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Biohazard Level 4: Ebola Strains

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    Posted: January 12 2009 at 9:50pm
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Level-4 Virus
 
 
Biohazard Level 4: Exclusively viruses that cause severe to fatal disease
 
 
Philippines has requested the three agencies send an expert mission to work with human and animal
health experts in the Philippines to further investigate the situation.
 
 
Reston ebolavirus

Virus classification
Group: Group V ((-)ssRNA)
Order: Mononegavirales
Family: Filovirus
Genus: Ebolavirus
Species: Reston ebolavirus
 
 
 
First Detection Of Ebola-Reston Virus In Pigs
.....................................................................
 
 
 

FAO/OIE/WHO offer assistance to the Philippines
 
 
MANILA 23 December 2008
 
 
Following the detection of the Ebola-Reston virus in pigs in the
Philippines, the UN Food and Agriculture Organization (FAO), the World Organisation for Animal
Health (OIE) and the World Health Organization (WHO) announced today that the government of
the Philippines has requested the three agencies send an expert mission to work with human and
animal health experts in the Philippines to further investigate the situation.
An increase in pig mortality on swine farms in the provinces of Nueva Ecija and Bulacan in 2007 and
2008 prompted the Government of the Philippines to initiate laboratory investigations.
 
Samples taken
from ill pigs in May, June and September 2008 were sent to international reference laboratories which
confirmed in late October that the pigs were infected with a highly virulent strain of Porcine
reproductive and respiratory syndrome (PRRS) as well as the Ebola-Reston virus.
 
 
Although co-infection in pigs is not unusual, this is the first time globally that an Ebola-Reston virus
has been isolated in swine. It is not, however, the first time that the Ebola-Reston virus has been
found in the Philippines : it was found in monkeys from the Philippines in outbreak s that occurred in
1989-1990, 1992, and 1996.
 
 
The E bola virus belongs to the Filoviridae family (filovirus) and is comprised of five distinct species:
Zaïre , Sudan , Côte d'Ivoire, Bundibugyo and Reston . Zaïre , Sudan and Bundibugyo species have
been associated with large Ebola hemorrhagic fever (EHF) outbreak s in Africa with high case fatality
ratio (25–90%) while Côte d'Ivoire and Reston have not.
 
Reston species can infect humans
 
but no serious illness or death in humans have been reported to date.
 
Since being informed of this event in late November, FAO, OIE and WHO have been making every
effort to gain a better understanding of the situation and are working closely with the Philippines
 
 
Government and local animal and human health experts.
The Department of Health of the Philippines has reported that initial laboratory tests on animal
handlers and slaughterhouse workers who were thought to have come into contact with infected pigs
were negative for Ebola Reston infection, and that additional testing is ongoing. The Bureau of Animal
 
 
Industry (BAI) of the Philippines Department of Agriculture has notified the OIE that all infected
animals were destroyed and buried or burned, the infected premises and establishments have been
disinfected and the affected areas are under strict quarantine and movement control. Vaccination of
swine against PRRS is ongoing in the Province of Bucalan. PRRS is not transmissible to humans.
 
 
The planned joint FAO/OIE/WHO team will work with country counterparts to address, through
field and laboratory investigation, important questions as to the source of the virus, its transmission,
its virulence and its natural habitat, in order to provide appropriate guidance for animal and human
health protection.
Until these questions can be answered, the FAO and WHO stressed the importance of carrying out
basic good hygiene practices and food handling measures.
 
 
Ebola viruses are normally transmitted via contact with the blood or other bodily fluids of an infected
animal or person. In all situations, even in the absence of identified risks, meat handling and
preparation should be done in a clean environment (table top, utensils, knives) and meat handlers
should follow good personal hygiene practices (e.g. clean hands, clean protective clothing). In general,
 
 
hands should be r egularly washed while handling raw meat.
Pork from healthy pigs is safe to eat as long as either the fresh meat is cooked properly (i.e. 70°C in
all part of the food, so that there is no pink meat and the juices run clear), or, in the case of uncooked
processed pork, national safety standards have been met during production, processing and
distribution.
 
