Ebola symptoms and signs

Ebola virus is one of a group of viruses that cause a hemorrhagic fever syndrome. Symptoms of Ebola virus infection are similar to those produced by other hemorrhagic fever viruses and include

  • fever,
  • fatigue,
  • malaise,
  • reddened eyes,
  • weakness,
  • joint pain,
  • muscle pain,
  • headache,
  • nausea,
  • vomiting, and
  • diarrhea.

Patients experience a loss of appetite and often stomach pains. Some patients experience

  • sore throat,
  • rash,
  • cough,
  • hiccups,
  • chest pain,
  • breathing problems, and
  • difficulty swallowing.

Later, as the disease progresses and worsens in severity, symptoms can include bleeding at various sites within or outside of the body.

Causes of Ebola virus disease

There are four different strains of the Ebola virus that cause Ebola hemorrhagic fever. Ebola virus belongs to the virus family known as Filoviridae.

Other ebola virus disease symptoms and signs

  • Bleeding
  • Bruising
  • Chest Pain
  • Chills
  • Confusion
  • Cough
  • Coughing Up Blood
  • Decreased Appetite
  • Dehydration
  • Diarrhea
  • Difficulty Breathing
  • Difficulty Swallowing
  • Fatigue
  • Fever
  • Headache
  • Hiccups
  • Joint Pain
  • Malaise
  • Muscle Pain
  • Nausea
  • Rash
  • Reddened Eyes
  • Sore Throat
  • Stomach Pain
  • Vomiting
  • Vomiting Blood
  • Weakness

Main Article on Ebola Virus Disease Symptoms and Signs

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Ebola Virus: Signs, Symptoms and Prevention

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What Is Ebola?

Ebola is a relatively rare and deadly virus found in various regions of Africa. A major outbreak in 2013 infected over 25,000 people killing more than 10,000.

While large scale outbreaks have occured, the virus is fairly rare and poses minimal risk to most travelers. Individuals going to rural areas or interacting with wildlife are at an incraesed risk.

Ebola symptoms include:

  • Fever
  • Muscle pain
  • Vomiting
  • Unexplained bleeding or hemorrhage

Early symptoms will appear anywhere from two to 21 days after exposure. Individuals are not contagious until symptoms are present.

How Does Ebola Spread?

Ebola spreads through direc contact with infected bodily fluids, contaminated medical supplies and, possibly, sexual contact. Infected fruit bats or monkeys are thought to be the source of human infection and should be avoided in an area with a history of cases. Similar to rabies, only mammals can carry Ebola. But, bushmeat (wild game) can be infected through a bat biting the animal.

Recent studies suggest someone who recovered from Ebola may be able to spread the disease through sexual contact. The exact vector and for how long someone could remain affected are under investigation.

Those at the highest risk of infection are healthcare and aid workers, especially in hosptial or clinic settings.

The virus cannot currently spread through air, water or food.

Where Is Ebola Found?

Ebola cases have been reported in 13 African countries: Senegal, Mali, Guinea, Sierra Leone, Liberia, Cote d’Ivoire, Nigeria, Gabon, Congo, Democratic Republic of the Congo, Uganda, South Sudan and South Africa.

West Africa and the Congo region have the highest chance of an outbreak due to the animals present in the region.

In the 2014 outbreak, aid workers, travelers and others carried Ebola to other countries in Africa and the world. It is important to make sure you take proper precautions while traveling to avoid contracting the virus and possibly bringing it home with you.

Is There a Vaccine Against Ebola?

There is currently no vaccine against Ebola available in the United States. Many vaccines are in stage one, two and three trials. But, few have been approved for use outside of outbreak areas. All vaccine supply is in reserve to help those who may be exposed to Ebola in a region and help stop its spread. Following CDC, WHO and other health recommendations is the best way to prevent the virus.

How Can I Prevent Ebola?

If you are traveling to an area with Ebola, be sure to follow all precautions given by the CDC and other health organizations. Before travel to any region, especially one with Ebola, be sure you have received all recommended or required vaccinations.

While in a region with Ebola, be sure to do the following:

  • Practice Careful Hygiene – Wash hands thouroughly with soap and water.
  • Blood and Body Fluids – Stay away from these items. This includes objects that have blood or body fluids on them.
  • Be Careful What You Do – Avoid funerals or burial rituals involving touching the dead. Stay away from bats or non-human primates and their meat.
  • Monitor At Home – When you return home, watch your health for 21 days for signs or symptoms of Ebola.

