Ebola

What is Ebola?

Ebola is a rare virus that causes fever, nausea, vomiting, diarrhea, weakness, and sometimes problems with how your blood clots. The clotting problems lead to internal bleeding, as blood leaks from small blood vessels in your body. The virus also causes inflammation and tissue damage.

From 2014 to 2015, a major epidemic of Ebola virus disease occurred in West Africa. Some smaller outbreaks have occurred there since. Another outbreak happened in 2018 in the Democratic Republic of the Congo, with more than 200 cases and more than 100 deaths, and it recurred there in 2020. No primary infection has occurred in other parts of the world. But travelers can bring the virus with them. 

Ebola is spread through direct contact with body fluids of people infected with it. These fluids are blood, saliva, sweat, tears, mucus, vomit, feces, breastmilk, urine, and semen. It's also spread by touching things that have been contaminated with these fluids.

Ebola is hard to treat, and often deadly.

What causes Ebola?

A virus causes Ebola. There are 6 types of Ebola viruses. Four of these viruses (Ebola, Sudan, Taï Forest, and Bundibugyo) can cause the disease in people. The Ebola viruses are:

• Ebola virus

• Sudan virus

• Taï Forest virus

• Bundibugyo virus

• Reston virus (known to cause disease in nonhuman primates and pigs, but not in people)

• Bombali virus (recently found in bats)

Who is at risk for Ebola?

You may be at risk for infection if you’ve recently been to a place where people have been sick with Ebola, or where animals may carry Ebola. You are at risk if you:

• Were in a place where people with Ebola were being treated and you had contact with them

• Touched blood or body fluids (saliva, sweat, tears, mucus, vomit, feces, breast milk, urine, or semen) from a person with Ebola

• Touched sheets, towels, clothes, personal objects, or other items that had contact with a person with Ebola

If you have been exposed to Ebola:

• Call your healthcare provider. They can talk with local health staff to see what action may be needed.

• Keep watch for early symptoms of Ebola for 21 days.

• Take your temperature every morning and evening. This is to check for fever.

If you have a fever or other Ebola symptoms:

• Don’t panic. Keep in mind that other illnesses can cause similar symptoms.

• Call the nearest hospital emergency room. Explain that you have been exposed to Ebola and have symptoms. Do this before going to the hospital. This will help the hospital staff get ready for your arrival.

• Keep in mind that hospital staff may wear protective equipment, such as masks, gowns, gloves, and eye protection. This is to prevent the possible virus from spreading.

• Follow all instructions the hospital staff gives you.

What are the symptoms of Ebola?

Symptoms of Ebola can start 2 to 21 days after being infected by the virus. They most often start about 8 to 10 days later. The first symptoms may seem like the flu.

Early symptoms include:

• Fever

• Chills

• Weakness and fatigue

• Severe headache

• Muscle and joint pains

• Loss of appetite

• Sore throat

These symptoms show up several days later:

• Confusion

• Chest pain

• Hiccups

• Trouble breathing

• Nausea and vomiting

• Diarrhea

• Stomach pain

• Urinating less than normal

• Sudden bleeding or bruising

• Red rash that doesn’t itch or hurt, and may peel after a while

• Redness and bleeding from the eyes, nose, mouth, and rectum

Later stages of the illness can cause:

• Organ failure

• Brain inflammation

• Seizures

• Lack of blood flow in the body (shock)

• Death

How is Ebola diagnosed?

The healthcare providers will ask about your health history. They will also ask you about possible exposures to Ebola, including recent travel and contact with sick people.

You will have tests to check for the cause of your symptoms. The symptoms of Ebola can also be caused by other viruses and bacteria. You may have tests, such as:

• Blood tests. Blood is taken from a vein in your arm or hand. This is done to check for the virus or the body's response to the virus (antibodies) that can show if you have an Ebola infection or other illness. Blood tests also check for problems with your blood, your kidneys, liver, and other organs.

• Oral swab. A stick with a small piece of cotton at the tip is wiped inside your mouth. This is done to check for viruses and bacteria in your saliva.

• Urine test. A sample of urine is collected. This is done to look for bacteria that may be causing your symptoms.

• Stool culture. A small sample of stool is collected from your rectum or from a bowel movement. The sample is checked for viruses and bacteria.

• Sputum culture. A small sample of mucus coughed from the lungs is collected. It's checked for viruses and bacteria.

How is Ebola treated?

Treatments for Ebola are given to help support your body while it fights the disease. These may include antibody therapies. Supportive care for Ebola may include:

• Fluids given by IV (intravenous) through a vein to help keep your body hydrated

• Supplemental oxygen or assisted ventilation to keep enough oxygen in your body

• Dialysis to help clear waste from the blood

• Medicines to help raise blood pressure that is too low

• Medicines to help your blood clot

Blood, urine, and other tests may be done regularly. This is to check for chemicals that show how well the organs are working. The tests also look for signs of the virus that continue or go away. Your blood pressure will be checked regularly.

In addition, the FDA has approved two antibody treatments that may be used to treat Ebola. There are also some experimental treatments available that are not yet proven to work and are still being testing. Treatments may include:

• Antibody therapy. Two types of these have been shown to reduce the risk of death from Ebola, are FDA-approved, and are in active use.

• Convalescent serum. This is the liquid part of blood (serum) taken from a person who is recovering from Ebola. It's then put into the body of a person sick with Ebola. The antibodies made by the recovered person may help the sick person better fight the infection.

• Medicines. This includes antiviral and other medicines that act on blood-clotting factors or parts of the Ebola virus.

Can Ebola be prevented?

The FDA has approved the vaccine rVSV-ZEBOV for Ebola for people 18 years and older. It's given as a one-time shot (injection) into the arm. Prevention is mainly done by not having contact with the virus and taking special care around the virus. To protect yourself:

• Follow all instructions you are given if you are in an area with Ebola.

• Wash your hands often, using soap and water. Or use an alcohol-based hand sanitizer often.

• Don't touch your eyes, nose, or mouth with your hands. If you must, make sure to wash your hands first.

• Cover any cuts, scrapes, or other wounds you have.

• Don’t touch body fluids from a person with Ebola.

• Don’t touch sheets, clothes, towels, medical supplies, or personal items of a person with Ebola.

• Healthcare providers caring for people with Ebola virus disease routinely wear caps covering their head, a mask shielding their face, and gowns and boots covering their body and shoes. They breathe air only through special respirators.

After you have Ebola

After recovering from Ebola, you may have body aches, weakness, eye irritation, or changes in vision or severe joint pain. These side effects may continue for weeks or months. Ebola can last in semen for at least three months after recovery. A man should use a condom, or not have sex during this period. Women should not breastfeed until talking with their healthcare provider. A person who has recovered from Ebola may be immune for at least 10 years or longer. It's not known if this includes immunity to all types of the virus. To learn more about Ebola, visit the CDC.

Key points about Ebola

• Ebola is a rare virus that causes fever, nausea, vomiting, diarrhea, weakness, and sometimes problems with how your blood clots.

• Ebola is spread through direct contact with body fluids of people infected with it. It is also spread by touching things that have been contaminated with these fluids.

• Ebola is hard to treat, and often deadly, and there are no treatments that can work.

• You may be at risk for infection if you’ve recently been to a place where people have been sick with Ebola, or where animals may carry Ebola.

• Treatments for Ebola are given to help support your body while it fights the disease. Some FDA-approved antibody treatments and experimental medicines are being used to treat the Ebola virus.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.