Ebola (Ebola virus disease)

What is Ebola disease?

Ebola disease is an often-deadly illness caused by a group of viruses known as orthoebolaviruses. It most commonly affects people and nonhuman primates, such as monkeys, chimpanzees, and gorillas. There are four orthoebolaviruses that cause disease in people: Ebola virus (Orthoebolavirus zairense); Sudan virus (Orthoebolavirus sudanense); Taï Forest virus (Orthoebolavirus taiense); and Bundibugyo virus (Orthoebolavirus bundibugyoense).

Who gets Ebola disease?

The viruses that cause Ebola disease have been found in wild animals (such as fruit bats, monkeys, chimpanzees, and gorillas) in certain parts of Africa and Asia. Outbreaks of Ebola disease in people have occurred in geographic locations where infected animals live. People can become infected with an Ebola virus after contact with infected wild animals or after contact with the blood or body fluids (urine, feces, saliva, sweat, vomit, breast milk, and semen) of infected people. People at higher risk of infection include healthcare workers, and family members or others who have close contact with infected people or who have contact with their bodies during funerals or burying rituals.

How is Ebola disease spread?

Ebola viruses can spread to people who have contact with an infected animal’s blood, body fluids, or tissues. Ebola viruses then spread from person-to-person through direct contact with blood or body fluids of a person who is sick with or has died from Ebola. This can happen when a person touches the infected body fluids or objects that have been contaminated with infected body fluids, such as medical equipment like needles and syringes. The virus enters the body through broken skin, through the eyes, nose, or mouth, or through sexual contact.

Ebola is not spread through the air (for example, by coughing or sneezing), by water, or through cooked food.

What are the symptoms of Ebola disease?

Symptoms of Ebola disease include fever, severe headache, muscle or joint pain, weakness, fatigue, sore throat, loss of appetite, diarrhea, vomiting, abdominal (stomach) pain, and, in some cases, unexplained hemorrhage (bleeding or bruising). Many of these symptoms are also present with other more common diseases, such as malaria and typhoid fever.

How soon after exposure do symptoms of Ebola disease appear?

Symptoms usually appear 8–10 days after exposure, with a range of 2–21 days.

How is Ebola disease diagnosed?

If Ebola is suspected, based on a person’s symptoms and exposure to an Ebola virus (such as having close contact with an Ebola-infected person), he or she should be isolated (separated from other people) immediately and the local health department should be notified. Special laboratory tests of the blood are needed to confirm the diagnosis of Ebola.

What is the treatment for Ebola disease?

Available treatments for Ebola disease vary depending on which virus a person is infected with. Supportive care, such as fluid therapy and relief from other symptoms, is an important part of treatment for all Ebola virus infections.

Two treatments have been approved by the U.S. Food and Drug Administration (FDA) to treat Ebola virus disease caused by Orthoebolavirus zairense in adults and children. The first drug, approved in October 2020, Inmazeb™, is a combination of three monoclonal antibodies. The second drug, Ebanga™, is a single monoclonal antibody and was approved in December 2020. Monoclonal antibodies are proteins produced in a laboratory or other manufacturing facility that act like natural antibodies to stop a germ, such as a virus, from multiplying after it has infected a person. These particular antibodies bind to part of the Ebola virus’s surface to prevent the virus from entering a person’s cells.

There is no FDA-authorized treatment for the three other viruses that can cause Ebola disease in people.

Do people who have been in contact with someone with Ebola disease need to be tested and treated?

Contacts of people with Ebola disease should monitor their health closely for 21 days after their exposure. If they feel ill with symptoms of Ebola disease, they should quickly notify their healthcare provider and local health department and mention that they have been in close contact with someone with Ebola.

How can Ebola disease be prevented?

There are several steps to take to prevent Ebola disease when living in or traveling to an area where the viruses that cause Ebola disease exist:

• Wash hands often with soap and water or use an alcohol-based hand sanitizer if soap and water are not available.
• Avoid contact with other people’s blood or body fluids.
• Do not handle items that might have come in contact with a person’s blood or body fluids, such as clothing, bedding, and medical equipment.
• Avoid participation in funerals or burial rituals that require handling a dead body.
• Avoid contact with bats and nonhuman primates or blood, fluids and raw meat prepared from these animals (bushmeat) or meat from an unknown source.
• Avoid contact with semen from a man who had Ebola disease until you know the virus is gone from the semen.

The FDA approved the Ebola vaccine rVSV-ZEBOV (called Ervebo™) on December 19, 2019. This is the first FDA-approved vaccine for Ebola virus disease caused by Orthoebolavirus zairense. This vaccine is recommended as a pre-exposure vaccine for certain adults who are at risk of being exposed to this Ebola virus (for example, outbreak responders, laboratorians or other staff at certain laboratories who handle specimens that might contain Ebola viruses, and healthcare personnel working at state or federally designated special pathogens treatment centers).

There is currently no FDA-licensed vaccine to protect against the three other viruses that can cause Ebola disease in people.

Could Ebola virus be used for bioterrorism?

Ebola viruses and other viruses that cause hemorrhagic fever are considered possible bioterrorism agents because these viruses could be intentionally released, spread from person-to-person, and cause severe disease or death.

How can I learn more about Ebola virus disease?

• If you have concerns about EVD, contact your healthcare provider.
• Call your local health department. You can find your local health department at vdh.virginia.gov/health-department-locator/.
• Visit the VDH website that contains information on Ebola disease at vdh.virginia.gov/surveillance-and-investigation/ebola/.
• Visit the CDC page on Ebola for more information at gov/vhf/ebola/index.html.