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Marburg virus

Definition:
Marburg virus or simply Marburg is the common name for the genus of viruses Marburgvirus, which contains one species, Lake Victoria marburgvirus. The virus causes the disease Marburg Hemorrhagic Fever (MHF), also referred to as Marburg Virus Disease, and previously also known as green monkey disease due to its primate origin. Marburg originated in Central and East Africa, and infects both human and nonhuman primates. The Marburg Virus is in the same taxonomic family as Ebola, and both are identical structurally although they elicit different antibodies.

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Ebola virus and Marburg virus live in animal hosts, and humans can contract the viruses from infected animals. After the initial transmission, the viruses can spread from person to person through contact with body fluids or contaminated needles.

Marburg virus is a severe and highly contagious form of haemorrhagic fever caused by a virus from the same family – the filoviruses – as Ebola haemorrhagic fever (EHF), although it’s not as deadly as its cousin.

No drug has been approved to treat Ebola virus or Marburg virus. People diagnosed with Ebola or Marburg virus receive supportive care and treatment for complications. Scientists are coming closer to developing vaccines for these deadly diseases.

The virus was first discovered in 1967, during simultaneous outbreaks at laboratories in the former Yugoslavia and Frankfurt and Marburg, Germany. Since 1967 sporadic small outbreaks have been reported but in 2004-5 a major outbreak in Angola led to more than 140 deaths from the Marburg virus.

Symptoms:
During the incubation period, which lasts between five and ten days, no symptoms are apparent.

You may click to see:Marburg Virus Pictures from CDC

Signs and symptoms typically begin abruptly within five to 10 days of infection. Early signs and symptoms include:

*Fever
*Severe headache
*Joint and muscle aches
*Chills
*Sore throat
*Weakness

Over time, symptoms become increasingly severe and may include:

*Nausea and vomiting
*Diarrhea (may be bloody)
*Red eyes
*Raised rash
*Chest pain and cough
*Stomach pain
*Severe weight loss
*Bleeding from the nose, mouth, rectum, eyes and ears

The disease can then become increasingly damaging, causing:

•Jaundice
•Delirium
•Liver failure
•Extensive haemorrhage from multiple sites, which can give rise to bloody diarrhoea and vomiting of blood (known as heamatemesis)

Many people infected with the virus die, usually from haemorrhagic shock or liver failure. In areas where medical support is poor, the death rate can be much higher. The infection can be difficult to diagnose, because many of the initial signs are similar to those of other infectious diseases, such as malaria or typhoid fever.

Causes:
The virus appears to be rare and only found in Africa where cases have occurred in Uganda, Kenya, Zimbabwe and Angola. In the natural habitat the reservoir of the virus is the Egyptian fruit bat, which is found in Africa, but how the virus jumps from animals to humans is not known. Some people have developed the disease after visiting caves where the bats are found.

Transmission from animals to humans:
The virus can be transmitted to humans by exposure to an infected animal’s bodily fluids. Examples include:

*Blood. Butchering or eating infected animals can spread the viruses. Scientists who have operated on infected animals as part of their research have also contracted the virus.

*Waste products. Tourists in certain African caves and some underground mine workers have been infected with the Marburg virus, possibly through contact with the feces or urine of infected bats.

Transmission from person to person :
Infected people typically don’t become contagious until they develop symptoms. Family members are often infected as they care for sick relatives or prepare the dead for burial.

Once a human is infected they can pass the virus on to others through their body fluids, most commonly blood but also faeces, saliva and vomit. The virus may also possibly be spread via aerosols of tiny infected droplets produced when patients cough and splutter. However, the research suggests that sick humans don’t usually generate sufficient volumes of infectious aerosols to pose a significant hazard to those around them.

Medical personnel can be infected if they don’t use protective gear such as surgical masks and latex gloves. Medical centers in Africa are often so poor that they must reuse needles and syringes. Some of the worst Ebola epidemics have occurred because contaminated injection equipment wasn’t sterilized between uses.

There’s no evidence that Ebola virus or Marburg virus can be spread via insect bites.

