1. INTRODUCTION

 

INTRODUCTION

 EBOLA VIRUS DISEASE (EVD) is also known as Ebola hemorrhagic fever.

 EVD is a severe contagious disease affecting humans and non-human primates. It can be transmitted to humans through direct contact with blood, tissue, body fluids and secretions from an infected animal or human.

 The causative agent is classified in the genus Ebolavirus of the Filoviridae family. As members of the order Mononegaviruses, filoviruses are filamentous enveloped viruses containing a non-segmented, negative-strand genomic RNA of approximately 19 kilobases.

 The first EVD outbreak was reported in Zaire (now Democratic Republic of Congo (DRC) in 1976 and the causative agent was named after the nearby Ebola River.

 The five known species in the genus Ebolavirus (EBOV) are:

 

•           Zaire ebolavirus (ZEBOV);

•           Sudan ebolavirus (SEBOV);

•           Bundibugyo ebolavirus (BEBOV);

•           Reston ebolavirus (REBOV) and

•           Tai Forest ebolavirus (TEBOV).

 

 Their genomes can differ by 30-40%.

 

All but REBOV have been detected only in Africa. REBOV was isolated in 1989-90 in Reston (USA) from macaques imported from the Philippines. In 2008, pigs from pig farms close to Manilla (Philippines) also tested positive for REBOV. The related Marburg virus, genus Marburgvirus, is morphologically indistinguishable and induces symptoms similar to Ebolavirus.

 The Ebola virus causes an acute, serious illness which is often fatal if untreated. EVD first appeared in 1976 in 2 simultaneous outbreaks, one in what is now Nzara, South Sudan, and the other in Yambuku, DRC.

 The latter occurred in a village near the Ebola River, from which the disease takes its name. The 2014–2016 outbreak in West Africa was the largest Ebola outbreak since the virus was first discovered in 1976. 

The outbreak started in Guinea and then moved across land borders to Sierra Leone and Liberia. The current 2018-2019 outbreak in eastern DRC is highly complex, with insecurity adversely affecting public health response activities.

The latest epidemic of Ebola Virus Disease (EVD) in Congo has rapidly evolved into a largest outbreak in history. Deployed in an operational environment characterized by ongoing volatility, EVD prevention, treatment and containment efforts have faced multiple difficulties.

 Mistrust of EVD responders by local communities, coupled with targeted attacks on healthcare workers and facilities, have proved to be serious operational challenges. 

Despite aggressive efforts to stamp out the disease across three provinces, the virus has continued to spread and is responsible for the deaths of 3,303 people to date (as of 24th November 2019) with an overall fatality rate of 67%.