Ebola Virus Disease

What is Ebola?

Ebola is a type of viral hemorrhagic fever caused by several species of viruses from the genus Ebolavirus. Symptoms of Ebola start out flu-like but can progress to severe vomiting, bleeding and neurological (brain and nerve) issues.

Ebola can spread to people from bats, nonhuman primates and antelope. From there it can spread from human to human and cause outbreaks (where large numbers of people get infected around the same time). Outbreaks mostly happen in parts of Africa.

If you could have been exposed to Ebola and have symptoms, go to the ER or seek immediate medical attention.

What is Ebola virus disease?

Ebola virus disease (EVD) is one of the diseases caused by ebolaviruses (specifically, Zaire ebolavirus) and known as “Ebola.” It’s the most common cause of Ebola outbreaks and deaths. Researchers have only tested the Ebola vaccine and treatments for efficacy against EVD, not other types of Ebola.

Types of Ebola

Viruses that cause Ebola are named after the location where they were first identified (even if there have been outbreaks in other locations since then). They include:

• Zaire ebolavirus. Also known as Ebola virus, Zaire ebolavirus causes Ebola virus disease (EVD).
• Sudan ebolavirus. Also known as Sudan virus, Sudan ebolavirus causes Sudan virus disease (SVD).
• Taï Forest ebolavirus. Also known as Taï Forest virus, Taï Forest ebolavirus causes Taï Forest virus disease (TAFV).
• Bundibugyo ebolavirus. Also known as Bundibugyo virus, Bundibugyo ebolavirus causes Bundibugyo virus disease (BDBV).

How common are Ebola outbreaks?

Ebola is rare. But outbreaks of Ebola disease have happened regularly since ebolaviruses were first recognized in 1976 in Zaire (now the Democratic Republic of Congo). Most outbreaks are caused by Zaire ebolavirus and Sudan ebolavirus.

The largest Ebola outbreak was the 2014-2016 outbreak of Zaire ebolavirus. In total, there were 28,646 cases and 11,323 deaths reported in 10 countries.

Does Ebola still exist between outbreaks?

Yes, Ebola still exists between outbreaks. It lives in infected animals but sometimes spreads to humans.

Has Ebola ever been in the U.S.?

Yes, during the 2014-2016 outbreak that started in Guinea, cases of Ebola were reported in the U.S. and some European countries. Most of the cases were medical aid workers whose symptoms started after returning to the U.S. from West Africa, or who were flown to the U.S. for medical treatment after contracting Ebola.

No Ebola outbreaks have ever started in the U.S.

What are the symptoms of Ebola disease?

Symptoms of Ebola include:

• Severe headache.
• Muscle pain.
• Sore throat.
• Rash or spots of blood under your skin (petechiae or purpura).
• Fatigue and weakness.
• Loss of appetite.
• Vomiting or diarrhea. This could be bloody.
• Bleeding or bruising.
• Red or bloodshot eyes.

Symptoms can come in phases, with flu-like symptoms first and severe symptoms (like vomiting and bleeding) following a few days later. Seek immediate medical attention if you have these symptoms.

What causes Ebola?

Four species of viruses cause Ebola disease in humans:

• Zaire ebolavirus.
• Sudan ebolavirus.
• Taï Forest ebolavirus.
• Bundibugyo ebolavirus.

Ebolaviruses start in bats, nonhuman primates (monkeys and apes) and antelope in countries of West, Central and East Africa. They all cause similar symptoms and spread in the same way.

How does Ebola disease spread?

Ebolaviruses spread through contact with the body fluids of infected humans or animals.

Body fluids include:

• Pee (urine).
• Poop (stool).
• Spit (saliva).
• Human milk.
• Vaginal fluids.

You can also get it from surfaces, objects or medical devices that are contaminated with the virus. Humans may get it from eating the meat of infected animals.

Ebola can stay in certain parts of your body for weeks or months, even after your symptoms go away. These include your eyes, central nervous system (including the fluid that surrounds your brain and spine) and semen.

How do humans get Ebola?

Bats, nonhuman primates and antelopes carry ebolaviruses. People usually get infected through contact with the body fluids or tissues from infected animals. Then it can spread to other humans, usually close family members or healthcare providers caring for them.

How is Ebola diagnosed?

Healthcare providers diagnose Ebola with a blood test. It can be difficult to diagnose since its symptoms are similar to other illnesses, like yellow fever, malaria and typhoid fever. Your provider will test you based on your symptoms and whether or not you could’ve been exposed to Ebola. Let your provider know about any recent travel or contact with people or animals that could’ve had Ebola.

