Ebola Virus Disease
EVD Description
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Hemorrhagic fever with case fatality rate up to 90%
Endemic areas: Central and West Africa
Wildlife reservoir: bats implicated
No cases in humans ever reported in U.S.
Transmission
• Direct contact with bodily fluids from infected person or
contaminated objects (e.g. needles)
• Incubation period: usually 8-10 days (range 2-21 days)
• High-risk individuals
– Health care workers
– Family members or others in close contact with EVD
patients
• Can spread quickly in health care settings
Signs and Symptoms
• Early signs non-specific: fever, malaise, weakness,
muscle pain, headache, sore throat, vomiting, diarrhea
• Late signs: bleeding, multi-organ dysfunction leading to
shock and death
Diagnosis
• Complicated by non-specific early symptoms
• BSL-3 lab required (BSL-4 for virus isolation)
Timeline of infection
Diagnostic tests available
Within a few days after onset
 Antigen-capture enzyme-linked
immunosorbent assay (ELISA) testing
 IgM ELISA
 Polymerase chain reaction (PCR)
 Virus isolation
Later in disease course or after recovery
 Serology: IgM and IgG
Retrospectively in deceased patients
 Immunohistochemistry testing
 PCR
 Virus isolation
Response
• Treatment
– Supportive only
– Prompt treatment important
• Prevention
– Standard, contact, droplet precautions
– Contact tracing, monitoring for 21 day incubation
period
– Immediate isolation of ill contacts
– Disinfection of contaminated surfaces, objects by
standard methods
– No vaccine available
Public Health Messaging
• Identify population at-risk: those with recent history of
travel to endemic areas
• Health care providers
– Should have low threshold of suspicion among
travelers returning from endemic areas
– Barrier precautions successfully prevent spread
• Travelers
– Should be aware of risk of EVD in endemic areas
– Avoid exposure to risk factors (caves or mines
inhabited by bats, healthcare settings where EVD is
present, close contact with EVD patients)