Quantum biochemical analysis of the binding interactions between a potential inhibitory drug and the Ebola viral glycoprotein.

Ebola virus disease (EVD) causes outbreaks and epidemics in West Africa that persist until today. The envelope glycoprotein of Ebola virus (GP) consists of two subunits, GP1 and GP2, and plays a key role in anchoring or fusing the virus to the host cell in its active form on the virion surface. Toremifene (TOR) is a ligand that mainly acts as an estrogen receptor antagonist; however, a recent study showed a strong and efficient interaction with GP. In this context, we aimed to evaluate the energetic affinity features involved in the interaction between GP and toremifene by computer simulation techniques using the Molecular Fractionation Method with Conjugate Caps (MFCC) scheme and quantum-mechanical (QM) calculations, as well as missense mutations to assess protein stability. We identified ASP522, GLU100, TYR517, THR519, LEU186, LEU515 as the most attractive residues in the EBOV glycoprotein structure that form the binding pocket. We divided toremifene into three regions and evaluated that region i was more important than region iii and region ii for the formation of the TOR-GP1/GP2 complex, which might control the molecular remodeling process of TOR. The mutations that caused more destabilization were ARG134, LEU515, TYR517 and ARG559, while those that caused stabilization were GLU523 and ASP522. TYR517 is a critical residue for the binding of TOR, and is highly conserved among EBOV species. Our results may help to elucidate the mechanism of drug action on the GP protein of the Ebola virus and subsequently develop new pharmacological approaches against EVD.Communicated by Ramaswamy H. Sarma.

Investigating and combatting the key drivers of viral zoonoses in Africa: an analysis of eight epidemics / Investigar e combater os principais promotores de zoonoses virais na África: uma análise de oito epidemias

Investigating the interplay of factors that result in a viral zoonotic outbreak is difficult, though it is increasingly important. As anthropogenic influences shift the delicate balance of ecosystems, new zoonoses emerge in humans. Sub-Saharan Africa is a notable hotspot for zoonotic disease due to abundant competent mammalian reservoir hosts. Furthermore, poverty, corruption, and an overreliance on natural resources play considerable roles in depleting biological resources, exacerbating the population's susceptibility. Unsurprisingly, viral zoonoses have emerged in Africa, including HIV/AIDS, Ebola, Avian influenza, Lassa fever, Zika, and Monkeypox. These diseases are among the principal causes of death in endemic areas. Though typically distinct in their manifestations, viral zoonoses are connected by underlying, definitive factors. This review summarises vital findings on viral zoonoses in Africa using nine notable case studies as a benchmark for future studies. We discuss the importance of ecological recuperation and protection as a central strategy to control zoonotic diseases. Emphasis was made on moderating key drivers of zoonotic diseases to forestall future pandemics. This is in conjunction with attempts to redirect efforts from reactive to pre-emptive through a multidisciplinary "one health" approach.

Investigar a interação de fatores que resultam em um surto zoonótico viral é difícil, embora seja cada vez mais relevante. À medida que as influências antropogênicas mudam o delicado equilíbrio dos ecossistemas, novas zoonoses surgem em humanos. A África Subsaariana é um ponto crítico notável para doenças zoonóticas devido a abundantes reservatórios mamíferos competentes. Além disso, a pobreza, a corrupção e o excesso de confiança nos recursos naturais desempenham papéis consideráveis no esgotamento dos recursos biológicos, exacerbando a suscetibilidade da população. Sem surpresa, zoonoses virais surgiram na África, incluindo HIV/AIDS, Ebola, gripe aviária, febre de lassa, zika e varíola dos macacos. Essas doenças estão entre as principais causas de morte em áreas endêmicas. Apesar de serem tipicamente distintas em suas manifestações, as zoonoses virais estão conectadas por fatores subjacentes e definitivos. Esta revisão resume descobertas vitais sobre zoonoses virais na África usando nove estudos de caso notáveis como referência para estudos futuros. Discutimos a importância da recuperação e proteção ecológica como estratégia central para o controle de doenças zoonóticas. Foi dada ênfase à moderação dos principais impulsionadores de doenças zoonóticas para prevenir futuras pandemias. Isso ocorre em conjunto com tentativas de redirecionar os esforços de reativos para preventivos por meio de uma abordagem multidisciplinar de "uma só saúde".

