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Ebola

Symptômes

Les analyses de laboratoire sont requises pour diagnostiquer la MVE, car les symptômes ressemblent beaucoup à ceux d’autres maladies infectieuses qui peuvent être présentes dans les mêmes régions, comme le paludisme. Plus de 90% des personnes infectées en meurt.

Transmission
  • De personne à personne.
    • Contact non protégé avec du sang, des liquides corporels ou des tissus d’une personne infectée présentant des symptômes de MVE. Les personnes infectées ne semblent pas transmettre la maladie avant l’apparition des symptômes.
    • Contact sexuel non protégé avec une personne se rétablissant de la MVE jusqu’à 12 mois après une infection par un virus Ebola.
    • En milieu de soins de santé, si les membres du personnel qui prennent soin d’une personne infectée par le virus :
      • n’utilisent pas les mesures de prévention et de contrôle des infections nécessaires, comme le lavage des mains, l’utilisation sécuritaire des aiguilles et l’isolement des patients
      • ne portent pas systématiquement et correctement l’équipement de protection individuelle requis, comme un masque, une blouse et des gants ainsi que les mesures de stérilisation du matériel accompagnées de mesure de destruction par incinération),…
  • Contact avec des objets contaminés.
    • Contact non protégé avec des surfaces souillées, des matériaux (comme de la literie) ou de l’équipement médical (comme des aiguilles) contaminés par le virus Ebola.
  • ,Des animaux aux humains (zoonose) notamment : gorilles, singes, chimpanzés, chauves-souris (rousettes), porcs-épics, antilopes des bois, porcs, …
  • Facteurs de risque
  1. Transmission par contamination,
  2. Transmission par surface,
  3. Consommation alimentaire d’animaux sauvages,
  4. Braconnage
  5. Risques sexuels,
  6. Risques Proffessionnel – personnel de santé,
  7. Par rapprochement physique,
  8. En agglomération par proximité de personnes,..

Prévention

Le diagnostic de la MVE est confirmé par des analyses de laboratoire. Votre médecin peut soupçonner un cas de MVE en se basant sur vos symptômes et vos renseignements, notamment vos antécédents de voyage. Au plus tôt détecté au plus de chance de survie. Consulté votre Zone de Santé.

La suivi est impératif.

Il n’existe actuellement aucun traitement homologué contre la MVE en particulier. Un diagnostic précoce est important. Les cas de MVE sont extrêmement difficiles à soigner, car les symptômes peuvent s’aggraver très rapidement. On peut donner de l’oxygène, des solutions intraveineuses ou d’autres médicaments aux patients pour aider à soulager leurs symptômes. L’Utilisation de médicaments expérimentaux en développement au niveau expérimental. Actuellement les personnes atteinte du MVE se portent volontaire pour des essais clinique – les résultats sont en cours. Voire situation au niveau de l’OMS.

Informations à l’attention des praticiens

ScienceDirect Search Results – Keywords(ebola)

Articles scientifiques parus dans New England


Ebola

Feldmann H., Sprecher A., and Geisbert T.W.|N Engl J Med 2020; 382:1832-1842…transmission could result, a disturbing thought. Disease and Pathogenesis. The clinical disease is no longer referred to as Ebola or Marburg hemorrhagic fever but rather as Ebola or Marburg virus disease (EVD or MVD), which better reflects the variable symptoms and downplays bleeding as a clinical…


A Longitudinal Study of Ebola Sequelae in Liberia

The PREVAIL III Study Group|N Engl J Med 2019; 380:924-934…studies from this and previous Ebola outbreaks suggest that patients who survive EVD can have a myriad of health complications. In addition, there is evidence that survivors may be the source of new infections because they can harbor and intermittently shed Ebola virus (EBOV) in semen, resulting…
ORIGINAL ARTICLEMAR 09, 2017

Chimpanzee Adenovirus Vector Ebola Vaccine
Ledgerwood J.E., DeZure A.D., Stanley D.A., et al.|N Engl J Med 2017; 376:928-938This update of a preliminary report from November 2014 presents safety, immunogenicity, and long-term durability data from a trial of an Ebola vaccine in humans that is based on a chimpanzee adenovirus type 3 construct with the Ebola Zaire and Sudan glycoprotein inserts.
ORIGINAL ARTICLEDEC 12, 2019

