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Ebola virus disease

Definition

Ebola is a severe and often deadly disease caused by a virus. Symptoms include fever, diarrhea, vomiting, bleeding, and often, death.

Ebola can occur in humans and other primates (gorillas, monkeys, and chimpanzees).

The 2014 Ebola outbreak in West Africa is the largest in history. About 70% of the people who have gotten Ebola in this outbreak have died.

The virus poses a very low risk to people in the United States.

For the most up-to-date information, please visit the Centers for Disease Control and Prevention's (CDC) website: http://www.cdc.gov/vhf/ebola/index.html.

Alternative Names

Ebola hemorrhagic fever; Ebola virus infection; Viral hemorrhagic fever; Ebola

Causes

WHERE EBOLA OCCURS

Ebola was discovered in 1976 near the Ebola River in the Democratic Republic of the Congo. Since then, several small outbreaks have occurred in Africa. The 2014 outbreak is the largest. Countries affected in this recent outbreak include:

  • Guinea
  • Liberia
  • Sierra Leone

Ebola has also been reported in:

  • Nigeria
  • Senegal
  • United States
  • Spain
  • Mali

Most of these cases are due to people traveling from a country where Ebola is present. In October 2014, the World Health Organization (WHO) declared both Nigeria and Senegal free of Ebola virus transmission.

As of November 2014, there have been 4 people diagnosed with Ebola in the United States. One case occurred in a man traveling from West Africa to Texas. He died from the disease. Two health care providers who cared for the man also contracted Ebola. A doctor who had treated Ebola patients in Guinea returned to New York City and was diagnosed with Ebola after developing symptoms. All three health care providers have recovered and no longer have the Ebola virus.

HOW EBOLA CAN SPREAD

Ebola does not spread as easily as more common illnesses such as colds, the flu, or measles. There is NO evidence that the virus that causes Ebola is spread through the air or water. A person who has Ebola CANNOT spread the disease until symptoms appear.

Ebola can ONLY spread between humans by direct contact with infected body fluids including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen. The virus can enter the body through a break in the skin or through mucous membranes, including the eyes, nose, and mouth.

Ebola can also spread by contact with ANY surfaces, objects, and materials that have been in contact with body fluids from a sick person, such as:

  • Bedclothes and bedding
  • Clothing
  • Bandages
  • Needles and syringes
  • Medical equipment

In Africa, Ebola may also be spread by:

  • Handling infected wild animals hunted for food (bushmeat)
  • Contact with blood or body fluids of infected animals
  • Contact with infected bats

Ebola does NOT spread through:

  • Air
  • Water
  • Food
  • Insects (mosquitoes)

Health care workers and people caring for sick relatives are most at risk for developing Ebola because they are more likely to come in to direct contact with body fluids.

Symptoms

The time between exposure and when symptoms occur (incubation period) is 2 to 21 days. On average, symptoms develop in 8 to 10 days.

Early symptoms of Ebola include:

  • Fever greater than 101.5°F (38.6°C)
  • Chills
  • Severe headache
  • Sore throat
  • Muscle pain
  • Weakness
  • Fatigue
  • Rash 
  • Abdominal (stomach) pain
  • Diarrhea
  • Vomiting

Late symptoms include:

  • Bleeding from the mouth and rectum
  • Bleeding from eyes, ears, and nose
  • Organ failure

A person who does not have symptoms 21 days after being exposed to Ebola will not develop the disease.

Treatment

There is no known cure for Ebola. Experimental treatments have been used, but none have been fully tested to see if they work well and are safe.

People with Ebola must be treated in a hospital. There, they can be isolated so the disease cannot spread. Health care providers will treat the symptoms of the disease.

Treatment for Ebola includes:

  • Fluids given through a vein (IV)
  • Oxygen
  • Blood pressure management
  • Treatment for other infections
  • Blood transfusions

Survival depends on how a person's immune system responds to the virus. A person also may be more likely to survive if they receive good medical care.

People who survive Ebola are immune from the virus for 10 years or more. They can no longer spread Ebola. However, men who survive can carry the Ebola virus in their sperm for as long as 3 months. They should abstain from sex or use condoms for 3 months.

Long-term complications can include joint and vision problems.

When to Contact a Medical Professional

Call your health care provider if you have traveled to West Africa and:

  • Know you have been exposed to Ebola
  • You develop symptoms of the disorder, including fever.

Getting treatment right away may improve the chances of survival.

Prevention

There is no vaccine to protect against Ebola. The CDC urges all United States residents to avoid travel to Liberia, Guinea, and Sierra Leone because of unprecedented outbreaks of Ebola in those countries.

If you plan to travel to one of the countries where Ebola is present, the CDC recommends taking the following steps to prevent illness:

  • Practice careful hygiene. Wash your hands with soap and water or an alcohol-based hand sanitizer. Avoid contact with blood and body fluids.
  • Avoid contact with people who have a fever, are vomiting, or appear ill.
  • Do not handle items that may have come in contact with an infected person's blood or body fluids. This includes 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 hospitals in West Africa where Ebola patients are being treated. If you need medical care, the United States embassy or consulate is often able to provide advice about facilities.
  • After you return, pay attention to your health for 21 days. Seek medical care right away if you develop symptoms of Ebola, such as a fever. Tell the health care providers that you have been to a country where Ebola is present.

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

  • Wear protective clothing, including masks, gloves, gowns, and eye protection.
  • Practice proper infection control and sterilization measures.
  • Isolate patients with Ebola from other patients.
  • Avoid direct 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 of a person who is sick with Ebola.

References

Centers for Disease Control and Prevention. Ebola (Ebola Virus Disease). Updated October 8, 2014. http://www.cdc.gov/vhf/ebola/index.html. Accessed 10/9/2014.

Gostin LO, Lucey D, Phelan A. The Ebola Epidemic: A Global Health Emergency. JAMA. 2014;312(11):1095-1096. PMID: 25111044. http://www.ncbi.nlm.nih.gov/pubmed/25111044.

World Health Organization. Ebola Virus Disease. Updated September 2014. http://www.who.int/mediacentre/factsheets/fs103/en/. Accessed 10/9/2014.


Review Date: 10/10/2014
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update 11/13/2014.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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