Updates in diagnosis and management of Ebola hemorrhagic fever

Salah Mohamed El Sayed, Ali A Abdelrahman, Hani Adnan Ozbak, Hassan Abdullah Hemeg, Ali Mohammed Kheyami, Nasser Rezk, Mohamed Baioumy El?Ghoul, Manal Mohamed Helmy Nabo

Abstract


Ebola hemorrhagic fever is a lethal viral disease transmitted by contact with infected people and animals. Ebola infection represents a worldwide health threat causing enormous mortality rates and fatal epidemics. Major concern is pilgrimage seasons with possible  transmission to Middle East populations. In this review, we aim to shed light on Ebola hemorrhagic fever as regard: virology,transmission, biology, pathogenesis, clinical picture, and complications to get the best results for prevention and management. We  also aim to guide future research to new therapeutic perspectives to precise targets. Our methodology was to review the literature  extensively to make an overall view of the biology of Ebola virus infection, its serious health effects and possible therapeutic benefits  using currently available remedies and future perspectives. Key findings in Ebola patients are fever, hepatic impairment, hepatocellular  necrosis, lymphopenia  (for T?lymphocyte and natural killer cells) with lymphocyte apoptosis, hemorrhagic manifestations, and  complications. Pathogenesis in Ebola infection includes oxidative stress, immune suppression of both cell?mediated and humoral immunities, hepatic and adrenal impairment and failure, hemorrhagic fever, activation of deleterious inflammatory pathways, for example, tumor necrosis factor?related apoptosis?inducing ligand, and factor of apoptotic signal death receptor pathways causing lymphocyte depletion. Several inflammatory mediators and cytokines are involved in pathogenesis, for example, interleukin?2, 6, 8, and 10 and others. In conclusion, Ebola hemorrhagic fever is a serious fatal viral infection that can be prevented using strict health measures and can be treated to some extent using some currently  available remedies. Newer treatment lines, for example, nigella
sativa may be promising.


Key words:  Ebola hemorrhagic fever, filoviruses, fruit bats, pathogenesis, reverse transcription?polymerase chain reaction


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