Ebola

About This Disease

Ebola Virus Disease (EVD) is a rare viral disease that can be fatal. Several countries in West Africa have been heavily affected by the largest EVD epidemic in history. Ebola does not occur naturally within the U.S.

Signs and Symptoms

Symptoms of Ebola include:

Fever
Severe headache
Muscle pain
Weakness
Fatigue
Diarrhea
Vomiting
Abdominal (stomach) pain
Unexplained hemorrhage (bleeding or bruising)

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days. Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

Transmission

Ebola is spread through direct contact with the blood or bodily fluids of an infected person who is showing symptoms of Ebola, or through exposure to objects (such as needles) that have been contaminated with infected bodily fluids. Infected individuals who do not have symptoms are not contagious. Ebola can also be transmitted through handling of infected animals such as bats or meat from infected animals (bushmeat). Ebola is not a respiratory disease like the flu, so it is not transmitted through the air.

Diagnosis

Diagnosing Ebola in a person who has been infected for only a few days is difficult because the early symptoms, such as fever, are nonspecific to Ebola infection and often are seen in patients with more common diseases, such as malaria and typhoid fever.

However, a person should be isolated and public health authorities notified if they have the early symptoms of Ebola and have had contact with:

blood or body fluids from a person sick with or who has died from Ebola,
objects that have been contaminated with the blood or body fluids of a person sick with or who has died from Ebola,
infected fruit bats and primates (apes and monkeys), or
semen from a man who has recovered from Ebola

Samples from the patient can then be collected and tested to confirm infection.

Ebola virus is detected in blood only after onset of symptoms, most notably fever, which accompany the rise in circulating virus within the patient’s body. It may take up to three days after symptoms start for the virus to reach detectable levels. Laboratory tests used in diagnosis include:

Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
IgM ELISA
Polymerase chain reaction (PCR)
Virus isolation

Treatment

Symptoms of Ebola and complications are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival:

Providing intravenous fluids (IV) and balancing electrolytes (body salts).
Maintaining oxygen status and blood pressure.
Treating other infections if they occur.

Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness.

Recovery from Ebola depends on good supportive care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It is not known if people who recover are immune for life or if they can become infected with a different species of Ebola. Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems.

Risk in Hawaii

Prevention

There is no FDA-approved vaccine available for Ebola.

If you travel to or are in an area affected by an Ebola outbreak, make sure to do the following:

Practice careful hygiene. For example, wash your hands with soap and water or an alcohol-based hand sanitizer and avoid contact with blood and body fluids (such as urine, feces, saliva, sweat, urine, vomit, breast milk, semen, and vaginal fluids).
Do not handle items that may have come in contact with an infected person’s blood or body fluids (such as clothes, bedding, needles, and medical equipment).
Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
Avoid contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals.
Avoid facilities in West Africa where Ebola patients are being treated. The U.S. embassy or consulate is often able to provide advice on facilities.
Avoid contact with semen from a man who has had Ebola until you know Ebola is gone from his semen.
After you return, monitor your health for 21 days and seek medical care immediately if you develop symptoms of Ebola.

Healthcare workers who may be exposed to people with Ebola should follow these steps:

Wear appropriate personal protective equipment (PPE).
Practice proper infection control and sterilization measures. For more information, see U.S. Healthcare Workers and Settings.
Isolate patients with Ebola from other patients.
Avoid direct, unprotected contact with the bodies of people who have died from Ebola.
Notify health officials if you have had direct contact with the blood or body fluids, such as but not limited to, feces, saliva, urine, vomit, and semen of a person who is sick with Ebola. The virus can enter the body through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth.