Ebola Outbreak 2014: Causes and Treatments

Ebola Outbreak 2014: Causes and Treatments Asra Ali Table of Contents (Jump to) 1.1 Introduction 1.2 History 1.3 Characteristic of EBOV 1.4 Symptoms 1.5 Diagnosis Methods 1.6 Treatments for Ebola Virus 1.7 Conclusions Reference list 1.1 Introduction EVD is a hemorrhagic illness having a severe fatality rate of 90% that has caused an epidemic in West Africa in the year 2014 (World Health Organization, 2014). This is considered to be the most deadly and the first to occur in West Africa and in its history. (Weekly Epidemiological Report, 2014). As mentioned above, the first outbreak of the virus took place in Central Africa; it consisted of nearly 5,000 cases up to date (World Health Organization, 2014). According to study conducted by Lamantagne et al (2014), states that that 30,000 individuals have been reported dead in the month of September 2014 itself. He also provokes that this has brought an urgency to bring the epidemic situation to a control. No current attacks in Sri Lanka with respect to Ebola have arose; however, Dr. P.G. Mahipala says that screening facilities have been attempted to monitor Sri Lankans and outsiders in the Katunayaka International Airport (Colombo page, 2014). Since certain studies confirm that Rousettus aegyptiacus is the natural reservoir of the virus, it is still challenging scientists to find out the exact route of transmission (Centers for Disease Control and Prevention, 2014). However, it is noted that Ebola is spread through direct contact. (Centers for Disease Control and Prevention, 2014). 1.2 History Ebola is a zoonotic disease caused by a viral pathogen that causes lethal hemorrhagic fever syndrome in humans (Sullivan, Yang andNabel, 2003). This disease is known to be caused by a RNA containing virus that belongs to the family of Filoviridae and genus of Ebola virus (Chowell and Nishiura, 2014). Ebola viral disease (EVD) is also known as Ebola hemorrhagic fever, which was first, discovered in 1976 near the Ebola River in the Central Africa, of the Democratic Republic of Congo (DRC), which was formerly known as Zaire (Draper, 2002). However, it was reported to have an outbreak of 284 people being infected with the disease having mortality rate of 53% that lasted for 27 years (Sullivan, Yang andNabel, 2003; Waterman, 1999). Furthermore, the second attack of Ebola emerged from Yambuka that was caused by one of the strains of Ebola virus known to be the Zaire Ebola virus (EBOZ) that had the highest mortality rate of 88% (Waterman, 1999) where 7 people were dead among 31 casualties ( Centers for Disease Control and Prevention, 2014). Tremendous research have been studied but never succeeded in finding the natural reservoir of the virus (Waterman, 1999). However, it is now concluded that since EVD is zoonotic disease, it is spread by Rousettus aegyptiacus of the fruit bat species of the sub-Saharan region and central African region. Figure 1 illustrates the historical outbreak of the virus (Feldmann, 2014) Figure 1: The Historical Outbreak of Ebola Virus (Waterman, 1999). Filoviridae viruses are usually found in green monkeys imported from Africa (Peters and Leduc, 1999). The first significant outbreak of Ebola occurred in Sudan that killed infected human and non-human primates (World Health Organization, 2014). However, the evolutionary history of Ebola remains unclear (Li and Chen, 2013). In 1989, Ebola appeared in monkey imported to Reston, Virginia, primate facility of Washington, DC (peters and peters, 1999). In addition, it has been reported that small subclinical outbreaks in the United States and Philippines had spread but were not so lethal for humans (CDC, 2003, sited in Casilas et al, 2003). Ebola usually has a fatality rate that often exceeds 80% (Geisbert et al, 2008). Although the clinical course is well known, the specific mechanisms underlying the pathogenicity of Ebola virus is not clearly known (Sullivan, Yang and Nabel, 2003). People are infected through the use of unsterilized needles and syringes (Peters and Peters, 1999). 