How is Ebola treated?

There are two monoclonal antibody treatments for Ebola virus disease, Inmazeb™ and Ebanga™. Monoclonal antibodies work like your body’s natural antibodies and help fight off the infection while your body builds its own defenses. Inmazeb is a combination of three monoclonal antibodies and Ebanga is a single monoclonal antibody. These treatments have only been tested in Zaire ebolavirus infections.

Providers will also try to manage your symptoms, treat any complications and keep your condition stable. They might give you:

• Intravenous (IV) fluids.
• Treatments for specific symptoms, like keeping your pain manageable or stabilizing your blood pressure.

Can Ebola disease be prevented?

People at high risk for Ebola can get the Ervebo® vaccine. This includes people who work with ebolaviruses in a lab and healthcare workers treating people with Ebola.

Public health organizations work to contain outbreaks of Ebola by monitoring for new cases and taking precautions to keep healthcare workers safe while caring for people with Ebola. Steps you can take include:

• Use protective equipment (such as a mask, goggles, apron and gloves) when caring for someone with Ebola. Avoid touching any of their body fluids and wash your hands after contact, even if you wear gloves.
• Use condoms or don’t have sex until tests confirm that ebolavirus isn’t present in your semen (or your sex partner’s, if they had Ebola). Even if you feel better, the virus can live in semen for a long time. There isn’t evidence that it’s contagious in vaginal fluids for as long.
• Avoid contact with anything that may have touched infected body fluids. Don’t touch semen unless tests confirm that it no longer carries the virus.
• Avoid touching the body of someone who died from Ebola, or use protective equipment if you have to. This includes funeral customs.
• Avoid contact with body fluids and tissues of animals (dead or alive) that could have Ebola.
• Don’t eat bush meat (the meat of wild animals).
• If you’ve recently returned from travel to a place where there’s an Ebola outbreak, monitor yourself for symptoms for 21 days. Get medical care right away if you develop symptoms.
• Isolate yourself from others if you could have Ebola.

What happens if you get Ebola?

If you’re sick with Ebola, you should avoid being around other people. Healthcare providers and others caring for you will need to take special precautions. This includes wearing protective gear and clothing (like masks, gloves, goggles and aprons) and isolating you from other people. Providers will need to monitor you closely for life-threatening complications.

The virus can also live in semen for a long time after you’re better. Use a condom when having sex to protect your partner from infection. Ask your provider about testing so you can know when you’re no longer contagious.

Long-term complications of Ebola

Even after you recover from Ebola, you may have long-lasting effects. These include:

• Headaches.
• Skin peeling.
• Vision problems (blurred vision, light sensitivity, vision loss).
• Numbness and tingling (peripheral neuropathy).
• Eye pain or redness.
• Muscle and joint pain.
• Stomach pain.

Can you survive Ebola disease?

Yes, many people survive Ebola. The average survival rate from all outbreaks is around 56%.

How many people have died from Ebola?

Since the first recorded outbreak in 1976, over 15,000 people have died from Ebola. Over 11,000 of them died in the 2014-2016 outbreak.

When should I see my healthcare provider?

If you could’ve been exposed to Ebola virus — for instance, you live in an area with animals that carry it or you’ve traveled to an area with an outbreak — and you develop symptoms, see a healthcare provider right away. Monitor yourself for symptoms for 21 days after exposure or returning from an area with an outbreak. Tell a provider that you could have Ebola and how you were exposed.

When should I go to the ER?

Go to the emergency room right away if you have symptoms of serious illness, including:

• High fever (over 103 degrees Fahrenheit or 40 degrees Celsius).
• Unusual bleeding.
• Severe headache.
• Chest or abdominal pain.
• Confusion or mental changes.

What questions should I ask my doctor?

It might be helpful to ask your healthcare provider:

• I’ve been exposed to Ebola — what symptoms should I look out for?
• How can I prevent spreading the virus to others?
• What are my treatment options?
• For how long am I contagious?

A note from Cleveland Clinic

Ebola outbreaks can generate a lot of scary headlines. But with advances in vaccines and treatments, more and more people can survive. Still, Ebola is life-threatening and can cause lasting health effects. If there’s a chance you could encounter Ebola, there are steps you can take to protect yourself and prevent the spread of the virus. If you think you’ve been exposed, keep an eye on your health and get medical attention right away if you notice symptoms.