The Reemergence of Ebola Hemorrhagic Fever, Democratic Republic of the Congo, 1995

Abstract

In May 1995, an international team characterized and contained an outbreak of Ebola hemorrhagic fever (EHF) in Kikwit, Democratic Republic of the Congo. Active surveillance was instituted using several methods, including house-to-house search, review of hospital and dispensary logs, interview of health care personnel, retrospective contact tracing, and direct follow-up of suspect cases. In the field, a clinical case was defined as fever and hemorrhagic signs, fever plus contact with a case-patient, or fever plus at least 3 of 10 symptoms. A total of 315 cases of EHF, with an 81% case fatality, were identified, excluding 10 clinical cases with negative laboratory results. The earliest documented case-patient had onset on 6 January, and the last case-patient died on 16 July. Eighty cases (25%) occurred among health care workers. Two individuals may have been the source of infection for >50 cases. The outbreak was terminated by the initiation of barrier-nursing techniques, health education efforts, and rapid identification of cases.

Neurological Complications of Ebola Virus Infection

“…These symptoms include petechiae, ecchymosis, oozing from venipuncture sites, mucosal hemorrhage, hematemesis, or melena [7]. Women who are pregnant may have spontaneous abortions associated with significant bleeding [21].…”

Ebola virus: new insights into disease aetiopathology and possible therapeutic interventions

“…In 1995, there was a large epidemic of ZEBOV HF involving 315 cases, with an 81% case fatality rate, in Kikwit, a community in the former Zaire (Ref. 1). Meanwhile, between 1994 and 1996, there were smaller outbreaks caused by ZEBOV in Gabon (Ref.…”

“…GP is the surface glycoprotein that forms the spikes on the virion and is the effector for receptor binding and membrane fusion (Refs 15,16). GP is synthesised as a precursor molecule, GP 0 ; this is postranslationally cleaved by furin or a furin-like endoprotease into two subunits -GP 1 and GP 2 -which are linked by disulphide bonds to form a heterodimer (Refs 17,18). Homotrimers of GP 1 -GP 2 form the virion spikes.…”

“…Clinical symptoms appear suddenly after an incubation period of 2 to 21 days (Ref. 1). Common presenting complaints include high fever, chills, malaise and myalgia (Refs 2, 3, 4, 5, 6, 7).…”

¿Qué deber saber un médico sobre el ébola?

“…La infecciones por Ébola solían acontecer en zonas rurales remotas con unos índices de fallecimientos muy elevadas con lo que la infección se contenía 11 . En esta epidemia, las cifras que se manejan de infectados y fallecidos sin precedentes ha sido provocada por la elevada movilidad a través de las fronteras 3 , por las infecciones secundarias ligadas al pobre sistema sanitario, la tardanza en el diagnóstico por lo inespecífico de los síntomas iniciales 12 , la pobre estructura sanitaria y de salud pública y los factores socio-culturales que hace que sea habitual tocar a los fallecidos o incluso tenerlos dentro del domicilio conviviendo con los familiares previamente a su entierro 1 .…”