 
Meat from sick pigs or pigs found dead should not be eaten and should not enter the food chain or be
given to other animals. Ill animals should be reported to the competent authorities and proper hygiene
precautions and protection should be taken when destroying and disposing of sick or dead pigs. The
Philippines Department of Agriculture has advised the Philippine public to buy its meat only from
National Meat Inspection Services certified sources.
 
 
As a general rule, proper hygiene and precautionary measures ( wearing gloves, goggles and protective
clothing) should also be exercised when slaughtering or butchering pigs. This applies both to
industrial and home-slaughtering of pigs. Children and those not involved in the process of
slaughtering should be kept away.

 

...................................

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More on Ebola in Pigs...
...................................................
 
 
 
 
 
 
 
 
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How is Ebola-Reston virus spread? Go%20to%20top%20of%20page

Evidence from prior outbreaks indicates that Ebola-Reston is highly transmissible by percutaneous exposure (injection) or by mucous membrane (eg., eye or respiratory tract) exposure to droplets of infected body fluids and tissues from infected animals.  As with other Ebola virus species, isolation of infected animals, and contact and droplet precautions (gowns, gloves, masks, eye protection) are indicated to prevent transmission.  During the outbreaks in U.S. monkey quarantine facilities in 1989 and 1990, there was transmission to animals in separate rooms that may have been due to small-particle aerosols; however, this mode of transmission has not been proven, and other possible explanations for these infections exist.

Veterinarians and those working with pigs are advised to wear protective clothing (gowns, gloves, masks, eye protection) when working around sick pigs suspected of harboring the virus. Meat from sick pigs should not enter the food chain.

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Ebola Virus Killing Gorillas, Chimps in Congo

by Elizabeth Shogren
 
All Things Considered
 
December 9, 2006
 
 
 
A new study confirms that the ebola virus is causing a massive die-off of gorillas and chimpanzees in Africa. Scientists differ on whether there's anything humans can do to help their closest relatives in the animal kingdom.
 
 
 
In the Lossi Sanctuary in the Republic of Congo, researchers had been tracking groups of gorillas for several years. Four years ago, they started to find gorilla carcasses. And over the next four months 130 of the 143 apes disappeared.

 
 
Peter Walsh took those numbers, plus some others, to figure out how big an impact ebola was having in this region.
"A bunch of fancy statistics" led Walsh to "a fairly clear story" that the outbreaks "had killed literally thousands of gorillas."
Walsh is a ecologist from the Max Planck Institute in Leipzig, Germany. He says this study looked at only one of the areas where apes were devastated by ebola.
 
 
 
He says the virus has covered between half and two-thirds of what he calls "the really good habitat for gorillas and chimpanzees in Central Africa."
Walsh hopes those numbers will spark action to save gorillas. He wants to give them a vaccine to protect them from ebola.
"This is a doable thing," he says. "But the problem is nobody has been trying to do it."
 
 
 
One reason they aren't is that there isn't a vaccine ready yet. Tom Geisbert is developing an ebola vaccine for the U.S. Army. He says researches have had success testing two vaccines on apes, but it will be years before they are ready.
"It's a long way from showing that a vaccine works in an animal in lab conditions to an animal in the field," Geisbert says.
What if a vaccine is developed? Sandy Harcourt of the University of California/Davis doubts you could give it to wild animals.
"I can't see that we can prevent the spread of ebola," he says.
 
 
Shooting wild apes with darts as they move through tropical forests is extremely hard, Harcourt points out. And if you gave the animals a vaccine hidden in a treat, dominant animals -- the big males -- would eat the share intended for the females and young.
Walsh hopes such challenges won't deter action.
 
"For me to know that they're all dying off and we could do something about it just rips me apart," he says.
His study appears in the current issue of Science.
 
 
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High%20resolution%20arenavir

Image, above: Vero E6 tissue culture cell infected with an arenavirus. Image shows extracellular virus particles budding from the cell surface. Magnification approx. 12,000 times.

Image courtesy Cynthia Goldsmith, MS, Infectious Disease

 
CDC
........
 
Special Pathogens Branch
................................................
 
Viral Hemorrhagic Fevers
.................................................

