Ebola Virus

Definition 

Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzee)

Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.

Outbreak

As of September 28, 2014, there have been 70 cases of Ebola virus disease reported in the Democratic Republic of the Congo. In total, 42 deaths have been reported. This outbreak is unrelated to the current outbreak of Ebola in West Africa.

Sign and Symptom 

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days. Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

• Fever (greater than 38.6°C or 101.5°F)
• Severe headache
• Muscle pain
• Weakness
• Diarrhea
• Vomiting
• Abdominal (stomach) pain
• Unexplained hemorrhage (bleeding or bruising)

Transmission

Until now, natural reservoir still not identified. However, researchers believe that the first patient becomes infected through contact with an infected animal.

When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with

• blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
• objects (like needles and syringes) that have been contaminated with the virus
• infected animals
• Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus.

Diagnosis  

Within a few days after symptoms begin, the diagnosis available : Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, IgM ELISA,Polymerase chain reaction (PCR),Virus isolation.

Later in disease course or after recovery, the diagnosis available is a IgG and IgM antibodies
Retrospectively in deceased patients, the diagnosis available is a Immunohistochemistry testing, PCR,Virus isolation.

 Source :

http://www.who.int/mediacentre/factsheets/fs103/en/

http://www.cdc.gov/vhf/ebola/index.html

Protein Energy Malnutrition (PEM)

Protein Energy Malnutrition (PEM)

Protein Energy Malnutrition is a form where there is inadequate from protein and energy intake. Marasmus and Kwashiokhor diseases very often attack in PEM case. Marasmus is a form of Protein energy malnutrition caused by energy and nutrients deficiency. While Kwashiorkhor is form condition caused by protein deficiency. Marasmic Kwashiorkor (marked protein deficiency and marked calorie insufficiency signs present, sometimes referred to as the most severe form of malnutrition).

Classification to diagnosis protein energy malnutrition :

1. Quac Stick.  The other perception to diagnosis malnutrition, The arm circumference was compared with the height of the individual and grades of malnutrition were identified in accordance with the percentage reduction in the arm circumference. A height measuring stick is marked off in arm circumference measurements (80% and 85% of normal) against height.  It compares mid-arm circumference with the height of the child.  
   
2. Wellcome classification is one such simple method for the diagnosis of clinical malnutrition.   
   
3. The Gomez classification (1950) as a method of diagnosing mild-moderate forms of malnutrition in the community and for the early identification of marasmus.
   The classification is based on weights of healthy American children under the age of 5 years, and the fiftieth percentile is taken as the standard. Malnutrition is graded into three degrees of increasing severity according to the percentage reduction in weight from the standard. First-degree malnutrition < 80% of the standard ,  Second-degree malnutrition < 70% of the standard, Third-degree malnutrition < 60% of the standard.
4. World Health Organization
   has developed a weight chart for international use.

 Diseases of Protein and energy malnutrition

1. Kwashiorkhor is form condition caused by protein deficiency. It presents with failure to thrive, edema, apathy, anorexia, diarrhoea and discoloration of the skin and hair. Sometimes they also called red baby. Edema is a clinical sign of kwashiorkhor. It appears first on the dorsum of the feet and ankles and spreads upwards to involve the rest of the body
   

   

   Kwasiorkhor

2. Marasmus  This usually occurs in younger children, with failure to thrive. Affected children are short and light for their age. In appearance they are shrinking and wizened due to lack of subcutaneous fat.

Marasmus

Source :
Mother and Child Nutrition in the Tropics and Subtropics. Chapter 7. Protein-energy Malnutrition
http://www.merckmanuals.com/professional/nutritional_disorders/undernutrition/protein-energy_undernutrition.html