Ebola Virus Disease

The largest recorded outbreak of EVD occurred in 2014. Starting in West Africa, many countries worldwide were affected by the outbreak, including the United States. Several U.S. citizens contracted Ebola, became symptomatic while in Africa, and were transported back to the United States for care. One individual died; the rest recovered and are now Ebola free. There have been no active U.S. cases of Ebola since 2014.  

EVD, previously known as Ebola hemorrhagic fever, is a disease caused by infection with one of the Ebola virus strains. Ebola viruses are found in several African countries. It was first discovered in 1976 near the Ebola River in the Democratic Republic of the Congo. Since then, outbreaks have appeared in multiple African countries.

Researchers do not know where Ebola comes from, but based on evidence and the nature of similar viruses, they believe the virus is animal-borne and that bats are the most likely reservoir.

Signs and Symptoms of EVD

Symptoms may begin between 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days. Infected individuals may have the following symptoms:

• Fever greater than 38°C or 100.4°F
• Severe headache
• Muscle pain and weakness
• Diarrhea and vomiting
• Abdominal (stomach) pain
• Unexplained hemorrhage (bleeding or bruising)

Recovery from Ebola depends on the patient’s immune response. Once someone recovers from Ebola, they can no longer spread the virus. People who recover from Ebola infection develop antibodies that last for at least 10 years.

However, Ebola virus can stay in bodily fluids including semen, breast milk, ocular fluid and spinal column fluid for a period of time after recovery. Ebola virus has been found in semen for up to 12 months. People who recover from Ebola should use condoms for 12 months from when they first get sick or until their semen tests negative for Ebola twice.

Transmission

When an infection occurs in humans, the virus can spread to others in several ways. Ebola spreads through direct contact (via broken skin or mucous membranes) with

• Blood or body fluids (including but not limited to urine, saliva, feces, vomit and semen) of a person who is sick with Ebola
• Objects that have been contaminated with the virus (like needles and syringes)
• Infected animals (by contact with blood or infected meat from wild primates or bats—this has only occurred in Africa)

Ebola is not spread through air, water, or in general, food (except in cases where people eat wild animals).

Risk of Exposure

Ebola is not spread through casual contact, so the risk of an outbreak in the United States is very low. Healthcare providers treating Ebola patients, as well as family and friends in close contact with Ebola patients, are at the highest risk of getting sick because they may encounter infected blood or bodily fluids.

Ebola poses no substantial risk to the general U.S. population. There have been no active cases of Ebola in the United States since 2014. Health officials know that Ebola causes public concern, but it is the mission of U.S. public health agencies to protect the health of all Americans, including those who may become ill while overseas.

Is there danger of Ebola spreading in Spokane County?

Ebola does not naturally occur in the United States and there have been no active travel-related cases since 2014. Health officials, including those in Spokane County, know how to stop Ebola’s spread. Their methods include

• Searching for at-risk people and isolating ill people
• Contacting people exposed to ill individuals
• Isolating those who have encountered ill individuals if they develop symptoms

Spokane County hospitals have specific medical equipment for healthcare workers to use when caring for a possible Ebola patient. Hospital staff know how to clean and dispose of contaminated instruments like needles and syringes. Health officials, medical staff and emergency medical services constantly train and plan for the possibility that an Ebola-infected patient could arrive at a Spokane County medical facility.

Is there danger of Ebola spreading widely in the United States?

In 2014, four cases were diagnosed in the United States. One was a person who was infected in Liberia, but didn’t have any symptoms until several days after arriving in Dallas. The individual has since died. Two others were healthcare workers who encountered the original patient and tested positive. They were treated and are now virus-free. The fourth case was a medical aid worker who returned to New York City from Guinea, where he served with Doctors Without Borders. The worker is now virus-free.

Several other U.S. citizens became sick with Ebola while in Africa, started showing symptoms, and were transported to the United States for care. Infection control procedures were followed during the patients’ transport to prevent the disease from being transmitted to others. One of these patients died after returning to the United States.

All other cases of human illness or death from Ebola occurred outside the United States, mostly in Africa.

Are people who are on planes with suspected patients at risk?

A person must have symptoms to spread Ebola to others. If an ill person shows symptoms of Ebola during a flight, CDC will recommend monitoring other passengers for signs of infection. 

