Ebola Flashcards
1
Q
- What order does Ebola belong to?
A
a. Mononegavirales
2
Q
- What family is the Ebola virus in?
A
a. Filoviridae
3
Q
- Ebola is enveloped/unenveloped?
A
a. Enveloped
4
Q
- What genetic material does Ebola contain?
A
a. negative-stranded RNA virus
5
Q
- How many structural and regulatory genes does it contain?
A
a. 7
6
Q
- What latin word do ebola get their name from?
A
a. Thread
7
Q
- What other virus are in the same family as ebola?
A
a. Marburg virus (1967)
b. Ebola virus (1976)
c. Cueva virus (2002)
8
Q
- When was Ebola first discovered? In what countries?
A
a. 1967
b. Ziare and sudan
9
Q
- Ebola is ______nm in diameter around _____nm in length
A
a. 80nm
b. 970nm
10
Q
- The surface of the Ebola virus is covered in _________ and ____nm spikes which project from the lipid bilayer
A
a. Viraly encoded glycoproteins
b. 7-10nm
11
Q
- The 7-10nm spikes are important for?
A
a. Attacing to the host cell and enteringthe host cell
12
Q
- What size is the Ebola genome? Which incoded for ho many proteins? And what are the proteins?
A
a. 18-19kb
b. 7 proteins
i. Glycoprotein
ii. Nucleoprotein
iii. Transcription factor VP 30
iv. Polymerase
v. Polymerase co-facter VP 35
vi. VP 24
vii. Matrix VP-40
13
Q
- How many species of Ebola are there? And what are they called? How many can infect man?
A
a. • Cote d’Ivorie ebola virus (Tai Forest): Man
b. • Sudan ebola virus: Man
c. • Zaire ebola virus: MAn
d. • Bundibugyo ebola virus: MAn
e. • Reston ebola virus: non-human primates: crab eating macaques
f. • Bombali ebola virus: 2018: bats Anotolian free tailed bat and little free tailed bat
g. Four
14
Q
- What Ebola only affects non-human primates? Which specific primate?
A
a. Reston ebola virus: non-human primates: crab eating macaques
15
Q
- Which Ebola was isolated in 20 18? And what animals does it effect?
A
a. Bombali ebola virus: 2018: bats Anotolian free tailed bat and little free tailed bat
16
Q
- Which form of Ebola vius is the most virulent?
A
a. • Zaire ebola virus: Man
17
Q
- What is the second most virulent Ebola in man?
A
a. Sudan ebola virus: Man
18
Q
- What is the third most virulent ebola in man?
A
a. Bundibugyo ebola virus: Man
19
Q
- What form of Ebola which can infect humans, has no humans died from?
A
a. Cote d’Ivorie ebola virus (Tai Forest): Man
20
Q
- What cells do Ebola typically replicate in when they have entered the bod?
A
a. monocytes/macrophages & dendritic cells
21
Q
- What is micropinocytosis.
A
a. macropinocytosis is (cytology) a form of endocytosis in which a large fluid-filled vesicle, or macropinosome, is pinched off from the cell membrane and brought into the interior of the cell.
22
Q
- What part of the cell membrane is pinched off when Ebola enters?
A
a. The ruffled section
23
Q
- Once the Ebola virus is in the cell within the vesicle the glycoproteins are clipped off by what protein?
A
a. CTSB Cathepsin B
24
Q
- When the CTSB cleaves the glycoproteins, exposes the ________ binding domain of the glucoprotein
A
a. putative receptors
25
25. The vesicle containing the viruses then fused with the ______ which is carrying the structure ______
a. Endosome
| b. NPC1
26
26. What is the NPC1 stand for? And what is it?
a. Niemann-Pick Disease, Type C1
| b. Cholesterol transporter
27
27. What complex mediates the binding of the NPC1 and the viral containing vacuole?
a. HOPS complex
28
28. What is the HOPS complex?
a. Homotypic vacuole fusion sorting complex
29
29. What has to take place inorder for the Ebola virus to be released into the cytoplasm?
a. The HOPS needs to bind the Endosome containing the NPCI and the vacuole holding the virus