1.3 Characteristic of EBOV EBOV are non-segmented, negative strand RNA viruses which constitute to the family Filoviridae (Stimola, 2011; Kim, 1999). The viral multiplies as a result of the genome coding capacity that produces a number of transcripts encoding for structural and non-structural glycoproteins (Mehedi, 2013). Ebola genome consists of seven genes where Viral Protein 40 (VP40) is expressed the most abundantly (Gyamfi et al, 2013). VP40 usually assembles on the inner leaflet of the plasma membrane, however the mechanistic details of plasma membrane by VP40 is not yet clearly known (Gyamfi et al, 2013). Hence, this is achieved by RNA editing, where non-template adenosine residues are in co-operated into the mRNA of EBOV at an editing site encoding for seven adenosine residues (Mehedi, 2013). Ebola enters the human cell by using one of the seven surface proteins available on the membrane, to trick the cell into thinking that the virus is not pathogenic thereby making the immune response inactive (Stimola,2011). Figure 2 illustrates an Electron Micrograph of Ebola virus Figure 2: Electron Micrograph of Ebola Virus (CDC, 2014). The virion containing RNA is a negative sense strand (complementary to RNA), therefore it is copied into a complementary plus-strand for protein formation to proceed for pathogenesis (Hunt, 2010).Virology studies have found very few about the EBOV as it contains genes less than a dozen when compared to other viruses like poxviruses and herpes viruses (Peters and Peters, 1999). The transmission of the virus usually takes place through broken skin or mucous membranes, with blood, secretions such as semen or any other body fluids such as breast milk of infected people (WHO, 2014). 1.4 Symptoms The incubation period of the virus is between 2 to 21 days (World Health Organization, 2014). Symptoms arises only after the first 10 days of infection which includes Fever, Severe Headache, chills, weakness, joint and muscle aches, (Mayo Clinic, 2014). Further Symptoms includes vomiting, diarrhea, impaired kidney and liver function where internal and external bleeding can persists (World Health Organization, 2014). As the virus enters the body, cytokines are released when reticuloendothelial cells encounter the virus which contributes to inflammatory responses that can be violent. (Sullivan, Yang and Nabel, 2003). Stimola (2011) explains that lungs are filled in blood that causes individuals to cough out blood. Furthermore, she states that bleeding from eyes and skin are also prominent features of the disease. Severe damage to the liver, with the combination of massive viremia, leads to disseminated intravascular coagulopathy and eventually, it infects the micro-vascular endothelial cells and compromises vascular integrity (Sullivan, Yang and Nabel, 2003). Diarrhea and vomiting is due to severe gastrointestinal illness and volume depletion with a series of metabolic disorders occurs, ultimately hypovolemic shock occurs (Lamantagne et al, 2014). 1.5 Diagnosis Methods Ebola is a disease that is unable to be distinguished among other diseases such as Malaria, Typhoid Fever and Meningitis (World Health Organization, 2014). This is because Ebola virus replicates at a very high rate which overwhelms the protein synthesis of infected cells and the host immune system (Sullivan, Yang and Nabel, 2003). Patients are diagnosed using various methods such as ELISA (Enzyme-Linked Immunosorbent Assay) technique, PCR (Polymerase Chain Reactions) and various other laboratory tests (Sullivan, Yang and Nabel, 2003). ELISA is sensitive and specific in determination of the viral antigens in serum that screen large numbers of suspect human samples in a short period of time (Peters and Peters, 1999). During infection it is known that both the proteins of host and viral cells contribute to the pathogenesis of Ebola Virus (Sullivan, Yang and Nabel, 2003). Further into the course of the disease or after the patients recovery immunoglobulin M and immunoglobulin G can be de tected (Turner and Cheryl, 2014). Table 1.1 illustrates the diagnostic methods available. Timeline of Infection Diagnostic Tests Available Within a few days after symptoms begin Antigens capture enzyme-linked immunosorbent assay (ELISA) testing. Immunoglobulin M ELISA PCR (Polymerase Chain Reactions) Virus Isolation Later in disease course or after recovery Immunoglobulin M and