Risk Factors:
For most people — including international travelers — the risk of getting Ebola or Marburg hemorrhagic fever is low. The risk increases if you:

*Travel to Africa. You’re at increased risk if you visit or work in areas where Ebola virus or Marburg virus outbreaks have occurred in the past.

*Conduct animal research. People are more likely to contract the Ebola or Marburg virus if they conduct animal research with monkeys imported from Africa or the Philippines.

*Provide medical or personal care. Family members are often infected as they care for sick relatives. Medical personnel also can be infected if they don’t use protective gear such as surgical masks and latex gloves.Prepare people for burial. The bodies of people who have died of Ebola or Marburg hemorrhagic fever are still contagious. Helping prepare these bodies for burial can increase your risk of developing the disease yourself.

Complications:
Both Ebola and Marburg hemorrhagic fevers lead to death for a high percentage of people who are affected. As the illness progresses, it can cause:

*Multiple organ failure
*Severe bleeding
*Jaundice
*Delirium
*Seizures
*Coma
*Shock

One reason the viruses are so deadly is that they interfere with the immune system’s ability to mount a defense. But scientists don’t understand why some people recover from Ebola and Marburg and others don’t.

For people who survive, recovery is slow. It may take months to regain weight and strength, and the viruses remain in the body for many weeks. People may experience:

*Hair loss
*Sensory changes
*Liver inflammation (hepatitis)
*Weakness
*Fatigue
*Headaches
*Eye inflammation
*Testicular inflammation

Diagnosis:
Ebola and Marburg hemorrhagic fevers are difficult to diagnose because many of the early signs and symptoms resemble those of other infectious diseases, such as typhoid and malaria. But if doctors suspect that you have been exposed to Ebola virus or Marburg virus, they use laboratory tests that can identify the viruses within a few days.

Most people with Ebola or Marburg hemorrhagic fever have high concentrations of the virus in their blood. Blood tests known as enzyme-linked immunosorbent assay (ELISA) and reverse transcriptase polymerase chain reaction (PCR) can detect specific genes or the virus or antibodies to them.

It is similar to Ebola using the Enzyme-Linked ImmunoSorbent Assay (ELISA) test. Polymerase Chain Reaction (PCR) technique has been successfully used for detection of Marburg virus. PCR detection for Marburg virus by Hänninen 2001

Treatment :
There is no cure for Marburg disease as there is no specific antiviral therapy indicated for treating Marburg, and hospital care is usually supportive in nature. Hypotension and shock may require early administration of vasopressors and haemodynamic monitoring with attention to fluid and electrolyte balance, circulatory volume, and blood pressure. Viral haemorrhagic fever (VHF) patients tend to respond poorly to fluid infusions and may develop pulmonary edema.

Prognosis:
If a patient survives, recovery is usually prompt and complete, though it may be prolonged in some cases, with inflammation or secondary infection of various organs, including: orchitis (testicles), hepatitis (liver), transverse myelitis (spinal cord), uveitis (eyes), and parotitis (salivary glands) Recovered patients often have little or no memory of being sick, though only 40-60% survive.

Prevention:
Strict hygiene measures help to prevent spread when an outbreak occurs, and an experimental vaccine is currently being tested.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/marburg_virus.shtml
http://www.mayoclinic.com/health/ebola-virus/DS00996
http://en.wikipedia.org/wiki/Marburg_virus
http://hardinmd.lib.uiowa.edu/cdc/275.html

http://hardinmd.lib.uiowa.edu/cdc/6562.html

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Ailmemts & Remedies

Chikungunya

Stegomyia aegypti (formerly Aedes aegypti) mos...
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Definition:
Chikungunya is viral fever caused by an alphavirus. Chikungunya is spread by the bite of Aedes and Culex mosquitoes.
This virus belongs to the genus Alphavirus in the Togaviridae family of viruses. Other Alphaviruses include the Sindbis, eastern and western encephalitis, Semliki Forest and Ross River viruses. The Togaviridae family also includes the genus Rubivirus   to which Rubella belongs.

