Current Status of the Biology, Pathogenesis, and Impacts of Ebola
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CURRENT STATUS OF THE BIOLOGY, PATHOGENESIS, AND IMPACTS OF EBOLA VIRUS A Paper Submitted to the Graduate Faculty of the North Dakota State University of Agriculture and Applied Science By Dalal Alamri In Partial Fulfillment of the Requirements for the Degree of MASTER OF SCIENCE Major Department: Microbiological Sciences March 2021 Fargo, North Dakota North Dakota State University Graduate School Title CURRENT STATUS OF THE BIOLOGY, PATHOGENESIS, AND IMPACTS OF EBOLA VIRUS By Dalal Alamri The Supervisory Committee certifies that this disquisition complies with North Dakota State University’s regulations and meets the accepted standards for the degree of MASTER OF SCIENCE SUPERVISORY COMMITTEE: Sheela Ramamoorthy Chair Sangita Sinha Brett Webb Approved: April 16, 2021 John McEvoy Date Department Chair ABSTRACT Ebola viruses (EV) are single-stranded negative-sense RNA viruses belonging to the Filoviridae family. There are 6 species of Ebola, and four of them can cause Ebola virus disease (EVD) in humans. Ebola viral hemorrhagic fever is one of the deadliest diseases known to infect humans and non-human primates. The primary mode of transmission of Ebola has been identified as direct contact with infected animals, humans and body fluids. The early diagnosis of EVD is difficult because of similarities of the initial disease presentation to influenza-like symptoms such as high fever, myalgia, fatigue, headache, and chills. The most common symptoms that have been reported from previous outbreaks were fever, sore throat, abdominal pain, vomiting, bleeding, diarrhea, and chest pain. Several methods have been used to detect Ebola such as ELISA, conventional RT-PCR, and real-time RT-PCR. Scientists have been working on several therapeutics and vaccines to prevent and treat Ebola. iii ACKNOWLEDGMENTS Firstly, I want to thank my thesis advisor Dr. Sheela Ramamoorthy, Associate Professor, at North Dakota State University. She always helps me whenever I have a question about my research. She guides me to the right the direction. I am very grateful about her valuable guidance and comments throughout the duration at the NDSU. Beside my advisor, I would like to thank my graduate committee: Professors Brett Webb and Sangita Sinha for their encouragement and insightful comments. Finally, I want to express my deepest gratitude to my mother and my family for providing me with the great support throughout the years of study and through my process of writing this thesis. To my beloved father, I would like to present my sincere thankfulness for your great role in my life; I miss you so much. I am deeply sad that you could not see me graduate. iv TABLE OF CONTENTS ABSTRACT ................................................................................................................................... iii ACKNOWLEDGMENTS ............................................................................................................. iv LIST OF TABLES ........................................................................................................................ vii LIST OF FIGURES ..................................................................................................................... viii LIST OF ABBREVIATIONS ........................................................................................................ ix 1. INTRODUCTION ...................................................................................................................... 1 2. VIRAL BIOLOGY ..................................................................................................................... 4 2.1. Classification of Ebola ......................................................................................................... 4 2.2. Epidemiology and Outbreak ................................................................................................ 5 2.3. Structure of Ebola Virus .................................................................................................... 10 2.4. Entry and Viral Replication ............................................................................................... 12 2.4.1. Viral Entry .................................................................................................................. 12 2.4.2. Genome, Transcription and Translation of Ebola ....................................................... 13 2.4.3. Replication and Transcription ..................................................................................... 13 3. PATHOGENESIS ..................................................................................................................... 15 3.1. Viral Ecology ..................................................................................................................... 15 3.1.1. Model of Human to Human Transmission .................................................................. 15 3.1.2. Factors Influencing the Spread ................................................................................... 17 3.2. Molecular Pathogenesis and Immune Subversion ............................................................. 19 3.3. Clinical Manifestations of Ebola ....................................................................................... 20 3.4. Detection and Diagnosis .................................................................................................... 21 3.4.1. Diagnosis Methods ...................................................................................................... 21 4. PREVENTION AND TREATMENT....................................................................................... 23 4.1. Immune Responses to Ebola .............................................................................................. 23 v 4.2. Antivirals ........................................................................................................................... 24 4.3. Passive Immunity with Antibodies .................................................................................... 25 4.4. Vaccines ............................................................................................................................. 26 4.5. Barriers to the Control and Prevention of Ebola ................................................................ 30 5. CONCLUSION ......................................................................................................................... 32 6. REFERENCES ......................................................................................................................... 34 vi LIST OF TABLES Table Page 1. The Major Outbreaks of Ebola Species .............................................................................. 9 2. The Functions of Ebola Viral Proteins.............................................................................. 12 3. The Antivirals and Vaccines ............................................................................................. 29 vii LIST OF FIGURES Figure Page 1. The Phylogenetic Tree of Ebola ......................................................................................... 5 2. The Outbreaks of Ebola ...................................................................................................... 7 3. The Molecular Structure of Ebola..................................................................................... 13 4. The Replication of Ebola .................................................................................................. 14 viii LIST OF ABBREVIATIONS BEBOV ..........................................................Bundibugyo EV DRC ...............................................................Democratic Republic of Congo EV ..................................................................Ebola virus EVD ...............................................................Ebola virus disease GP ..................................................................Glycoprotein KPN‐α1 ..........................................................Karyopherin α 1 NP ..................................................................Nucleoprotein NC ..................................................................Nucleocapsid ORF ................................................................Open reading frame PI3K ...............................................................Phosphoinositide-3 Kinase-Akt PACT .............................................................PKR‐activating protein REBOV ..........................................................Reston Ebolavirus RLR ................................................................RIG I like receptor LP ...................................................................RNA polymerase SEBOV ..........................................................Sudan Ebola virus ICEBOV .........................................................Tai Forest Ebola virus VP ..................................................................Viral proteins VSV................................................................Vesicular stomatitis virus YMH ..............................................................Yambuku Mission Hospital BSL-4 .............................................................Biosafety level 4 containment APCs ..............................................................Antigen-presenting cells EHF ................................................................Ebola hemorrhagic fever NK ..................................................................Natural