awareness

1. About Ebola Virus Disease
Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by
infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman
primates (monkeys, gorillas, and chimpanzees).
Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are
five identified Ebola virus species, four of which are known to cause disease in humans: Ebola
virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest
ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus).
The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in
humans.
Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the
Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have
appeared sporadically in Africa.
The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence
and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats
are the most likely reservoir. Four of the five virus strains occur in an animal host native to
Africa.
Signs and Symptoms
 Fever (greater than 38.6°C or 101.5°F)
 Severe headache
 Muscle pain
 Weakness
 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.

2. Transmission
Because the natural reservoir host of Ebola viruses has not yet been identified, the manner in
which the virus first appears in a human at the start of an outbreak is unknown. However,
researchers believe that the first patient becomes infected through contact with an infected
animal.

3. When an infection does occur in humans, the virus can be spread in several ways to others. Ebola
is spread through direct contact (through broken skin or mucous membranes in, for example, the
eyes, nose, or mouth) with
 blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast
milk, and semen) of a person who is sick with Ebola
 objects (like needles and syringes) that have been contaminated with the virus
 infected animals
 Ebola is not spread through the air or by water, or in general, by food. However, in
Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for
food) and contact with infected bats. There is no evidence that mosquitos or other insects
can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes)
have shown the ability to become infected with and spread Ebola virus.
Healthcare providers caring for Ebola patients and the family and friends in close contact with
Ebola patients are at the highest risk of getting sick because they may come in contact with
infected blood or body fluids of sick patients.
During outbreaks of Ebola, the disease can spread quickly within healthcare settings (such as a
clinic or hospital). Exposure to Ebola can occur in healthcare settings where hospital staff are not
wearing appropriate protective equipment, including masks, gowns, and gloves and eye
protection.
Dedicated medical equipment (preferable disposable, when possible) should be used by
healthcare personnel providing patient care. Proper cleaning and disposal of instruments, such as
needles and syringes, is also important. If instruments are not disposable, they must be sterilized
before being used again. Without adequate sterilization of the instruments, virus transmission can
continue and amplify an outbreak.
Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus
has been found in semen for up to 3 months. People who recover from Ebola are advised to
abstain from sex or use condoms for 3 months.
Q&As on Transmission
What are body fluids?
Ebola has been detected in blood and many body fluids. Body fluids include saliva, mucus,
vomit, feces, sweat, tears, breast milk, urine, and semen.
Can Ebola spread by coughing? By sneezing?
Unlike respiratory illnesses like measles or chickenpox, which can be transmitted by virus
particles that remain suspended in the air after an infected person coughs or sneezes, Ebola is
transmitted by direct contact with body fluids of a person who has symptoms of Ebola disease.

4. Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient
with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that
person’s eyes, nose or mouth, these fluids may transmit the disease.
What does “direct contact” mean?
Direct contact means that body fluids (blood, saliva, mucus, vomit, urine, or feces) from an
infected person (alive or dead) have touched someone’s eyes, nose, or mouth or an open cut,
wound, or abrasion.
How long does Ebola live outside the body?
Ebola is killed with hospital-grade disinfectants (such as household bleach). Ebola on dried on
surfaces such as doorknobs and countertops can survive for several hours; however, virus in
body fluids (such as blood) can survive up to several days at room temperature.
Are patients who recover from Ebola immune for life? Can they get it again -
the same or a different strain?
Recovery from Ebola depends on good supportive clinical care and a patient’s immune response.
Available evidence shows that people who recover from Ebola infection develop antibodies that
last for at least 10 years, possibly longer.
We don’t know if people who recover are immune for life or if they can become infected with a
different species of Ebola.
If someone survives Ebola, can he or she still spread the virus?
Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus
has been found in semen for up to 3 months. People who recover from Ebola are advised to
abstain from sex or use condoms for 3 months.
Can Ebola be spread through mosquitos?
There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals
(for example, humans, bats, monkeys and apes) have shown the ability to spread and become
infected with Ebola virus.

5. Risk of Exposure
Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the
Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks of
Ebola among humans have appeared sporadically in Africa.
Risk
All cases of human illness or death from Ebola have occurred in Africa (with the exception of
several laboratory contamination cases: one in England and two in Russia). On 9/30/2014, CDC
confirmed, the first travel-associated case of Ebola to be diagnosed in the United States.
Healthcare providers caring for Ebola patients and the family and friends in close contact with
Ebola patients are at the highest risk of getting sick because they may come in contact with the
blood or body fluids of sick patients. People also can become sick with Ebola after coming in
contact with infected wildlife. For example, in Africa, Ebola may spread as a result of handling
bushmeat (wild animals hunted for food) and contact with infected bats. The virus also can be
spread through contact with objects (like clothes, bedding, needles, syringes/sharps or medical
equipment) that have been contaminated with the virus or with infected animals.
Past Ebola Outbreaks
Past Ebola outbreaks have occurred in the following countries:
 Democratic Republic of the Congo (DRC)

6.  Gabon
 South Sudan
 Ivory Coast
 Uganda
 Republic of the Congo (ROC)
 South Africa (imported)
Current Ebola Outbreak in West Africa
The 2014 Ebola epidemic is the largest in history and is affecting multiple countries in West
Africa.
Prevention
MSF (Médecins Sans Frontières) health staff in protective clothing constructing perimeter for
isolation ward.
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.
 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.

7.  Avoid hospitals in West Africa where Ebola patients are being treated. The U.S. embassy
or consulate is often able to provide advice on facilities.
 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 protective clothing, including masks, gloves, gowns, and eye protection.
 Practice proper infection control and sterilization measures. For more information, see
“Infection Control for Viral Hemorrhagic Fevers in the African Health Care Setting”.
 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, 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
Diagnosis
Diagnosing Ebola in an 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 are seen often in patients
with more commonly occurring diseases, such as malaria and typhoid fever.
However, if a person has the early symptoms of Ebola and has had contact with the blood or
body fluids of a person sick with Ebola, contact with objects that have been contaminated with
the blood or body fluids of a person sick with Ebola, or contact with infected animals, they
should be isolated and public health professionals notified. Samples from the patient can then be
collected and tested to confirm infection.

8. Laboratory tests used in diagnosis include:
Timeline of Infection Diagnostic tests available
Within a few days after
symptoms begin
 Antigen-capture enzyme- linked immunosorbent assay
(ELISA) testing
 IgM ELISA
 Polymerase chain reaction (PCR)
 Virus isolation
Later in disease course or after
recovery
 IgM and IgG antibodies
Retrospectively in deceased
patients
 Immunohistochemistry testing
 PCR
 Virus isolation
Treatment
No FDA-approved vaccine or medicine (e.g., antiviral drug) is available for Ebola.
Symptoms of Ebola 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.

9. 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 isn't 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.