The ebolavirus is one of the two known filoviruses, and a filamentous shaped RNA virus that causes severe hemorrhagic fever. The ebolavirus is an acellular, enveloped, and negative stranded RNA virus. The ebolavirus belongs in the virus family filovirdae (Towner 1). There are five known species currently of the ebolavirus genus; Zaire ebolavirus (EBOV), Sudan ebolavirus, Bundibugyo ebolavirus, Tai forest ebolavirus, and Reston ebolavirus. Each filovirus is comprised of 19 kilobases that contain 7 distinct genes, each that function as a separate transcriptional unit that encode for certain proteins (Messaoudi 664). Two of the 7 nucleoproteins encoded, glycoprotein (GP) and viral protein 35 (VP35) are key components in the pathogenesis of the ebolavirus and crucial in understanding the disease. The ebolavirus, like any virus, needs a host to be pathogenic. Once the ebolavirus comes in contact with a human or non-human primate host, the virus is extremely toxic and often deadly. The full disruption of pathophysiology involves attachment, entry, synthesis, assembly, and release (Bauman 732). After coming in contact with the host cell that can be infected, the ebolavirus attaches to the cell, inserts the RNA coding and replicates at an exponential rate. The ebolavirus must be uncoated in order to release the genetic material. The normal physiology of the human cell contains membranes rafts, small structures composed of lipids and proteins that work as a dependent group among other components of the membrane. The membrane rafts in homeostasis function to aid in signaling, protein sorting, and cellular moving. The ebolavirus compromises the normal pathophysiology of the human cell by using the membrane rafts to enter the human cell (Bauman 78). The glycoprotein produced from the ebolavirus genetic material is responsible for mediation into the host cell of the environment that the ebolavirus comes in contact with. Viral internalization occurs by micropinocytosis (Messaoudi 664). Once the ebolavirus has entered the host and come in contact with the cell wall through chemical communication between attachment proteins and complementary receptors, the ebolavirus enters the cell membrane and overrides the normal cell pathophysiology by inserting the viral genetic instruction (Bauman 289). Due to the rapid replication of the ebolavirus, there is also a high level of cell death, which causes severe hemorrhagic bleeding (Bauman 375). After replication has occurred, the virus is released by budding (Messaoudi 665). The ebolavirus is so deadly because along with viral replication and cell damage, the host’s immune response is drastically compromised (Messaoudi 667). Ebolavirus can be transmitted animal to animal, animal to human, and human to human (McKee 1). The human to human transmission, however, results in an excessive inflammatory response of high fever, vascular leakage, and coagulopathy (Messaoudi 664). The EBOV was the prominent virus attributed to the most recent outbreak in West Africa that concluded in 2016. Filoviruses commonly use bats as reservoir hosts, and the disease is not toxic to the reservoir host it originates from. In fact, despite being highly virulent in humans, the ebolavirus is not pathogenic in certain animals that it begins in (Messaoudi 663). Signs and symptoms of the ebolavirus include high fever, extreme fatigue, muscle pain, headache, sore throat, vomiting, symptoms of kidney and liver failure, or external and internal bleeding (WHO par. 8). The ebolavirus is also known to cause vision problems and joint pain in survivors (McKee 1). Ebolavirus is a disease that threatens populations in Africa near tropical rainforests or by a certain 3 species of fruit bats (Cole 2). The first outbreak of the ebolavirus occurred in 1976 in the Democratic Republic of the Congo, near the Ebola river (Messaoudi 664). From 1976 to 2012, there were confirmed 2,387 cases with 1,590 deaths (Cole 18). In 2014, the EBOV broke out in New Guinea, then later spread to Sierra Leone and Liberia (Towner 1). In 2007, there was an outbreak of the ebolavirus in Uganda, which left 37 Ugandans dead and 149 suspected cases (Towner 2). The ebolavirus is contagious through bodily fluids, therefore populations with lower sanitization standards are more susceptible to developing the ebolavirus. Without proper medical facilities, health professionals and protocols for dealing the disease, the ebolavirus is more likely to infect more people. The ebolavirus is deadly and contagious to some extent, however the media portrays dramatizes the disease unnecessarily. With proper sanitization methods and avoiding transfer of body fluids, the Ebola virus is not easily transferred. A lower socioeconomic status increases the odds of a population contracting the ebolavirus, due to lack of healthcare necessities. However, each case is taken seriously and requires health professionals, protocol and immediate response. The ebolavirus can be damaging to communities, especially communities in Africa that are more susceptible to contracting the ebolavirus (Cole 18). The ebolavirus is one of the worlds deadlier pathogens, with a 90% fatality rate (Bauman 78). The ebolavirus is an extreme threat to communities in Africa especially if one person becomes affected. The social structure of communities impacted by the ebolavirus is threatened, and can continue to be threatened by the ebolavirus long term. For instance, the most recent outbreak in Sierra Leone took away a majority of the adult population, leaving the elderly and children without the means to utilize agricultural practices and land (Cole 41). The recent outbreak also left thousands of children orphaned. Due to the already weak government structures that exist in the countries where ebolavirus impacts, the ebolavirus causes a major disruption in the functioning of the government. The ebolavirus requires the different governments to work together to develop policy regarding travel, prevention methods, and health awareness.