30
30. Once the virus is released into the cytoplasm what takes place?
a. Secondary infection of neighbouring cells
31
31. Once the cells begin to get infected what does the immune response do?
a. Cytokine storm
| b. Release of inflammatory mediators
32
32. What mechanisms does the body use to try and fight the Ebola virus?
a. Tetherin: BS-2 or CD317
33
33. What is tetherin? What causes it to be released? were does it localise the virus?
a. A human cellular protein which inhibits retroviruses infection by preventing the diffusion of virus particles after budding from infected cells
b. High levels of interferon
c. Membrane of the infected cell
34
34. What protein can Ebola disable? And which what protein signals the disabling?
a. Tetherin
| b. Glucoprotein
35
35. _______: Marburg virus: European laboratory workers ______ number of cases and _____ deaths. _______ were imported from Uganda. Lab workers were working with the blood.
a. 1967
b. 31
c. 7
d. Green
36
36. ______: Ebola virus; Ebola Zaire; Ebola Sudan/ This was why there are two subtypes
a. 1976
37
37. ____ and ______: Ebola Reston USA and Italy Imported _____from Philippines, from a breeding centre
a. 1989
b. 1992
c. Macaques
38
38. ______: Ebola Côte d'Ivoire: Chimpanzee
a. 1995
39
39. ______: Ebola Reston – ________ in Philippines
a. 2008
| b. Pigs
40
40. OutBreaks:
a. 1976 CRC: ______ case ______ Death ______ Strain ______& Case Fatality
b. 1976 Sudan: ______ case ______ Death ______ Strain______& Case Fatality
c. 1995: DRC: ______ case ______ Death ______ Strain______& Case Fatality
d. 2000: Uganda: ______ case ______ Death______ Strain______& Case Fatality
e. 2003: Congo: ______ case ______ Death______ Strain______& Case Fatality
f. 2007 DRC: ______ case ______ Death______ Strain______& Case Fatality
g. 2007 Uganda: ______ case ______ Death______ Strain______& Case Fatality
h. 2012 DRC: ______ case ______ Death______ Strain______& Case Fatality
i. 1976 CRC: ______ case ______ Death ______ Strain ______& Case Fatality
ii. 1976 Sudan: ______ case ______ Death ______ Strain______& Case Fatality
iii. 1995: DRC: ______ case ______ Death ______ Strain______& Case Fatality
iv. 2000: Uganda: ______ case ______ Death______ Strain______& Case Fatality
v. 2003: Congo: ______ case ______ Death______ Strain______& Case Fatality
vi. 2007 DRC: ______ case ______ Death______ Strain______& Case Fatality
vii. 2007 Uganda: ______ case ______ Death______ Strain______& Case Fatality
viii. 2012 DRC: ______ case ______ Death______ Strain______& Case Fatality
41
41. Where do you find the Zaire ebolavirus?
a. West , central Africa
42
42. Where do you find the sudan ebola virus?
a. South Sudan
b. Uganda
c. East parts of the DRC
43
43. Where do you find tai forest ebola?
a. Coat de ivorie
44
44. Where do you find the Bundibugyo virus
a. East DRC
45
45. Where do you find the Bombali ebolavirus?
a. Kenya
| b. Sirre Leonne
46
46. Can Bombali ebolavirus spill over to humans? And from what animal?
a. Unknown
| b. Bats
47
47. Where do you find Ebola reston?
a. Phillipines
48
48. What is the Reseviour for the tentitvely?
a. Bats
49
49. What is the issue with identify the reseviour of bats?
a. They only found 1/5th the virus and that’s why it says bats
50
50. What range do the bats that carry Ebola cover?
a. Africa, southeast assia and Australia
51
51. What other animals has EBOLA bee isolated n?
a. Antelope
b. Bush pigs
c. Non-human primates
52
52. How do people become infected with EBOLA?
a. Sexual transmitted
b. Breast Milk
c. Saliva
d. Semen
e. Bloods
53
53. How long can Ebola live in the SPERMS?
a. 512 days
54
54. What is an issue with getting people to listen to western scientist? What incident happened? What other issues have arisen?
