existing data from Liberia, sensitivity analysis of various epidemic scenarios was used to inform the model structure, estimate the basic reproduction number ℜ₀ and investigate how the vaccination could effectively change the course of the epidemic. RESULTS: If a randomized mass vaccination strategy was adopted, vaccines would be administered prophylactically or as early as possible (depending on the availability of vaccines). An effective vaccination rate threshold for Liberia was estimated as 48.74% among susceptible individuals. If a ring vaccination strategy was adopted to control the spread of the Ebola virus, vaccines would be given to reduce the transmission rate improving the tracing rate of the contact persons of an infected individual. CONCLUSION: The extended SEIHFR model predicted the total number of infected cases, number of deaths, number of recoveries, and duration of outbreaks among others with different levels of interventions such as vaccination rate. This model may be used to better understand the spread of Ebola and develop strategies that may achieve a disease-free state.

Genital hygiene behaviors and practices: a cross-sectional descriptive study among antenatal care attendees

The female genital tracts harbor a wide variety of microorganisms' knowns as microflora mostly constituted by lactobacilli, involved in the healthy state of the vagina without causing infection. Urinary tract infections (UTI) are frequent in pregnant women due to physiological and anatomical changes that occur during pregnancy. These infections can result to disabilities or serious health problems both for the mother and the new-born. Vaginal douching has been reported among risky practices associate with UTIs. However, this remains debatable and contradictory when other studies report the benefit effects of vaginal cleaning in infection prevention. The aim of this study was to assess pregnant women behaviors and practices regarding genital hygiene. This was a cross sectional descriptive study conducted on exhaustive sample of pregnant women coming for antenatal visits in Lafé Sub-divisional Hospital (SDH) and Baleng Catholic Health Center (BCHC) between 16 and 30 September 2013. Data were collected using a paper based standardized questionnaire directly self-administered after obtain a free consent. Overall, 80 pregnant women were enrolled. The majority of them had attended at least primary education (97.5%; n=78/80) and many were lived in couple (81.25%; n=65/80). Almost one on three participants identified antenatal consultation (ANC) as a key element to be taken into account by pregnant women. 70.1% (n=56/80) of women declared wearing undergarments in cotton. Regarding the daily vaginal douching behaviors, the majority (76.3%; n=61/80) of participants used the recommended gynecological measure, while the remaining use self-prescribed measures. Both genital parts (vulva area and vagina) were cleaned and use of water was mostly cited (63.8%; n=51/80). Almost one participant on four (n=29/80) use antiseptic solutions for genital cleaning. Antiseptic solutions were associated with water in 34.5% of cases (n=10/29), and in 65.5% (n=19/29) of cases it was used only for the vagina. Our findings suggest that knowledge and genital hygiene cleaning practices are acceptable among our study population. Risky practices such as use of antiseptic solutions and synthetic underwear's were reported. Skills of health care providers on good hygiene practices for pregnant should be improved and community-based communication strategies need to be implemented to reach all women of child bearing age

Memorias de un enfermero cubano cara a cara con el Ébola en Guinea Conakry / Memories of a Cuban Nurse face to face with Ebola in Guinea Conakry

Introducción: La enfermedad ocasionada por el virus Ébola ha sido la peor epidemia en África Occidental entre 2014 y 2015, se infectaron más de 27 000 personas, con más de 11 000 muertes en Guinea, Liberia y Sierra Leona. Cuba fue de los primeros países del mun do en dar respuesta al llamado de la Organización Mundial de la Salud y la Organización de Naciones Unidas para enfrentar la epidemia en los países afectados, enviando 256 profesionales Médicos y Enfermeros del Contingente Internacional "Henry Reeve". Objetivo: Exponer la experiencia de un enfermero cubano en el enfrentamiento de la epidemia del virus Ébola en África Occidental. Métodos: La investigación se realizó desde una perspectiva cualitativa, a fin de poner exponer las experiencias vividas por los colaboradores de la Brigada Médica Cubana "Henry Reeve" que enfrentaron la epidemia de Ébola en Guinea Conakry desde octubre de 2014 hasta mayo de 2015. Conclusiones: Los colaboradores regresaron con la satisfacción del deber cumplido, con cero casos confirmados de Ébola en el Centro de tratamiento y en la prefectura de Coyah, se concluyó la misión con una evaluación satisfactoria(AU)

