Abuja - How is Ebola treated, how easy is it to
contract it, can it be prevented and how likely is it
to spread from west Africa? The National Institute
for Communicable Diseases (NICD) answers these
pressing questions.
What is Ebola virus disease?
Ebola virus disease (EVD) was previously known as
Ebola haemorrhagic fever.
It is a severe, often fatal disease in humans and
nonhuman primates (monkeys, gorillas and
chimpanzees).
EVD is caused by a virus, and first appeared in
1976 when two outbreaks (one in an area near
the Ebola River in Democratic Republic of Congo,
and the other in South Sudan) occurred. Since
then, sporadic outbreaks have occurred, most
commonly in the Democratic Republic of Congo,
Uganda, South Sudan, Congo and Gabon.
The origin of Ebola virus is not known, but fruit
bats are thought to be the likely host of the virus.
How do people become infected with Ebola
virus?
Ebola virus is transmitted to humans through
direct contact with the blood, secretions, organs
or other bodily fluids of infected animals (which
include chimpanzees, gorillas, bats, monkeys,
forest antelope and porcupines). This occurs
when hunters/other persons come into contact
with dead animals found lying in the rainforest, or
handling raw meat of infected animals.
Once a person is infected, the Ebola virus can
spread to other people in the community.
Infection occurs from direct contact (through
broken skin or mucous membranes, including the
nose, eyes and mouth) with blood, or other bodily
fluids and secretions (including stool, urine, saliva,
semen) of infected people.
Less commonly, infection can also occur from
direct contact (through broken skin or mucous
membranes, including the nose, eyes and mouth)
with environments that are contaminated with an
Ebola patient’s infectious blood or body fluids,
such as soiled clothing, bed linen, or used
needles.
Burial ceremonies in which mourners have direct
contact with the body of the deceased person
have also been responsible for spreading
infection in some outbreaks.
Who is at risk for becoming infected with Ebola
virus?
During EVD outbreaks, the following persons are
most at risk for infection: Healthcare workers
Family members or friends in close contact with
infected people, because they come in close
contact with infectious secretions/bodily fluids
when caring for ill persons
Mourners who have direct contact with the bodies
of the deceased as part of burial ceremonies
Hunters/other persons in the rain forest who
come into contact with infected animals in the
forest
What are the signs and symptoms of EVD?
After infection with the Ebola virus, there is an
incubation period of 2 – 21 days (on average, 8 –
10 days) after which the person will start to
experience symptoms. The initial symptoms
include fever, weakness and lethargy, muscle
pain, headache and sometimes sore throat.
This is followed by vomiting, diarrhoea,
abdominal pain, and sometimes a rash. Some
patients may experience bleeding inside and
outside of the body; this is the most serious
complication.
How is EVD diagnosed?
EVD can only be confirmed through laboratory
testing, usually a blood test. A specialised
laboratory at the National Institute for
Communicable Diseases in Johannesburg is able
to test for Ebola virus infection.
What is the treatment of EVD?
There is no medication available to treat the
Ebola virus itself. Standard treatment for EVD is
limited to supportive therapy, and severely ill
patients require intensive supportive care. This
consists of balancing the patient’s fluids and
electrolytes, maintaining their oxygen status and
blood pressure, and treating them early for any
complicating infections.Some patients will recover
with the appropriate medical care.
To control further spread of Ebola virus, patients
that are suspected to have EVD should be isolated
from other patients and treated by healthcare
workers using very strict precautions to prevent
being infected.
Experimental treatment has been tested in
animal models, but has not yet been used in
humans.
Can EVD be prevented?
There is no licensed vaccine for EVD. Several
vaccines are being tested, but none are available
for clinical use as yet. Preventing initial cases is
challenging, since it is still not known how exactly
Ebola virus is maintained in nature and what
preventive interventions would be successful.
Once an initial case of EVD occurs in a community,
preventing spread to other people is critical. This
includes educating the general public about the
disease and how it can be prevented from
spreading further.
How can healthcare workers protect
themselves from infection with Ebola virus?
Healthcare workers are at high risk of exposure to
the virus when caring for Ebola patients, and
need to apply additional infection control
precautions over and above the standard
healthcare precautions.
This includes wearing personal protective
equipment (including gloves, masks, gowns and
goggles), ensuring complete equipment
sterilisation, and the routine use of disinfectant.
Infected patients must be isolated from other
patients and cared for by staff who are trained in
the appropriate infection control measures.
Is it safe to travel during an outbreak of EVD?
The World Health Organization regularly reviews
the public health situation and recommends any
travel or trade restrictions if necessary. At
present, no travel or trade restrictions are
recommended.
The risk of infection for travellers is very low, even
if the visit included travel to the local areas from
which primary cases have been reported.
Infection with Ebola virus requires direct contact
with blood, secretions, organs or other body
fluids of infected living or dead persons or
animals, all of which are unlikely exposures for
the average traveller.
There is no risk of Ebola virus transmission during
the incubation period and only low risk of
transmission in the early phase of disease.
Historically, several cases of haemorrhagic fever
(Ebola, Marburg, Lassa, Crimean Congo
haemorrhagic fever) disease were diagnosed after
long-distance travel but none developed the
symptoms during the international travel and no
persons who came into contact with the patients
during travel were infected.