What You Should Know About Ebola Virus Disease
What is Ebola virus disease?
Ebola virus disease (formerly
known as Ebola haemorrhagic fever) is a severe, often fatal illness, with a
death rate of up to 90%. The illness affects humans and nonhuman primates
(monkeys, gorillas, and chimpanzees). Ebola first appeared in 1976 in two
simultaneous outbreaks, one in a village near the Ebola River in the Democratic
Republic of Congo, and the other in a remote area of Sudan. The origin of the
virus is unknown but fruit bats (Pteropodidae) are considered the likely host
of the Ebola virus, based on available evidence.
What are typical signs and symptoms of infection?
Find out typical symptoms of
Ebola infection
Sudden onset of fever,
intense weakness, muscle pain, headache and sore throat are typical signs and
symptoms. This is followed by vomiting, diarrhoea, rash, impaired kidney and
liver function, and in some cases, both internal and external bleeding.
Laboratory findings include
low white blood cell and platelet counts, and elevated liver enzymes.
The incubation period, or the
time interval from infection to onset of symptoms, is from 2 to 21 days. The
patients become contagious once they begin to show symptoms. They are not
contagious during the incubation period.
Ebola virus disease
infections can only be confirmed through laboratory testing.
Frequently Asked Questions
During Ebola Outbreak
Is it safe to travel during
an outbreak? What is WHO’s travel advice?
During an outbreak, WHO
reviews the public health situation regularly
During an outbreak, WHO
reviews the public health situation regularly and recommends any travel or
trade restrictions, if necessary, and may inform national authorities to
implement it. WHO is currently reviewing its recommendations for travel and
expects to issue advice in the coming days.
While travellers should
always be vigilant with regard to their health and those around them, the risk
of infection for travellers is very low since person-to-person transmission
results from direct contact with the body fluids or secretions of an infected
patient.
Is it safe to travel with persons who have Ebola?
As with any illness or
disease, it is always possible that a person who has been exposed to Ebola
virus may choose to travel. If the individual has not developed symptoms , they
cannot transmit EVD to those around them. If the individual does have symptoms,
they should seek immediate medical attention at the first sign they are feeling
unwell. This may require either notifying the flight crew or ship crew or, upon
arrival at a destination, seeking immediate medical attention. Travellers who
show initial symptoms of EVD should be isolated to prevent further
transmission. Although the risk to fellow travellers in such a situation is very
low, contact tracing is recommended under these circumstances.
Is it safe to travel to West Africa on business or to
visit family and friends?
The risk of a tourist or
businessman/woman becoming infected with Ebola virus during a visit to the
affected areas and developing disease after returning is extremely low, even if
the visit included travel to the local areas from which primary cases have been
reported. Transmission requires direct contact with blood, secretions, organs
or other body fluids of infected living or dead persons or animal, all of which
are unlikely exposures for the average traveller. In any event, tourists are
advised to avoid all such contacts.
If you are visiting family or
friends in the affected areas, the risk is similarly low, unless you have
direct physical contact with a person who is ill or who has died. If this is
the case, it is important to notify public health authorities and engage in
contact tracing. Contact tracing is used to confirm you have not been exposed
to EVD and to prevent further spread of the disease through monitoring.
WHO’s general travel advice
Travelers should avoid all contact with
infected patients.
Health workers traveling to affected areas
should strictly follow WHO-recommended infection control guidance.
Anyone who has stayed in areas where cases
were recently reported should be aware of the symptoms of infection and seek
medical attention at the first sign of illness.
Clinicians caring for
travelers returning from affected areas with compatible symptoms are advised to
consider the possibility of Ebola virus disease.
For additional travel advice,
please read the Travel and transport risk assessment: Recommendations for
public health authorities and transport sector at
http://who.int
During an outbreak, numbers of cases reported by
health officials can go up and down? Why?
During an Ebola outbreak,
figures can change daily.
During an Ebola outbreak, the
affected country’s public health authority reports its disease case numbers and
deaths. Figures can change daily. Case numbers reflect both suspected cases and
laboratory-confirmed cases of Ebola. Sometimes numbers of suspected and
confirmed cases are reported together. Sometimes they are reported separately.