Introduction: The Ebola virus disease has been the worst epidemic in West Africa between 2014 and 2015, more than 27 000 people were infected, with more than 11 000 deaths in Guinea, Liberia and Sierra Leone. Cuba was one of the first countries worldwide to respond to the call of the World Health Organization and the United Nations to confront the epidemic in the affected countries, sending 256 medical professionals and nurses of Henry Reeve International Contingent. Objective: To present a Cuban nurse's experience in confronting the Ebola virus epidemic in West Africa. Methods: The research was conducted from a qualitative perspective, in order to expose the experiences lived by the collaborators of Henry Reeve Cuban Medical Brigade, who confronted the Ebola epidemic in Guinea Conakry from October 2014 to May 2015. Conclusions: The collaborators returned with the satisfaction of the duty fulfilled, with zero confirmed cases of Ebola in the Treatment Center and in the Coyah prefecture; the mission was concluded with a satisfactory evaluation(AU)

A novel carbon nanoparticle probe-based ultrasensitive lateral flow assay for rapid detection of Ebola virus / 生物工程学报

Ebola virus (EBOV) is an extremely contagious pathogen first discovered in Africa associated with severe hemorrhagic disease in humans and nonhuman primates, which has resulted in at least 28 500 suspected cases and 11 300 confirmed deaths in 2014-2016 Ebola epidemic in West Africa. Rapid and sensitive detection of EBOV is the key to increasing the probability of survival and reducing infection rates in pandemic regions. Here, we report an ultrasensitive and instrument-free EBOV detection assay based on colloidal carbon immunochromatography. Carbon nanoparticle-labeled rabbit anti-EBOV-VP40 IgG were concentrated in the conjugate pad, monoclonal antibody (McAb, 4B7F9) against EBOV-VP40 and goat anti-rabbit IgG were immobilized on the nitrocellulose membrane with 2 μL/cm at a concentration of 1 mg/mL as test and control lines, respectively. Then the sample application pad, conjugate release pad, nitrocellulose membrane and absorbent pad were assembled into a lateral flow test strip. The test strip shows strong specificity against related viruses that share similar clinical symptoms and geographic range with EBOV, including marburg virus, influenza virus, yellow fever virus and dengue virus. In addition, 1 500 negative serums were tested with false-positive rate of 1.3‰ which significantly lower than that of ReEBOV™ colloidal gold test kit recommended by World Health Organization (WHO). The sensitivity of this strip was analyzed using inactivated EBOV with detection limit of 100 ng/mL (10⁶ copies/mL) which clearly higher than that of ReEBOV™ dipstick (10⁸ copies/mL). Furthermore, the strip showed excellent thermal stability characteristics in room temperature and could be as a point-of-care (POC), ultra-sensitive and specific promising candidate for EBOV serological screening in rural Africa or entry/exit ports.

Purification and characterization of monoclonal IgG antibodies recognizing Ebola virus glycoprotein