Immunoglobulin G anti-bodies Retrospectively in deceased patients Immunohistochemistry testing Polymerase Chain Reaction Virus Isolation Table 1.1: Diagnostic Methods (CDC, 2014). Detection can also depend on molecular techniques including multiple reverse transcriptase PCR assays. (Feldmann, 2014). Immunohistochemistry, PCR and Isolation of the Virus are also performed (Turner and Cheryl, 2014). Laboratory testing using polymerase chain reaction gives a specific result and this is used widely as a result (Lamontagne, 2014). Antigen detection maybe performed to confirm immediate diagnosis, whereas, assays for detection of anti-bodies are secondary tests that are primarily important (Feldmann, 2014). Samples from patients are extreme biohazard risk in which laboratory testing on non-inactivated samples and should be conducted under maximum protective conditions (World Health Organization, 2014). 1.6 Treatments for Ebola Virus Recovery from Ebola depends on good clinical care and the patients immune response (CDC, 2014). The Global Health Security Agenda aims to strengthen public health systems that need to eradicate the deadly EVD (Frieden et al, 2014). Standard precautions are used by health care workers by using personal protection equipment to prevent exposure from the infected (Turner and Cheryl, 2014). Effective way to keep away from the Ebola virus is to use Soap, dilute bleach, or any alcohol based hand sanitizers, which readily disrupts the envelope of the single stranded RNA virus (lamantagne et al, 2014). Three core interventions have stopped every pathogenic disease and the way of transmission. These are exhaustive case and contact tracing, effective response to patients and the community, and preventive interventions (Lamantagne et al, 2014). There is no proven treatment available for Ebola Virus Disease but through supportive care rehydration with oral or intravenous fluids for specific symptoms, improves survival (World Health Organization, 2014). Currently available antiviral medications are not effective (Turner and Cheryl, 2014). When a person can no longer drink, intravenous medications are given and delivery of appropriate replacement solutions are required but in some cases the victims die due to inadequate intravenous fluid resuscitation (Lamantagne et al,2014). Passive transfer of antibodies in animal models only delayed the onset of symptoms and did not alter overall survival (Sullivan, Yang and Nabel, 2003). The activated allogeneic lymphocytes and the increased number of platelets erythrocytes, and plasma were probably beneficial (Peters and Peters, 1999). People who recover from Ebola develop antibodies that last for at least 10 years (CDC, 2014). Some people who have recovered from the infection of Ebola have developed complications as joint and vision problems which could be there for a long time (CDC, 2014). In Ebola infection the ability of neutralizing antibodies to serve as passive immunotherapies is not well understood (Lee and Saphire, 2014). 1.7 Conclusions Ebola is a viral hemorrhagic zoonotic disease that is caused by the genus Ebola virus that consists of negative sense RNA (Sullivan, Yang andNabel, 2003). This was first discovered in the 1976 in the central Africa of DRC. (Draper, 2002). Since then, there have been many outbreaks that have been identified having a mortality rate of over 90% (World Health Organization, 2014). Ebola is transmitted by the vector Rousettus aegyptiacus (fruit bat) that infects humans and non-human primates through direct contact such as body fluids and physical contact (Feldmann, 2014). Symptoms are usually vomiting, diarrhea that lead to multiple organ failure and hemorrhage (Mayo Clinic, 2014). Therefore adequate diagnosis such as PCR and other various techniques such ELISA are used (Turner and Cheryl, 2014). Simultaneously, treatments are also been done to patients such as vaccination of antibodies and drug therapy.