Epidemiology and pathogenesis of Ebola viruses

Petr Michalek, Ludmila Krejcova, Vojtech Adam, Rene Kizek


The Ebola viruses (EBOV) are enveloped, non-segmented, negative-sense, single-stranded RNA viruses, with size of genome approximately 19 kbp [2]. The virion is pleomorphic, producing ‘U’- shaped, ‘6’-shaped, or circular forms [3]. The EBOV may cause a disease in humans as well as in non-human primates, called Ebola virus disease (EVD). EBOV are firstly described in 1976, since than five species of the EBOV were described since. Four of them: Sudan virus (SUDV), Ebola virus (EBOV, known as Zaire), Taï Forest virus (TAFV), and Bundibugyo virus (BDBV) cause acute and lethal disease in human population [4, 5]. The fifth, Reston virus (RESTV), differs from each other, it has been caused disease only in monkeys, chimpanzees, and gorillas and it is apparently maintained in an animal reservoir in the Philippines and has not been found in Africa [6, 7]. Since 1976, more than twenty outbreaks of EVD have been reported in Africa [8]. The current outbreak, West Africa Ebola Outbreak 2014 (WAEO), first reported by the World Health Organization (WHO) on 22 March 2014, was caused by ZEBOV and is responsible for more than ten thousands death [9]. In addition to the three most affected countries in sub-Saharan Africa (Guinea, Liberia ad Sierra Leone), EBOV cases have been reported in the Great Britain, the United States and Spain [1, 10]. The behavior of WAEO was so alarming, that some countries decided to implement special measures for air plane transport of passengers from affected countries [11].

