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Virus Ebola virus:

Ebola was identified in September 1976 by Belgian doctor Peter Piot of the Institute of Tropical Medicine in d’Anvers. The name of the virus is Ebola because it refers to a river in the north of Zaire. This epidemic started in December 2013. In July 2014, it evolved in a worrying way in Guinea, Liberia and Sierra Leone. The epidemic intensified in March 2014. It was the largest and most complex since the discovery of the virus in 1976. Since March 2014 the epidemic has the characteristic of spreading from one country to another. In all, ebola has 28,512 cases and 11,313 deaths.

It is an RNA virus. The virus is made of lipid membrane, capsid, polymerase, RNA and glycoprotein.

There are six species of viral ebola virus : Bundibugyo ebolavirus, ebolavirus Taï Forest, Reston ebolavirus, ebolavirus Sudan, Zaire ebolavirus and Bombali ebolavirus.

Most of them are the cause of related haemorrhagic fevers in humans, but of variable intensity: while the lethality of the Ebola virus can reach 90%, that of the Sudan virus is less, and that of the Reston virus almost zero. As for the Bombali virus, its pathogenicity is still unknown.

Direct contact with body fluids (blood, vomit, diarrhea, sweat, suppurations, saliva, semen …) of an infected person is the main way of human-to-human contamination. The most infectious fluids are currently blood, stool and vomit. The virus is not transmitted by air. The risk of spread among hospital staff is very high, especially if sterilization of the equipment is not ensured. In endemic areas, non-compliance with health and safety rules has caused the death of several doctors and nurses during epidemics, and it favors nosocomial contamination. Close contact, that is, direct contact with the body fluids of an infected person, living or dead, is a source of contagion; the funeral rituals of certain peoples of Central Africa consisting of washing the body, then rinsing their hands in a common basin, have also often promoted the spread of the virus in the family and friends of the deceased.Transmission to humans appears to be linked to the handling of primates (dead or alive) infected with the virus.

The incubation period varies from 2 to 21 days, most often from 4 to 9 days. One week after symptoms start, virions invade the infected person's blood and cells. The most affected cells are monocytes, macrophages and dendritic cells. The progression of the disease generally affects the functioning of vital organs, in particular the kidneys and liver. This causes significant internal bleeding. Death occurs shortly afterwards from multiple organ failure and cardio-respiratory shock.

The disease caused by the virus is fatal in 20% to 90% of cases. This large difference is due to the fact that the Ebola virus is particularly dangerous in Africa, where care is limited and difficult to provide to populations. If the virus has no specific treatment, many symptomatic treatments (resuscitation, rehydration, transfusion, etc.) can help prevent the patient's death. An experimental live attenuated vaccine gives encouraging results in monkeys. It was administered in March 2009 to a researcher working on the virus, after a possible accidental contamination. The evolution has been favorable.

The precautions to be taken are :

-Slaughter of infected animals using gloves and a mask, with careful monitoring of the burial or incineration of carcasses, may be necessary to reduce the risk of transmission from animals to humans. Restricting or prohibiting the movement of animals from infected flocks to other areas can reduce the spread of the disease

-Products (blood and meat) must be cooked carefully before consumption.

-Communities affected by the Ebola virus must inform the population of the nature of the disease and of the measures taken to contain the outbreak, including during funeral rites. People who die from this infection should be buried quickly and without risk.

-The imposition of quarantine, the ban on going to hospitals, the suspension of the practice of patient care and funerals as well as the separation of patients in separate huts which are disinfected (from bleach two weeks apart is enough), sometimes burned after the death of their occupants, help stem epidemics. In the field, there is still no safer measure except the wearing of the air filter.

-Laboratory research must be carried out in biosafety level 4 containment facilities. Level 4 laboratories are fully autonomous and have a specialized ventilation system, an entry and exit airlock, biological protection enclosures. class III, etc. Sterilization and decontamination procedures are rigorously applied and employees wear a pressurized suit.

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Ne pas supprimer SVP

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