Ebola: Symptoms, Transmission & Treatment

Ebola is a serious infectious disease caused by the Ebola virus. It can cause symptoms such as a sudden high fever, nausea, headache, muscle pain, vomiting, and diarrhea.

In some cases, Ebola can progress to hemorrhagic fever. Symptoms can appear up to 21 days after contact with the virus.

Ebola can be transmitted through contact with infected animals or with the blood, urine, feces, vomit, semen, vaginal fluids, or other bodily fluids of infected people. Treatment is done in the hospital and should be started as soon as symptoms appear to prevent life-threatening complications.

Ebola symptoms

The main symptoms of Ebola are:

• High fever that starts suddenly

• Headache or muscle pain

• Loss of appetite

• Nausea or vomiting

• Diarrhea or abdominal pain

• Sore throat or hiccups

• Red eyes

Early symptoms of the Ebola virus can take 2 to 21 days to appear after infection. According to the CDC, symptoms often begin as “dry” symptoms, such as fever, aches, pains, and fatigue, before progressing to “wet” symptoms, such as diarrhea, vomiting, and unexplained bleeding.

It is important to go to the emergency room immediately if Ebola symptoms appear, so treatment can be started and life-threatening complications can be prevented.

Severe symptoms

After 1 week, Ebola can progress and cause hemorrhagic fever, with severe symptoms such as bleeding from the nose, ears, mouth, or genital area, vomiting or diarrhea with blood, or blood spots or blister-like lesions on the skin.

During this stage, symptoms may worsen and include cough, shortness of breath, and brain-related changes such as confusion or extreme weakness. These complications can be life-threatening and may lead to coma.

Confirming a diagnosis

Ebola is diagnosed in the hospital by a healthcare provider, often in coordination with an infectious disease specialist and public health officials. Diagnosis is based on symptoms, possible exposure to infected people or animals, recent travel to an outbreak area, and blood testing.

In addition, the doctor may order tests such as RT-PCR to identify the Ebola virus, as well as a complete blood count (CBC), coagulation tests, metabolic panel, arterial blood gas (ABG) test, creatine phosphokinase test, urine tests, and chest X-ray.

How it spreads

Ebola transmission occurs through:

1. Body fluids

The Ebola virus can be easily transmitted through direct contact with the blood, saliva, urine, feces, tears, sweat, breast milk, or semen of infected people, even after death.

Ebola can also spread if an infected person coughs or sneezes without covering their mouth and nose. Unlike the flu, though, a person usually needs very close and frequent contact to become infected.

2. Objects or surfaces

Ebola can also be transmitted through contact with objects from an infected or deceased person that are contaminated with the virus, such as personal clothing, bedding, or towels, for example.

In addition, the Ebola virus can survive for a few hours on dry surfaces, such as countertops or doorknobs, or for a few days in damp or wet environments.

The Ebola virus can survive for a few weeks on objects or surfaces in places with low temperatures.

3. Sexual contact

Vaginal, anal, or oral sex is another way the Ebola virus can be transmitted, as it may be present in semen even after recovery from the infection.

4. Infected animals

Contact with bodily fluids from animals infected with the Ebola virus is another way the infection can spread to humans. The virus can also be transmitted during hunting or by eating contaminated animals.

5. Vertical transmission

Vertical transmission is the transmission of the Ebola virus from mother to baby, which can happen during pregnancy, delivery, or breastfeeding.

This is because the Ebola virus may be present in the amniotic fluid or breast milk, as well as in other bodily fluids from the woman that can infect the baby after birth.

Risk factors

The main factors that increase the risk of Ebola are:

• Travel to regions with an Ebola outbreak, such as Africa

• Contact with people, bodily fluids, surfaces, or objects infected with the Ebola virus

• Working in funeral homes or participating in the burial of people with Ebola

• Visiting or working in laboratories or hospitals

• Recent contact with infected bats, chimpanzees, gorillas, monkeys, antelopes, and porcupines

The Ebola virus is easily transmitted after symptoms appear and is not transmitted during the incubation period.

Treatment options

According to the CDC, there are two FDA-approved monoclonal antibody treatments in the US for Ebola disease caused by the Zaire ebolavirus species: Ebanga (ansuvimab-zykl) and Inmazeb (a combination of atoltivimab, maftivimab, and odesivimab-ebgn). The person should remain in isolation to avoid spreading the virus to others.

Treatment aims to keep the person hydrated and maintain normal blood pressure and oxygen levels. In addition, medications may be recommended to control pain, fever, diarrhea, and vomiting, as well as specific medications to treat other infections that may also be present.

Prevention measures

Measures to prevent the Ebola virus include:

• Avoid outbreak areas.

• Wash hands with soap and water several times a day.

• Stay away from people with Ebola, as well as those who have died from Ebola, because they can also transmit the disease.

• Do not eat bushmeat, and be careful around bats that may be contaminated with the virus, as they are natural reservoirs.

• Do not eat fruit that has been bitten by animals, as it may be contaminated with saliva from infected animals, especially in outbreak areas where fruit bats are present.

• Do not touch the bodily fluids of an infected person, such as blood, vomit, feces or diarrhea, urine, secretions from coughing and sneezing, or genital fluids.

• Wear gloves, protective clothing, and a mask when coming into contact with an infected person, avoid touching the person, and disinfect all materials after use.

• Burn all clothing from a person who died from Ebola.

Because Ebola infection can take up to 21 days to be detected, during an Ebola outbreak it is recommended to avoid traveling to affected areas, as well as to places that border these countries.

Another helpful measure is to avoid public places with large crowds, because it is not always possible to know who may be infected and transmission can occur through direct contact with infected bodily fluids.