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Book Review
Ebola and Marburg Viruses:
A View of Infection Using Electron Microscopy
Elena I. Ryabchikova and Barbara B.S. Price
Batelle Press, Columbus, Ohio, ISBN: 1-57477-131-0, Pages: 211, including
index, Price: US $56.00
Suggested citation
for this article:
Rollin P. Ebola and Marburg viruses: a view of infection using electron
microscopy [book review]. Emerg Infect Dis [serial on the Internet]
2004 Aug [date cited]. Available from: http://www.cdc.gov/ncidod/EID/vol10no8/04-0350.htm
More than 25 years have passed since the discovery of a filovirus, Marburg
virus, which caused an epidemic of hemorrhagic fever among laboratory
workers in Marburg, Germany, in 1967. The persons affected had contact
with the blood or tissues of monkeys or with other infected persons. Marburg
virus has reappeared only three times since its discovery, with the largest
and most recent outbreak occurring in 1999 in Durba, Democratic Republic
of the Congo. Ebola virus, another filovirus, was first described in 1976
during two hemorrhagic fever epidemics in Zaire and Sudan. Since then,
Ebola virus has caused large hospital outbreaks of hemorrhagic fever in
Kikwit, Zaire, in 1995, and Gulu, Uganda, in 2000. Ebola virus has also
been implicated in small chains of transmission among persons with direct
contact with intermediary hosts, mostly nonhuman primates in the central
African countries of Gabon and Republic of the Congo.
The reservoirs for both viruses are still unknown, and the rarity of
outbreaks and the remote location of human outbreaks make it difficult,
if not impossible, to study the pathogenesis of the human disease. Thus,
animal models have been the best, and often only, approach available for
studying the progression of disease caused by Marburg and Ebola viruses.
Dr. Ryabchikova, the principal author of this book, and her laboratory
group have studied the pathogenesis of filoviruses for several decades
by using animal models and electron microscopy, a unique approach that
has made her one of the few filovirus experts in the world. This book
is a compilation not only of her work but of all the information available
on Marburg and Ebola viruses.
The first three chapters of the book provide a general review of filovirus
history, laboratory methods (with an emphasis on electron microscopy),
viral structure, morphology, and replication. Chapters 4 and 5 provide
more specific details on infection of the target cells (macrophages and
reticuloendothelial system) in different organs and during the course
of filoviral infection. In chapter 6, the authors deal with the "hemorrhagic"
side of Ebola and Marburg virus infection. Not all patients infected with
these viruses bleed, and when bleeding disorders do occur, no correlated
infection of endothelial and hematopoietic cells occurs. Dr. Ryabchikova
has found that changes in the microcirculation system, such as the appearance
of hemorrhages, clotting, and fibrin deposits, vary by virus and by animal
species. Chapter 7, which describes pathologic changes in the organs during
the course of filoviral infection, could have been combined with chapter
5. Likewise, the last chapter, which covers immunopathology, appears more
like a discussion of the previous chapters.
Much of the data have already been published in the Russian or Western
literature. However, this book provides one source for all information
available on Marburg and Ebola viruses and has a great advantage over
other sources. The number and the quality of the illustrations are impressive,
and a comprehensive index is provided. The book will prove useful to clinicians
and researchers interested in understanding the pathogenesis of hemorrhagic
fevers, and it will provide researchers working with other viruses a lesson
in the benefits of using electron microscopy technology.
Pierre Rollin*
*Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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