A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics
Mulangu S., Dodd L.E., Davey R.T., et al.|N Engl J Med 2019; 381:2293-2303…(a single human monoclonal antibody derived from an Ebola survivor), or REGN-EB3 (a coformulated mixture of three human IgG1 monoclonal antibodies). ZMapp was chosen as the control on the basis of data from the Partnership for Research on Ebola Virus in Liberia II (PREVAIL II) trial. The current…
ORIGINAL ARTICLEOCT 12, 2017

Ebola RNA Persistence in Semen of Ebola Virus Disease Survivors — Final Report
Deen G.F., Broutet N., Xu W., et al.|N Engl J Med 2017; 377:1428-1437…Prevention (CDC) joined the government of Sierra Leone in marking the end of the most recent flare-up of Ebola virus disease (EVD) in the country; and in June 2016, the WHO declared the end of Ebola virus (EBOV) transmission in the Republic of Guinea and in Liberia. Unprecedented in its magnitude,…
ORIGINAL ARTICLEJAN 26, 2017

A Recombinant Vesicular Stomatitis Virus Ebola Vaccine
Regules J.A., Beigel J.H., Paolino K.M., et al.|N Engl J Med 2017; 376:330-341This final report updates preliminary data on an attenuated, replication-competent, recombinant vesicular stomatitis virus–based vaccine candidate designed to prevent Ebola virus disease. The results supported the safety and immunogenicity of up to two doses of the vaccine.
ORIGINAL ARTICLEAPR 01, 2021

Brief Report: Ebola Virus Transmission Initiated by Relapse of Systemic Ebola Virus Disease
Mbala-Kingebeni P., Pratt C., Mutafali-Ruffin M., et al.|N Engl J Med 2021; 384:1240-1247Human-to-human transmission of Ebola virus (EBOV) typically occurs through direct contact with infectious blood or bodily fluids (e.g. semen or breast milk). EBOV persistence has been well documented in survivors of Ebola virus disease (EVD). Although secondary transmission through contact with…
EDITORIALDEC 12, 2019

Monoclonal Antibody Therapy for Ebola Virus Disease
Levine M.M.|N Engl J Med 2019; 381:2365-2366Early reports in 1976 and 1995 documented cases in the Democratic Republic of Congo (DRC) of what we now know to be Ebola virus disease (EVD) caused by Zaire ebolavirus. The reports showed high case fatality rates and a propensity for transmission to close contacts such as family members caring for…
ORIGINAL ARTICLEOCT 13, 2016

A Randomized, Controlled Trial of ZMapp for Ebola Virus Infection
The PREVAIL II Writing Group|N Engl J Med 2016; 375:1448-1456Ebola virus causes a devastating clinical illness that is associated with high mortality. In this trial conducted primarily in West Africa during an outbreak, ZMapp (a cocktail of three monoclonal antibodies against Ebola) showed some clinical activity.
ORIGINAL ARTICLEAPR 28, 2016

A Monovalent Chimpanzee Adenovirus Ebola Vaccine Boosted with MVA
Ewer K., Rampling T., Venkatraman N., et al.|N Engl J Med 2016; 374:1635-1646In this phase 1 study involving 76 healthy volunteers in England, a single dose of a monovalent chimpanzee adenovirus vaccine elicited immune responses to Ebola virus. The immune response was superior after a booster dose of a modified vaccinia Ankara strain.
ORIGINAL ARTICLEJAN 07, 2016

Effect of Artesunate–Amodiaquine on Mortality Related to Ebola Virus Disease
Gignoux E., Azman A.S., de Smet M., et al.|N Engl J Med 2016; 374:23-32A shortage of artemether–lumefantrine at the Ebola treatment center in Liberia led to the use of artesunate–amodiaquine for malaria treatment during a 12-day period. In this setting, artesunate–amodiaquine use was associated with a 31% lower risk of death from Ebola.
ORIGINAL ARTICLEJAN 07, 2016