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It is an insect-borne virus, of the genus, Alphavirus, that is transmitted to humans by virus-carrying Aedes mosquitoes. There have been recent outbreaks of CHIKV associated with severe morbidity. CHIKV causes an illness with symptoms similar to dengue fever. CHIKV manifests itself with an acute febrile phase of the illness lasts only two to five days. Followed by a prolonged arthralgic disease that affects the joints of the extremities. The pain associated with CHIKV infection of the joints persists for weeks or months.

It is a rare viral infection transmitted by the bite of an infected mosquito. It is characterized by a rash, fever, and severe joint pain (arthralgias) that usually lasts for three to seven days. Because of its effect on the joints, Chikungunya has been classified among the Arthritic Viruses. It primarily occurs in tropical areas of the world.

Chikungunya was first described in 1955, following an outbreak on the Makonde Plateau, along the border between Tanganyika and Mozambique in 1952.

Chikungunya is found in Africa, southern India, Pakistan, South-East Asia and the Philippines and occurs predominantly during the rainy season. The range of hosts includes humans, primates, other mammals, and birds. In October 2006, the World Health Organization (WHO) reported chikungunya fever outbreaks in eight states in India.

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ChickV Map

Chikungunya virus..

Between March 2005 and February 2006, 1,722 cases of chikungunya were reported in La Reunion, an island in the Indian Ocean east of Madagascar (territory of France). Two-hundred deaths were attributed to chikungunya.

Signs and symptoms:
Symptoms include:

*high fever
*joint pain with or without swelling (arthritis or arthralgia), typically in the knee, ankle and small joints of the extremities
*chills
*headache
*low back pain
*rash
*vomiting
*mild hemorrhaging may be present especially in children

Asymptomatic (“silent”) infections are common, and immunity is long lasting.

The incubation period of Chikungunya disease is from two to four days. Symptoms of the disease include a fever up to 39 C (102.2 F), a petechial or maculopapular rash of the trunk and occasionally the limbs, and arthralgia or arthritis affecting multiple joints. Other nonspecific symptoms can include headache, conjunctival injection, and slight photophobia. Typically, the fever lasts for two days and then ends abruptly. However, other symptoms, namely joint pain, intense headache, insomnia and an extreme degree of prostration last for a variable period; usually for about 5 to 7 days. Patients have complained of joint pains for much longer time periods depending on their age.

Diagnosis:
Common laboratory tests for chikungunya include RT-PCR, virus isolation, and serological tests.

*Virus isolation provides the most definitive diganosis but takes 1-2 weeks for completion and must be carried out in Biosafety level 3 laboratories. The technique involves exposing specific cell lines to samples from whole blood and identifying chikungunya virus-specific responses.

*RT-PCR using nested primer pairs to amplify several Chikungunya-specific genes from whole blood. Results can be determined in 1-2 days.

*Serological diagnosis requires a larger amount of blood than the other methods and uses an ELISA assay to measure Chikungunya-specific IgM levels. Results require 2-3 days and false positives can occur with infection via other related viruses such as O’nyong’nyong virus and Semliki Forest Virus.

Causes:
Chikungunya virus is indigenous to tropical Africa and Asia, where it is transmitted to humans by the bite of infected mosquitoes, usually of the genus Aedes. CHIK fever epidemics are sustained by human-mosquito-human transmission. The word “chikungunya” is thought to derive from description in local dialect of the contorted posture of patients afflicted with the severe joint pain associated with this disease. The main virus reservoirs are monkeys, but other species can also be affected, including humans.

Treatment:
There are no specific treatments for Chikungunya. There is no vaccine currently available. A Phase II vaccine trial, sponsored by the US Government and published in the American Journal of Tropical Medicine and Hygiene in 2000, used a live, attenuated virus, developing viral resistance in 98% of those tested after 28 days and 85% still showed resistance after one year.

Chikungunya fever is not a life threatening infection. Symptomatic treatment for mitigating pain and fever using anti-inflammatory drugs along with rest usually suffices. While recovery from chikungunya is the expected outcome, convalescence can be prolonged (up to a year or more), and persistent joint pain may require analgesic (pain medication) and long-term anti-inflammatory therapy.