PURPOSE: The goal of this study was to purify and characterize Ebola virus glycoprotein (GP)-specific IgG antibodies from hybridoma clones. MATERIALS AND METHODS: For hybridoma production, mice were injected by intramuscular-electroporation with GP DNA vaccines, and boosted with GP vaccines. The spleen cells were used for producing GP-specific hybridoma. Enzyme-linked immunosorbent assay, Western blot assay, flow cytometry, and virus-neutralizing assay were used to test the ability of monoclonal IgG antibodies to recognize GP and neutralize Ebola virus. RESULTS: Twelve hybridomas, the cell supernatants of which displayed GP-binding activity by enzyme-linked immunosorbent assay and the presence of both IgG heavy and light chains by Western blot assay, were chosen as a possible IgG producer. Among these, five clones (C36-1, D11-3, D12-1, D34-2, and E140-2) were identified to secrete monoclonal IgG antibodies. When the monoclonal IgG antibodies from the 5 clones were tested for their antigen specificity, they recognized GP in an antigen-specific and IgG dose-dependent manner. They remained reactive to GP at the lowest tested concentrations (1.953–7.8 ng/mL). In particular, IgG antibodies from clones D11-3, D12-1, and E140-2 recognized the native forms of GP expressed on the cell surface. These antibodies were identified as IgG1, IgG2a, or IgG2b kappa types and appeared to recognize the native forms of GP, but not the denatured forms of GP, as determined by Western blot assay. Despite their GP-binding activity, none of the IgG antibodies neutralized Ebola virus infection in vitro, suggesting that these antibodies are unable to neutralize Ebola virus infection. CONCLUSION: This study shows that the purified IgG antibodies from 5 clones (C36-1, D11-3, D12-1, D34-2, and E140-2) possess GP-binding activity but not Ebola virus-neutralizing activity.

Knowledge, attitudes, and behavioural risk factors regarding zoonotic infections among bushmeat hunters and traders in Nsukka, southeast Nigeria / 한국역학회지

OBJECTIVES: In light of the dramatic spread of Ebola virus in some parts of Africa and the 2014 outbreak in Nigeria, a study was conducted to evaluate bushmeat dealers' knowledge and attitudes about zoonotic infections and the risk of transmission to humans. METHODS: A cross-sectional survey was conducted in a community in Nsukka, southeast Nigeria. Hunters (n=34) and bushmeat traders (n=42) were interviewed. A semi-structured questionnaire was used to generate the data. The Fisher exact test was used to evaluate the significance of differences between these groups. RESULTS: Only 11.8% of the hunters, as compared to 35.7% of the traders, had no knowledge of possible causes of zoonotic infections (p < 0.05). However, 64.7% of the hunters, compared to 38.1% of the traders, were ignorant regarding the responsibility of public health personnel and veterinarians (p < 0.05), and 76.5% of the hunters compared to 42.9% of the traders were ignorant regarding the existence of zoonoses in Nigeria (p < 0.05). A statistically significant difference was also found between these groups regarding the risk of contracting an infection from ectoparasites (p < 0.05). The attitudes of respondents towards zoonotic diseases did not differ significantly between the groups. CONCLUSION: The level of awareness about zoonotic diseases was low in this area, underscoring the need for interventions.

Knowledge, attitudes, and behavioural risk factors regarding zoonotic infections among bushmeat hunters and traders in Nsukka, southeast Nigeria / 한국역학회지

OBJECTIVES: In light of the dramatic spread of Ebola virus in some parts of Africa and the 2014 outbreak in Nigeria, a study was conducted to evaluate bushmeat dealers' knowledge and attitudes about zoonotic infections and the risk of transmission to humans.METHODS: A cross-sectional survey was conducted in a community in Nsukka, southeast Nigeria. Hunters (n=34) and bushmeat traders (n=42) were interviewed. A semi-structured questionnaire was used to generate the data. The Fisher exact test was used to evaluate the significance of differences between these groups.RESULTS: Only 11.8% of the hunters, as compared to 35.7% of the traders, had no knowledge of possible causes of zoonotic infections (p < 0.05). However, 64.7% of the hunters, compared to 38.1% of the traders, were ignorant regarding the responsibility of public health personnel and veterinarians (p < 0.05), and 76.5% of the hunters compared to 42.9% of the traders were ignorant regarding the existence of zoonoses in Nigeria (p < 0.05). A statistically significant difference was also found between these groups regarding the risk of contracting an infection from ectoparasites (p < 0.05). The attitudes of respondents towards zoonotic diseases did not differ significantly between the groups.CONCLUSION: The level of awareness about zoonotic diseases was low in this area, underscoring the need for interventions.