Selection of phage-displayed antibodies with high affinity and specificity by electrophoresis in microfluidic devices.

A method development aimed for high-throughput and automated antibody screening holds great potential for areas ranging from fundamental molecular interactions to the discovery of novel disease markers, therapeutic targets, and monoclonal antibody engineering. Surface display techniques enable efficient manipulation of large molecular libraries in small volumes. Specifically, phage display appeared as a powerful technology for selecting peptides and proteins with enhanced, target-specific binding affinities. Here, we present a phage-selection microfluidic device wherein electrophoresis was performed under two orthogonal electric fields through an agarose gel functionalized with the respective antigen. This microdevice was capable of screening and sorting in a single round high-affinity phage-displayed antibodies against virus glycoproteins, including human immunodeficiency virus-1 glycoprotein 120 or the Ebola virus glycoprotein (EBOV-GP). Phages were differentially and laterally swept depending on their antigen affinity; the high-affinity phages were recovered at channels proximal to the application site, whereas low-affinity phages migrated distal after electrophoresis. These experiments proved that the microfluidic device specifically designed for phage-selection is rapid, sensitive, and effective. Therefore, this is an efficient and cost-effective method that allowed highly controlled assay conditions for isolating and sorting high-affinity ligands displayed in phages.

Ebola: uma ameaça à Saúde Pública e à fauna silvestre / Ebola: a threat to public health and wildlife

Este artigo de revisão sumariza conhecimentos sobre a sintomatologia, patogenia, fatores epidemiológicos para algumas espécies da fauna silvestre acometidas pela virose, lista espécies silvestres vulneráveis à doença do vírus Ebola (EVD) e espécies de animais domésticos não vulveráveis, evidencia o uso de modelos animais para estudos objetivando a defesa de humanos e de animais contra essa doença e destaca a ameaça à saúde dos animais silvestres representada pela EVD.(AU)

This review article summarizes knowledge about the symptomatology, pathogenesis, epidemiological factors for some wildlife species affected by the virus, lists wild species vulnerable to Ebola virus disease (EVD) and non-vulverable species of domestic animals, highlights the use of animal models for studies aimed at the defense of humans and animals against this disease and highlights the threat to the health of wild animals represented by the EVD.(AU)

Strategies in Medicinal Chemistry to Discover New Hit Compounds against Ebola Virus: Challenges and Perspectives in Drug Discovery.

Ebola Virus (EBOV) is an infectious disease that mainly affects the cardiovascular system. It belongs to the Filoviridae family, consisting of filamentous envelopes and non-segmented negative RNA genome. EBOV was initially identified in Sudan and Zaire (now named the Democratic Republic of Congo) around 1967. It is transmitted mainly by contact with secretions (blood, sweat, saliva, and tears) from infected wild animals, such as non-human primates and bats. It has gained more prominence in recent years due to the recent EBOV outbreaks that occurred from 2013 to 2016, resulting in approximately 28,000 infected individuals, with a mortality rate of 40- 70%, affecting mainly Liberia, Guinea, and Sierra Leone. Despite these alarming levels, there is still no FDA-approved drug for the effective treatment of these diseases. The most advanced drug to treat EBOV is remdesivir. However, it is a high-cost drug and is available only for intravenous use. In this sense, more investments are needed in the research focused on the development of new antiviral drugs. In this context, medicinal chemistry strategies have been improving and increasingly discovering new hits that can be used in the future as a treatment against these diseases. Thus, this review will address the main advances in medicinal chemistry, such as drug discovery through computational techniques (virtual screening and virtual high throughput screening), drug repurposing, phenotypic screening assays, and employing classical medicinal chemistry, such as bioisosterism, metabolism-based drug design, and the discovery of new inhibitors through natural products, thereby presenting several promising compounds that may contain the advance of these pathogens.

A Journey into the Clinical Relevance of Heme Oxygenase 1 for Human Inflammatory Disease and Viral Clearance: Why Does It Matter on the COVID-19 Scene?