How Is Ebola Treated?

There is no cure for Ebola. Most treatment is to help with symptoms and includes hydration, blood transfusion and treating secondary infections. Recovery depends on supportive care.

Death and long-term side effects occur in a large portion of patients. Joint and vision issues are the most common long-term effects.

Are There Any Active Ebola Outbreaks?

While there is no active Ebola outbreak, some outbreaks have raised concerns.

The most recent outbreak in the Democratic Republic of the Congo lasted from May 11, 2017 to July 1, 2017 killing three people and infecting up to 20 more. The DR Congo was also the site of a 2014 outbreak infecting 66 and killing at 49.

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On This Page:
What Is Ebola?
How Does Ebola Spread?
Where Is Ebola Found?
Is There a Vaccine Against Ebola?
How Can I Prevent Ebola?
How Is Ebola Treated?
Are There Any Active Ebola Outbreaks?

Signs and Symptoms

Symptoms may appear anywhere from 2 to 21 days after contact with the virus, with an average of 8 to 10 days. The course of the illness typically progresses from “dry” symptoms initially (such as fever, aches and pains, and fatigue), and then progresses to “wet” symptoms (such as diarrhea and vomiting) as the person becomes sicker.

Primary signs and symptoms of Ebola often include some or several of the following:

  • Fever
  • Aches and pains, such as severe headache, muscle and joint pain, and abdominal (stomach) pain
  • Weakness and fatigue
  • Gastrointestinal symptoms including diarrhea and vomiting
  • Abdominal (stomach) pain
  • Unexplained hemorrhaging, bleeding or bruising

Other symptoms may include red eyes, skin rash, and hiccups (late stage).

Many common illnesses can have the same symptoms as EVD, including influenza (flu), malaria, or typhoid fever.

EVD is a rare but severe and often deadly disease. Recovery from EVD depends on good supportive clinical care and the patient’s immune response. Studies show that survivors of Ebola virus infection have antibodies (proteins made by the immune system that identify and neutralize invading viruses) that can be detected in the blood up to 10 years after recovery. Survivors are thought to have some protective immunity to the type of Ebola that sickened them.

Related Resources

At first, Ebola symptoms seem like those of many other viruses. According to the CDC, the patient will usually experience the following symptoms:

  • A fever greater than 101.5 degrees Fahrenheit (38.6 degrees Celsius)
  • Muscle pain
  • Severe headache
  • Weakness
  • Diarrhea
  • Vomiting
  • Abdominal pain

Some patients also bleed from the nose and mouth. This is called hemorrhagic syndrome and usually occurs only in the late stages of the disease. Typically, the Ebola virus causes hemorrhagic syndrome in 30 to 50 percent of patients, said Angela Rasmussen, a research assistant professor of microbiology at the University of Washington.

Other symptoms that occur in advanced stages of EVD include rash and symptoms of impaired kidney and liver function, such as blood in the stool, according to WHO.

Because the symptoms of Ebola are so much like those of other diseases, medical professionals use a series of tests to diagnose EVD. According to WHO, common tests include the following:

  • Virus isolation by cell culture
  • Antibody-capture enzyme-linked immunosorbent assay (ELISA)
  • Serum neutralization test
  • Antigen-capture detection tests
  • Electron microscopy
  • Reverse transcriptase polymerase chain reaction (RT-PCR) assay

How is Ebola spread?

Ebola is not an airborne virus. Unlike some other viruses, the Ebola virus can only be spread by body fluids. Therefore, Ebola spreads through human-to-human transmission via direct contact, according to WHO. Direct contact means that blood, secretions, organs or other body fluids containing the virus must come into contact with broken skin or the mucous membranes of a healthy individual in order for the virus to be transmitted. The fluids may come directly from the infected patient or from surfaces touched by the sick individual, such as bedding or clothing.

A WHO Ebola Situation Assessment for Oct. 6, 2014, states that the virus is most easily transmitted through blood, feces and vomit. Breast milk, urine and semen have also been found to transmit the Ebola virus, and it is believed that it may even be transmitted through tears and saliva.

Ebola is not spread through the air. This means that a person cannot contract the virus from breathing the same air as an infected individual. However, if an infected individual directly sneezes on a person and the mucus from that sneeze comes into contact with an open cut or the eyes, nose or mouth of someone else, there is a chance of infection. WHO has not documented cases of this actually happening, though.

Health workers are at the highest risk of contracting Ebola. Health workers are between 21 and 32 times more likely to be infected with Ebola than people in the general adult population, according to WHO, and, two-thirds of those infected have died.