Sources

Ebola Virus Disease | CDC | https://www.cdc.gov/vhf/ebola/index.html

What is Ebola Virus? | CDC | https://www.cdc.gov/vhf/ebola/about.html

Transmission | CDC | https://www.cdc.gov/vhf/ebola/transmission/index.html

Recommendations for Breastfeeding in the Context of Ebola Virus Disease | CDC | https://www.cdc.gov/vhf/ebola/hcp/recommendations-breastfeeding-infant-feeding-ebola.html

Ebola | DOH | https://www.doh.wa.gov/Emergen...

Prevention

According the the FDA, currently, there are no FDA-approved vaccines or drugs to prevent or treat Ebola.

Can hospitals in Spokane County care for an Ebola patient?

All Spokane County hospitals are capable of following CDC’s infection control recommendations and are capable of safely managing a patient with Ebola.

Travel

There are currently no Ebola-related travel restrictions to countries where Ebola outbreaks have occurred. If a person travels to or is in an area affected by an Ebola outbreak, they should do the following:

• Practice careful hygiene. Avoid contact with blood and body fluids.
• Do not handle items that may be contaminated by an infected person’s blood or bodily fluids.
• Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
• Avoid contact with bats and nonhuman primates or blood, fluids and raw meat prepared from these animals.
• Avoid hospitals where Ebola patients are being treated. The U.S. embassy or consulate may provide advice on facilities.
• After returning to Spokane, contact Spokane Regional Health District at 509.324.1442. Staff will assist individuals in monitoring their health for 21 days and provide guidance on how to seek medical care if Ebola symptoms develop

Why were ill Americans with Ebola brought to the U.S. for treatment? How is CDC protecting the American public?

A U.S. citizen has the right to return to the United States. While CDC can use several methods to prevent disease from entering the United States, CDC must balance the public health risk to others with the individual’s rights. Patients who came back to the United States for care were transported with necessary infection control procedures in place. To prevent others from getting sick, the individuals were sent to healthcare facilities capable of safely caring for them.

During Travel

CDC works with international public health organizations, federal agencies, and the travel industry to identify sick travelers arriving in the United States and take public health actions to prevent the spread of communicable diseases. Airlines are required to report any onboard deaths or ill travelers meeting certain criteria to CDC before arriving in the United States. If an ill traveler landed in Spokane County, Spokane Regional Health District would work with CDC and other partners to determine whether any public health action is needed.

If a traveler is infectious or exhibiting symptoms during or after a flight, CDC investigates exposed travelers and works with Spokane Regional Health District, the airline, federal partners and the state health department to notify them and take any necessary public health action.

In the United States

CDC has staff working 24/7 at 20 Border Health field offices located in international airports and land borders. CDC staff are ready 24/7 to investigate cases of ill travelers on planes and ships entering the United States.

CDC works with partners at all ports of entry into the United States to help prevent infectious diseases from being introduced and spread in the United States.

What to do when returning to the U.S. from an area where an outbreak is occurring?

Contact Spokane Regional Health District at 509.324.1442 for information about monitoring. This is especially important for those who

• Were in an area with an Ebola outbreak, particularly if there was contact with blood, bodily fluids or items contaminated by blood or bodily fluids
• Visited a hospital or clinic where Ebola patients were being treated or participated in burial rituals/practices
• Had contact with wild animals or raw meat

Seek medical care immediately if a fever (temperature of 100.4°F/ 38.0°C) develops along with any of the following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain or unexplained bruising or bleeding.

Call a doctor before going to the office or emergency room and tell them about recent travel and symptoms. This information is important because it helps the doctor provide care to those who are ill and protect other people who are in the same medical setting.  

Sources

Ebola Virus Disease | CDC | https://www.cdc.gov/vhf/ebola/index.html

What is Ebola Virus? | CDC | https://www.cdc.gov/vhf/ebola/about.html

Prevention | CDC | https://www.cdc.gov/vhf/ebola/prevention/index.html

Treatment | CDC | https://www.cdc.gov/vhf/ebola/treatment/index.html Ebola | DOH | https://www.doh.wa.gov/Emergen...

There have been only four cases of Ebola diagnosed in the United States.

Source

2014-2016 Ebola Outbreak in West Africa | CDC | https://www.cdc.gov/vhf/ebola/...