Heme oxygenase 1 (HO-1), the rate-limiting enzyme in heme degradation, is involved in the maintenance of cellular homeostasis, exerting a cytoprotective role by its antioxidative and anti-inflammatory functions. HO-1 and its end products, biliverdin, carbon monoxide and free iron (Fe2+), confer cytoprotection against inflammatory and oxidative injury. Additionally, HO-1 exerts antiviral properties against a diverse range of viral infections by interfering with replication or activating the interferon (IFN) pathway. Severe cases of coronavirus disease 2019 (COVID-19), an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are characterized by systemic hyperinflammation, which, in some cases, leads to severe or fatal symptoms as a consequence of respiratory failure, lung and heart damage, kidney failure, and nervous system complications. This review summarizes the current research on the protective role of HO-1 in inflammatory diseases and against a wide range of viral infections, positioning HO-1 as an attractive target to ameliorate clinical manifestations during COVID-19.

Protocolo de vigilancia en salud pública: Ébola / Public health surveillance protocol

La enfermedad producida por el virus del Ébola (EVE), antes llamada fiebre hemorrágica del Ébola es una enfermedad grave, a menudo mortal en el ser humano. Es transmitida por animales salvajes y se propaga en las poblaciones humanas por transmisión secundaria de persona a persona. Esta enfermedad es endémica en el continente africano; los brotes de EVE tienen una tasa de letalidad aproximadamente del 50%, según documentación de las regiones de África occidental. En brotes anteriores de EVE (1976-2014), las tasas fueron del 25% al 90%

Ebola virus disease (EVD), formerly called Ebola hemorrhagic fever is a disease serious, often fatal in humans. It is transmitted by wild animals and spreads in human populations by secondary transmission from person to person. Is disease is endemic on the African continent; sprouts of EVD have a fatality rate of approximately 50%, according to documentation from the African regions western. In previous EVD outbreaks (1976-2014), rates were from 25% to 90%

The Power of Music to Prevent and Control Emerging Infectious Diseases.

Music is a powerful approach to engage communities and disseminate information. Specifically, health campaigns employing music have been used to promote behaviors that can prevent emerging infectious diseases (EIDs). For example, hip hop artists supported campaigns to prevent acquired immunodeficiency syndrome in the 70s in the United States, while Brazilian funk promoted vaccination to mitigate the ongoing COVID-19 pandemic. Similarly, we broadcast musical messages in local languages to increase community awareness and support prevention measures in Guinea and Liberia in response to the recent Ebola outbreak in 2021. Given the potential of music to promote both individual and population-level behavioral changes to prevent transmission, there is a need to consolidate information on music-based health interventions, and on how we can measure their effectiveness. In this perspective, we provide examples of relevant initiatives, discussing challenges and solutions associated with implementing interventions based on our experience with the 2021 Ebola outbreak. We recommend four steps for a successful music-based health intervention including (1) establishing a task force, (2) compose a "catchy" song including critical preventive measures, (3) deliver the song to the target audience, and (4) evaluate the campaign effectiveness. We argue that close interactions between scientists and musicians can produce rapid musical content for disease prevention. We also identify and discuss several methodological frameworks for testing the effectiveness of such interventions. We conclude that support from public health authorities, government media departments, and international agencies, is necessary to deliver wide outreach and long-term sustainability of musical messaging toward effective EID prevention.

Preparedness Tested: Severe Cerebral Malaria Presenting as a High-Risk Person Under Investigation for Ebola Virus Disease at a US Hospital.

In 2019, a 42-year-old African man who works as an Ebola virus disease (EVD) researcher traveled from the Democratic Republic of Congo (DRC), near an ongoing EVD epidemic, to Philadelphia and presented to the Hospital of the University of Pennsylvania Emergency Department with altered mental status, vomiting, diarrhea, and fever. He was classified as a "wet" person under investigation for EVD, and his arrival activated our hospital emergency management command center and bioresponse teams. He was found to be in septic shock with multisystem organ dysfunction, including circulatory dysfunction, encephalopathy, metabolic lactic acidosis, acute kidney injury, acute liver injury, and diffuse intravascular coagulation. Critical care was delivered within high-risk pathogen isolation in the ED and in our Special Treatment Unit until a diagnosis of severe cerebral malaria was confirmed and EVD was definitively excluded.This report discusses our experience activating a longitudinal preparedness program designed for rare, resource-intensive events at hospitals physically remote from any active epidemic but serving a high-volume international air travel port-of-entry.

Small interfering RNA for cancer treatment: overcoming hurdles in delivery.