†¦. And proper sanitary implication that provides a better health system and to re duce the epidemic of Ebola (Stimola, 2011). Reference list Adu-Gyamfi, E., Soni, S.P., Xue, Y., Digman, M.A., Gratton, E. and Stahelin, R.V., (2013) ‘The Ebola Virus matrix protein penetrates into the plasma membrane: a key step in viral protein 40 (VP40) oligomerization and viral egress’, PubMed, 288(8), pp.5779-5789. [Online]. doi:10.1074/Jbc.M112.443960 (Accessed: 01 November 2014). Allison, S. P. (2002) Epidemics. Google Books [Online].Available at: http://books.google.co.uoks?id=FohdK6o8WICprintsec=frontcoverdq=books+on+ebolahl=ensa=Xei=nnEVVJ-HK8XsaPb8gdgFv (Accessed: 31 October 2014). Casillas, A.M., Nyamathi, A.M., Sosa, A., Wilder, C.L. and Sands, H. (2003) ‘A Current Review of Ebola Virus: Pathogenesis, Clinical Presentation, and Diagnostic Assessment’,Biological Research for Nursing, 9, pp.268-275. [Online]. DOI: 10.1177/1099800403252603 (Accessed: 31 October 2014). Centers for Disease Control and Prevention (2014)Ebola (Ebola virus disease).Available at:http://www.cdc.gov/vhf/ebola/symptoms/index.html?s_cid=cs_3923(Accessed: 31 October 2014). Colombo Page News Desk (2014) Sri Lanka Ebola Screening Facilities at International Airport Ready. Available at: www.colombopage.com/archieve_14B/Aug10_1407656253CH.php (Accessed: 02 November 2014). Epidemiological Unit Ministry of Health (2014) Ebola hemorrhagic fever: fact sheet. Available at: www.epid.gov.lk/web/attachments/article/146/Ebola_hemorrhagic_fever_Sheet.pdf (Accessed: 02 November 2014). Feldmann, H., (2014) ‘Ebola-A growing Threat’, The New England Journal of Medicine, 371, pp. 1375-1378. [Online].doi:10.1056/NEJMP1405314 (Accessed: 02 November 2014). Frieden, T.R., Damon, I., Bell, B.P., Kenyon, T. and Nichol, S. (2014) ‘Ebola 2014 – New Challenges, new global response and responsibility’, 371, pp. 1177-1180.[Online].doi: 10.1056/NEJMp1409903 (Accessed: 2 November 2014). Hunt, M., (2010) Virology, Available at: http://pathmicro.med.sc.edu/mhunt/rna-ho.htm (Accessed: 01 November 2014). King, J.W., Khan, A.A., Chunha, B.A., Kerkering, T.M., Malik, R. and Talavera, F. (2003)Medscape.Available at: http://emedicine.medscape.com/article/216288-overview(Accessed: 31 October 2014). Lamontagne, F., Clement, C., Fletcher, T., Jacob, S.T., Fischer, W. A. and Fowler, R. A. (2014). ‘Doing Todays’ Work Superbly well-Treating Ebola with Current Tools’ The New England Journal Of Medicine, 371, pp.1565-1566.[Online].doi: 10.1056/NEJMp1411310 (Accessed: 03 November 2014). Lee, J. and Saphire, E. (2009). ‘Ebola virus glycoprotein structure and mechanism of entry’, Future Virology, 4(6), pp.621-635.[Online]. Doi: 10.2217/fvl.09.56 (Accessed: 03 November 2014). Li, Y.H. and Chen, S.P., (2014) ‘Evolutionary history of Ebola virus’, Epidemiology and Infection, 142(6), pp.1138-1145.[Online].doi:http://dx.doi.org/10.1017/S0950268813002215 (Accessed: 02 November 2014). Makashkevich, V.N., Schneider, B.J., McNally, M.L., Milhollen, M.A., Pang, J.X. and Kim, P.S. (1999) ‘Core structure of the envelope glycoprotein GP2 from Ebola virus at 1.9-A resolution’, PNAS, 96(6).[Online].doi:10.1073/pnas.96.6.2662 (Accessed: 03 November 2014). Mayoclinic Staff (2014) Available at: http://www.mayoclinic.org/diseases-conditions/ebola-virus/basics/symptoms/con20031241 (Accessed: 01 November 2014). Mehedi, M., Hoenen, T., Robertson, S., Ricklefs, S., Dolan, M.A., Taylor, T., Falzarano, D., Ebihara, H., Porcella, S.F. and Feldmann, H. (2013) ‘Ebola virus RNA editing depends on the primary editing site sequence and an upstream secondary structure’, PubMed, 9(10). [Online].doi:10.1371/journal.ppat.1003677 (Accessed: 01 November 2014). Peters, C. J. and Peters, J. W. (1999) ‘An introduction to Ebola: The Virus and the disease’, The Journal of Infectious Disease, 179(1), pp. ix-xvi [Online].doi:1086/514322 (Accessed: 03 November 2014). Stimola, A. (2011) Ebola; Epidemics and Society, New York: The Rosen Publishing Group. Sullivan, N., Yang, Z.Y., and Nabel, G. J. (2003) ‘Ebola virus pathogenesis: implications for vaccines and therapies’, Journal of Virology, 77(18), pp. 9733-9737. [Online].doi: 10.1128/JVI.77.18.9733-9737.2003 (Accessed: 03 November 2014). Turner and Cheryl, R.N., (2014) ‘Ebola Virus disease: An emerging threat’, Nursing2014, 44(9), pp.68-69. [Online].doi:10.1097/01.NURSE.0000453010.02525.ca (Accessed: 01 November 2014). World Health Organization (2014) Ebola Virus Disease: fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs103/en/ (Accessed: 31 October 2014).

