آشنایی با ویروس ابولا (Ebola)

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Ebola ی 

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؟اين ویروس نخستین بار در سال ۱۹۷۶ میلادی خته شد. *در سال ۱۹۷۶ ابولا حدود ۳۰۰ نفر را مبتلا كرد و با ‎er ve‏ ا ل ا لل 0 شدند و در سال ‎١990‏ از اين ويروس ‎8١‏ درصد ‎ep tiv.‏ ا #در سال ‎٠١١1‏ نيز با انتشار مجدد اين ويروس كه 1 ا 0 سيرالئون و ليبريا كسترش يافته است. 

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200 miles 200 km NIGERIA X 100 miles 100 km “ ‘GUINEA Gueckedou: Origin of outbreak Ebola deaths = Closed borders Monrovia m 1-10 11-50 8 51-0 ‏لا‎ 101-0 Source: 301-1000 National health ministries and WHO. 

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‎ia Gatien Wir Health‏ ی ‎‘inated pain cog ella ay yy, yeas aes, Nae‏ ‏و ‎Afr‏ ام موم نت مس اه مش یط ‎‘heme tte oo aoe 1 20 i od ‎ ‎ 

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When Ebola hit Nigeria in July and August, residents at his hospital bought used personal protective suits on the black market for as much as 50 000 Nigerian Naira ($338) in case they were asked to see a patient suspected of having the virus; the suits are only supposed to be used once. And in Freetown, Sierra Leone, medical residents are mouming the 

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But cases of Ebola in the global North pale compared to West Africa, where more than 8000 persons have contracted the disease and over 3850 have died of it, according to the 

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® Ebola hemorrhagic fever ‏*؟ یکی از رودخانه‌های جمهوری دموکراتیک‎ Ay 1976 1977 1979 13994 Bh} 1996-97 2000-203 PAY 2007-2009 2011 2012 ‏للم‎ ‎2014 

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Clinical presentation and course of illness + Usually abrupt onset 3-12 days after exposure + Nonspecific initial signs and symptoms: fever and malaise followed by anorexia, headache, myalgia, arthralgia, sore throat, chest or retrosternal pain, con- junctival infection, lumbosacral pain, maculopapular rash + Gastrointestinal signs and symptoms follow in first few days: nausea, vomiting, epigastric and abdominal pain, diarrhea « Early-stage EVD may be confused with other infectious diseases (e.g., malaria, typhoid fever, septicemia including meningococcemia, and pneumonia) + Hemorrhage seen in about 50% of patients, mostly in later stages, usually lead- ing to death within days + Patients with fatal disease tend to have more severe clinical signs early and to die from complications (e.g., multiorgan failure, septic shock) between days 6 and 16 + Nonfatal cases may improve around day 6-11 

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علا ثم ‎Roy tlie es ROL elses Tooke‏ ‎we‏ ‏7 ‎sa‏ 0 م نك ‎POU [es‏ تك #استفراغ #اسهال ‎gee Sti‏ ل ا 0 كت 

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۹0 FDR) ا ا ل ا . 5-9 روز بيمار رو از يا در مى اورد. پر 1۳ Cee) 

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Initial evaluation + Clinical criteria: fever >38.6°C (>101.5°F) with addtional symptoms listed above + Epidemiologic risk factors: + Contact within previous 3 weeks with blood or other body fluids of patient with known or suspected EVD + Residence in or travel to area with active EVD transmission + Participation in funeral and burial rituals in cisease-endemic areas «Direct handling of bas, rodents, or primates from disease-endemic areas + Use personal protective equipment to examine persons with suspected infection + [solate patients immediately to prevent transmission 

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250 5 Liberia Sierra Leone = Guinea 200 150 No. of Cases 100 50 Numbers of Confirmed and Probable Ebola Cases Reported Weekly from Guinea, Sierra Leone, and Liberia from December 23, 2013, to August 11, 2014. Data are from the WHO. 

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19 ا ل ‎e RCS Ita ae RC Tore ae‏ 1 215 *انتقال بیماری از طریق هوا هنوز در محیط طبیعی به ثبت نرسیده 555 *بازماندگان مذکر تقریباً تا دو ماه اين بیماری را از طریق مایع منی انتقال 0 pra.) 

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(2 ۱ testing of blood samples sould be performed at highest biosafety زا ۲۵ ان «hina ew days ar ymptos bes atigecatureenyme inked im nosorbert assay ELISA) IM ELISA polymerase haeaction asa + Laerncourse filles or ale recove virus isolation, lM andl atibody testing 

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1 پادتن‌ها و ۱۸ ویروس و يا خود آن 

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Treatment + There are no approved, specfc treatments or vaccines + Provide supportive cae for complications, such as hypovolemia electrolyte ab- nionmalties, refractory shock, hypoxemia, hemorrhage, septic shock, mult organ flue, and disseminated intravascular coagulation + Recommended care: volume repletion, maintenance of blood pressure (with vaso pressosif needed), maintenance of oxygenation, pain contro, nutritional suppor, treatment of secondary bacterial infetons and preexisting conditions + Implement infection prevention and control measures; consider al bodily lids and clinical specimens potentialy infectious 

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چرا اپیدمی ابولا در آفریقا به اين بزرگی ۱ Poverty 