The Special Pathogens Branch (SPB) primarily works with hemorrhagic fever viruses that are classified as

biosafety level four (BSL-4) pathogens.
 
A list of these viruses appears in the SPB disease information index.
The Division of Vector-Borne Infectious Diseases, also in the National Center for Infectious Diseases, works with the non-BSL-4 viruses that cause two other hemorrhagic fevers, dengue hemorrhagic fever and yellow fever.
 

VHFs are caused by viruses of four distinct families: arenaviruses, filoviruses, bunyaviruses, and flaviviruses. Each of these families share a number of features:
They are all RNA viruses, and all are covered, or enveloped, in a fatty (lipid) coating.
Their survival is dependent on an animal or insect host, called the natural reservoir.
The viruses are geographically restricted to the areas where their host species live.
 
Humans are not the natural reservoir for any of these viruses. Humans are infected when they come into contact with infected hosts. However, with some viruses, after the accidental transmission from the host, humans can transmit the virus to one another.
 
Human cases or outbreaks of hemorrhagic fevers caused by these viruses occur sporadically and irregularly. The occurrence of outbreaks cannot be easily predicted.
With a few noteworthy exceptions, there is no cure or established drug treatment for VHFs.
In rare cases, other viral and bacterial infections can cause a hemorrhagic fever; scrub typhus is a good example.
 
 
What carries viruses that cause viral hemorrhagic fevers? 
Viruses associated with most VHFs are zoonotic. This means that these viruses naturally reside in an animal reservoir host or arthropod vector. They are totally dependent on their hosts for replication and overall survival. For the most part, rodents and arthropods are the main reservoirs for viruses causing VHFs. The multimammate rat, cotton rat, deer mouse, house mouse, and other field rodents are examples of reservoir hosts.
 
 
Arthropod ticks and mosquitoes serve as vectors for some of the illnesses.
 
However, the hosts of some viruses remain unknown -- Ebola and Marburg viruses are well-known examples.
Where are cases of viral hemorrhagic fever found? 
Taken together, the viruses that cause VHFs are distributed over much of the globe.
 
 
However, because each virus is associated with one or more particular host species, the virus and the disease it causes are usually seen only where the host species live(s). Some hosts, such as the rodent species carrying several of the New World arenaviruses, live in geographically restricted areas. Therefore, the risk of getting VHFs caused by these viruses is restricted to those areas. Other hosts range over continents, such as the rodents that carry viruses which cause various forms of hantavirus pulmonary syndrome (HPS) in North and South America, or the different set of rodents that carry viruses which cause hemorrhagic fever with renal syndrome (HFRS) in Europe and Asia.
 
A few hosts are distributed nearly worldwide, such as the common rat. It can carry Seoul virus, a cause of HFRS; therefore, humans can get HFRS anywhere where the common rat is found.
 
 
While people usually become infected only in areas where the host lives, occasionally people become infected by a host that has been exported from its native habitat.
 
For example, the first outbreaks of Marburg hemorrhagic fever, in Marburg and Frankfurt, Germany, and in Yugoslavia, occurred when laboratory workers handled imported monkeys infected with Marburg virus.
 
 
Occasionally, a person becomes infected in an area where the virus occurs naturally and then travels elsewhere. If the virus is a type that can be transmitted further by person-to-person contact, the traveler could infect other people. For instance, in 1996, a medical professional treating patients with Ebola hemorrhagic fever (Ebola HF) in Gabon unknowingly became infected.
 
 
When he later traveled to South Africa and was treated for Ebola HF in a hospital, the virus was transmitted to a nurse. She became ill and died. Because more and more people travel each year, outbreaks of these diseases are becoming an increasing threat in places where they rarely, if ever, have been seen before.
 
 
How are hemorrhagic fever viruses transmitted? 
Viruses causing hemorrhagic fever are initially transmitted to humans when the activities of infected reservoir hosts or vectors and humans overlap. The viruses carried in rodent reservoirs are transmitted when humans have contact with urine, fecal matter, saliva, or other body excretions from infected rodents.
 