Evaluation of Convalescent Plasma for Ebola Virus Disease in Guinea
van Griensven J., Edwards T., de Lamballerie X., et al.|N Engl J Med 2016; 374:33-42The use of convalescent plasma to treat Ebola virus disease has been a focus of interest since Ebola virus was first identified in the 1970s. However, in this report from Guinea, the use of convalescent plasma did not significantly improve survival.
ORIGINAL ARTICLEDEC 17, 2015

Brief Report: Molecular Evidence of Sexual Transmission of Ebola Virus
Mate S.E., Kugelman J.R., Nyenswah T.G., et al.|N Engl J Med 2015; 373:2448-2454…The survivor was discharged from the Ebola treatment unit on October 7 and reported no subsequent illness. On September 20, clinical signs of EVD developed in the survivor’s former wife, who was estranged from the survivor. She was admitted to an ELWA Ebola treatment unit on September 24 and died…
ORIGINAL ARTICLEJUN 18, 2015

Brief Report: Persistence of Ebola Virus in Ocular Fluid during Convalescence
Varkey J.B., Shantha J.G., Crozier I., et al.|N Engl J Med 2015; 372:2423-2427…viremia. Case Report. A previously healthy 43-year-old male physician received a diagnosis of EVD on September 6, 2014, while he was working in an Ebola treatment unit in Kenema, Sierra Leone. He was transferred to Emory University Hospital in Atlanta and arrived 4 days after the onset of symptoms.…
ORIGINAL ARTICLENOV 27, 2014

Ebola Virus Disease in the Democratic Republic of Congo
Maganga G.D., Kapetshi J., Berthet N., et al.|N Engl J Med 2014; 371:2083-2091On August 24, 2014, when the eyes of the world were on the spreading West African outbreak of Ebola virus disease (EVD), the World Health Organization (WHO) was notified of another EVD outbreak in the vicinity of Boende town, Équateur province, in western Democratic Republic of Congo (DRC). Boende…
ORIGINAL ARTICLEOCT 09, 2014

Brief Report: Emergence of Zaire Ebola Virus Disease in Guinea
Baize S., Pannetier D., Oestereich L., et al.|N Engl J Med 2014; 371:1418-1425In March 2014, an outbreak of Ebola virus disease associated with a high fatality rate was identified in Guinea, with evidence of ongoing person-to-person transmission. In this update to the preliminary report, the virus is found to be a new strain related to Zaire ebolavirus.
ORIGINAL ARTICLE, JAN 01, 2015

Clinical Presentation of Patients with Ebola Virus Disease in Conakry, Guinea, Bah E.I., Lamah M.-C., Fletcher T., et al.|N Engl J Med 2015; 372:40-47Ebola virus is one of three members of the Filoviridae family and comprises five distinct species. Infection with Zaire ebolavirus (EBOV) has historically resulted in the highest case fatality rate — up to 90%. Outbreaks typically originate with introduction of the virus into humans from a wild… PERSPECTIVESEP 25, 2014

The International Ebola Emergency
Briand S., Bertherat E., Cox P., et al.|N Engl J Med 2014; 371:1180-1183Immediate priorities for control of the ongoing Ebola epidemic are early diagnosis, patient isolation, contact tracing, strict adherence to laboratory biosafety guidelines, barrier nursing procedures, use of personal protective equipment by clinicians, and safe burials.
EDITORIALNOV 20, 2014

Ebola and Quarantine
Drazen J.M., Kanapathipillai R., Campion E.W., et al.|N Engl J Med 2014; 371:2029-2030The governors of a number of states, including New York and New Jersey, recently imposed 21-day quarantines on health care workers returning to the United States from regions of the world where they may have cared for patients with Ebola virus disease. We …
PERSPECTIVEOCT 30, 2014

Ebola Then and Now
Breman J.G. and Johnson K.M.|N Engl J Med 2014; 371:1663-1666In 1976, an international group of scientists flew to Zaire to help elucidate and control an outbreak of lethal hemorrhagic fever. The current Ebola epidemic has much in common with that first Ebola outbreak, and similar approaches may bring it under control.

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