In many ways, cancer cells are different from healthy cells. A lot of tactical nano-based drug delivery systems are based on the difference between cancer and healthy cells. Currently, nanotechnology-based delivery systems are the most promising tool to deliver DNA-based products to cancer cells. This review aims to highlight the latest development in the lipids and polymeric nanocarrier for siRNA delivery to the cancer cells. It also provides the necessary information about siRNA development and its mechanism of action. Overall, this review gives us a clear picture of lipid and polymer-based drug delivery systems, which in the future could form the base to translate the basic siRNA biology into siRNA-based cancer therapies.

Factores pronósticos clínicos determinantes en la supervivencia de pacientes con el virus Ébola / Clinical prognostic factors determining the survival of patients with the Ebola virus

Introducción: La enfermedad por el virus del Ébola presenta una elevada letalidad, por lo cual resulta de gran interés la realización de investigaciones que aborden las manifestaciones clínicas que pudieran ser factores pronósticos de supervivencia. Objetivo: Evaluar factores pronósticos de los pacientes enfermos de ébola. Métodos: El universo lo constituyó la totalidad (n = 350) de pacientes ingresados. Se emplearon medidas de resumen para variables cualitativas, estimaciones puntuales y por intervalos para las cuantitativas, así como las pruebas de significación Kaplan-Meier, regresión de Cox y Odds Ratio. Se trabajó con un nivel de confiabilidad del 95 por ciento. Resultados: La supervivencia global fue del 42,5 por ciento. La media de supervivencia, de aproximadamente 10 días (IC: 9 - 11 días). Los pacientes que ingresaron en estado grave (OR = 3,76), que tuvieron dolor lumbar (OR = 2,24), que refirieron cefalea (OR = 2,22), que presentaron fiebre (OR=2,16), que aquejaron de dolor abdominal (OR=1,95) y a quienes se les constató inyección conjuntival (OR = 1,86), tuvieron mayor probabilidad de fallecer, que quienes ingresaron sin estos síntomas y signos. Conclusiones: La supervivencia fue elevada, pese a las complicaciones presentadas. Los síntomas y signos predictores de muerte en los pacientes fueron: la gravedad del paciente al momento del ingreso, la presencia de dolor lumbar, cefalea, fiebre, dolor abdominal e inyección conjuntival(AU)

Introduction: Ebola virus disease has a high lethality, which is why it is of great interest to carry out research that addresses clinical manifestations that could be prognostic factors for survival. Objective: To evaluate prognostic factors of Ebola patients. Methods: the universe was constituted by the totality (n = 350) of admitted patients. Summary measures were used for qualitative variables, point and interval estimates for quantitative variables, as well as Kaplan-Meier significance tests, Cox regression and Odds Ratio. We worked with a 95% level of reliability. Results: The overall survival was 42.5 por ciento. The average survival, approximately 10 days (CI: 9-11 days). Patients who were admitted in serious condition (OR = 3.76), who had low back pain (OR = 2.24), who reported headache (OR = 2.22), who presented fever (OR = 2.16), who they suffered from abdominal pain (OR = 1.95) and who were found to have conjunctival injection (OR = 1.86), were more likely to die than those who entered without these symptoms and signs. Conclusions: Survival was high, despite the complications presented. The symptoms and predictive signs of death in the patients were: the severity of the patient at admission, the presence of low back pain, headache, fever, abdominal pain and conjunctival injection(AU)

Nanoplasmid Vectors Co-expressing Innate Immune Agonists Enhance DNA Vaccines for Venezuelan Equine Encephalitis Virus and Ebola Virus.

DNA vaccines expressing codon-optimized Venezuelan equine encephalitis virus (VEEV) and Ebola virus (EBOV) glycoprotein genes provide protective immunity to mice and nonhuman primates when delivered by intramuscular (IM) electroporation (EP). To achieve equivalent protective efficacy in the absence of EP, we evaluated VEEV and EBOV DNA vaccines constructed using minimalized Nanoplasmid expression vectors that are smaller than conventional plasmids used for DNA vaccination. These vectors may also be designed to co-express type I interferon inducing innate immune agonist genes that have an adjuvant effect. Nanoplasmid vaccinated mice had increased antibody responses as compared to those receiving our conventional pWRG7077-based vaccines when delivered by IM injection, and these responses were further enhanced by the inclusion of the innate immune agonist genes. The Nanoplasmid VEEV DNA vaccines also significantly increased protection against aerosol VEEV challenge as compared to the pWRG7077 VEEV DNA vaccine. Although all mice receiving the pWRG7077 and Nanoplasmid EBOV DNA vaccines at the dose tested survived EBOV challenge, only mice receiving the Nanoplasmid EBOV DNA vaccine that co-expresses the innate immune agonist genes failed to lose weight after challenge. Our results suggest that Nanoplasmid vectors can improve the immunogenicity and protective efficacy of alphavirus and filovirus DNA vaccines.