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Vaccine 

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Ebola viruses represent a class of filoviruses that causes severe hemorrhagic fever with high mortality, Recognized fist in 1976 in the Democratic Republic of Congo, outbreaks continue to occur in equatorial Africa A safe and efective Ebola virus vaccine is needed because ofits continued emergence and is potential fr use for biodefense, We report the safety and immunogenicity of an Ebola virus vaccine in its first phase J human stud A threesplasmid DNA vaccine encoding the envelope glycoproteins (GP) from the Zaire and Sudan/Gulu species as well as the nucleoprotein was evaluated in a randomized, placebo-controlled, double-blinded, dose escalation study, Healthy adults, ages 18 to 44 years, were randonized to receive three injections of vaccine at 2 mg (a = 5), 4 mg (n = 8), o 8 mg (n = 8) or placebo (n = 6), Immunogenicity was assessed by enzyme-linked immunosorbent assay (ELISA), immunoprecipitation-Western blotting, intracellular cytokine staining (ICS), and enzyme-linked immunospot assay, The vaccine was wellfolerated, with no significant adverse events or coagulation abnormalities, Specific antibody responses to at east one of the three antigens encoded by the vaccine as assessed by ELISA and CD4* Tell GP-spectc responses as asseed by ICS were detected in 20/20 vaccines, CD8* Tell GP-specfic responses were detected by ICS assay in 620 vacines, This Bbola viru DNA vaccine vas safe and immunogenic in humans, Further assessment of the DNA platform alone and in combination with repliction-defective adenoviral vector vaccines, in concert with challenge and immune data from nonhuman primates, will facilitate evaluation and potential licensure ofan Ebola virus vacine under the Animal Rule, 

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Ww the Ebola epidemic in West Africa continu- the monovalent form is based on ing to grow, the World Health Organization the Zaire strain of Ebola virus, a which is the cause of the current (WHO) convened an urgent meeting on September 29 West African epidemic, and the and 30 to assess the efforts under way to evaluate and _ bivalent form includes the Sudan strain of the virus as well (see produce safe and effective Ebola GP HSW S06H Both vaceine!Gaa® Fig. 1). The mionovalent form will vaccines as soon as possible’ didates have demonstrated 100% be eValuated in a nonrandomized, ‘The 70 scientists, public health efficacy in studies in nonhuman opendabel study involving 60 officals, and representatives from primates,** but how that will adult volunteers who will receive industry and regulatory bodies translate to human subjects re- the vaccine at three different who gathered in Geneva discussed mains unknown. The phase 1 doses (1x10! vp, 2.5x10% vp, and two vaccine candidates at length trials of both vaccines use dose- 5x10 vp), The bivalent form will — cAd3-EBOV (cAd3), from response designs structured to be evaluated in a nonrandom- GlaxoSmithKline (GSK) and the determine the level of humoral ized, open-label study involving US. National Institute of Allergy and cellular immunity that can be 20 adult volunteers who will re- and Infectious Diseases (NIAID), induced. The minimum antibody —eeive the vaccine at two different and rVSVAG-EBOV-GP (®VSV), titer needed to confer protection doses (2x10:°PU and 2x10PU). from NewLink Genetics and the in humans is unknown, Because Both studies will assess safety, Public Health Agency of Canada. of the small numbers of partici- side effects, and immunogenicity, Several other vaccine candidates pants in these trials, they will pro- including antibody responses as are at earlier, preclinical stages vide data only on common adverse measured by enzymetinked im- in the development pipeline. events. munosorbent assay (ELISA) and Phase 1 studies of cAd3 have The cAd3 vaccine is being test- neutralization assays and T-cell begun in the United States and the ed in both bivalent (ClinicafTrials immune responses as measured United Kingdom, and researchers gov number, NCT02231866) and by intracellular cytokine staining. plan to begin enrollment for trials monovalent (NCT02240875) forms; Investigators anticipate that pre- 

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‘A. Recombinant VSV vaccine وح سس اس تس ۷ اراس ]الا بر او Deletion of fasogenic VSV.G protein with substitution of Ebolavirs Zare-stran Kikwit enelope protein 00 B_NIAID/GSK cAd3 Ebola vaccine 1 replaced with ‏مقع‎ GP gene inserts ممه Es deleted Figure 1. Structures of Ebola Vaccine Candidates AVSV (Panel A) and cAd3 (Panel 8(. 

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۳ renee 

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*حفظ وضعيت طبيعى بدن 1 Pa nes *#مصرف داروهای ل ۱0 ا 1 *کنترل درد pwr) ۹ ‏بیوتیک و دارو‎ al jl oolaiw!* BOC p Cr nN eas sagil slacigat yo” 

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(2۱7۱5 1) Effective Post-Exposure Treatment of Ebola ‏ونر‎ 2) A DNA Vaccine for Ebola Virus Is Safe and Immunogenic in a Phase | Clinical Trial Ebola Vaccine — An Urgent International Priority 4) Ebola virus disease) te MOAT te etecege ‏ا‎ Estimating the Future Number of Cases in the Ebola Epidemic — Liberia and Sierra Leone, 2014-2015 6) Understanding the dynamics of Ebola epidemics 7) C-Type Lectins DC-SIGN and L-SIGN Mediate Cellular Entry by Ebola Virus in cis and in trans Endosomal Proteolysis of the Ebola Virus Glycoprote in Is Necessary for Infection 4 5 9