 
The viruses associated with arthropod vectors are spread most often when the vector mosquito or tick bites a human, or when a human crushes a tick. However, some of these vectors may spread virus to animals, livestock, for example. Humans then become infected when they care for or slaughter the animals.
 
 
Some viruses that cause hemorrhagic fever can spread from one person to another, once an initial person has become infected.
 
Ebola, Marburg, Lassa and Crimean-Congo hemorrhagic fever viruses are examples. This type of secondary transmission of the virus can occur directly, through close contact with infected people or their body fluids. It can also occur indirectly, through contact with objects contaminated with infected body fluids.
 
For example, contaminated syringes and needles have played an important role in spreading infection in outbreaks of Ebola hemorrhagic fever and Lassa fever.
 
 
What are the symptoms of viral hemorrhagic fever illnesses? 
Specific signs and symptoms vary by the type of VHF, but initial signs and symptoms often include
 
marked fever,
fatigue,
dizziness,
muscle aches,
loss of strength, and
exhaustion.
 
Patients with severe cases of VHF often show signs of bleeding under the skin, in internal organs, or from body orifices like the mouth, eyes, or ears.
 
However, although they may bleed from many sites around the body, patients rarely die because of blood loss.
 
Severely ill patient cases may also show shock, nervous system malfunction, coma, delirium, and seizures. Some types of VHF are associated with renal (kidney) failure.
 
 
How are patients with viral hemorrhagic fever treated? 
Patients receive supportive therapy, but generally speaking, there is no other treatment or established cure for VHFs. Ribavirin, an anti-viral drug, has been effective in treating some individuals with Lassa fever or HFRS. Treatment with convalescent-phase plasma has been used with success in some patients with Argentine hemorrhagic fever.
 
 
 
How can cases of viral hemorrhagic fever be prevented and controlled? 
With the exception of yellow fever and Argentine hemorrhagic fever, for which vaccines have been developed, no vaccines exist that can protect against these diseases. Therefore, prevention efforts must concentrate on avoiding contact with host species. If prevention methods fail and a case of VHF does occur, efforts should focus on preventing further transmission from person to person, if the virus can be transmitted in this way.
 
 
Because many of the hosts that carry hemorrhagic fever viruses are rodents, disease prevention efforts include
controlling rodent populations;
discouraging rodents from entering or living in homes or workplaces;
encouraging safe cleanup of rodent nests and droppings.
 
For hemorrhagic fever viruses spread by arthropod vectors, prevention efforts often focus on community-wide insect and arthropod control. In addition, people are encouraged to use insect repellant, proper clothing, bednets, window screens, and other insect barriers to avoid being bitten.
 
 
 
For those hemorrhagic fever viruses that can be transmitted from one person to another, avoiding close physical contact with infected people and their body fluids is the most important way of controlling the spread of disease.
 
 
Barrier nursing or infection control techniques include isolating infected individuals and wearing protective clothing. Other infection control recommendations include proper use, disinfection, and disposal of instruments and equipment used in treating or caring for patients with VHF, such as needles and thermometers.
 
 
In conjunction with the World Health Organization, CDC has developed practical, hospital-based guidelines, titled Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting.  The manual can help health-care facilities recognize cases and prevent further hospital-based disease transmission using locally available materials and few financial resources.
 
 
What needs to be done to address the threat of viral hemorrhagic fevers? 
Scientists and researchers are challenged with developing containment, treatment, and vaccine strategies for these diseases. Another goal is to develop immunologic and molecular tools for more rapid disease diagnosis, and to study how the viruses are transmitted and exactly how the disease affects the body (pathogenesis). A third goal is to understand the ecology of these viruses and their hosts in order to offer preventive public health advice for avoiding infection.
 
 
 
 
 
 
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...............................................................................................................................
 
Isolation of the virus requires Biosafety Level 4 facilities.
 
Argentinian hemorrhagic fever: Junin virus
International Classification of Disease Codes
Disease ICD-9-CM ICD-10
Hemorrhagic fever due
to Junin virus

A96.0
The virus can be spread by aerosols and person-to-person transmission has been reported. The virus is carried by rodents, especially mice of the genus Callomys and is stable in their droppings. Typically the virus is inhaled, but it is also possible that it may entered through small abrasions or cuts in the skin.
 
