BLEEDING LOVE Samantha, a 27 year old nurse, works in West Africa recently tended a dece...

Get Started. It's Free
or sign up with your email address
BLEEDING LOVE Samantha, a 27 year old nurse, works in West Africa recently tended a deceased patient who snared animals in jungle. by Mind Map: BLEEDING LOVE          Samantha, a 27 year old nurse, works in West Africa recently tended a deceased patient who snared animals in jungle.

1. Signs & Symptoms

1.1. Early symptoms

1.1.1. Fever

1.1.2. Headache

1.1.3. Lethargic with Sore Throat

1.1.4. Joint & Muscle Pain

1.2. Later symptoms

1.2.1. Vaginal Bleeding

1.2.2. Gastrointestinal Tract Abnormalities

1.2.3. Dry cough

2. Supportive Care Treatment

2.1. Fluid and electrolyte rehydration

2.1.1. Oral

2.1.2. Intravenous

2.2. Blood products

2.2.1. Packed red blood cell

2.2.2. Platelet

2.2.3. Fresh frozen plasma

2.3. Medication / Drug

2.3.1. Antipyretic

2.3.2. Antimicrobial

2.3.3. Analgesic

2.3.4. Antiemetic

2.4. Vaccine

2.4.1. Under trials

3. Prevention & Control

3.1. Proper personal protective equipment (PPE)

3.2. Travel restriction

3.3. Avoid eating bush meat

3.4. Avoid contact with infected people

3.5. Quarantine infected people

3.6. Do not touch infected dead bodies

3.7. Action

3.7.1. Collaboration

3.7.2. Campaign

3.7.3. Media

4. Differential Diagnosis

4.1. Influenza

4.1.1. Airborne transmission

4.1.2. Respiratory tract infection

4.2. Malaria

4.2.1. Mosquitoe-borne

4.2.2. Parasitic protozoa

4.3. Ebola

4.3.1. Zoonotic pathogen

4.3.2. Epidemic in West Africa

4.3.3. Hemorrhage

4.4. Typhoid Fever

4.4.1. Bacterial infection

4.4.2. Spread by eating contaminated food

5. Characteristics of Ebola Virus

5.1. (-) single stranded RNA virus

5.2. Family : Filoviridae

5.3. Genus : Ebolavirus

5.4. Incubation period

5.4.1. 2 to 21 days

6. Epidemiology

6.1. First appeared in 1976

6.2. Cause largest outbreak in year 2014-2015, occurred in West Africa

6.3. Nearly 29000 probable, suspected or laboratory-confirmed cases, with more than 11000 deaths

7. Pathogenesis

7.1. Immune System Evasion

7.1.1. Ab dependent enhancement (ADE) Abs bind to the virus GP spikes C1q binds to Ab-GP complex, enhance them to bind to C1q ligands on the host cell surface

7.1.2. Blockade of IFN pathway VP35 compete with retinoic acid-inducible gene 1 (RIG1) protein VP24 blocks STAT1

7.1.3. Soluble sGP is being encoded Have an anti-inflammatory role Has many similar epitopes with GP

7.2. Connecting the Cellular Mechanism to Hemorrhagic Fever

7.2.1. Attack macrophages & monocytes Release large amount of IL-6, IL-8 & TNF-alpha Increase vascular permeability Recruit more macrophages to the area Hepatocytes are being destroyed, cell signals cannot be cleared from bloodstream

7.2.2. Impaired IFN response Virus VP35 Bind to dsRNA, further suppressing the RLR-mediated IFN response, Interact with PACT, an activator of the IFN-induced antiviral kinase protein kinase R (PKR). Virus VP24 Bind to karyopherin-α (KPNA) proteins, preventing their interaction with tyrosine-phosphorylated signal transducer & activator of transcription 1 (STAT1)

7.2.3. sGP Limit WBC movement

8. Life cycle

8.1. Virus entry into host cell

8.1.1. Macropinocytosis Outward extension of plasma membrane that can fold back upon themselves

8.2. Virus replication

8.2.1. Virus protein VP30 Transcription activation factor VP24 Inhibit virus transcription & replication Binds to NP, prevent function of VP35, VP30 or L Convert virus transcriptional/replication active form to one that is ready for virion assembly & exit from host cell

8.3. Virus budding and exit from host cell

8.3.1. GP expression Loss of cell to cell contacts Loss of attachment to its substrate

8.3.2. VP40 Interacts with human ubiquitin ligase Nedd4 Transported to plasma membrane using COPII transport system Virus moves through lipid rafts where the final assembly & budding of the virions occur

9. Lab Diagnosis

9.1. Complete Blood Count (CBC)

9.1.1. Leukopenia

9.1.2. Thrombocytopenia

9.2. Liver Function Test

9.2.1. Aspartate aminotransferase

9.2.2. Alanine aminotransferase

9.3. Coagulation Test

9.3.1. Prothrombin time

9.4. Urinalysis

9.4.1. Creatinine level

9.4.2. BUN

9.5. Virus Isolation

9.5.1. Cell culture

9.6. Serological Test

9.6.1. ELISA Antigen & Antibody detection

9.7. Reverse Transcription-Polymerase Chain Reaction (RT-PCR)

9.7.1. RNA detection

10. Transmission

10.1. Direct contact

10.1.1. Animal to human Bats Wild animals

10.1.2. Human to human Ebola patients (live or dead) Blood or bodily fluids Sexual Transmission Semen of recovered person

10.2. Indirect contact

10.2.1. Contaminated surface & environment Funerals Syringe & needle