Feiten en fabels rond Ebola
Eric C.M. van Gorp
Prof. of Medicine
Dept. of Viroscience/ Workinggroup of Exotic Viral Infections [EVI]
Working group on
Exotic Viral Infections
VHF = viral hemorrhagic fevers
> Dengue
> Hanta
> Ebola
> …. …
Encefalitis
> Rabies
> West Nile
>……
WHO reference centre
Fabels
•  Ebola is een ziekte van Afrika
•  De wereld kan niets doen
•  …
FEITEN
Living circumstances
Cryptosporidiosis
Cyclosporiasis
H5N1 avian influenza
Multidrug-resistant tuberculose
Vancomycin-resistant
Staphylococcus aureus
Diphtheria
v-CJD
Lyme disease
E coli 0557:H7
E coli 0557:H7
West Nile virus
Hantavirus
puimonary
syndrome
Vancomycin-resistant
Staphylococcus aureus
Hepatitis C
Lassa fever
Rift Valey fever
Dengue
hemorrhagic
fever
Ebola
hemorrhagic
fever
HIV
Typhoid fever
Human monkeypox
Plague
Cholera
Marburg virus
Drug-resistant malaria
Nipah virus
•  Immune enhancement
Developing disease is the result of a complex interac6on between: •  plasma leakage/ hemorrhagic
tendency/ disease severity
•  host factors
•  virus/ virulence
•  vector
•  environment/ climate
•  infection pressure/ immunity
of the population
Hemorrhagic fevers
Family
Filoviridae
Genus
Filovirus
Arenaviridae
Arenavirus
Bunyaviridae
Nairovirus
Crimean-Congo
hemorrhagic fever
Phlebovirus
Hantavirus
Rift Valley fever
Agents of HFRS
and HPS
Flavivirus
Dengue
Yellow fever
Omsk HF
Flaviviridae
Virus
Ebola
Marburg
Lassa
New World
Arenaviridae
Kyasanur Forest
disease
Disease
Ebola HF
Marburg HF
Lassa fever
New World HF
(Argentinean HF,
Bolivian HF, etc.)
Crimean-Congo HF
Incubation
2-21
2-14
5-16
7-14
Vector
Unknown
Unknown
Rodent
Rodent
3-12
Tick
Rift Valley Fever
HF renal syndrome/
Hantavirus pulmonary
syndrome
DF, DHF, DSS
Yellow fever
Omsk HF
2-6
9-35
Mosquito
Rodent
5-8
3-6
2-9
Mosquito
Mosquito
Tick
Kyasanur Forest disease 2-9
Tick
Geographic spread VHF
Dengue
Yellow fever
Rift valley fever
Geographic spread VHF
Ebola, Marburg
Lassa
Crimean-Congo
HF
e.g. Dengue
Countries/Areas at risk of Dengue transmission
Jan. isoth.
10. C
Nepal
Hawaii
Sudan
Hongkong SAR
Bhutan
Macao SAR
Galapagos Islands
Madagascar-La Reunion
Easter Isands
Jul. isoth.
10. C
Geographic extension of dengue
Risk of dengue
transmission
e.g.Yellow fever
e.g. Yellow fever
Marburg virus
Lassa virus
Ebola virus
Geographic spread VHF
Ebola, Marburg
Lassa
Crimean-Congo
HF
Marburg virus infection
in The Netherlands: “out of Africa”
•  a Dutch woman died
from Marburg virus
infection in The
Netherlands
•  she had visited a bat
cave in Uganda 2
weeks earlier
Timen et al., EID 2009
"Python cave" Maramagambo forest
Ebola Viral Disease [EVD]
Signs and symptoms and transmission
Triage
Treatment
Conclusions VHF - EVD
Clinical picture -> Aspecific presentation
Transmission -> [EVD] Zoonotic infection -> Living circumstances
Awareness -> Preparedness
Adequate isolation facilities -> Trained healthcare workers
Start prompt treatment -> Fluid, fluid, fluid…
VHF as Import disease
Myth or reality?
The chance may still be relatively small
although
realistic
and
increasing
Acknowledgements
Chantal Reusken
Byron Martina
Annemiek van der Eijk
Jeroen van Kampen
Corine Geurts - van Kessel
Suzan Diepstraten - Pas
Martin Schutten
Pieter Fraay
Prof. Marion Koopmans