Ebola, a virus found in West and Central Africa, has been in and out of the headlines over the years, often causing a lot of fear. However, thanks to years of research by doctors and scientists, we now have some effective vaccines and treatments for Ebola’s most common cause, as well as more information about how to prevent it in the first place.
What is Ebola?
“Ebola disease” is caused by a viral infection. The name Ebola comes from a river in the Democratic Republic of Congo, in Africa, near where the disease was first identified in the 1970s. Since then, we have discovered other viruses in the same group (Ebola/Zaire, Sudan, Bundibugyo, and Taï Forest viruses) that all occur in sub-Saharan Africa and cause the same type of symptoms. Illness caused by any of these viruses is referred to as “Ebola disease”, but the treatments are slightly different depending on which virus caused the illness.
How does Ebola spread?
Ebolaviruses are spread to people by infected animals (like bats, antelopes, or monkeys) through contact with their blood, urine, feces, or raw meat. The infection can then be spread from person to person through contact with body fluids like blood, saliva, urine, stool, and vomit, or items like needles, clothes, or bedsheets that have been contaminated with these fluids. The virus has also been detected in semen for over a year after recovery from the infection. Ebolaviruses are not spread through food, water, or the air.
Who is at risk?
There have only been a handful of cases of Ebola in the U.S. in the past, all in people who either traveled to an area where an Ebola outbreak was occurring or were caring for people who had traveled and became sick with Ebola.
The people at highest risk for getting Ebola are those with very close contact to an infected person or their body. This includes family members or healthcare workers who cared for a sick person, as well as people performing burial rites that involve touching a sick person’s body after death. People who touch or eat the meat of sick animals in areas where the virus circulates are also at risk.
What are the symptoms?
People with Ebola initially experience flu-like symptoms, like fever, sore throat, muscle aches, weakness, and headache. In this stage, it can be tricky to figure out if they have Ebola disease or another infection like COVID-19, strep throat, malaria, or typhoid. Later, they develop red eyes, rash, abdominal pain, and severe vomiting and diarrhea that can lead to dehydration. Some people develop liver and kidney problems, brain inflammation, or problems with blood clotting that can lead to significant bleeding. Pregnant women may have miscarriages.
Ebola requires close monitoring and specialized care. In countries without a lot of healthcare resources, the disease can lead to death in more than half of cases, but in countries with lots of medical capabilities, the death rate is usually lower.
People who recover from Ebola disease can suffer from fatigue, anxiety, depression, headaches, vision changes, muscle/joint pain, stomach upset, and inflammation around the heart and testicles for a long time after the infection. These symptoms are usually managed by specialists until they resolve.
How is Ebola treated?
There are currently two antibody treatments approved to treat the most common cause of Ebola disease. Although the antibody treatments cannot be used for Ebola disease caused by Sudan, Bundabugyo, or Taï Forest viruses, some similar treatments are being tried for those infections. Remdesivir, an antiviral medicine used to treat COVID-19, has been studied for Ebola, but was not as good as the antibody treatments at preventing death, so it is no longer recommended in most cases.
Studies have shown that good hospital care – with careful monitoring and replacement of fluids, blood sugar, and electrolytes and management of any liver, kidney, or bleeding problems that may occur – improves outcomes. This type of intense monitoring is easier to do in settings like the United States, where there are generally more hospital resources available.
What should I do if I think I’ve been exposed to Ebola?
A person exposed to an Ebolavirus becomes sick within three weeks of being infected, with most exhibiting symptoms by ten days. For this reason, people are asked to stay home (quarantine) for 21 days after possible exposure to Ebola. People with Ebola are not infectious to other people until they have symptoms.
People who think they have been exposed to Ebola but don’t feel sick should stay home and away from others and contact their doctor or local health department for further instructions. There is an approved vaccine for the most common cause of Ebola disease that, if given before a person feels sick, appears to be very effective at preventing illness.
People who have been exposed to Ebola and feel sick should seek medical care, but should warn the 9-1-1 operator, clinic, or hospital ahead of time so that the staff can wear appropriate protective gear.
How do I protect myself?
If you are traveling, look up the area where you’ll be going to see what illnesses are common or circulating. Consider postponing or changing travel plans if there is a current outbreak of Ebola. If you must go, take careful precautions as below to avoid exposure.
Wash hands frequently. If you don’t have access to soap and water, alcohol-based hand sanitizer can be used.
Avoid contact with blood and body fluids of any person, particularly someone who is sick.
Avoid handling items exposed to an infected person’s blood or body fluids.
Do not touch the body of someone who has died from Ebola.
Do not touch the bodies, blood, or fluids of sick or dead animals, and do not touch or eat raw meat prepared from these animals.
Seek medical care immediately if you develop fever after traveling, especially if you traveled to an area with a known Ebola outbreak. Let your doctor know of any other symptoms, including headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
If you are sick, limit your contact with other people until you go to the doctor. Do not travel anywhere else besides a healthcare facility.
If you or your partner have had Ebola in the past, be sure to practice safe sex until testing shows that the virus is gone.
Rachel A. Martin-Blais, MD, is a pediatric infectious disease specialist at Nationwide Children's Hospital.
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