a. They don’t trust the advice and isgnore
b. Ebola team were murdered
c. Looting of hospitals
55
55. What is the only Ebola virus known to be spread by aerosol?
a. Ebola Reston
56
56. How much Bush meat is confiscated at airports? What species does this meat come from?
a. 1 ton each year in the UK ports and airports
| b. Giraffe, rats, chimpanzees, antelope
57
57. How long does it take for initial acute onset symptoms to begin? What is the possible range?
a. 8-10days
| b. 2-20 days
58
58. What are initial symptoms?
a. Initial: Fever, chills, myalgias, malaise, anorexia
b. 5 days p.i.: GI symptoms - nausea, vomiting, watery diarrhoea, abdominal pain
c. Other - headache, conjunctivitis, hiccups, rash, chest pain, shortness of breath, confusion, seizures
d. Haemorrhagic symptoms in 18% of cases
59
59. What other diseases present as the same initially?
a. Malaria, typhoid fever, meningococcemia, Lassa fever & other bacterial infections
60
60. How many people infected complain of having a headache?
a. >50%
61
61. What eye issues can happen as a result of infection?
a. Conjunctivitis
62
62. What is an unusualk symptom of Ebola? Why did this happen?
a. Hiccups
| b. Reduction in oxygen
63
63. How many people actually show the heamoraghic symptoms of ebola?
a. 18%
64
64. What do the early non-specific smptoms progress to ?
a. Hypovolemic shock and multi-organ failure
b. • Haemorrhagic disease
c. • Death
65
65. How long to non-fatal cases take to begin improvements?
a. 6–11 days after symptoms onset
66
66. Where are 70% of tha fatality rates reported?
a. Rural Africa
67
67. What can increase survival rates?
a. intensive care, especially early intravenous and electrolyte management, may increase survival rate
68
68. The outbreak between ____-_____ predicted that those who presented with more severe initial symptoms lead to higher rates of fatalities
a. 2014 – 2017
69
69. Where do people typically bleed from when they have the heamorpgheic version?
a. Ears, eys, and mouth
70
70. What were the general clinical manifestations?
a. Fever (87%), fatigue (76%), arthralgia (39%), myalgia (39%)
71
71. What were the neurological manifestations?
a. Headache (53%), confusion (13%), eye pain (8%), coma (6%)
72
72. What are the cardiovascular manifestations?
a. Chest pain (37%),
73
73. What are the pulmonary manifestation?
a. Cough (30%), dyspnea (23%), sore throat (22%), hiccups (11%)
74
74. What are the gastrointestinal manifestations?
a. Vomiting (68%), diarrhea (66%), anorexia (65%), abdominal pain (44%), dysphagia (33%), jaundice (10%)
75
75. What are the Hematological manifestations?
a. Any unexplained bleeding (18%), melena/haematochezia (production of black stool)(6%),
b. haematemesis (vomit blood)(4%), vaginal bleeding (3%), gingival bleeding (2%),
c. haemoptysis (Coughing up blood)(2%), epistaxis (nose) (2%), bleeding at injection site (2%),
d. haematuria (1%), petechiae/ecchymoses (1%)
76
76. What are the integumentary manifestations?
a. Conjunctivitis (21%), rash (6%)
77
77. What is the 2014 hospitalised fatality rate?
a. 55-62% fatality rate in hospitalised patients in 2014
78
78. Patients who survive often have signs of clinical improvement by ________ week of illness
a. 2 weeks
79
79. Antibody with neutralising activity against Ebola persists >______ yr p.i.
a. 12
80
80. Prolonged convalescence issues?
a. Includes arthralgia, myalgia, abdominal pain, extreme fatigue & anorexia; many symptoms resolve by 21 months
b. • Significant arthralgia and myalgia may persist for >21 months
c. • Skin sloughing and hair loss has also been reported
81
81. The inflmation response results in an endokine strom resulting in?
a. Endothelial damage: become permeable and leaky
b. Multiorgan dysfunction from drop in pressure
c. The body then releases: Diffuse Intravascular coagulopathy (DIC)
