EBOLA AND MARBURG VIRUS INFECTIONS

Microbiology: -

The family Filoviridae contains two genera, Marburgvirus and Ebolavirus, that consist of negative-sense, single-stranded RNA viruses. Ebolavirus has 5 species named for their original site of recognition.

• With the exception of Reston virus (an Ebola virus), all Filoviridae are African viruses that cause severe disease with high mortality rates.
• Both Marburg virus and Ebola virus are biosafety level 4 pathogens because of the high mortality rate from infection and the aerosol infectivity of the agents.

EPIDEMIOLOGY: -

Marburg virus was first identified in 1967; in 2004–2005, a Marburg virus epidemic occurred in Angola, with >250 cases and a case-fatality rate of 90%. Ebola virus was first identified in 1976 and has been associated with several epidemics of severe HF; the mortality rate ranges from 50 to 90%, depending on the species.

• Human-to-human transmission occurs, but epidemiologic studies have failed to yield evidence for an important role (like that documented in Ebola disease in monkeys) of airborne particles in human Ebola disease.
• The reservoir is unknown, but speculation currently centers on bats.

PATHOGENESIS: -

Both viruses replicate well in virtually all cell types, and viral replication is associated with cellular necrosis. Acute infection is associated with high levels of circulating virus and viral antigen. Fatal cases are associated with the lack of an antibody response, but clinical recovery is probably mediated by the cellular immune response since convalescent-phase plasma is not protective.

CLINICAL MANIFESTATIONS: -

After a 7- to 10-day incubation period, pts experience an abrupt onset of fever, severe headache, myalgia, nausea, vomiting, diarrhea, prostration, and depressed mentation.

• A maculopapular rash may appear at day 5–7 and is followed by desquamation. Bleeding may occur at this time and is apparent from any mucosal site and into the skin.
• The fever may break after 10–12 days, and the pt may eventually recover.
• Recrudescence and secondary bacterial infection may occur.
• Leukopenia is common early on and is followed by neutrophilia.

Thrombocytopenia, transaminitis, and jaundice are common.

HOMEOPATHIC MANAGEMENT: -

The medicines that can be thought of use are: -

• Crotalus
• Lachesis
• Phosphorus
• Arsenic
• Millifolium.