Ebola treatment

There is no cure for Ebola, nor are there any vaccines that can prevent the disease. Those who recover from the disease do so through the strength of their own immune system, according to the CDC. Doctors have found that one of the most important treatments for patients afflicted with the virus is simply keeping them well hydrated and helping them breathe, to give their immune system a better chance to fight off the disease.

Doctors are trying several experimental treatments on patients. Some doctors are giving patients blood transfusions from those who have survived Ebola. The hope is that the survivor’s antibodies will help the recipient’s immune system fight off the virus. A 1995 study published in the Journal of Infectious Disease found that this treatment may be helpful to reduce the number of deaths from EDV.

ZMapp is one experimental treatment for Ebola. This treatment contains three monoclonal antibodies that may bind to the virus, so that the immune system can clear out the virus. “So far, the published work indicates that ZMapp can cure monkeys up to five days after they’ve been given a lethal dose of Ebola virus,” Lai said. Africa has approved of the use of ZMapp and the United States fast-tracked the drug in 2015 to get quicker Food and Drug Administration approval.

One of the survivors of Ebola, Dr. Kent Brantly, was treated with ZMapp, the Washington Post reported. “Although ZMapp has been provided on a compassionate basis for several people in this current outbreak, we don’t have enough numbers to know if the drug is effective in humans from a statistical point of view,” Lai said.

Brincidofovir is another experimental treatment for EDV. This oral drug prevents the virus from replicating itself. Its Phase 3 clinical testing was performed in 2015 with disappointing results, according to a report in Globe Newswire. Phase 3 testing means it has been given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments and collect information that will allow the treatment to be used safely, according to the National Institutes of Health.

Recovery and immunity

According to WHO one in three people infected with Ebola survive. As of March 13, 2016, 10,000 people have survived the Ebola virus, according to the CDC. Survivors are often faced with continuing problems. Many are ostracized by their community because of misunderstandings about how the virus is spread, according to the International Federation of Red Cross and Red Crescent Societies. WHO has set up a page that offers insight into the lives of survivors of Ebola.

Ebola can also cause other changes in the body after the virus had been cured. For example, one survivor experienced a change in eye color due to inflammation and very high blood pressure in his left eye, according to a report in The New England Journal of Medicine. When fluid in the eye was tested, it was found to contain the Ebola virus, but was believed to not be contagious. Survivors can also experience persistent insomnia, hearing loss, seizures and body aches.

According to the CDC, research shows that patients who recover from Ebola can develop antibodies that will protect them from the virus for at least 10 years, or possibly even longer. There have been cases recorded, though, where a person who was previously cured of the virus becomes sick months later. It is thought that in some cases the virus can hide from the immune system to avoid being completely destroyed.

Also, after the patient recovers, he or she is no longer contagious. There is one exception, though. A recovered patient can still spread the virus with semen for up to three months after they recover. Doctors advise anyone who is recovering from Ebola to use condoms or to refrain from intercourse for three months.

Prevention

Most people outside of West Africa do not need to worry about Ebola prevention. Only those who live in an area affected by Ebola and medical professionals are in danger of contracting the virus. For those individuals, the CDC has a tip sheet on ways to prevent infection.

Measures are being taken by world health organizations to halt the spread of the disease. In October 2014, WHO and the Liberian Ministry of Health, with support from USAID, created a training program for health workers who are treating patients with Ebola. The program focuses on patient care, infection prevention and control. Six Ebola survivors are helping with the project, to give an inside look at what it is like to have the disease.

Companies are also producing machines that will make disinfection easier for clinics and hospitals. For example, medical device maker Xenex, based in San Antonio, Texas, has developed a robot that uses pulses of ultraviolet UV-C rays to disinfect hospital rooms. The company claims it can rid any room of Ebola in two minutes.

Additional resources

  • The Economist: Ebola in Africa- the end of a tragedy?
  • NPR: Politics And Ebola Are Not Such Strange Bedfellows, Report Says
  • CDC: Enhanced Ebola Screening to Start at Five U.S. Airports and New Tracking Program for all People Entering U.S. from Ebola-affected Countries

Ebola virus disease

The Ebola virus causes an acute, serious illness which is often fatal if untreated. EVD first appeared in 1976 in 2 simultaneous outbreaks, one in what is now Nzara, South Sudan, and the other in Yambuku, DRC. The latter occurred in a village near the Ebola River, from which the disease takes its name.