Ebola virus disease: An emerging and re-emerging viral threat.

The genus Ebolavirus from the family Filoviridae is composed of five species including Sudan ebolavirus, Reston ebolavirus, Bundibugyo ebolavirus, Taï Forest ebolavirus, and Ebola virus (previously known as Zaire ebolavirus). These viruses have a large non-segmented, negative-strand RNA of approximately 19 kb that encodes for glycoproteins (i.e., GP, sGP, ssGP), nucleoproteins, virion proteins (i.e., VP 24, 30,40) and an RNA dependent RNA polymerase. These viruses have become a global health concern because of mortality, their rapid dissemination, new outbreaks in West-Africa, and the emergence of a new condition known as "Post-Ebola virus disease syndrome" that resembles inflammatory and autoimmune conditions such as rheumatoid arthritis, systemic lupus erythematosus and spondyloarthritis with uveitis. However, there are many gaps in the understanding of the mechanisms that may induce the development of such autoimmune-like syndromes. Some of these mechanisms may include a high formation of neutrophil extracellular traps, an uncontrolled "cytokine storm", and the possible formation of auto-antibodies. The likely appearance of autoimmune phenomena in Ebola survivors suppose a new challenge in the management and control of this disease and opens a new field of research in a special subgroup of patients. Herein, the molecular biology, pathogenesis, clinical manifestations, and treatment of Ebola virus disease are reviewed and some strategies for control of disease are discussed.

El contenido visual publicado en prensa durante una crisis sanitaria: El caso del Ébola, España 2014 / Visual content published by the press during a health crisis: The case of Ebola, Spain, 2014 / O conteúdo visual publicado na imprensa durante uma crise sanitária: o caso do Ebola, Espanha 2014

Ante el escaso número de estudios en este ámbito, el objetivo es analizar el contenido visual en la prensa durante la crisis sanitaria del Ébola en España que ocasionó gran alarma en la sociedad en 2014. En una muestra nacional de diarios, se identifica contenido visual en el 92% (n=160) de artículos sobre el Ébola y en el 87,5% (n=14) de portadas. La fotografía es el recurso más usado (69,2%), seguido de gráficos (9,2%) e infografías (8,8%), mientras que 'conflicto' es el encuadre más frecuente (42%). Se detecta un aumento rápido del contenido visual en los primeros dos días de la crisis que disminuye paulatinamente a partir del quinto día (p<.001). Este estudio puede abrir nuevas vías de investigación para profundizar en la investigación del contenido visual, especialmente durante la crisis sanitaria dada la gran importancia que adquiere la comunicación.(AU)

Considering the scarce number of studies in this sphere, the objective is to analyze the visual content published by the press during the health crisis of Ebola in Spain, which caused great alarm in that society in 2014. In a sample of Spanish newspapers, visual content was identified in 92% (n=160) of the articles about Ebola and in 87.5% (n=14) of front pages. Photography was the most used resource (69.2%), followed by graphs (9.2%) and infographics (8.8%), while 'conflict' was the most frequent framing (42%). A rapid increase in the use of visual content was detected in the first two days of the crisis, followed by a gradual decrease from the fifth day onwards (p <0.001). This study can open new research paths for further investigation of visual content, especially during a health crisis, due to the great importance communication acquires in this situation.(AU)

Considerando o número escasso de estudos neste âmbito, o objetivo é analisar o conteúdo visual na imprensa durante a crise sanitária do Ebola na Espanha, que causou um grande alarme na sociedade em 2014. Em uma amostra de diários nacionais, identifica-se conteúdo visual em 92% (n = 160) dos artigos sobre o Ébola e em 87,5% (n = 14) das capas. A fotografia é o recurso mais utilizado (69,2%), seguido por gráficos (9,2%) e inforgráficos (8,8%), enquanto 'conflito' é o enquadramento mais frequente (42%). Detecta-se um rápido aumento no conteúdo visual nos dois primeiros dias da crise, que diminui gradativamente a partir do quinto dia (p <0,001). Este estudo pode abrir novas vias de pesquisas que aprofundem na investigação do conteúdo visual, especialmente durante uma crise sanitaria devido à grande importância que a comunicação adquire.(AU)

