Dispelling the myths of viral infections: Management of Ebola Virus Disease and Monkeypox (Mpox)

Question 1

Dispelling the myths of viral infections: Management of Ebola Virus Disease and Monkeypox (Mpox). Who is the speaker?

a. Ofelia Solem
b. Jennifer Aying
c. Warly Remegio
d. Teresita Medina

Answer 1

Ofelia Solem

Question 2

Chain of infection

Answer 2

• Infectious agent
• Reservoir
• Portal of exit
• Mode of transmission
• Portal of entry
• Susceptible host

Question 3

6 kinds of ebola virus and their specific species

Answer 3

1. Ebola virus (species Zaire ebolavirus)
2. Sudan virus (species Sudan ebolavirus)
3. Tal Forest virus (species Tal Forest ebolavirus
   formerly Cote D’Ivoire ebolavirus)
4. Bundibugyo virus (species Bundibugyo
   ebolavirus)
5. Reston virus (species Reston ebolavirus)
6. Bombali virus (species Bombali ebolavirus

Question 4

Ebola Virus Disease or formerly known as ____ is a rare but severe often fatal illness in humans. It also affects nonhuman primates such as ____, ____, ____.

Answer 4

• Viral Hemorrhagic Fever
• monkeys, gorillas, chimpanzees

Question 5

The first link of Ebola infection is the ____

Answer 5

infectious agent

Question 6

Among the 6 ebola virus species, which 4 are the infectious ones?

a. Ebola virus (species Zaire ebolavirus)
b. Sudan virus (species Sudan ebolavirus)
c. Tal Forest virus (species Tal Forest ebolavirus formerly Cote D’Ivoire ebolavirus)
d. Bundibugyo virus (species Bundibugyo ebolavirus)
e. Reston virus (species Reston ebolavirus)
f. Bombali virus (species Bombali ebolavirus)

Answer 6

• Zaire
• Sudan
• Tai Forest
• Bundibugyo

Question 7

____ year first Ebola Infection at Equateur Province, now DRC

Answer 7

1976

Question 8

What is the reservoir of the ebola virus?

Answer 8

Bats

Question 9

What if the portal of exit for ebola virus?

Answer 9

• GI, GU tract
• Shed their waste such as urine and feces

Question 10

What is the mode of transmission of ebola virus?

Answer 10

Direct contact (ex. direct contact of blood and body fluids (urine, feces))

Question 11

What if the portal of entry for ebola virus?

Answer 11

• GI
• Skin/mucous membrane

Question 12

What are the susceptible host for ebola virus?

Answer 12

animal or human

Question 13

A person with signs and symptoms compatible with Ebola disease and epidemiological risk factor within ____ days before onset of symptoms

Answer 13

21 days

Question 14

What are the signs and symptoms of ebola suspect

Answer 14

• Fever =/>100.4
• HA, muscle and joint pain
• Weakness, fatigue, loss of appetite
• GI symptoms including abdominal pain, diarrhea, vomiting
• Red eyes, skin rash, hiccups, unexplained bleeding and bruising

Question 15

What are the possible risks/causes of contracting ebola virus?

Answer 15

• Contact with symptomatic person with suspected or confirmed Ebola disease or any objects contaminated by their body fluids
• Experiencing a breach in infection prevention and control precautions that resulted in the potential for contact with body fluids of a patient with suspected or confirmed Ebola disease
• Contact with semen from a man who has recovered from Ebola disease

Question 16

____ is the diagnostic test of choice for ebola virus

Answer 16

Reverse transcription polymerase chain reaction (RT-PCR)

Question 17

In ebola, does doing RT-PCR test before 72 hours mean you can rule out the disease?

Answer 17

No, it needs to be >72 hours to rule out ebola

Question 18

2 treatment for ebola vrius are ____ and ____

Answer 18

1. Inmazeb- combination of 3 monoclonal antibodies
2. Ebanga- single monoclonal antibody

Question 19

____ is a single dose vaccine effective against Zaire ebolavirus

Answer 19

Ervebo

Question 20

For contact precautions, what are the necessary things/procedure to have/do?