Enfermedad por el virus Ébola medidas de bioseguridad / Ebola virus disease biosafety measures

Resumen El virus Ébola representa el patógeno prototipo de fiebre hemorrágica viral, causando una enfermedad severa de alta tasa de mortalidad. Esta alta mortalidad, combinada con la ausencia de vacunación y de un tratamiento específico, hace que el virus Ébola sea un patógeno importante para la salud pública. La fiebre hemorrágica de Ébola se cree es una zoonosis con persistencia del virus en especies de reservorios encontrados en áreas endémicas. A pesar de todos los esfuerzos realizados en cada brote para identificar los reservorios naturales no se conocen huéspedes potenciales ni los artrópodos vectores. El manejo de los casos está basado en el aislamiento de los pacientes y en el uso de barreras de aislamiento, tales como ropa e implementos de protección como respiradores. Debido a su rápida propagación la OMS declaró que la enfermedad por el virus Ébola representa una emergencia de salud pública más allá de las fronteras y exhortó a la comunidad internacional a tomar las acciones necesarias para detener la epidemia.

Abstract Ebola virus is regarded as the prototype pathogen of viral hemorrhagic fever, causing severe disease and high case fatality rates. This high fatality, combined with the absence ot treatment and vaccination options, makes Ebola virus an important public health pathogen. Ebola hemorrhagic fever is thought to be a classic zoonosis with persistence of the Ebola virus in a reservoir species generally found in endemic areas. Although much effort has been made to identify the natural reservoirs with every large outbreak of Ebola hemorrhagic fever, neither potential hosts norarthropod vectors have been identified. Case management is based on isolation of patients and use of strict barrier nursing procedures, such as protective clothing and respirators. In addition, its rapid propagation has led the Word Health Organization (WHO) to declare on August 2014 that Ebola virus disease represents a public health emergency of international concern and urged the international community to take action to stop its spread.

Implementing EBS in Palestine

The Ministry of Health of the occupied Palestinian territory [oPt] conducted a workshop on implementation of Event Based Surveillance [EBS] system. Recent outbreaks of MERS-CoV, Zika and Ebola in different parts of the world are reminders of the need to enhance national early warning capacity through establishment of EBS

Seroprevalence of Ebola virus infection in Bombali District, Sierra Leone

A serosurvey of anti-Ebola Zaire virus nucleoprotein IgG prevalence was carried out among Ebola virus disease survivors and their Community Contacts in Bombali District, Sierra Leone. Our data suggest that the specie of Ebola virus (Zaire) responsible of the 2013-2016 epidemic in West Africa may cause mild or asymptomatic infection in a proportion of cases, possibly due to an efficient immune response

Preferential production of IgM-secreting hybridomas by immunization with DNA vaccines coding for Ebola virus glycoprotein: use of protein boosting for IgG-secreting hybridoma production

PURPOSE: The goal of this study was to investigate the utility of DNA vaccines encoding Ebola virus glycoprotein (GP) as a vaccine type for the production of GP-specific hybridomas and antibodies. MATERIALS AND METHODS: DNA vaccines were constructed to express Ebola virus GP. Mice were injected with GP DNA vaccines and their splenocytes were used for hybridoma production. Enzyme-linked immunosorbent assays (ELISAs), limiting dilution subcloning, antibody purification methods, and Western blot assays were used to select GP-specific hybridomas and purify monoclonal antibodies (MAbs) from the hybridoma cells. RESULTS: Twelve hybridomas, the cell supernatants of which displayed GP-binding activity, were selected by ELISA. When purified MAbs from 12 hybridomas were tested for their reactivity to GP, 11 MAbs, except for 1 MAb (from the A6-9 hybridoma) displaying an IgG2a type, were identified as IgM isotypes. Those 11 MAbs failed to recognize GP. However, the MAb from A6-9 recognized the mucin-like region of GP and remained reactive to the antigen at the lowest tested concentration (1.95 ng/mL). This result suggests that IgM-secreting hybridomas are predominantly generated by DNA vaccination. However, boosting with GP resulted in greater production of IgG-secreting hybridomas than GP DNA vaccination alone. CONCLUSION: DNA vaccination may preferentially generate IgM-secreting hybridomas, but boosting with the protein antigen can reverse this propensity. Thus, this protein boosting approach may have implications for the production of IgG-specific hybridomas in the context of the DNA vaccination platform. In addition, the purified monoclonal IgG antibodies may be useful as therapeutic antibodies for controlling Ebola virus infection.