Libro Heroes de a pie / Book Heroes on foot

Este libro narra la historia íntima de diversas epidemias y de situaciones de alerta en salud pública ocurridas en el último cuarto de siglo en Colombia. Es la historia de los epidemiólogos que fueron al terreno con el propósito de controlarlas, de las personas que las padecieron y, a veces, de los profesionales de la salud que atendieron a la población. Pero este libro también cuenta cómo fue el desarrollo del programa que entrenó a esos epidemiólogos, de esas mujeres y esos hombres que han logrado mitigar el impacto de aquellas amenazas para la salud colectiva, o incluso evitar que hubieran ocurrido. En el argot médico son llamados epidemiólogos de campo, pero, por su anonimato y sacrificio, estas páginas los reconocen con justeza como unos "héroes de a pie".

This book tells the intimate history of various epidemics and public health alert situations that occurred in the last quarter of a century in Colombia. It is the story of the epidemiologists who went to the field with the purpose of controlling them, of the people who suffered them and, sometimes, of the health professionals who attended the population. But this book also tells how was the development of the program that trained those epidemiologists, those women and those men who have managed to mitigate the impact of those threats to collective health, or even prevent them from happening. In medical jargon they are called field epidemiologists, but, because of their anonymity and sacrifice, these pages rightly recognize them as "walking heroes."

¿La información sobre salud está condicionada por la nacionalidad de los enfermos? El ébola como estudio de caso / Does health news depend on patients' nationality? An Ebola case study

Resumen La salud cada vez tiene más presencia en la prensa generalista, especialmente cuando los temas que se abordan afectan a países desarrollados. Esta investigación expone las diferencias que se generan en la cobertura periodista cuando ocurre un hecho relevante como pueda ser una epidemia y que afecta tanto a países occidentales como a países africanos subdesarrollados. El trabajo que presentamos evidencia que en la epidemia de Ébola, reconocida como tal por la Organización Mundial de la Salud en el año 2014, el volumen de las noticias sobre la epidemia solo aumentó la información relativa a esta enfermedad cuando hubo occidentales afectados directamente por la misma. Así se observa en los resultados que ofrece el análisis de contenido realizado en tres diarios de diferentes nacionalidades como son el español El País, el francés Le Figaro y el mexicano Reforma durante las fechas de marzo de 2014 a enero de 2015.

Abstract It is increasingly common to see the issue of health included in the general press, particularly when the topic being discussed affects developed nations. This research project shows the differences that appear in press coverage when there is a relevant event, such as an epidemic, which affects both developed, western nations and underdeveloped African ones. This work shows that, in the case of the Ebola epidemic - which was recognised as such by the World Health Organisation in 2014 -, the press only gave the problem greater coverage when there were cases of westerners being directly affected by it. That can be observed in the results of the content analysis in three daily newspapers from different countries: El País (Spain), Le Figaro (France) and Reforma (Mexico), between March 2014 and January 2015.

Intervención educativa sobre el Ébola para estudiantes de Medicina de. 5to año. Septiembre - noviembre 2018 / Educational intervention about Ébola for 5th year medicine students. September- november 2018

RESUMEN Introducción: el virus del Ébola es el causante de la enfermedad vírica febril hemorrágica del Ébola: infecciosa, altamente contagiosa, muy severa, afecta tanto a animales como a seres humanos, presenta alta mortalidad y constituye un problema de salud que, sin un control adecuado, puede llegar a convertirse en epidemia de alcance mundial. Objetivo: evaluar el nivel de conocimientos acerca de la enfermedad del Ébola en los estudiantes de 5to año de Medicina, de la Universidad de Ciencias Médicas de Holguín, Cuba. Métodos: se realizó un estudio de intervención educativa sobre la enfermedad del Ébola, mediante un programa educativo a partir de la identificación de las necesidades de aprendizaje de los estudiantes de 5to año de Medicina, a través de un cuestionario para medir el nivel de conocimientos sobre aspectos de esta dolencia Resultados: el grupo de edades con mayores conocimientos sobre el tema fue el de 21 a 24 años (60,52%). El sexo femenino predominó sobre el masculino en cuanto a conocimientos de la enfermedad (82,85%). Al presenciar un largometraje como parte del programa educativo confeccionado, los estudiantes de 21 a 24 años mostraron mayor dominio (65,51%). Conclusiones: previo a nuestra intervención, el nivel de conocimiento de los estudiantes sobre la enfermedad del Ébola eran incorrectos. Se aplicó el método de intervención educativa de forma satisfactoria. Al culminar, se modificó el nivel de conocimientos incorrectos y los suficientes y correctos se incrementaron.

