What is Ebola?
Ebola virus disease is a severe illness that was first discovered in humans in 1976 in South Sudan and the Democratic Republic of the Congo, formerly Zaire.1,2 Since then, a number of outbreaks have occurred in central and western Africa.
Symptoms can occur abruptly and include fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, stomach pain and bleeding or bruising.3 Without prompt and appropriate treatment as many as 90% of people who become sick with Ebola virus disease die.2 The fatality rate is much lower among those who receive immediate medical treatment including optimal full supportive care including fluids, oxygen and medications to manage symptoms ranging from vomiting to fever.2,4
Is Ebola contagious?
Ebola is highly contagious, but it is transmitted only through direct contact with bodily fluids. It is not spread through the air or casual contact. The incubation period for Ebola – meaning the time after infection and before symptoms appear – is 2 to 21 days.3 People with Ebola are not contagious until they begin having symptoms. People who have died from Ebola remain contagious.
Where does Ebola come from?
Scientists aren’t positive but believe outbreaks begin when the virus is transmitted from bats (which aren’t affected by the virus) to other animals, such as gorillas, chimpanzees and antelope (which are affected). People can become infected by hunting and handling or eating the meat of infected wild animals (bushmeat). It then spreads from person to person.2
There is no cure for Ebola, but promising experimental medications are in development. Several investigational antiviral treatments are being provided to people with laboratory-confirmed Ebola and preliminary evidence has shown favorable results for two treatment options, REGN-EB3 or mAb114.5 While research is ongoing, people who become infected are given supportive therapy, including fluids and oxygen as well as medications to manage vomiting, diarrhea, pain, fever and blood pressure.2,4
Avoid traveling to areas where there is an Ebola outbreak. If you do travel to such an area, avoid contact with people who are sick or have died of Ebola, particularly their bodily fluids or objects their fluids have touched.6 Further, an experimental vaccine that has been shown to be effective in preventing Ebola is being given to those who have been in contact with someone who has the disease, contacts of those contacts, as well as to health care workers and other front-line workers likely exposed to Ebola virus.2,7
EBOLA HISTORY AND RISK TO THE U.S.
There have been many Ebola outbreaks since the first known outbreak in 1976, all in sub-Saharan (west, east and central) Africa. By far the deadliest outbreak occurred in 2014-2016 when more than 11,000 people died (most in west African Guinea, Liberia and Sierra Leone).8 The current outbreak, which began Aug. 1, 2018 in the DRC, is the second largest outbreak to date, and more than 1,800 people died in the first year.9
Is Ebola a threat to the United States?
Currently Ebola is not considered a threat outside of certain countries in sub-Saharan Africa. Very few people with Ebola have been outside of that area. During the 2014-2016 outbreak, 11 people with Ebola were treated in the United States, nine of whom had contracted it in western Africa, most as health care workers. Two died – a Liberian visiting the United States and a doctor who had treated Ebola patients in Sierra Leone. Two American nurses contracted the disease while treating the Liberian patient, but both recovered. In other words, only two people have ever been infected with Ebola while on American soil and neither died. By comparison, CDC estimated 79,000 Americans died from influenza during the 2017-2018 flu season.10
What happens if a person with Ebola comes to the United States?
Several people with Ebola received treatment in the U.S. during the 2014-2016 outbreak, leading to increased awareness of the disease and its symptoms. Protocols have been put in place to ensure safe care for patients as part of the U.S. HHS National Ebola and Education Centers.
How can we decrease the risk that a person with Ebola comes to the United States?
Controlling the outbreak at its source remains the most effective way to prevent the outbreak from spreading to other countries. Trade and travel restrictions may seem to be a protective response, but are more likely to lead to additional negative consequences for affected communities and individuals and interfere with accurate monitoring at border checkpoints.
What are authorities trying to do to contain the outbreak?
The current outbreak has eluded control for more than a year due to an ongoing public health and humanitarian crisis that includes armed conflict, political instability, internal displaced persons, mass migration and an over-burdened and resource-limited public health infrastructure.11 Concerned that the outbreak is threatening other countries, the World Health Organization declared a public health emergency of international concern -- a PHEIC -- a decision supported by the U.S. Centers for Disease Control and Prevention.12,13 The goal is to raise awareness and promote better local and international cooperation to coordinate responses to prevent further spread.
The CDC and USAID are working with authorities to provide technical assistance and expertise including disease tracking, case investigation, contact tracing, case management, infection prevention and vaccination campaigns while the National Institutes of Health is supporting the randomized controlled trial of four investigational treatments.14 These activities are supported by emergency Congressional funding which expired in September. It is urgent that Congress provide additional funding to help countries stop health threats at their source before international spread.
We live in a globalized world and modern transportation means infectious diseases can spread anywhere. The CDC estimates it takes only 36 hours for a pathogen to spread from a remote village to any major city in the world. The United States’ help and expertise in addressing and containing this and other outbreaks is vital to enhancing health systems capacities worldwide, and to protecting public health at home.