As far as managing the ebolavirus, there is unfortunately no treatment. Antiviral medication is limited as is, and the ebolavirus is not well understood within the scientific community. Prevention is a key method of management. Prevention of ebolavirus includes limiting contact with bodily fluids, especially through syringes, when the virus is present within a community. When researching the ebolavirus, it is important to take extra precaution to follow protocol and lab techniques in order to prevent contamination as a result of laboratory testing. Travel to and from certain communities must be limited if the ebolavirus is present. For instance, flights to and from Africa were prohibited for a period of time during the 2014-2016 outbreak. Ebolavirus disease can be drastically prevented by practicing isolation and quarantine techniques in hospitals and avoiding bodily fluids of the sick (Cole 12). In Sierra Leone, officials campaigned a “stay at home house to house” initiative that proved effective, with 92 bodies recovered and 56 Ebola cases diagnosed (Cole 17). Prohibiting travel internationally, nationally, and even locally, proved to be effective. Diagnosing properly, following Biosafety Level 4 protocols among health responders, and providing necessary health care facilities to administer and manage the ill are effective measures according to evidence-based practice. Proper burial methods of the dead can also limit the spread of the disease (Messaoudi 673). Without certified treatment for ebolavirus, evidence based practice is limited, however preventative measures and management of the disease are the best source of effectiveness currently.
There is no current treatment plan of pharmacological intervention for the ebolavirus. Fluid replacement is the only treatment for the ebolavirus, however this treatment only goes as far as to manages the symptoms (Messaoudi 663). Scientists are working on a vaccine that is effective on humans, but there is currently no drug that is used in r
esponse to ebolavirus. In 2003, scientists thought to have developed a vaccine that was effective on monkeys with the ebolavirus, however a similar vaccine has not yet been created for humans. Fluid replacement can be possible by oral and IV fluids and blood transfusions to replace the rapid fluid loss (Cole 29). Scientists are working to understand how to use blocking molecules in membrane rafts (Bauman 78). Researchers are also researching a compound produced by hookworms that disrupts blood coagulation in order to combat the toxicity of the ebolavirus (Bauman 299).
As stated earlier, because no treatment for ebolavirus exists, prevention is a crucial component. First, the ebolavirus must utilize effective diagnostic testing to confirm the presence of the disease within the community. It is important for the public to be aware. The government has the responsibility to notify the community, neighboring countries, and even countries internationally. The governments must organize funding and resources if the ebolavirus is to be prevented further. Health responders and people must exercise sterile techniques, which include wearing a hazmat suit and avoiding possible infection. It is important to wash hands. The victims of the ebolavirus must be buried properly. Basic sanitization needs to be heeded during ebolavirus outbreaks (WHO par. 12).
The ebolavirus is deadly. The disease, however, is not common in developed nations, and countries not in Africa. If the ebolavirus is contracted, necessary disease response measure must be taken. Scientists are working to discover a pharmacological treatment to the ebolavirus.