ABSTRACT Introduction: Èbola virus causes hemorrhagic febrile viral disease of Èbola, a severe infectious disease, highly contagious, with a high mortality level, which affects animals and humans; a health problem which may become epidemic worldwide without a suitable control. Objective: evaluate knowledge about Èbola disease of 5th year medicine students from September to November 2018. Methods: an educational intervention study about Èbola disease for 5th year medicine students, through an educational program from the identification of their needs, with one summary to measure their knowledge level about fundamental aspects of this disease, was carried out. Results: the age group with suitable knowledge about the subject was between 21 and 24 (60, 52%). Females predominated with (82, 85%). When they all watch the film included in the educational program, the same age group predominated (65, 51%). Conclusions: before the intervention, 5th year medicine student's knowledge level about Èbola disease was inadequate. Educational intervention method was successfully applied. As the conclusion of the educational intervention, adequate and sufficient knowledge increased and those incorrect were modified.

Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional (VIII) / Ebola epidemic in Africa: Cuban medical experience in this international health emergency (VIII)

RESUMEN La misión de la brigada médica perteneciente al Contingente Internacional Especializado en Situaciones de Desastres y Graves Epidemias "Henry Reeve", que laboró en Sierra Leona, terminó el 1ro de abril de 2015, con sus objetivos cumplidos. Fueron atendidos 1589 pacientes y confirmados 619 con el ébola (38,9 %), se disminuyó el índice de mortalidad de 92 % a 43,3 % y se salvaron 351 vidas entre el 5 de noviembre de 2014 y el 10 de marzo de 2015. En total se trabajaron 377 días, con 6024 horas de estancia en el Centro de Tratamiento del Ébola y 2217 horas vistiendo el equipo de protección individual. Sus integrantes recibieron reconocimientos nacionales e internacionales y numerosas distinciones que avalaron el desempeño de tan exitosa encomienda.

ABSTRACT The mission of the medical brigade belonging to the "Henry Reeve "International Contingent Specialized in Situations of Disasters and Serious Epidemics, which worked in Sierra Leone, ended on April 1, 2015, with its objectives fulfilled. 1589 patients were treated and 619 confirmed with Ebola (38.9%), the death rate was reduced from 92% to 43.3% and 351 lives were saved from November 5, 2014 to March 10, 2015. they worked 377 days in all, with 6024 hours of stay in the Ebola Treatment Center and 2217 hours wearing the personal protection equipment. Its members received national and international recognition and numerous distinctions that endorsed the performance of such a successful mission.

Caracterización clínico epidemiológica de pacientes con ébola en un centro de tratamiento de Sierra Leona / Clinical-epidemiological characterization of Ebola disease in patients at a treatment center in Sierra Leone

Introducción: La enfermedad del ébola se dio a conocer por primera vez en 1976, con una letalidad muy elevada en todos los brotes detectados. Objetivo: Caracterizar clínica y epidemiológicamente a los pacientes portadores de la enfermedad por el virus del Ébola. Métodos: Se realizó un estudio observacional, descriptivo y transversal en 424 pacientes ingresados en un centro de tratamiento de ébola en la República de Sierra Leona, África occidental, con el diagnóstico confirmado mediante la técnica de reacción en cadena de la polimerasa para virus Ébola, durante el período de noviembre de 2014 hasta marzo de 2015. Resultados: Se muestra que el grupo etario más afectado fue el de 25 a 34 con un 25,9 por ciento. La mayor letalidad se presentó en los pacientes con más de 65 años de edad con un 44,4 por ciento. El síntoma que prevaleció fue la fiebre para un 61,8 por ciento, y el hipo se presentó en el 88,8 por ciento de los fallecidos. Conclusión: Se concluye que la enfermedad no tuvo distinción significativa con el sexo. La mayor letalidad se presentó en las edades geriátricas. Los síntomas más frecuentes fueron la fiebre, diarrea y el decaimiento. El hipo fue el signo que más se presentó en los pacientes que fallecieron(AU)