A serological test for Chikungunya is available from the University of Malaya in Kuala Lumpur, Malaysia.

Chloroquine is gaining ground as a possible treatment for the symptoms associated with chikungunya, and as an anti-inflammatory agent to combat the arthritis associated with Chikungunya virus. A University of Malaya study found that for arthritis-like symptoms that are not relieved by aspirin and non-steroidal anti-inflammatory drugs (NSAID), chloroquine phosphate (250 mg/day) has given promising results. Research by an Italian scientist, Andrea Savarino, and his colleagues together with a French government press release in March 2006 have added more credence to the claim that chloroquine might be effective in treating chikungunya. Unpublished studies in cell culture and monkeys show no effect of chloroquine treatment on reduction of chikungunya disease. The fact sheet on Chikungunya advises against using aspirin, ibuprofen, naproxen and other NSAIDs that are recommended for arthritic pain and fever.

DNA vaccine: ….>click  &  see
DNA vaccination is a technique for protecting an organism against disease by injecting it with genetically engineered DNA to produce an immunological response. Nucleic acid vaccines are still experimental, and have been applied to a number of viral, bacterial and parasitic models of disease, as well as to several tumour models. DNA vaccines have a number of advantages over conventional vaccines, including the ability to induce a wider range of immune response types.A recent study report that a novel consensus-based approach to vaccine design for Chikungunya virus, employing a DNA vaccine strategy. The vaccine cassette was designed based on CHIKV Capsid and Envelope specific consensus sequences with several modifications, including codon optimization, RNA optimization, the addition of a Kozak sequence, and a substituted immunoglobulin E leader sequence. Analysis of cellular immune responses, including epitope mapping, demonstrates that these constructs induces both potent and broad cellular immunity in mice. In addition, antibody ELISAs demonstrate that these synthetic immunogens are capable of inducing high titer antibodies capable of recognizing native antigen. Taken together, these results support further study of the use of consensus CHIKV antigens in a potential vaccine cocktail.

Prognosis:
Recovery from the disease varies by age. Younger patients recover within 5 to 15 days; middle-aged patients recover in 1 to 2.5 months. Recovery is longer for the elderly. The severity of the disease as well as its duration is less in younger patients and pregnant women. In pregnant women, no untoward effects are noticed after the infection.

Ocular inflammation from Chikungunya may present as iridocyclitis, and have retinal lesions as well.

Pedal oedema (swelling of legs) is observed in many patients, the cause of which remains obscure as it is not related to any cardiovascular, renal or hepatic abnormalities.

Prevention:
The most effective means of prevention are those that protect against any contact with the disease-carrying mosquitoes. These include using insect repellents with substances like DEET (N,N-Diethyl-meta-toluamide; also known as N,N’-Diethyl-3-methylbenzamide or NNDB), icaridin (also known as picaridin and KBR3023), PMD (p-menthane-3,8-diol, a substance derived from the lemon eucalyptus tree), or IR3535. Wearing bite-proof long sleeves and trousers (pants) also offers protection. In addition, garments can be treated with pyrethroids, a class of insecticides that often has repellent properties. Vaporized pyrethroids (for example in mosquito coils) are also insect repellents. Securing screens on windows and doors will help to keep mosquitoes out of the house. In the case of the day active Aedes aegypti and Aedes albopictus, however, this will only have a limited effect, since many contacts between the vector and the host occur outside. Thus, mosquito control is especially important.

Preventive measures include the same as those for other mosquito-associated diseases (e.g. malaria, malaria, yellow fever, west nile virus).

No vaccine is available against this virus infection. Prevention is entirely dependent upon taking steps to avoid mosquito bites and elimination of mosquito breeding sites.