1. Kuhn, J.H., et al., Filovirus RefSeq Entries: Evaluation and Selection of Filovirus Type Variants, Type Sequences, and Names. Viruses-Basel, 2014. 6(9): p. 3663-3682.
2. WHO. Current Situation. 2015; Available from: http://apps.who.int/ebola/en/current-situation.
3. Bray, M. and F.A. Murphy, Filovirus research: Knowledge expands to meet a growing threat. Journal of Infectious Diseases, 2007. 196: p. S438-S443.
4. Reid, S.P., et al., Ebola virus VP24 binds karyopherin alpha 1 and blocks STAT1 nuclear accumulation. Journal of Virology, 2006. 80(11): p. 5156-5167.
5. Muyembe-Tamfum, J.J., et al., Ebola virus outbreaks in Africa: Past and present. Onderstepoort Journal of Veterinary Research, 2012. 79(2): p. 06-13.
6. Del Rio, C., et al., Ebola hemorrhagic Fever in 2014: the tale of an evolving epidemic. Annals of internal medicine, 2014. 161(10): p. 746-8.
7. Feldmann, H. and T.W. Geisbert, Ebola haemorrhagic fever. Lancet, 2011. 377(9768): p. 849-862.
8. CDC. Ebola outbreak in West Africa 2014. 2014; Available from: http://www.cdc.gov/vhf/Ebola/outbreaks/2014-west-africa/index.html.
9. WHO. Statement on the 1st meeting of the IHR Emergency Committee on the 2014 Ebola outbreak in West Africa. 2014; Available from: http://www.who.int/mediacentre/news/statements/2014/ebola-20140808/en/.
10. Chevalier, M.S., et al., Ebola Virus Disease Cluster in the United States - Dallas County, Texas, 2014. Mmwr-Morbidity and Mortality Weekly Report, 2014. 63(46): p. 1087-1088.
11. Kalra, S., et al., The emergence of ebola as a global health security threat: from ‚lessons learned‘ to coordinated multilateral containment efforts. Journal of global infectious diseases, 2014. 6(4): p. 164-77.
12. Weingartl, H.M., et al., Transmission of Ebola virus from pigs to non-human primates. Scientific Reports, 2012. 2.
13. Georges, A.J., et al., Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: Epidemiologic and health control issues. Journal of Infectious Diseases, 1999. 179: p. S65-S75.
14. Paessler, S. and D.H. Walker, Pathogenesis of the Viral Hemorrhagic Fevers. Annual Review of Pathology: Mechanisms of Disease, Vol 8, 2013. 8: p. 411-440.
15. Mahanty, S. and M. Bray, Pathogenesis of filoviral haemorrhagic fevers. Lancet Infectious Diseases, 2004. 4(8): p. 487-498.
16. Nishiura, H. and G. Chowell, Early transmission dynamics of Ebola virus disease (EVD), West Africa, March to August 2014. Eurosurveillance, 2014. 19(36): p. 5-10.
17. Mari Saez, A., et al., Investigating the zoonotic origin of the West African Ebola epidemic. EMBO molecular medicine, 2015. 7(1): p. 17-23.
18. Groseth, A., H. Feldmann, and J.E. Strong, The ecology of Ebola virus. Trends in Microbiology, 2007. 15(9): p. 408-416.
19. Malloy, C.D. and J.S. Marr, Evolution of the Control of Communicable Diseases Manual: 1917 to 2000. Journal of public health management and practice : JPHMP, 2001. 7(5): p. 97-104.
20. Koroma, V., Ebola‘s lost ward (vol 513, pg 474, 2014). Nature, 2014. 516(7531): p. 298-298.
21. Leroy, E.M., et al., Early immune responses accompanying human asymptomatic Ebola infections. Clinical and Experimental Immunology, 2001. 124(3): p. 453-460.
22. Baize, S., et al., Inflammatory responses in Ebola virus-infected patients. Clinical and Experimental Immunology, 2002. 128(1): p. 163-168.
23. Leirs, H., et al., Search for the Ebola virus reservoir in Kikwit, Democratic Republic of the Congo: Reflections on a vertebrate collection. Journal of Infectious Diseases, 1999. 179: p. S155-S163.
24. Morvan, J.M., et al., Identification of Ebola virus sequences present as RNA or DNA in organs of terrestrial small mammals of the Central African Republic. Microbes and Infection, 1999. 1(14): p. 1193-1201.
25. Leroy, E.M., et al., Fruit bats as reservoirs of Ebola virus. Nature, 2005. 438(7068): p. 575-576.
26. Pourrut, X., et al., Spatial and temporal patterns of Zaire ebolavirus antibody prevalence in the possible reservoir bat species. Journal of Infectious Diseases, 2007. 196: p. S176-S183.
27. Negredo, A., et al., Discovery of an Ebolavirus-Like Filovirus in Europe. Plos Pathogens, 2011. 7(10).
28. Wittmann, T.J., et al., Isolates of Zaire ebolavirus from wild apes reveal genetic lineage and recombinants. Proceedings of the National Academy of Sciences of the United States of America, 2007. 104(43): p. 17123-17127.
29. Bermejo, M., et al., Ebola outbreak killed 5000 gorillas. Science, 2006. 314(5805): p. 1564-1564.
30. Leroy, E.M., et al., Multiple Ebola virus transmission events and rapid decline of central African wildlife. Science, 2004. 303(5656): p. 387-390.
31. Ansari, A.A., Clinical features and pathobiology of Ebolavirus infection. Journal of Autoimmunity, 2014. 55: p. 1-9.
32. Fauci, A.S., Ebola - Underscoring the Global Disparities in Health Care Resources. New England Journal of Medicine, 2014. 371(12): p. 1084-1086.
33. Rasmussen, A.L., et al., Host genetic diversity enables Ebola hemorrhagic fever pathogenesis and resistance. Science, 2014. 346(6212): p. 987-991.
34. Bausch, D.G., et al., Assessment of the risk of Ebola virus transmission from bodily fluids and fomites. Journal of Infectious Diseases, 2007. 196: p. S142-S147.
35. Peters, C.J. and J.W. LeDuc, An introduction to Ebola: The virus and the disease. Journal of Infectious Diseases, 1999. 179: p. IX-XVI.
36. Towner, J.S., et al., Rapid diagnosis of Ebola hemorrhagic fever by reverse transcription-PCR in an outbreak setting and assessment of patient viral load as a predictor of outcome. Journal of Virology, 2004. 78(8): p. 4330-4341.
37. Miranda, M.E.G. and N.L.J. Miranda, Reston ebolavirus in Humans and Animals in the Philippines: A Review. Journal of Infectious Diseases, 2011. 204: p. S757-S760.
38. Qiu, X., et al., mAbs and Ad-Vectored IFN-alpha Therapy Rescue Ebola-Infected Nonhuman Primates When Administered After the Detection of Viremia and Symptoms. Science Translational Medicine, 2013. 5(207).
39. Carrion, R., Jr., et al., A small nonhuman primate model for filovirus-induced disease. Virology, 2011. 420(2): p. 117-124.
40. Funk, D.J. and A. Kumar, Ebola virus disease: an update for anesthesiologists and intensivists. Canadian Journal of Anesthesia-Journal Canadien D Anesthesie, 2015. 62(1): p. 80-91.
41. Hofmann-Winkler, H., F. Kaup, and S. Poehlmann, Host Cell Factors in Filovirus Entry: Novel Players, New Insights. Viruses-Basel, 2012. 4(12): p. 3336-3362.
42. Alimonti, J., et al., Evaluation of transmission risks associated with in vivo replication of several high containment pathogens in a biosafety level 4 laboratory. Scientific Reports, 2014. 4.
43. Jahrling, P.B., et al., PRELIMINARY-REPORT - ISOLATION OF EBOLA VIRUS FROM MONKEYS IMPORTED TO USA. Lancet, 1990. 335(8688): p. 502-505.
44. Geisbert, T.W., et al., Pathogenesis of Ebola hemorrhagic fever in cynomolgus macaques - Evidence that dendritic cells are early and sustained targets of infection. American Journal of Pathology, 2003. 163(6): p. 2347-2370.

pdfPDF