The Pathogenesis of Ebola Virus Disease

For almost 50 years, ebolaviruses and related filoviruses have been repeatedly reemerging across the vast equatorial belt of the African continent to cause epidemics of highly fatal hemorrhagic fever. The 2013-2015 West African epidemic, by far the most geographically extensive, most fatal, and long...

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Bibliographic Details
Published in:Annual review of pathology 2017-01, Vol.12 (1), p.387-418
Main Authors: Baseler, Laura, Chertow, Daniel S, Johnson, Karl M, Feldmann, Heinz, Morens, David M
Format: Article
Language:English
Subjects:
Disease Outbreaks - prevention & control
Ebola
ebolavirus
Ebolavirus - classification
Ebolavirus - isolation & purification
Ebolavirus - pathogenicity
epidemic
filovirus
Hemorrhagic Fever, Ebola - epidemiology
Hemorrhagic Fever, Ebola - pathology
Hemorrhagic Fever, Ebola - transmission
Humans
viral disease pathogenesis
viral hemorrhagic fever
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Summary:For almost 50 years, ebolaviruses and related filoviruses have been repeatedly reemerging across the vast equatorial belt of the African continent to cause epidemics of highly fatal hemorrhagic fever. The 2013-2015 West African epidemic, by far the most geographically extensive, most fatal, and longest lasting epidemic in Ebola's history, presented an enormous international public health challenge, but it also provided insights into Ebola's pathogenesis and natural history, clinical expression, treatment, prevention, and control. Growing understanding of ebolavirus pathogenetic mechanisms and important new clinical observations of the disease course provide fresh clues about prevention and treatment approaches. Although viral cytopathology and immune-mediated cell damage in ebolavirus disease often result in severe compromise of multiple organs, tissue repair and organ function recovery can be expected if patients receive supportive care with fluids and electrolytes; maintenance of oxygenation and tissue perfusion; and respiratory, renal, and cardiovascular support. Major challenges for managing future Ebola epidemics include establishment of early and aggressive epidemic control and earlier and better patient care and treatment in remote, resource-poor areas where Ebola typically reemerges. In addition, it will be important to further develop Ebola vaccines and to adopt policies for their use in epidemic and pre-epidemic situations.
ISSN:1553-4006
1553-4014
DOI:10.1146/annurev-pathol-052016-100506