Web EpiMonitor

Uncommonly Reported & Detailed Facts About Ebola Virus Disease From CDC and WHO

1. Period of Infectivity

The incubation period, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days. Symptoms may appear anywhere from 2 to 21 days after exposure to ebolavirus--though 8-10 days is most common.

People are infectious as long as their blood and secretions contain the virus. For this reason, infected patients receive close monitoring from medical professionals and receive laboratory tests to ensure the virus is no longer circulating in their systems before they return home. When the medical professionals determine it is okay for the patient to return home, they are no longer infectious and cannot infect anyone else in their communities.

Men who have recovered from the illness can still spread the virus to their partner through their semen for up to 7 weeks after recovery. For this reason, it is important for men to avoid sexual intercourse for at least 7 weeks after recovery or to wear condoms if having sexual intercourse during 7 weeks after recovery.

2. Infection and Transmission

In Africa, fruit bats are believed to be the natural hosts of Ebola virus. The virus is transmitted from wildlife to people through contact with infected fruit bats, or through intermediate hosts, such as monkeys, apes, or pigs that have themselves become infected through contact with bat saliva or feces.

People may then become infected through contact with infected animals, either in the process of slaughtering or through consumption of blood, milk, or raw or undercooked meat.

The virus is then passed from person to person through direct contact with the blood, secretions or other bodily fluids of infected persons, or from contact with contaminated needles or other equipment in the environment.

3.  Preventive Measures

Raising awareness of the risk factors for infection and the protective measures that should be taken is the only way to reduce human infection and subsequent deaths. Close unprotected physical contact with Ebola patients should be avoided. Appropriate use of gloves and personal protective equipment (including hand hygiene before putting on, and especially after taking off personal protective equipment) should be practised when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.

4. Nosocomial Transmission

Almost all transmission of the virus to health-care workers has been reported when basic infection control measures have not been observed. Health-care workers caring for any patient should practice standard precautions. When caring for patients with suspected or confirmed Ebola virus infection, health-care workers should apply, in addition to standard precautions, other infection control measures to avoid any exposure to patients’ blood and body fluids and with possibly contaminated environments.

5. Burial

Preparation for burial of the bodies of persons who have died from Ebola virus disease also carries high risks of transmission of the virus. Those who have died from the disease should be promptly and safely buried.

6. Signs and symptoms

Ebola virus is the cause of a viral hemorrhagic fever disease. EVD, which has a case fatality rate of up to 90%, is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache, nausea and sore throat. This is followed by vomiting, diarrhoea, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings frequently include low white blood cell and platelet counts and elevated liver enzymes.

7. Diagnosis and treatment

When considering the diagnosis of EVD, other, more common diseases should not be overlooked; for example, malaria, typhoid fever, shigellosis,

cholera, leptospirosis, plague,rickettsiosis, relapsing fever, meningitis, hepatitis and other viral haemorrhagic fevers.

Definitive diagnosis of EVD is made through laboratory testing. Because samples from patients are a source of infection risk for others, testing is conducted under maximum biological containment conditions.

No vaccine is available, nor is there any specific treatment. Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes, or intravenous fluids.

8. What Virus Strain Is It?

Ebola first appeared in 1976 in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.

Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with genus Marburgvirus and genus Cuevavirus. Genus Ebolavirus comprises 5 distinct species:

►  Bundibugyo ebolavirus (BDBV)

►   Zaire ebolavirus (EBOV)

►   Reston ebolavirus (RESTV)

►   Sudan ebolavirus (SUDV)

►   Taï Forest ebolavirus (TAFV)

BDBV, EBOV, and SUDV have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not.  The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date.  Samples taken from patients in this outbreak have tested positive for EBOV.

Genetic analysis of the virus indicates that it is closely related (97-98% identical) to variants of Ebola virus identified earlier in the Democratic Republic of the Congo and Gabon.

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