i. Small clots in narrow vesciles
82
82. When is the peak of interferon production? What does this stimulate?
a. 2-3 days
| b. Inflammatory response
83
83. What increase after the peak interferon?
a. Viral RNA
b. IgM
c. IgG
84
84. What do the people who survive maintain high levels of?
a. IgG
85
85. What animals can get Ebola Zaire? And how does it affect them?
Same clinical course as humans
b. − Domestic animals don’t develop disease
c. − Pigs can develop and transmit infection
86
86. What is the primate mortality rate with ebola Reston?
a. ~82%
87
87. Philippines
a. • 1989-1990 – Reston_______: Traced back to macaques in Philippines in breeding facilities
b. • 1992-1993 – Sienna, Italy: Philippines Traced back to macaques in _____in breeding facilities
c. • 1996-_______, America: when it was discovered to be aerosol as it was spread between huts with no crossover of staff
d. • 2008/9 –_____, Philippines: abattoir: pigs with Reston and workers were ill, showed antibodies
e. • 2015 –_____, Manilla
i. Virginia
ii. Philippines
iii. Texas
iv. Pigs
v. macaques
88
88. What percentage of workers were found to be serologically positive in the macaque breeding centers in the phillipense? What test was used for testing? How did is present?
a. 20%
b. Fleurescent antibody tests: IFAT
c. Asymptomatic
89
89. ____ outbreak, Meliandou, _____, _____ year old was patient zero, and spread to healthcar workers in Jan-March _______.
a. 2013
b. Guinea
c. 2 year old
d. 2014
90
90. 2013: First diagnosed ________, dies within ____ days. Symptoms. Then passed to? How did it initially spread to a new village? What countries did it spread to
a. Emile
b. 4days
c. Fever, black stools, vomiting
d. Family
e. Granny and nurse health care system
f. Guinea, Liberia, and Sierra Leone
91
91. What is a cultural issue with ebola?
a. Its common for family members to clean the bodies of dead people
b. People kiss the dead body
92
92. How many people are allocated to one doctor in Liberia?
a. 70,000
93
93. What country closed its borders with Guinness in the 2014 outbreak? Did it work
a. Senegal
| b. nope
94
94. Where have cases been reported outside of Africa?
a. USA
b. UK
c. Most of Europe
95
95. What type of lab do you need for diagnosis? And what type of lab do you need to isolate it?
a. BSL-3
| b. BSL-4
96
96. What diagnostics test can be used at the early stages?
a. Antigen-capture enzyme-linked
b. immunosorbent assay (ELISA) testing
c. IgM ELISA
d. Polymerase chain reaction (PCR)
e. Virus isolation
97
97. What can be used for diagnosis later?
a. Serology: IgM and IgG
98
98. What diagnosis can be used in diseased patients?
a. Immunohistochemistry testing
b. PCR
c. Virus isolation
99
99. What is the longest IgM has been shown to last in people?
a. IgM
100
100. What are the treatments for Ebola?
a. • No approved treatments available for EVD
b. • Clinical management focus - supportive care of complications:
c. – hypovolemia, electrolyte abnormalities, hematologic abnormalities, refractory shock,
d. hypoxia, haemorrhage, septic shock, multi-organ failure, and DIC
101
101. What recommended care is encouraged?
a. Recommended care includes:
b. – volume repletion
c. – maintenance of blood pressure (with vasopressors if needed)
d. – maintenance of oxygenation
e. – pain control
f. – nutritional support
g. – treating secondary bacterial infections and pre-existing comorbidities
102
102. Are there any vaccines for Ebola?
a. • rVSV ZEBOV (Ervebo) - 2019- Guinea, Liberia, Sierra Leone
b. 2nd vaccine - 2 doses called Zabdeno (Ad26.ZEBOV) & Mvabea (MVA-BN-Filo) for individuals 1 year & older
c. Zmapp: secret serum, hyper immune from survirers
d. BCx-4430: adenosine anolog inhibits RNA function
e. Tekmira: siRNA
103
103. What preventions and controls are there?
a. • Protective clothing
i. – Disposable gowns, gloves, masks & shoe covers, protective eyewear when splashing might occur, or if patient is disoriented or uncooperative
b. • WHO and CDC developed manual
i. – “Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting”