Thus, numbers can shift between suspected and confirmed cases.
Analyzing case data trends,
over time, and with additional information, is generally more helpful to assess
the public health situation and determine the appropriate response.
How does WHO protect health during outbreaks?
WHO actions to prepare for
and respond to Ebola outbreaks
WHO provides technical advice
to countries and communities to prepare for and respond to Ebola outbreaks.
WHO actions include:
v disease surveillance and information-sharing across
regions to watch for outbreaks;
v technical assistance to investigate and contain health
threats when they occur – such as on-site help to identify sick people and
track disease patterns;
v advice on prevention and treatment options;
v deployments of experts and the distribution of health
supplies (such as personal protection gear for health workers) when they are
requested by the country;
v communications to raise awareness of the nature of the
disease and protective health measures to control transmission of the virus;
v activation of regional and global networks of experts
to provide assistance, if requested, and mitigate potential international
health effects and disruptions of travel and trade.
What about health workers? How should they protect
themselves while caring for patients?
Important actions to reduce
or stop the spread of the virus and protect health workers
Health workers treating
patients with suspected or confirmed illness are at higher risk of infection
than other groups.
During an outbreak a number
of important actions will reduce or stop the spread of the virus and protect
health workers and others in the health-care setting. These actions are called
“standard and other additional precautions” and are evidence-based
recommendations known to prevent the spread of infections. The following
questions and answers describe the precautions in detail.
Should patients with suspected or confirmed Ebola
virus be separated from other patients?
Isolating patients with
suspected or confirmed Ebola virus disease in single isolation rooms is
recommended. Where isolation rooms are not available, it is important to assign
designated areas, separate from other patients, for suspected and confirmed
cases. In these designated areas, suspect and confirmed cases should also be
separate. Access to these areas should be restricted, needed equipment should
be dedicated strictly to suspected and confirmed EVD treatment areas, and
clinical and non-clinical personnel should be exclusively assigned to isolation
rooms and dedicated areas.
Are visitors allowed in areas where patients suspected
or confirmed Ebola virus disease are admitted?
Stopping visitor access to
patients infected with EVD is preferred. If this is not possible, access should
be given only to those individuals who are necessary for the patient’s
well-being and care, such as a child’s parent.
Is protective equipment required when caring for these
patients?
In addition to standard
health-care precautions, health-care workers should strictly apply recommended
infection control measures to avoid exposure to infected blood, fluids, or
contaminated environments or objects – such as a patient’s soiled linen or used
needles. All visitors and health-care workers should rigorously use what is
known as personal protective equipment (PPE). PPE should include at least:
gloves, an impermeable gown, boots/closed shoes with overshoes, a mask, and eye
protection for splashes (goggles or face shields).
Is hand hygiene important?
Hand hygiene is essential and
should be performed:
before donning gloves and wearing PPE on entry to the isolation room/
area;
before any clean or aseptic procedures is
being performed on a patient;
after any exposure risk or actual exposure
with a patient’s blood or body fluids; after touching (even potentially)
contaminated surfaces, items, or equipment in the patient’s surroundings; and after
removal of PPE, upon leaving the isolation area.
It is important to note that
neglecting to perform hand hygiene after removing PPE will reduce or negate any
benefits of the PPE.
Either an alcohol-based hand
rub or soap and running water can be used for hand hygiene, applying the
correct technique recommended by WHO. It is important to always perform hand
hygiene with soap and running water when hands are visibly soiled.
Alcohol-based hand rubs should be made available at every point of care (at the
entrance and within the isolation rooms and areas); running water, soap, and
single use towels should also be always available.
What other precautions are necessary in the
health-care setting?
Other key precautions are
safe injection and phlebotomy procedures, including safe management of sharps,
regular and rigorous environmental cleaning, decontamination of surfaces and
equipment, and management of soiled linen and of waste.
In addition, it is important
to ensure safe processing of laboratory samples from suspected or confirmed
patients with EDV and safe handling of dead bodies or human remains for
post-mortem examination and burial preparation. Any health-care workers and
other professionals undertaking these tasks in connection with suspected or
confirmed patients with Ebola virus disease should wear appropriate PPE and
follow precautions and procedures recommended by WHO.
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