Ebola virus – from neglected threat to global emergency state / Vírus ébola – de ameaça negligenciada ao estado de emergência global

SUMMARY Objective: This review aims to update knowledge about Ebola virus disease (EVD) and recent advances in its diagnosis, treatment and prevention. Method: A literature review was performed using the following databases: ISI Web of Knowledge, PubMed, IRIS, Scopus and the websites of the CDC and the WHO. Additionally, we have included articles and reports referenced in the basic literature search, and news that were considered relevant. Results: The Ebola virus, endemic in some parts of Africa, is responsible for a severe form of hemorrhagic fever in humans; bats are probably its natural reservoir. It is an extremely virulent virus and easily transmitted by bodily fluids. EVD's complex pathophysiology, characterized by immunosuppression as well as stimulation of an intense inflammatory response, results in a syndrome similar to septic shock. The diagnosis is difficult due to the initial symptoms that mimic other diseases. Despite the high mortality rates that can amount to 90%, a prophylaxis (chemical or vaccine) or effective treatment does not exist. Two vaccines and experimental therapies are being developed for the prevention and treatment of EVD. Conclusion: Although the virus is known for about 40 years, the lack of knowledge obtained and the disinterest of government authorities in the countries involved justify the state of emergency currently exists regarding this infectious agent. Only the coordination of multiple entities and the effective commitment of the international community will facilitate the control and effective prevention of EVD.

RESUMO Objetivo: esta revisão tem como objetivo atualizar os conhecimentos sobre a doença do vírus ébola (DVE) e sobre os recentes avanços nos métodos de diagnóstico, tratamento e prevenção. Método: foi realizada uma revisão de literatura, utilizando as seguintes bases de dados: ISI Web of Knowledge, PubMed, IRIS, Scopus e os sites do Centers for Disease Control and Prevention (CDC) e da Organização Mundial da Saúde (OMS). Adicionalmente, foram incluídos artigos e relatórios referenciados na pesquisa bibliográfica de base e notícias consideradas relevantes. Resultados: o vírus ébola, endêmico de algumas regiões da África, é responsável por uma forma grave de febre hemorrágica no homem, e os morcegos são provavelmente o seu reservatório natural. É um vírus extremamente virulento e de fácil transmissão pelos fluidos corporais. A complexa fisiopatologia da doença, caracterizada pela imunossupressão e pelo estímulo a uma intensa resposta inflamatória, resulta em uma síndrome semelhante ao choque séptico. O seu diagnóstico é difícil, por causa da sintomatologia inicial, que mimetiza outras doenças. Apesar das altas taxas de mortalidade, que podem alcançar os 90%, não existe profilaxia (química ou vacinal) ou tratamento eficaz. Encontram-se em desenvolvimento duas vacinas e terapias experimentais para a prevenção e o tratamento da DVE. Conclusão: apesar de ser um vírus conhecido há cerca de 40 anos, o escasso conhecimento obtido e o desinteresse das entidades governamentais de países envolvidos justificam o estado de emergência que se vive atualmente em relação a esse agente infeccioso. A coordenação por múltiplas entidades e o empenho efetivo da comunidade internacional facilitarão o seu controle e a prevenção eficaz.