The 2014–2016 outbreak in West Africa was the largest Ebola outbreak since the virus was first discovered in 1976. The outbreak started in Guinea and then moved across land borders to Sierra Leone and Liberia. The current 2018-2019 outbreak in eastern DRC is highly complex, with insecurity adversely affecting public health response activities.

The virus family Filoviridae includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. Within the genus Ebolavirus, six species have been identified: Zaire, Bundibugyo, Sudan, Taï Forest, Reston and Bombali. The virus causing the current outbreak in DRC and the 2014–2016 West African outbreak belongs to the Zaire ebolavirus species.

Transmission

It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as fruit bats, chimpanzees, gorillas, monkeys, forest antelope or porcupines found ill or dead or in the rainforest.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with:

  • Blood or body fluids of a person who is sick with or has died from Ebola
  • Objects that have been contaminated with body fluids (like blood, feces, vomit) from a person sick with Ebola or the body of a person who died from Ebola

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This occurs through close contact with patients when infection control precautions are not strictly practiced.

Burial ceremonies that involve direct contact with the body of the deceased can also contribute in the transmission of Ebola.

People remain infectious as long as their blood contains the virus.

Symptoms

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is from 2 to 21 days. A person infected with Ebola cannot spread the disease until they develop symptoms.

Symptoms of EVD can be sudden and include:

  • Fever
  • Fatigue
  • Muscle pain
  • Headache
  • Sore throat

This is followed by:

  • Vomiting
  • Diarrhoea
  • Rash
  • Symptoms of impaired kidney and liver function
  • In some cases, both internal and external bleeding (for example, oozing from the gums, or blood in the stools).
  • Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Diagnosis

It can be difficult to clinically distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis. Confirmation that symptoms are caused by Ebola virus infection are made using the following diagnostic methods:

  • antibody-capture enzyme-linked immunosorbent assay (ELISA)
  • antigen-capture detection tests
  • serum neutralization test
  • reverse transcriptase polymerase chain reaction (RT-PCR) assay
  • electron microscopy
  • ·virus isolation by cell culture.

Careful consideration should be given to the selection of diagnostic tests, which take into account technical specifications, disease incidence and prevalence, and social and medical implications of test results. It is strongly recommended that diagnostic tests, which have undergone an independent and international evaluation, be considered for use.

  • Diagnostic tests evaluated through the WHO Emergency Use Assessment and Listing process

Current WHO recommended tests include:

  • Automated or semi-automated nucleic acid tests (NAT) for routine diagnostic management.
  • Rapid antigen detection tests for use in remote settings where NATs are not readily available. These tests are recommended for screening purposes as part of surveillance activities, however reactive tests should be confirmed with NATs.

The preferred specimens for diagnosis include:

  • Whole blood collected in ethylenediaminetetraacetic acid (EDTA) from live patients exhibiting symptoms.
  • Oral fluid specimen stored in universal transport medium collected from deceased patients or when blood collection is not possible.

Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All biological specimens should be packaged using the triple packaging system when transported nationally and internationally.

Treatment

Supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated.

In the ongoing 2018-2019 Ebola outbreak in DRC, the first-ever multi-drug randomized control trial is being conducted to evaluate the effectiveness and safety of drugs used in the treatment of Ebola patients under an ethical framework developed in consultation with experts in the field and the DRC.

Vaccines

An experimental Ebola vaccine proved highly protective against EVD in a major trial in Guinea in 2015. The vaccine, called rVSV-ZEBOV, was studied in a trial involving 11 841 people. Among the 5837 people who received the vaccine, no Ebola cases were recorded 10 days or more after vaccination. In comparison, there were 23 cases 10 days or more after vaccination among those who did not receive the vaccine.

The rVSV-ZEBOV vaccine is being used in the ongoing 2018-2019 Ebola outbreak in DRC.
Initial data indicates that the vaccine is highly effective.

WHO’s Strategic Advisory Group of Experts has stated the need to assess additional Ebola vaccines.

Prevention and control

Good outbreak control relies on applying a package of interventions, including case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures (including vaccination) that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:

  • Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats, monkeys, apes, forest antelope or porcupines and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
  • Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
  • Outbreak containment measures, including safe and dignified burial of the dead, identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days, the importance of separating the healthy from the sick to prevent further spread, and the importance of good hygiene and maintaining a clean environment.
  • Reducing the risk of possible sexual transmission, based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of EVD practice safer sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for Ebola virus.

