埃博拉与埃博拉病毒Ebola

Afterseveral-yearsstudyinbiology,allofushavegotbasalknowledgeaboutvirus&diseases.Nowwewilltalkaboutviruses&diseaesthatwearefamiliarwithornotfamiliarwith.Areyouready?ShantouUniversityMedicalCollege第一页，共36页。VirusesthatwearefamiliarwithHIVBirdFluVirusSmallpox(天花)RabiesVirusSARSMeaslesVirusTobaccoMosaicH1N1Virus狂犬麻疹Thinkafterclass:AsforH1N1/H7N9,whatareH&Nstandfor?第二页，共36页。What'sthevirusdiseasecrosstheWesternAfricanow?Right!It'sEbolaVirus!EbolavirusShantouUniversityMedicalCollege第三页，共36页。Questionsthatyouareexpectedtoanswer

duringthispresentation.

1.Howmanyvirusesarethispresentationtalkabout?2.Doyouknowthemainwaysfordiseasespropagation(传播)?Andwhat`sthat?

talkingeatingtogethershakehandsunquarantedfood未检疫的食物transfusionsexanimalsmother&babyShantouUniversityMedicalCollege第四页，共36页。RNAvirusshapeofstrandEbolahemmorrhagicfeverDiewithinafewdaysFatalityrates:50%~90%ShantouUniversityMedicalCollege第五页，共36页。IntroductionofEbolaandthehistoryofitFindoutwhyEbolaisagreatchallengeHowseriousEbolaisHowtodealwithEbolavirusdiseasesNewsofEbolaShantouUniversityMedicalCollege第六页，共36页。BriefintroductionEbolaShantouUniversityMedicalCollege第七页，共36页。Ebolavirusisazoonoticpathogen.

埃博拉病毒是一种人畜共患的病原体Ebolavirusisoneofthefourebolavirusesknowntocausediseaseinhumans.Ithasthehighestcase-fatalityrateoftheseebolaviruses,averaging83%sincefirstdescribedin1976,althoughfatalityratesupto90%havebeenrecordedinoneepidemic(2002–03).埃博拉病毒是“埃博拉系列”四大致病性病毒之一。自1976年首次发现以来，埃博拉出血热（埃博拉病毒引起的疾病）的平均死亡率为83%，但这个数字在2002年的统计中，一度高达90％。第八页，共36页。ThehistoryofEbola1976-1979:ThefirstrecordedEbolaoutbreaks1994-1997:Ebolaresurgence2000-2004:AnemerginggeographicpatternofE.ZaireandresurgenceofE.SudanE.ZaireoutbreaksE.SudanoutbreaksHumanoutbreaks第九页，共36页。TypesofEbolavirusSofar,Ebolavirusisdividedintofoursubtypes,namedtheEbola

Zairetype

(EBO

-Z),

Ebola

-Sultan

type

(EBO

-S),

Ebola

-Lestontype

(EBO

-R)

andEbola

-

IvoryCoasttype

(EBO

-CI).Differentsubtypeshavedifferentinfluence.第十页，共36页。ThecommoncharactersofEbolacertainheatresistanceTheincubationperiod:2to21days,Latentperiodwithoutinfectivity.WidespreadpopulationsusceptibilityShantouUniversityMedicalCollege第十一页，共36页。HighriskgroupMedicalworkersBodyprocessingpersonnelShantouUniversityMedicalCollege第十二页，共36页。CleaningstuffConnectwithinfectedanimals第十三页，共36页。InfluenceSofar,Ebolaisoneofthevirusofhighestfatality（致命性）rateintheworld,ashighas90%.WHOhaslistedEbolaasoneofthemostseverevirusharmfultohuman,itsbiologicalsecuritylevelis"thefourthvirus“.AIDSLevel2SARSLevel3Level4EbolaShantouUniversityMedicalCollege第十四页，共36页。EbolamaybeusedforWAR!AccordingtotheUSAscientistsfromFortDetrick（德瑞克堡）andBiopreparatmechanism,duringthecoldwartheEbolavirushasbeenconsideredastheSovietbiologicalweapons.Terroristweapons:combiningthesmallpoxvirus(天花病毒).Example:In1992,theleaderoftheAUMShinrikyo（奥姆真理教）inJapan,AsaharaShiakiko,hopedtogetEbolavirusastheHolocausttool（屠杀性工具）

