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6 24 people who had been in close contact with infected family members but had never become ill. In 11 people, the researchers found antibodies to the Ebola virus, indicating they had been infected. Seven of the 11 people also had genetic material from the Ebola virus in their blood

7 Symptomless Ebola is likely due to a particularly strong immune response : The researchers suggest that viral replication in these cases was controlled by effective inflammatory responses triggered 4 6 days after infection. These responses were characterised by detectable concentrations of several cytokines, such as interleukin (IL)-1, IL-6, and tumour-necrosis factor (TNF).

8 Therapy and vaccine No specific treatment or vaccine is yet available for Ebola haemorrhagic fever. Several vaccine candidates are being tested but it could be several years before any are available. Experimental studies involving the use of hyperimmune sera on animals have demonstrated no protection against the disease. A new drug therapy has shown early promise in laboratory studies and is currently being evaluated further. However, this too will take several years.

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10 Findings Both treatment regimens prolonged survival time 33% survival rate in the treatment group. Survivors are still alive and healthy after 9 months. All but one of the 17 controls died. The mean survival for the six rnapc2-treated macaques that died was 11 7 days compared with 8 3 days for untreated controls (p=0 0184). rnapc2 attenuated the coagulation response the proinflammatory response

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12 Accelerated vaccination for Ebola virus haemorrhagic fever in non-human primates. Sullivan NJ, Geisbert TW, Geisbert JB, Xu L, Yang ZY, Roederer M, Koup RA, Jahrling PB, Nabel GJ. Nature 424, (07 August 2003) Here, we report the development of accelerated vaccination against Ebola virus in non-human primates.. The antibody response to immunization with an adenoviral (ADV) vector encoding the Ebola glycoprotein (GP) was induced more rapidly than with DNA priming and ADV boosting, but it was of lower magnitude. Even when animals were immunized once with ADV-GP/NP and challenged 28 days later, they remained resistant to challenge with either low or high doses of virus..this accelerated vaccine provides an intervention that may help to limit the epidemic spread of Ebola, and is applicable to other viruses.

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14 RESERVOIR

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16 We tested for EBO virus in the organs of 242 small mammals captured during ecological studies in the Central African Republic. EBO virus glycoprotein or polymerase gene sequences were detected by reverse transcription PCR in RNA extracts of the organs of 7 animals and by PCR in DNA extract of one animal. Neither live virus nor virus antigen was detected in any organ sample. Direct sequencing of amplicons identified the virus as being of the Zaire/Gabon subtype. Virus-like nucleocapsids were observed by electron microscopy in the cytoplasm of the spleen cells of one animal. The animals belonged to two genera of rodents (Muridae; Mus setulosus, Praomys sp1 and P. sp2) and one species of shrew (Soricidae; Sylvisorex ollula). These preliminary results provide evidence that common terrestrial small mammals living in peripheral forest areas have been in contact with the EBO virus and demonstrate the persistence of EBO virus RNA and DNA in the organs of the animals.

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19 Deel 2 Overige VHF van de bende van 4 (nosocomiale infecties door EBO, MAR,Lassa & CCHF) & andere VHF

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21 Negative stain image of an isolate of Marburg virus, showing filamentous particles as well as the characteristic "Shepherd's Crook". Magnification approximately 100,000 times. Image courtesy of Russell Regnery, Ph.D., DVRD, NCID, CDC. Patient with acute fever, bleeding tendency and red conjunctivae. This clinical presentation resembles severe leptospirosis, but in this case, the patient had Marburg Haemorrhagic Fever. Patient died next day. Durba, DRC, Copyright R. Colebunders - ITM

22 Hard tick: female Hyalomma aegyptium. Copyright ITM

23 Fever

24 Lassa

25 Lassa between and people get Lassa fever in West Africa each year approximately 15 to 20 % of patients hospitalized for Lassa fever die from the illness; there are about 5000 deaths a year however, approximately 80 percent of human infections with Lassa virus are mild or asymptomatic, and 1 percent of infections overall result in death

26 Lassa in some areas of eastern Sierra Leone, the disease accounts for 30 % of medical deaths in-hospital 30 % of deafness 70 % of spontaneous abortion 8 to 52 % of the population are seropositive

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28 Arenavirussen : Nieuwe wereld

29 GELE KOORTS "Yellow fever with haematemesis (""vomito negro""). Photo prof Eyckmans, copyright ITM"

30 Gele Koorts

31 Dengue

32 :// Rift Valley, Kenya.

33 Map Rift Valley Fever, seroprevalence in sheep

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