Answer 20

• private room
• PPE-gown
• gloves
• dedicated equipment
• disinfect room focus high touched area
• limit transport

Question 21

For droplet precautions, what are the necessary things/procedure to have/do?

Answer 21

• private room
• PPE-mask
• mask patient if transport outside room
• resp hygiene

Question 22

For a airborne precautions, what are the necessary things/procedure to have/do?

Answer 22

• AIIR (Airborne Infection Isolation Room)
• PPE-N95
• limit transport
• mask patient
• restrict susceptible HCP (certain disease)

Question 23

What are the needed things/procedures in managing clinically STABLE or don’t have bleeding, vomiting or diarrhea ebola patient?

Answer 23

• Gown- fluid-resistant gown that extends to at least mid-calf or fluid-resistant coveralls without integrated hood
• Full face shield
• Facemask
• Gloves with extended cuffs: Two pairs of gloves should be worn and at a minimum, outer gloves should have extended cuffs

Question 24

What are the needed things/procedures in managing clinically UNSTABLE or have bleeding, vomiting or diarrhea ebola patient?

Answer 24

• Impermeable gown or impermeable overall
• Respiratory head and face protection
• PAPR with full-face covering and head-shroud or N95 respirator in combination with surgical hood extending to shoulders and full face shield
• Gloves with extended cuffs. Two pairs of gloves should be worn. At a minimum, outer gloves should have extended cuffs
• Boot cover or shoe cover (when wearing coveralls with integrated shoe cover)
• Apron

Question 25

Protocols for ebola infection prevention

Answer 25

- Identify - Isolate - Inform

Question 26

2 genetic clades of mpox virus

Answer 26

1. Central African (Congo Basin) clade 2. West African clade

Question 27

**MONKEYPOX** Virus reservoir?

Answer 27

African rodents and nonhuman primates

Question 28

**MONKEYPOX** Portal of exit?

Answer 28

- Blood, GU, GI, Resp tract

Question 29

**MONKEYPOX** Mode of transmission?

Answer 29

- Animal bites or scratches, handling wild game or contact with infected animal product - Direct close personal skin to skin contact with mpox rash and scabs including saliva, upper respiratory secretions (snot, mucus) and areas around the anus, rectum or vagina - Direct contacts with objects and surfaces that have been used by a person with mpox - Spread to fetus during pregnancy or to newborn during and after birth - Possible that people with mpox can spread it to animals through close contacts

Question 30

**MONKEYPOX** Portal of entry

Answer 30

Blood, Resp tract, Skin/mucous membrane

Question 31

**MONKEYPOX** Susceptible Host

Answer 31

animals, human

Question 32

**MONKEYPOX** Most susceptible hosts?

Answer 32

- Immunocompromised - Pregnant - With atopic dermatitis or eczema - Young children under 8 years old

Question 33

**MONKEYPOX** Incubation period without symptoms? How long does illness lasts?

Answer 33

Incubation period- 3-17 days (no symptoms); illness lasts 2-4 weeks

Question 34

____ or next generation sequencing in a clinical specimen or isolation of mpox virus in culture from a clinical specimen

Answer 34

Polymerase chain reaction (PCR) testing

Question 35

____ during prodromal stage can be a clinical feature to distinguish mpox from chickenpox or smallpox

Answer 35

Lymphadenopathy

Question 36

**MONKEYPOX TREATMENT** ____ and ____: include hydration, nutritional supplementation and prevention of secondary infections

Answer 36

Supportive care and pain control

Question 37

**MONKEYPOX TREATMENT** ____ an antiviral medication FDA approved as investigational New Drug or compassionate use for the treatment of mpox

Answer 37

Tecovirimat (TPOXX)

Question 38

____ a 2 dose vaccine approved for the prevention of smallpox and mpox for high risk population

Answer 38

JYNNEOS

Question 39

____ is a 1 dose vaccine- approved for immunization against smallpox and mpox for high risk population

Answer 39

ACAM2000