Controlling infection in health-care settings

Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Ebola virus should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with EVD, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Ebola infection should be handled by trained staff and processed in suitably equipped laboratories.

Care for people who recovered from EVD

A number of medical complications have been reported in people who recovered from Ebola, including mental health issues. Ebola virus may persist in some body fluids, including semen. Ebola survivors need comprehensive support for the medical and psychosocial challenges they face and also to minimize the risk of continued Ebola virus transmission. To address these needs, a dedicated programme can be set up for care for people who recovered from Ebola.

  • For more, read the Guidance on clinical care for survivors of Ebola virus disease

Ebola virus is known to persist in immune-privileged sites in some people who have recovered from Ebola virus disease. These sites include the testicles, the inside of the eye, and the central nervous system. In women who have been infected while pregnant, the virus persists in the placenta, amniotic fluid and fetus. In women who have been infected while breastfeeding, the virus may persist in breast milk.

Relapse-symptomatic illness in someone who has recovered from EVD due to increased replication of the virus in a specific site is a rare event, but has been documented. Reasons for this phenomenon are not yet fully understood.

Studies of viral persistence indicate that in a small percentage of survivors, some body fluids may test positive on reverse transcriptase polymerase chain reaction (RT-PCR) testing for Ebola virus for longer than 9 months.

More surveillance data and research are needed on the risks of sexual transmission, and particularly on the prevalence of viable and transmissible virus in semen over time. In the interim, and based on present evidence, WHO recommends that:

  • All Ebola survivors and their sexual partners should receive counselling to ensure safer sexual practices until their semen has twice tested negative. Survivors should be provided with condoms.
  • Male Ebola survivors should be offered semen testing at 3 months after onset of disease, and then, for those who test positive, every month thereafter until their semen tests negative for virus twice by RT-PCR, with an interval of one week between tests.
  • Ebola survivors and their sexual partners should either:
    • abstain from all types of sex, or
    • oobserve safer sex through correct and consistent condom use until their semen has twice tested negative.
  • Having tested negative, survivors can safely resume normal sexual practices without fear of Ebola virus transmission.
  • Based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of Ebola virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus.
  • Until such time as their semen has twice tested negative for Ebola, survivors should practice good hand and personal hygiene by immediately and thoroughly washing with soap and water after any physical contact with semen, including after masturbation. During this period, used condoms should be handled safely, and safely disposed of, so as to prevent contact with seminal fluids.
  • All survivors, their partners and families should be shown respect, dignity and compassion.

Interim advice on the sexual transmission of the Ebola virus disease

WHO response

WHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus disease and supporting at-risk countries to develop preparedness plans. This document provides overall guidance for control of Ebola and Marburg virus outbreaks:

  • Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation

When an outbreak is detected WHO responds by supporting community engagement, disease detection, contact tracing, vaccination, case management, laboratory services, infection control, logistics, and training and assistance with safe and dignified burial practices.

WHO has developed detailed advice on Ebola infection prevention and control:

  • Infection prevention and control guidance for care of patients with suspected or confirmed Filovirus haemorrhagic fever in health-care settings, with focus on Ebola

Table: Chronology of previous Ebola virus disease outbreaks

Year Country EVD Cases Deaths Case fatality
2018-2019 Democratic Republic of the Congo Zaire ongoing
2018 Democratic Republic of the Congo Zaire 54 33 61%
2017 Democratic Republic of the Congo Zaire 8 4 50%
2015 Italy Zaire 1 0 0%
2014 Spain Zaire 1 0 0%
2014 UK Zaire 1 0 0%
2014 USA Zaire 4 1 25%
2014 Senegal Zaire 1 0 0%
2014 Mali Zaire 8 6 75%
2014 Nigeria Zaire 20 8 40%
2014-2016 Sierra Leone Zaire 14124* 3956* 28%
2014-2016 Liberia Zaire 10675* 4809* 45%
2014-2016 Guinea Zaire 3811* 2543* 67%
2014 Democratic Republic of the Congo
2012 Democratic Republic of Congo Bundibugyo 57 29 51%
2012 Uganda Sudan 7 4 57%
2012 Uganda Sudan 24 17 71%
2011 Uganda Sudan 1 1 100%
2008 Democratic Republic of Congo Zaire 32 14 44%
2007 Uganda Bundibugyo 149 37 25%
2007 Democratic Republic of Congo Zaire 264 187 71%
2005 Congo Zaire 12 10 83%
2004 Sudan Sudan 17 7 41%
2003 (Nov-Dec) Congo Zaire 35 29 83%
2003 (Jan-Apr) Congo Zaire 143 128 90%
2001-2002 Congo Zaire 59 44 75%
2001-2002 Gabon Zaire 65 53 82%
2000 Uganda Sudan 425 224 53%
1996 South Africa (ex-Gabon) Zaire 1 1 100%
1996 (Jul-Dec) Gabon Zaire 60 45 75%
1996 (Jan-Apr) Gabon Zaire 31 21 68%
1995 Democratic Republic of Congo Zaire 315 254 81%
1994 Côte d’Ivoire Taï Forest 1 0 0%
1994 Gabon Zaire 52 31 60%
1979 Sudan Sudan 34 22 65%
1977 Democratic Republic of Congo Zaire 1 1 100%
1976 Sudan Sudan 284 151 53%
1976 Democratic Republic of Congo Zaire 318 280 88%