Museum Of Fine Arts Boston Essay

A flaw inherent to many business models is that the business/organization relies on a generic analysis of their resources instead of taking into account their specific product/market combination. The MFA is a museum, a school, a publisher, a retailer, a restaurateur, a film-theater, and more. Each demands unique research and analysis. A fusion of information would enable the MFA to establish an ongoing and effective strategic plan. Identification and discussion of three types of resources the MFA possesses with reference to the advantages of those resources. Three core resources (collections, audience, and exhibitions) and three supporting resources (facilities, financial, and organization) make the achievement of their strategic plan possible. Collections established a continued need to improve the quality of the collection, its management and care and provide electronic access to the collection. Audience included the need to engage, educate, and delight visitors as well as retain and expand the audience by better understanding the needs of their highly segmented target market. Special exhibitions entailed the creation of an exhibition schedule that met a variety of goals including an intellectual contribution, the attraction of visitors and revenue generation. Special-exhibition attendance is unpredictable and requires research to make reliable revenue forecasts. The supporting resources: Facilities focused specifically on enlarging and improving the museum. Financial reiterated the need for fiscal stability and fund-raising that would support facility expansion as well as other identified strategic needs. The MFA needs to maintain a balanced budget. Due to the American system of funding arts the MFA relies almost exclusively on private funding and its revenues come from memberships, admissions, sales of merchandise, restaurant food sales, school tuition, contributions, gifts and grants, and investments. The external relations group competes with other New England institutions for donations as well as educational institutions (Harvard) and area hospitals. Organization focuses on the adoption of an audience-aware, results-oriented, experimental attitude and realignment of the divisions within the MFA in order to support the strategic focus. This includes the MFA’s relationships with its customers, employees, donors and outside organizations; branding (which is directly related to mission and must be clear, specific, and not to be interpreted as a routine promise). The MFA needs to differentiate their purpose [other than to educate] from that of other museums. Their brand needs to be credible, meaningful and dependent upon a realistic mission statement. One type of resource that the organization needs to improve A significant issue for the museum is how to increase the visitor-experience in the museum. Research has revealed some key deficiencies in the visitor’s experience in the museum. Unique brand awareness challenges face the MFA because they are a non-profit multi-dimensional art institution with a highly segmented target market. The museum put together a cross-functional team that focused on initiatives related to orientation, customer service, on-site communications, and team undertook numerous initiatives to enhance the overall visitor experience of the MFA. Conclusion: why attendance is an important resource on which the MFA should focus. The museum’s will undoubtedly get focus and attract renewed attention in 2010 when the new wing opens but a continued strategy to improve core attendance is an ongoing priority. Critical questions remain: How does the MFA ensure continued, satisfactory visitor attendance? Continued education of their market, delivery on their mission and quality visitor experience. References Rangan, V. K. , Bell, M. (2005). Case 16. Museum of Fine Arts Boston. (pp. 530-557). Boston: Harvard Business School Publishing. Chiagouris, L. (2005). Article 13. Nonprofits can take Cues from the Biz World. Branding Roadmap Takes Shape. In Marketing Management Magazine. (September/October 2005, pp. 52-54). New York: Pace University’s Lubin School of Business. Developing Competitive Advantage and Strategic Focus. In Chapter 5 Lecture Notes. (2008). Thomson Learning Inc.