A US vaccine developed by the Salk Institute is no longer manufactured.
 
A safe and effective vaccine providing long-term protection (Candid-1) is available in Argentina and has the status of an Investigational New Drug in the United States.
 
 
Kill the virus with 1% Bleach
....................................................
 
 
 
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Virus identified - nurse ill

........................................................................

12/10/2008 21:50  - (SA)  
 
 
 
Johannesburg - The mystery viral haemorrhagic fever which killed three people in South Africa has been provisionally identified as an arenavirus, the National Institute for Communicable Diseases and the Department of Health said on Sunday.

"The causative agent of the disease... may be a rodent-borne arenavirus related to the Lassa fever virus of West Africa," NICD's Dr Lucille Blumberg told reporters at the Charlotte Maxeke Johannesburg Academic Hospital.

She said tests done by the NICD and the Centres for Disease Control in Atlanta, US, indicated that the disease seemed to be a kind of an arenavirus.

The World Health Organisation has also been providing technical assistance in identifying the virus.

Arenaviruses cause chronic infections in multimammate mice - a kind of wild mouse - who excrete the virus in their urine which can then contaminate human food or house dust.

Viruses similar to the Lassa fever virus have been found in rodents in Africa, but other than in West Africa have not been found to cause diseases in humans.

More tests needed

She said there was no indication that arenaviruses which could cause disease in humans were present in South African rodents.

Blumberg said further tests still needed to be done.

"It needs to be determined whether it is a previously unrecognised member of the arenaviruses and what its distribution is," she said.

The NICD's Robert Swanepoel said there were viruses of this family in southern Africa, but that this could be an undiscovered kind.

"Not every country has been thoroughly searched," he said.

He said the kind of rodents that carried the virus were not generally found in urban areas.

"They are out there, but are attracted [to human dwellings] if there is inadequate waste disposal."

Crops and animal feed also sometimes attracted them, he said.

He said the effects of the various viruses could range from causing mild fevers to being lethal.

'Very lethal'

There were only three cases to go on for the kind of arenavirus now discovered, but "it looks like it is very lethal", he said.

Head of the NICD's Special Pathogens Unit, Dr Janusz T Paweska, said the arenavirus diagnosis came about after a number of tests.

Biopsies conducted on the last two victims where infected tissues, skin, liver and muscles were tested were critically important in being able to make a diagnosis.

A blood sample obtained in Zambia from the first victim also confirmed test results.

He said doctors were now waiting for the virus to grow in cell culture to conduct further tests to identify what strain it was.

Lived on smallholding

Gauteng Health MEC Brian Hlongwa said the first victim of the virus was 36-year-old Cecilia van Deventer, who was airlifted from Zambia to the Morningside Medi-Clinic in Sandton on September 12 in a critical condition.

She is known to have lived on a smallholding on the outskirts of Lusaka where she kept three horses and other animals, although the exact point of contamination has never been discovered.

She fell ill on September 8 and was treated in three different hospitals in Lusaka. Once in South Africa she was treated for tick-bite fever and other potential infections, but died two days later.

She was not tested for viral haemorrhagic fever.

On September 27 a Zambian paramedic who had accompanied her to South Africa was admitted to the hospital with similar flu-like symptoms, fever and a skin rash. In his case, viral haemorrhagic fever was queried.

He developed diarrhoea, severe headaches, nausea and vomiting and although he initially seemed to respond to treatment, died on October 2 at the clinic.

A third victim of the virus was a nurse from Morningside Medi-Clinic who had attended to Van Deventer.

She became ill with fever 18 days after Van Deventer was admitted to the hospital and consulted a general practitioner, receiving intravenous therapy.

She was then referred to Robinson Hospital in Randfontein and later transferred due to a bedding shortage to Sir Albert Clinic. Here she was treated for a suspected case of meningitis.

Her condition deteriorated and she died last Sunday.

A fourth person, a contract cleaner working at Morningside Medi-Clinic, Maria Mokubung, 37, died in Charlotte Maxeke.

Two people in isolation

Earlier this week the Health Department said her death was not related to viral haemorrhagic fever.