* Include Suspect, Probable and Confirmed EVD cases.

Ebola

Ebola hemorrhagic fever is caused by a virus. It is a severe and often fatal disease. It can affect humans and other primates. Researchers believe that the virus first spreads from an infected animal to a human. It can then spread from human to human through direct contact with a patient’s blood or secretions.

Symptoms of Ebola may appear anywhere from 2 to 21 days after exposure to the virus. Symptoms usually include

  • Fever
  • Headache
  • Joint and muscle aches
  • Weakness
  • Diarrhea
  • Vomiting
  • Stomach pain
  • Lack of appetite

Other symptoms including rash, red eyes, and internal and external bleeding, may also occur.

The early symptoms of Ebola are similar to other, more common, diseases. This makes it difficult to diagnose Ebola in someone who has been infected for only a few days. However, if a person has the early symptoms of Ebola and there is reason to suspect Ebola, the patient should be isolated. It is also important to notify public health professionals. Lab tests can confirm whether the patient has Ebola.

There is no cure for Ebola. Treatment involves supportive care such as fluids, oxygen, and treatment of complications. Some people who get Ebola are able to recover, but many do not.

Centers for Disease Control and Prevention

Ebola Symptoms

Early symptoms of Ebola infection may be mild, but as the virus replicates, symptoms become much more severe.

The Ebola virus is one of several viruses in the world that cause hemorrhagic fever, or fever and other symptoms accompanied by bleeding.

In its early stages, however, symptoms of Ebola are often mild and easily confused with other illnesses that cause fever, according to the Centers for Disease Control and Prevention (CDC).

That makes it extremely important to know whether a person with symptoms has been in contact with someone known to be infected with Ebola, or in a geographic area where there is currently an Ebola outbreak.

Even having visited an area where Ebola is endemic may raise suspicions that a person with fever and general malaise may have Ebola.

Early Symptoms

Symptoms of Ebola usually begin anywhere between 2 and 21 days after exposure to the Ebola virus, according to the World Health Organization (WHO).

The early signs and symptoms of Ebola may be mild and nonspecific:

  • Low fever
  • Fatigue
  • Mild queasiness or feeling of being ill

Diagnosis on the basis of early symptoms is not possible, but if a doctor suspects that a person may have Ebola, the person should be isolated to prevent transmission to others, and blood samples can be taken to determine if Ebola virus infection is the cause of their symptoms.

Advanced Symptoms

As the Ebola virus replicates in the person’s body, its effects become much more severe and possibly fatal.

The advanced signs and symptoms of Ebola infection include:

  • High fever
  • Muscle aches
  • Headache
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Bleeding from the eyes, ears, gums, nose, rectum, and internal organs
  • Bruising of the skin, indicating internal bleeding
  • Organ failure (e.g., kidney, respiratory, or liver failure)
  • Low blood pressure
  • Delirium
  • Coma

At the worst stage of the illness, patients can lose 5 to 10 quarts of fluid a day through vomiting and diarrhea.

Mainstays of Ebola treatment therefore include the administration of intravenous fluids and electrolyte replacement to prevent dehydration.

A person who has advanced symptoms of Ebola is highly infectious, and healthcare workers must take extraordinary precautions to avoid coming into contact with the person’s blood or bodily fluids.

Outcomes

The recorded death rates from Ebola outbreaks occurring before the 2014 outbreak have been high, ranging from 50 to 90 percent, depending on which strain of the virus was involved in the outbreak.

Those who die from Ebola generally do so within one to two weeks of developing symptoms.

Among those who survive, recovery can take about two to four weeks, and the virus can remain active in certain bodily fluids and tissues for months.

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