inZairewithother4omembers.Fortunately,hedidnotsucceed.第十五页，共36页。Ebolaisthedeadlyviruswhichhasnotbeenconqueredbyhumans,itisthe“Goldbachconjecture”(歌德巴赫猜想)thatdifficltforthemedicalworldtoaddress._____DavidL.Haymann-theAmericaInfectiousdiseaseexpertsShantouUniversityMedicalCollege第十六页，共36页。HowseriousEbolavirusis?Transmisson（传播）Signsandsymptoms（症状）Theinfectionprocess（感染过程）ShantouUniversityMedicalCollege第十七页，共36页。TransmissionNormalpersonwithaninfectedperson`sblood、secretions、organorotherbodyfluidscanalsobeinfected.(接触易感染者的体液、分泌物等的正常人都有可能被感染.)patients’vomitandwastehaveextremelystronginfectivity.Bloodsaliva唾液fluid体液excretion排泄物vomitorganShantouUniversityMedicalCollege第十八页，共36页。SignsandsymptomsofEbolausuallybeginsuddenlywithan

influenza-likestagecharacterizedbyfatigue,fever,headaches,joint,muscle,andabdominalpain.（埃博拉出血热患者刚开始的各方面症状类似于流行性感冒）Whatproblemsthatthistrait(特点)canbringabout?SignsandSymptomsShantouUniversityMedicalCollege第十九页，共36页。Theincubationperiod(潜伏期）

Theaveragetime:8to10daysButitcanvarybetween2to21daysTheinfectionprocessTheearlysymptomIssimilartomalaria(疟疾),denguefever(登革热)orothertropicalfeversbleedingphase(出血期）Firstsymptomsafter5to7days

reddeningoftheeyes

bloodyvomitBleedingintotheskinpurpura（紫癜）ecchymoses（瘀斑）

hematomas（血肿）ShantouUniversityMedicalCollege第二十页，共36页。

Allpeopleinfectedshowsomesignsof

circulatorysystem（循环系统）

involvement,including

impairedbloodclotting（凝血障碍）.Iftheinfectedpersondoesnotrecover,deathdueto

multipleorgandysfunctionsyndrome（多器官功能障碍综合征）

occurswithin7to16days(usuallybetweendays8and9)afterfirstsymptoms.Ingeneral,thedevelopmentofbleedingsymptomsoftenindicatesaworseprognosis（预后）andthisbloodlosscanresultindeath.

ShantouUniversityMedicalCollege第二十一页，共36页。HowtodealwiththeEbolavirusdiseases?TreatmentPreventionShantouUniversityMedicalCollege第二十二页，共36页。TreatmentNoebolavirus-specific（特异性）treatmentexists.Treatmentisprimarilysupportiveinnature.Thesemeasuresmayincludepainmanagement,medicationsfornausea（恶心）,feverandanxiety,aswellasfluidsbymouthorbyintravenous（静脉注射）.Bloodproductssuchaspackedredbloodcells,platelets（血小板）orfreshfrozenplasma（血浆）mayalsobeused.ShantouUniversityMedicalCollege第二十三页，共36页。Prevention第二十四页，共36页。InfectioncontrolandcontainmentRecommendedmeasuresIsolationsterilizing（消毒的）equipmentandsurfaceswearingprotectiveclothingAresearcherworkingwiththeEbolaviruswhilewearingaBSL-4positivepressuresuittoavoidinfection（BSL4级防护服）IfapersonwithEboladies,directcontactwiththebodyofthedeceasedpatientshouldbeavoided.ShantouUniversityMedicalCollege第二十五页，共36页。Example:Duringthe2014outbreak,Liberia（利比里亚）closedschools.

Quarantine（检疫）Quarantine,alsoknownasenforcedisolation（强制隔离）,isusuallyeffectiveindecreasingspread.Governmentsoftenquarantine(对…检疫)areaswherethediseaseisoccurringorindividualswhomaybeinfected.ShantouUniversityMedicalCollege第二十六页，共36页。Contacttracing

isregardedasimportanttocontainanoutbreak.-Itinvolvesfindingeveryonewhohadclosecontactwith

infectedindividualsandwatchingforsignsofillnessfor21days.(调查与患者密切接触人的症状）

-Ifanyofthesecontactscomesdownwiththedisease,theyshouldbeisolated,tested,andtreated.-Thenrepeattheprocessbytracingthecontacts'contacts.Thethirdmethod:ContacttracingShantouUniversityMedicalCollege第二十七页，共36页。NewsofEbolaShantouUniversityMedicalCollege第二十八页，共36页。Ebolacrisis:

LiberiadoctortreatspatientswithHIVdrugs

ShantouUniversityMedicalCollege第二十九页，共36页。ThomasEricThefirstEbolapatientfoundinAmericaShantouUniversityMedicalCollege第三十页，共36页。NewYork'sJFKAirporttoBeginEbolaScreeningProgramShantouUniversityMedicalCollege第三十一页，共36页。BritainholdsEbolaoutbreaktestEbolamonitoringrisesasSpaintriestoc