On Sunday, Blumberg said a female nurse and a male paramedic were currently in isolation after they had had contact with the deceased.

The paramedic had contact with Van Deventer and after developing flu-like symptoms and a fever was admitted to Flora Clinic. He was subsequently transferred to Morningside Medi-Clinic and diagnosed with kidney stones.

On Sunday Blumberg said it was "less likely" he had the virus.

The second person in isolation is a nurse who had contact with the paramedic that died. She has developed symptoms similar to the three deceased and is receiving anti-viral medication called ribavirin.

Nurse's condition 'highly suspect'

The Department of Health said she was presently stable.

Asked whether she could have contracted the virus, Blumberg said her condition was "highly suspect".

She said she could not say how her condition was likely to progress.

This week three other people who had been hospitalised after contact with the deceased were discharged.

On Friday morning the 11-year-old son of the nursing sister who had died and his 23-year-old nanny were discharged.

A cleaning supervisor at Morningside Medi-Clinic who had been admitted to the Chris Hani Baragwanath Hospital on Monday with symptoms of viral haemorrhagic fever was also released.

151 people still being tracked

On Sunday, Hlongwa said the cleaning supervisor was currently "well".

All three continued to be monitored as part of the disease surveillance system currently tracking 151 people who had had contact with the deceased.

Blumberg said arenaviruses could cause a disease that spreads from human to human through contact fluid.

In hospital settings, special precautions were needed when nursing patients.

People in contact with those who had contracted the virus must be monitored for 21 days following their last contact with the patient.

Their body temperature was monitored and those who developed fever or illness were admitted to an isolation ward in the hospital.

Blumberg said there was a drug which showed promising results in treating patients if their illness was recognised early.

Those who have been in contact with patients but are well, do not spread infection.

'Step forward'

On Sunday, Hlongwa said the diagnosis of the virus was a step forward.

"We are now a step further because we know specifically what we are dealing with."

However, it was still vital to conduct more tests to find out what kind of arenavirus it was, he said.

Health Department director-general Thami Mseleku cautioned South Africans not to now fear that every mouse that came their way contained the virus.

Since the virus first broke out, medical officials have been at pains to emphasise that the general public was not at risk as only people who had been in direct contact with the bodily fluids of a person who had a confirmed case of the virus could be infected.

- SAPA

 
 
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AVI BioPharma Announces FDA Clears IND Applications For Clinical Trials Of RNA Therapeutic Agents

For Treatment Of Ebola And Marburg Viruses

Article Date: 30 Dec 2008 - 1:00 PST

AVI BioPharma, Inc. (NASDAQ: AVII), a developer of RNA-based drugs, announced that it learned earlier today that it has received verbal clearance from the United States Food and Drug Administration (FDA) for the Investigational New Drug (IND) applications filed in November for its two lead products for Marburg and Ebola viruses. AVI BioPharma expects to receive written confirmation of the IND clearances from the FDA in early 2009.

source
http://www.medicalnewstoday.com/articles/134105.php

 
 
 
 
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Hemorrhagic Fever Viruses Have Been Weaponized
..............................................................................................................................................
 
Evidence 
MEDLINE was searched from January 1966 to January 2002. Retrieved references, relevant material published prior to 1966, and additional sources identified by participants were reviewed.

 
Participants 
The Working Group on Civilian Biodefense included 26 representatives from academic medical centers, public health, military services, governmental agencies, and other emergency management institutions.

 
Conclusions 
Weapons disseminating a number of HFVs could cause an outbreak of an undifferentiated febrile illness 2 to 21 days later, associated with clinical manifestations that could include rash, hemorrhagic diathesis, and shock. The mode of transmission and clinical course would vary depending on the specific pathogen. Diagnosis may be delayed given clinicians' unfamiliarity with these diseases, heterogeneous clinical presentation within an infected cohort, and lack of widely available diagnostic tests. Initiation of ribavirin therapy in the early phases of illness may be useful in treatment of some of these viruses, although extensive experience is lacking.

 
There are no licensed vaccines to treat the diseases caused by HFVs.
 
.................................................................
 