To avoid mosquito bites:
* Wear full sleeve clothes and long dresses to cover the limbs;
* Use mosquito coils, repellents and electric vapour mats during the daytime;
* Use mosquito nets – to protect babies, old people and others, who may rest during the day. The effectiveness of such nets can be improved by treating them with permethrin (pyrethroid insecticide). Curtains (cloth or bamboo) can also be treated with insecticide and hung at windows or doorways, to repel or kill mosquitoes.

Mosquitoes become infected when they bite people who are sick with chikungunya. Mosquito nets and mosquito nets and mosquito coils will effectively prevent mosquitoes from biting sick people.

To prevent mosquito breeding
The Aedes mosquitoes that transmit chikungunya breed in a wide variety of manmade containers which are common around human dwellings. These containers collect rainwater, and include discarded tires, flowerpots, old oil drums, animal water troughs, water storage vessels, and plastic food containers. These breeding sites can be eliminated by

*Draining water from coolers, tanks, barrels, drums and buckets, etc.;*Emptying coolers when not in use;
* Removing from the house all objects, e.g. plant saucers, etc. which have water collected in them
* Cooperating with the public health authorities in anti-mosquito measures.
Role of public health authorities
* National programme for prevention and control of vector borne diseases should be strengthened and efficiently implemented with multisectoral coordination

* Legislations for elimination of domestic/peridomestic mosquitogenic sites should be effectively enforced

*Communities must be made aware of the disease and their active cooperation in prevention and control measures elicited .
Read about other arboviral infections:

*Rift Valley Fever

*Dengue Fever

*Yellow Fever: The Disease and Symptoms

*Yellow Fever Infection: Historical Perspective

*Yellow Fever Vaccine: Disease Prevention

Epidemiology
Chikungunya virus is an alphavirus closely related to the O’nyong’nyong virus,[15] the Ross River virus in Australia, and the viruses that cause eastern equine encephalitis and western equine encephalitis

Chikungunya is generally spread through bites from Aedes aegypti mosquitoes, but recent research by the Pasteur Institute in Paris has suggested that chikungunya virus strains in the 2005-2006 Reunion Island outbreak incurred a mutation that facilitated transmission by Aedes albopictus (Tiger mosquito). Concurrent studies by arbovirologists at the University of Texas Medical Branch in Galveston Texas confirmed definitively that enhanced chikungunya virus infection of Aedes albopictus was caused by a point mutation in one of the viral envelope genes (E1). Enhanced transmission of chikungunya virus by Aedes albopictus could mean an increased risk for chikungunya outbreaks in other areas where the Asian tiger mosquito is present. A recent epidemic in Italy was likely perpetuated by Aedes albopictus.

In Africa, chikungunya is spread via a sylvatic cycle in which the virus largely resides in other primates in between human outbreaks.

History
The name is derived from the Makonde word meaning “that which bends up” in reference to the stooped posture developed as a result of the arthritic symptoms of the disease. The disease was first described by Marion Robinson and W.H.R. Lumsden[22] in 1955, following an outbreak in 1952 on the Makonde Plateau, along the border between Mozambique and Tanganyika (the mainland part of modern day Tanzania).

According to the initial 1955 report about the epidemiology of the disease, the term chikungunya is derived from the Makonde root verb kungunyala, meaning to dry up or become contorted. In concurrent research, Robinson glossed the Makonde term more specifically as “that which bends up.” Subsequent authors apparently overlooked the references to the Makonde language and assumed that the term derived from Swahili, the lingua franca of the region. The erroneous attribution of the term as a Swahili word has been repeated in numerous print sources. Many other erroneous spellings and forms of the term are in common use including “Chicken guinea”, “Chicken gunaya,” and “Chickengunya”.

Since its discovery in Tanganyika, Africa in 1952, chikungunya virus outbreaks have occurred occasionally in Africa, South Asia, and Southeast Asia, but recent outbreaks have spread the disease over a wider range.

You may click to learn more about Chikungunya.:->.………………(1)………(2)……..(3)

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Chikungunya
http://microbiology.suite101.com/article.cfm/chikungunya

http://www.webmd.com/a-to-z-guides/chikungunya

http://www.searo.who.int/en/Section10/Section2246.htm

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