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ABSTRACT OF THE WEEK

Acta médica portuguesa

[Disease Caused by Filoviruses: An Update].

Doença Causada por Filovírus: Uma Atualização.

Acta Med Port. January 2025;38(1):42 - 48. Portuguese

Rafael Marx de Andrade1, Andreia Paulos2, Emilia Valadas3, Vitor Laerte Pinto Junior4
1 Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.; 2 Unidade Local de Saúde da Arrábida. Setúbal. Portugal.; 3 Clínica Universitária de Doenças Infecciosas. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.; 4 Faculdade de Medicina. Universidade de Lisboa. Lisboa; Unidade Local de Saúde da Arrábida. Setúbal. Portugal.

Abstract

The Marburg and Ebola viruses belong to the Filoviridae family and are known to cause emerging zoonotic diseases. These viruses have a high case fatality rate and are easily transmissible from person to person, which makes them capable of triggering outbreaks, including in non-endemic regions, and are also considered agents of bioterrorism. Fruit bats are the natural reservoirs of these filoviruses. Transmission to humans occurs through direct contact with bodily fluids or tissues from infected animals or humans. The most severe form of filovirus disease manifests as mucocutaneous hemorrhage, often accompanied by multiorgan failure, which is the main cause of death. Traditionally, these diseases are classified in the group of viral hemorrhagic fevers, although this term is being abandoned, as there are not always hemorrhagic manifestations or fever in the patient's clinical history. Currently, no specific antiviral treatment for filovirus disease exists, and the therapeutic approach consists of supportive measures. However, for the Zaire Ebola virus (EBOV), monoclonal antibodies have already been licensed for treatment and post-exposure prophylaxis, in addition to three vaccines available. Due to the public health importance and the possibility of cases outside Africa, this review aims to improve clinical knowledge and the approach to suspected cases of FD. Improved surveillance and preparedness for potential global outbreaks are essential measures to effectively respond to these public health threats and to ensure that healthcare professionals are well-informed and prepared to deal with these diseases.

PubMed Other Abstract

Os vírus Marburgo e Ébola pertencem à família Filoviridae e são conhecidos por causar doenças zoonóticas emergentes. Estes vírus apresentam alta letalidade e são facilmente transmissíveis de pessoa para pessoa, o que os torna potencialmente capazes de desencadear epidemias, inclusive em regiões não endémicas, sendo também considerados agentes de bioterrorismo. Os morcegos frugívoros são os reservatórios naturais destes filovírus. A transmissão para humanos ocorre através do contacto direto com fluidos corporais ou tecidos de humanos ou animais infetados. A forma mais grave da doença causada por filovírus manifesta-se como hemorragia mucocutânea, frequentemente acompanhada por falência multiorgânica, que é a principal causa de morte. Tradicionalmente, estas doenças são classificadas no grupo das febres hemorrágicas virais, embora este termo esteja a ser abandonado, pois nem sempre há manifestações hemorrágicas ou febre na história clínica dos doentes. Atualmente, não existe um tratamento antiviral específico para a doença causada por filovírus, e a abordagem terapêutica consiste em medidas de suporte. Existem, no entanto, três vacinas licenciadas para o vírus Ébola do Zaire assim como anticorpos monoclonais indicados no tratamento e na profilaxia pós-exposição. Devido à importância em termos de saúde pública e à possibilidade da ocorrência de casos fora de África, esta revisão tem como objetivo aprimorar o conhecimento clínico e a abordagem de casos suspeitos de doença causada por filovírus. A melhoria na vigilância e a preparação para potenciais surtos globais são medidas essenciais para obter uma resposta eficaz a estas ameaças de saúde pública e para garantir que os profissionais de saúde estão bem informados e preparados para lidar com estas doenças.

Keywords
Communicable Diseases; Ebolavirus; Emerging; Filoviridae; Filoviridae Infections; Marburgvirus;

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