c. • Chemical toilet for suspected VHF patients
d. • Disinfect & dispose of instruments
104
104. What happens with traditional cures?
a. Chewing bitter cola (Gracinia cola or G. Afzelii)
b. – Eating ewedu; Cochorus olitorius
c. – Salt bath & drink
d. – Kerosene bath
e. – Bleach bath (sodium hypochlorite)
105
105. What did more people die from during the Ebola outbreak then in theEbola in Nigeria?
a. Salt drinks and baths
106
106. Ebola biological weapon
a. • Outbreak of undifferentiated febrile illness 2-
i. 21 days following attack
ii. −Could include
1. Rash, haemorrhagic diathesis and shock
b. • Diagnosis could be delayed
i. −Unfamiliarity
ii. −Lack of diagnostic tests
c. −Ebola causes high mortality rates: possible 90%
107
107. What does protein V40 do? What is it
a. Membrane associated protein
b. Matric protein
c. Blocks immune response
d. Virus budding
e. Viral assembly
108
108. What is the nucleocapsid? What is it made from? What does it do?
a. Nuceloproteins
| b. Encapsulates the viral genome
109
109. What is VP30? What does it do?
a. Involved in RNA transcription
| b. Phosphoproteins
110
110. What is VP35? What does it do?
a. A nucleocapsid protein that
| b. inhibits the antiviral immune response
111
111. What is VP 24?
a. Membrane associated protein
b. Matric protein
c. Blocks immune response
d. Virus budding
e. Viral assembly
112
112. What is a glycoprotein and what does it do?
a. Located on the cell envelop
| b. Aid attachment to host cell
113
113. What part of the human cell plays a role in the attachment of the Ebola virus?
a. DC-SIGN and DC-SIGNR
114
114. When Ebola enters the cell what is this process called and what mediatest eh process?
a. Macropinocytosis or clathrin-mediated endocytosis.
| b. Clathrin
115
115. How Does Macropinocytosis take place?
a. In this process, ruffled segments of the host’s plasma membrane protrude outward from the cell and form invaginations where the virus utilizes glycoproteins in order to attach to the surface of the plasma membrane. Macropinocytosis is a process in which the Eukaryotic host cells form macropinosomes, segments of plasma membranes that extend out from the cell approximately 0.2-10 µm, in order to incorporate the virus into the cell. The formation of macropinosomes occurs spontaneously, as a result of the activation of various growth factors, or simultaneously with the intake of cellular molecules or extracellular fluid.
116
116. If ________ is missing Ebolavirus cannot leave the vesicle in order to replicate and cause infection in other cells.
a. NPC1 cholesterol transporter
117
117. What does the viral RNA transcribe? And what determines their length?
a. seven monocistronic mRNAs whose length is determined by highly conserved start and stop signals.
118
118. What is the RNA transcription process?
a. The transcription process begins with the binding of the polymerase complex to a single binding site located within the leader region of the genome. The complex then slides along the RNA template and sequentially transcribes the individual genes in their 3’ to 5’ order. Encapsidated, negative-sense genomic ssRNA is used as a template for the synthesis (3′-5′) of polyadenylated, monocistronic mRNAs and, using the host cell’s ribosomes, tRNA molecules, etc., the mRNA is translated into individual viral proteins.
119
119. What happens once replication of viral proteins reach a high density level?
a. Using the negative-sense genomic RNA as a template, a complementary +ssRNA is synthesized; this is then used as a template for the synthesis of new genomic (-)ssRNA, which is rapidly encapsidated
120
120. What type proteins are recruited from the cell for the virus to exit? What are the specific proteins? What do they do?
a. ESCRT endosomal sorting complex required for transport
b. ESCRT-0, ESCRT-I, ESCRT-II, and ESCRT-III
c. ESCRT-0, ESCRT-I, ESCRT-II: cleaves the bud neck from its cytosolic face
d. ESCRT-III: cleaves the bud neck from its cytosolic face
121
121. What cells does the Ebola Virus infect?
a. EBOV productively infects a broad range of cell types such as monocytes, macrophages, dendritic cells, endothelial cells, fibroblasts, hepatocytes, and adrenal cortical cells. Following host cell attachment (Figure 1), the virus is internalized by macropinocytosis, a non-selective process of engulfment