Hemorrhagic Fever Viruses
 
Historically, the term viral hemorrhagic fever (VHF) has referred to a clinical illness associated with fever and a bleeding diathesis caused by a virus belonging to 1 of 4 distinct families:

Filoviridae, Arenaviridae, Bunyaviridae, and Flaviviridae
 

The Working Group on Civilian Biodefense previously established a list of key features that characterize biological agents that pose particularly serious risks if used as biological weapons against civilian populations:
 
(1) high morbidity and mortality;

(2) potential for person-to-person transmission;

(3) low infective dose and highly infectious by aerosol dissemination, with a commensurate ability to cause large outbreaks;

(4) effective vaccine unavailable or available only in limited supply;

(5) potential to cause public and health care worker anxiety;

(6) availability of pathogen or toxin;

(7) feasibility of large-scale production;

(8) environmental stability; and

(9) prior research and development as a biological weapon.

Some HFVs
 
exhibit a significant number of these key characteristics and pose serious risk as biological weapons, including Ebola and Marburg viruses (Filoviridae), Lassa fever and New World arenaviruses (Arenaviridae), Rift Valley fever (Bunyaviridae), and yellow fever, Omsk hemorrhagic fever, and Kyasanur Forest disease (Flaviviridae).
 
 
Several viruses that can cause VHF will not be considered further in this analysis. Dengue is excluded because it is not transmissible by small-particle aerosol,7 and primary dengue causes VHF only rarely. Crimean-Congo hemorrhagic fever (CCHF) and the agents of hemorrhagic fever with renal syndrome (HFRS) also have been excluded after much deliberation.

 
Although these pathogens can cause VHF and may be transmissible by small-particle aerosol, the working group noted that technical difficulties (ie, barriers to large-scale production) currently preclude their development as mass casualty weapons.
 
 
Crimean-Congo hemorrhagic fever and the agents of HFRS do not readily replicate to high concentrations in cell cultures, a prerequisite for weaponization of an infectious organism. However, CCHF, the agents of HFRS, and dengue may carry great morbidity and mortality in naturally occurring outbreaks.

 
In particular, CCHF may be transmitted from person to person, has a high case-fatality rate, and is endemic in central Asia and southern Africa. We acknowledge that technical difficulties may be overcome with advances in technology and science, and these excluded viruses may become a greater threat in the future. Other sources provide information on the viruses not addressed herein.8-12
 
 
The consequences of an unannounced aerosol attack with an HFV are the primary focus of this analysis. A variety of attack scenarios with these agents are possible.

This analysis does not attempt to forecast the most likely but focuses on perhaps the most serious scenario.
 
 
Understanding and planning for a covert aerosol attack with HFVs will improve preparedness for other scenarios as well.
 
 
Ribavirin
 
is the only potentially effective drug available for selected hemorrhagic fever because it is approved by the FDA for another indication. However, it is not effective against all of the HFVs and it is not widely available.
 
 
The supply of ribavirin should be rapidly augmented, and studies to demonstrate its efficacy and safety against selected HFVs should be conducted to support an FDA approval for those indications. We also recommend the addition of intravenous and oral formulations of ribavirin to the
 
 
US National Pharmaceutical Stockpile (a repository of antibiotics, chemical antidotes, and other medical supplies managed by
 
 
the CDC that may be emergently sent to the site of a disaster anywhere in the United States). New antiviral therapies should be pursued for the treatment of all HFVs, including those excluded from this article. The effects of any developed therapy in pediatric populations should also be evaluated.
 
 
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Viral Hemorrhagic Fevers
 
 
 
Clinical Presentation
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Common presenting complaints are fever, myalgia, and prostration; clinical examination may reveal only conjunctival injection, mild hypotension, flushing and petechial hemorrhages.
 
 
Full-blown VHF typically evolves to shock and generalized bleeding from the mucous membranes and often is accompanied by evidence of neurological, hematopoietic or pulmonary involvement.
 
VHF mortality may be substantial, ranging from 5 - 20percent or higher in recognized cases.
 

