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Ebola Virus Disease (EVD) is a severe, often fatal illness in humans and nonhuman primates. It is caused by the Ebola virus, a member of the Filoviridae family. Since its discovery in 1976, Ebola has sparked fear and scientific inquiry due to its high mortality rate and the dramatic nature of its outbreaks [1].

Origins and transmission

Ebola was first identified in two simultaneous outbreaks in Nzara, South Sudan, and Yambuku, Democratic Republic of Congo, near the Ebola River, which gave the virus its name. The natural reservoir of the Ebola virus is believed to be fruit bats, which transmit the virus to other animals, including monkeys, chimpanzees, and humans. Human-to-human transmission occurs through direct contact with the blood, secretions, organs, or other bodily fluids of infected people and with surfaces and materials (e.g., bedding, clothing) contaminated with these fluids. Traditional burial practices, where mourners have direct contact with the body of the deceased, have also been linked to the spread of the virus [2].

Symptoms and pathophysiology

The incubation period of Ebola ranges from 2 to 21 days. Initial symptoms include sudden onset of fever, fatigue, muscle pain, headache, and sore throat. These are followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g., oozing from the gums, blood in the stools). The virus can cause severe immunosuppression and multi-organ failure. It targets a variety of cell types, including immune cells and endothelial cells, leading to a breakdown of the vascular system. This can result in widespread haemorrhaging, organ failure, and, often, death [3].

Diagnosis and treatment

Diagnosing Ebola requires specialized laboratory tests, including antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, polymerase chain reaction (PCR), and virus isolation. Early diagnosis is crucial for containing outbreaks and improving survival rates. Currently, there is no specific antiviral treatment approved for Ebola, but various therapeutic approaches, including monoclonal antibodies (like the REGN-EB3 and mAb114 treatments) and antiviral drugs (like remdesivir), have shown promise in clinical trials. Supportive care - rehydration, maintaining oxygen status and blood pressure, and treating secondary infections - significantly improves survival rates [4].

Prevention and control

Prevention of Ebola relies on strict infection control measures. This includes wearing protective clothing, using proper sterilization techniques, and avoiding contact with infected individuals or animals. During outbreaks, rapid identification and isolation of cases, contact tracing, and safe burials are crucial to preventing further spread. The development of vaccines has been a significant advancement in Ebola prevention. The rVSV-ZEBOV vaccine, which has shown to be highly effective in protecting against the Zaire Ebola virus, is a major breakthrough. It has been deployed in outbreak zones, particularly during the 2018–2020 Ebola outbreaks in the Democratic Republic of Congo, with promising results [5].

Outbreaks and global response

Ebola has caused several major outbreaks, most notably the 2014–2016 West Africa outbreak, which resulted in over 28,000 cases and 11,000 deaths. This outbreak highlighted the need for improved global health infrastructure and rapid response mechanisms. The international response, led by the World Health Organization (WHO), various governments, and non-governmental organizations, included massive efforts in treatment, containment, and research. Subsequent outbreaks have continued to test global health preparedness. In recent years, advancements in rapid diagnostic tests, vaccines, and therapeutics have improved the ability to manage and contain Ebola outbreaks more effectively [6].

Results and Discussion

Recent advancements in the understanding and management of Ebola Virus Disease (EVD) have significantly improved the ability to diagnose, treat, and prevent outbreaks. Studies have demonstrated the efficacy of new diagnostic tools, such as rapid antigen-capture Enzyme-Linked Immunosorbent Assay (ELISA) tests and Polymerase Chain Reaction (PCR) assays, which have shortened the time, needed to confirm infections and enabled more effective containment strategies. These diagnostic advancements are crucial, as early identification and isolation of cases are vital for controlling the spread of the virus [7].

In terms of treatment, although no specific antiviral has yet been universally approved; significant progress has been made with experimental therapies. Monoclonal antibodies like REGN-EB3 and mAb114 have shown considerable promise in clinical trials, improving survival rates among infected individuals. Additionally, antiviral drugs such as remdesivir have been explored for their potential effectiveness against the Ebola virus. Supportive care, which includes rehydration, maintaining oxygen levels, and treating secondary infections, remains a cornerstone of patient management and has been shown to significantly improve outcomes [8].

Preventive measures have also seen notable improvements. The rVSV-ZEBOV vaccine has been a groundbreaking development, demonstrating high efficacy in protecting against the Zaire Ebola virus. Its deployment in outbreak regions, particularly during the 2018–2020 outbreaks in the Democratic Republic of Congo, has contributed to controlling the spread of the virus and protecting healthcare workers and vulnerable populations. Despite these advancements, challenges remain in addressing Ebola outbreaks. The 2014–2016 West Africa outbreaks underscored the need for a coordinated global response and highlighted gaps in healthcare infrastructure, particularly in resource-limited settings. The international community, led by organizations such as the World Health Organization (WHO), has since improved outbreak response mechanisms, including better surveillance, faster deployment of medical resources, and more robust contact tracing and safe burial practices [9,10].

Conclusion

Ebola remains a formidable public health challenge, but advancements in science and medicine have significantly improved our ability to combat this deadly virus. Continued vigilance, research, and international cooperation are essential to prevent future outbreaks and protect vulnerable populations. The lessons learned from past outbreaks underscore the importance of preparedness and the need for a robust global health infrastructure to respond to emerging infectious diseases.

Acknowledgement

None

Conflict of Interest

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1. Stuart K, Losordo M, Olin P, Drawbridge M (2013) . Aquac Res 46: 2124-2132.

, ,

2. Komrakova M, Holtz W (2009) . Aquac 286: 156-163.

,

3. Gomes LC, Roubach R, Araujo‐Lima CA, Chippari‐Gomes AR, Lopes NP, et al. (2007) . JWAS 34: 76-84.

, Crossref

4. Stuart K, Losordo M, Olin P, Drawbridge M (2018) . Aquac 493: 229-232.

,

5. Zink IC, Benetti DD, Douillet PA, Margulies D, Scholey VP (2011) . N Am J Aquac 73: 42-48.

, , Crossref

6. Stieglitz JD, Benetti DD, Serafy JE (2012) . Aquac 364: 293-297.

, ,

7. Colburn HR, Walker AB, Berlinsky DL, Nardi GC (2008) . JWAS 39: 678-683.

, ,

8. Estudillo CB, Duray MN (2003) . Aquac 219: 279-290.

,

9. Vandborg M (2011) . Int J Gynecol Cancer 21: 967–974.

, , Crossref

10. Brand A (2007) . Aust Fam Physician 36: 116–120.

,