Appendix E: Racial Formation

University of Phoenix Material Appendix E Part I Define the following terms: |Term |Definition | |Racial formation | | | |Too look at a race as a socially constructed identity. | |Segregation |Setting apart or separating things or people and may refer to. |De jure segregation | | | |Segregation or isolation of individual from main group that Is imposed by law | |Pluralism |A condition in which numerous distinct ethnic, religious, or cultural groups are present and | | |tolerated within society | |Assimilation |The process whereby a minority group gradually adopts the customs attitude of the prevailing | | |culture. |Part II Answer the following questions in 150 to 350 words each: †¢ Throughout most of U. S. history in most locations, what race has been the majority? What is the common ancestral background of most members of this group? It shows that the whites were the majority group threw out history, also it was deemed by the color of your skin also meaning if you had ligh ter looking skin the you were consider to be white , but if you had the darker looking color of skin then you were deemed to be of a different race. †¢ What are some of the larger racial minorities in U. S. history? What have been the common ancestral backgrounds of each of these groups?When did each become a significant or notable minority group? Hispanics really outnumber the African Americans as the largest minority group in Us history for the first time and that’s when the government starting counting the nations population more than two centuries ago. The Census Bureau’s confirmed a symbolic milestone for a nation whose history has been mainly black and white racial dynamics. They also said that it is adding a new dimension to everything from product making to politics learning the about their ethnic background. http://usatoday30. usatoday. com/news/nation/census/2003-06-18-Census_x. htm †¢ †¢ In what ways have laws been used to enforce discriminati on? Provide examples.These laws were intended against which racial minorities? Professor Gates from Harvard University was arrested by police investigating a possible break in at his own house. A lot of the Harvard faculty thought it was racial profiling. Again another incident was another Professor Counter which is in neuroscience, was almost arrested by Harvard Security in 2004 after being mistaken for robbery suspect as he crossed the Harvard Yard, Security officers threatened him to be arrested when he couldn’t produce his identification badge. Both professor are thinking that black men are being targeted by the Cambridge police department. http://www. boston. com/news/local/breaking_news/2009/07/harvard. html In what ways have laws been used to eliminate discrimination? Provide examples. Did the laws work to eliminate discrimination? This country has taken a huge step forward and has accepted some new changes and the remaining have not adapted to change. For example wher e at one time it was okay to discriminate against race, for its wrong today, but yet we are more accepting Bisexuals/Homosexuals to our country, instead of pushing them away. So now we are accepting gay marriage, and then we have others who do not. So what this is saying is laws are helping to change but not eliminate it, and that will take some time to do and a shift in culture and society. Lindsey Metzler

Do Men Get Paid More Than Women - 1716 Words

Gender Pay Gap When I was younger, I was taught I can be anything I want to be in the world, as long as I put all my energy and time into it. When I got my first job, me and a male co-worker performed the same tasks every day, but when we compared paychecks his wages were higher than mines. We both worked for the company the same amount of time, but he was promoted over me even though I applied for a promotion. I always thought, well the managers truly believed he deserved the position because he was more qualified than me, but turns out it was gender bias. Oprah Winfrey quoted â€Å"Excellence is the best deterrent to racism or sexism†, meaning that excellence does not have any bias or discrimination. So my research question is why do men get†¦show more content†¦Weber and Durkheim’s ideas are not directly related to my social problem. In the early 1800s women were seen as inferior towards men. Women never had a voice, and was always controlled by a male relative. Females moving from girlhood to womanhood their fathers were in charge of their everyday events and growing up they had to respect every male relative in their families. Once a woman is married her duty is to her husband that will make all the family decisions. The goal of a woman during this time period was to bear and raise the children, tend to the house chores like cooking and cleaning, and finally serving her husband. Women did not have any rights and were prohibited to receive education or engage in professions allowed to men. Only rich and wealthy families were allowed to educated their daughters but only through the knowledge of reading, writing and etiquette on becoming a proper woman. Even though women could not work high end jobs, they still did minor jobs by either working in factories or in domestic service like cleaning, becoming a nanny, co oking, and doing laundry for wealthy families. 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Parents of girls vary in their way of instilling this gender bias. Often girls are encouraged not to play with the boys, to dress a certain way to avoid looking â€Å"manly† or to play with dolls instead of trucks. For centuries women have been denied the same rights as men. But Why? Women and menRead MoreWomens Unequal Pay1333 Words   |  5 PagesDeclaration of Independence states that, â€Å"all men are created equal.† According to this constitution that we live in correlation with, it suggest and says that we are the same, no one is greater than anyone, whether it be a woman or man. In response to the statement, why should women be paid less than men? Woman should and deserve the right be paid equally for the same jobs they possess in comparison to men. 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