Diagnosis
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The natural distribution and circulation of VHF agents are geographically restricted and mechanistically linked with the ecology of the reservoir species and vectors. Therefore, a high index of suspicion and elicitation of a detailed travel history are critical in making the diagnosis of VHF.
 
 
When large numbers of patients present with VHF manifestations in the same geographical area over a short period of time, medical personnel should suspect the possibility of a bio-warfare attack (particularly if the virus causing the VHF is not endemic to the area).

 
VHF should be suspected in any patient who has traveled to an area where the etiologic virus is known to occur if the patient presents a severe febrile illness and evidence of vascular involvement (i.e., subnormal blood pressure, postural hypotension, petechiae, hemorrhagic diathesis, flushing of the face and chest, nondependent edema)
 
 
 
Signs and symptoms suggesting additional organ system involvement are
 
 common (headache, photophobia, pharyngitis, cough, nausea or vomiting, diarrhea, constipation, abdominal pain, hyperesthesia, dizziness, confusion, tremor),
 
but they rarely dominate the picture. A macular eruption occurs in most patients who have Marburg and Ebola hemorrhagic fevers; this clinical manifestation is of diagnostic importance.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 14 2009 at 11:55am


...They have abandoned patients in health units for fear of being infected

 


Ebola Reston is suspected to be airborne?  (transmitted by the air)
 
 
 
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excerpt-


Ugandan officials clamped a quarantine on the Bundibugyo region and appealed for help in dealing with the outbreak of Ebola, a contagious disease that kills up to 90 percent of those infected, AFP reported.


However efforts to contain the outbreak, which began in September but was definitively identified as Ebola only last week, have been hampered by medical personnel becoming infected and others fleeing.


"We have a shortage of health workers and we need more because those who were there on the ground have been infected: two doctors, a medical officer and a nurse," said Sam Zaramba, the country's top government physician.


"Health workers are terribly afraid. They have abandoned patients in health units for fear of being infected," a government official told the state-owned New Vision newspaper.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 30 2009 at 8:36am
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...77 blood samples taken from persons who may have been exposed to Ebola Reston Virus (ERV). 
 
 
 
 
 
UPDATE NO. 3 ON THE ONGOING INVESTIGATION ON THE EBOLA RESTON VIRUS
Joint DA-DOH
 
 
 
Press Release
 
30 January 2009
 
 
The Department of Health and the Department of Agriculture have received the results
 
of 77 blood samples taken from persons who may have been exposed to Ebola Reston
 
Virus (ERV). 
 
Of these 77 samples tested at the Research Institute for Tropical Medicine (RITM), 37
 
were sent to the US Centers for Disease Control and Prevention (CDC) for further
 
tests.
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Levygoddess Quote  Post ReplyReply Direct Link To This Post Posted: January 30 2009 at 4:49pm
I dont understand this. I watch a blog closely that is in that region and they have not been reporting this information. They are one of the medical teams there that treat ebola and they have not referred to any recent outbreaks.
God put us here for a reason
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 30 2009 at 5:31pm
hi...please let me know if you are speaking of a team in Africa or in the Philippines.
 
 
 
hello?  interested to know where those people are located.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: January 31 2009 at 10:14am
 
 
Previous NEWS on a Philippines Pig Farm...
 
 
Market News / Philippines: Ebola virus discovered in the pig
 
December 22, 2008

Pig farm area of 30 hectares in the Philippine city of Barangay Parian, was placed on quarantine to prevent the spread of the Ebola virus Reston.

This decision was taken after the Philippine Institute of Tropical Medicine reviewed all the pigs on the Lambin farm and found that the majority of animals infected with the Ebola Reston virus.

Immediately quarantine was imposed, to see that no infected pigs did not hit the market and has no new supply of pigs in the infected area.

The farm will be under observation for 24 hours a day, to see clearly that all instructions are executed.
 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Levygoddess Quote  Post ReplyReply Direct Link To This Post Posted: January 31 2009 at 6:17pm
They are in Africa, sorry Mary didnt see this till now. They are in Uganda in the village where ebola was wide spread last year. It was so sad to read for a while how everyone was so scared and people were becoming ill every day. It seems to come in waves. This is scary that it is now in the Phillipines
God put us here for a reason
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