Introduction: Ebola disease was first reported in 1976 with a very high lethality in all outbreaks. Objective: To clinically and epidemiologically characterize the patients carriers of Ebola virus disease. Methods: we conducted an observational, descriptive and cross-sectional study in 424 patients admitted to an Ebola Treatment Center in the Republic of Sierra Leone, West Africa from November 2014 to March 2015. The polymerase chain reaction technique for Ebola virus confirmed the diagnosis. Medical records provided all data. Results: The age group most affected was 25 to 34 (25.9 percent). The highest lethality occurred in those over 65 years of age (44.4 percent ). Fever was the prevailing symptom (61.8 percent) and hiccups occurred in 88.8 percent of the deceased. Conclusion: Clinical manifestations were variable, although fever was the main symptom. Hiccup was a sign of poor prognosis when associated with a higher percentage of mortality. Lethality was high(AU)

Influencia de los procederes de enfermería en la sobrevivencia de los pacientes afectados por el Ébola / Influence of Nursing Procedures in the Survival of Patients Affected by Ebola

Introducción: El virus del Ébola causa una enfermedad grave sumamente infecciosa, que lleva rápidamente a la muerte, con una tasa de letalidad de hasta 90 por ciento, pero puede prevenirse. Objetivo: Describir relevancia de los procederes de enfermería en la sobrevivencia de los pacientes afectados por el Ébola Métodos: Estudio descriptivo, de corte transversal en Liberia, África Occidental, en el periodo de noviembre 2014 a febrero 2015. El universo estuvo constituido por 203 pacientes a quienes se les aplicó procederes de enfermería por enfermeros que integraron la brigada médica cubana. La información se obtuvo de la observación directa y la revisión de la base de datos estadística de la misión cubana en Liberia, se procesó mediante el Sistema SPSSS versión 11,5 a través de técnicas de estadística descriptiva. Resultados: Predominó el sexo masculino (55,66 por ciento), diciembre fue el mes de mayor ingreso (36,45 por ciento), la mayoría de los pacientes fueron ingresados en la salas de sospechosos (60,09 por ciento), predominó la administración de medicamentos por vía oral, con 820 procederes (52,59 por ciento), se logró que 51,25 por ciento de los pacientes atendidos egresaran vivos, siendo el mes de enero el de mayor letalidad (66,70 por ciento). Conclusiones: La labor realizada por los enfermeros cubanos en la lucha contra el Ébola en Liberia, África Occidental, y el cumplimiento estricto de los protocolos según procederes de enfermería contribuyó al control hemodinámico de los pacientes atendidos y a la disminución paulatina de la epidemia, así como la letalidad por dicho evento(AU)

Introduction: Ebola virus causes a highly infectious and serious disease, which quickly leads to death, with a death rate of up to 90 percent, but it can be prevented. Objective: To describe the relevance of nursing procedures in the survival of patients affected by Ebola. Methods: Descriptive, cross-sectional study carried out in West Africa, Liberia in the period from November 2014 to February 2015. The study population consisted of 203 patients who were applied nursing procedures by personnel who were part of the Cuban medical brigade. The information was obtained by direct observation and review of the statistical database of the Cuban mission in Liberia; and processed through the system SPSSS version 11.5, through descriptive statistics techniques. Results: The male sex predominated (55.66 percent). December was the month with highest admittance (36.45 percent); the majority of patients were admitted to the ward of suspects (60.09 percent). The administration of oral medications predominated, with 820 procedures (52.59 percent). It was achieved for 51.25 percent of the patients attended to be discharged alive, the month of January accounting for the highest mortality (66.70 percent). Conclusions: The work carried out by the Cuban nurses in the fight against Ebola in West Africa, Liberia and the strict compliance with the protocols according to nursing procedures contributed to the hemodynamic control of the patients attended and the gradual reduction of the epidemic, as well as the mortality for the event(AU)