Ebola

Ebola disease is a rare but severe illness that affects humans and can be fatal. On average, about half of those infected do not survive, although fatality rates have ranged from 25% to 90% during past outbreaks.¹

The disease first appeared in 1976 near the Ebola River in central Africa.¹ Since then, outbreaks have occurred in several regions, with the largest recorded between 2014 and 2016. ²

Ebola disease is caused by a group of viruses in the Orthoebolavirus genus of the filoviridae family.³ Three types are known to cause large outbreaks in humans:³

• Ebola virus – Ebola virus disease
• Sudan virus – Sudan virus disease
• Bundibugyo virus – Bundibugyo disease virus

We will refer Orthoebolaviruses as generic Ebola viruses in this document.

Symptoms typically appear 2 to 21 days after exposure with an infected individual or animal, with most cases developing within 8 to 10 days.⁴ Ebola disease often progresses in two stages:

Early stage (“dry”) symptoms:⁵

• Fever
• Muscle or joint pains
• Severe headache
• Weakness and fatigue
• Sore throat
• Loss of appetite

Later stage (“wet”) symptoms:⁵

• Unexplained bleeding or bruising
• Gastrointestinal symptoms – such as abdominal pain, nausea, vomiting, and/or diarrhea

Other symptoms may include confusion, red eyes, skin rash, chest pain, shortness of breath, hiccups, or seizures.⁵

Because early symptoms can resemble common illnesses such as influenza, malaria or pneumonia, early medical evaluation is critical.⁵ Early intervention and treatment can improve outcomes. Anyone suspected of being in contact with Ebola disease and showing symptoms should seek immediate medical attention.

Ebola disease spreads through direct contact with infected humans or animals and their body fluids. It does not spread through the air like respiratory viruses.⁴

Transmission can occur through contact with:⁶

• Blood or body fluids (e.g., urine, saliva, sweat, feces, vomit, breast milk, amniotic fluid, semen)
• Contaminated Objects (e.g., clothing, bedding, needles, medical equipment)
• Infected animals, such as fruit bats or nonhuman primates

Certain body fluids, including semen, may carry the virus for some time after recovery. The virus enters the body through broken skin or mucous membranes (eyes, nose or mouth). A person can only spread the virus after symptoms begin, and risk increases as illness progresses. The virus can survive on dry surfaces, like doorknobs and countertops for several hours; in body fluids like blood, the virus can survive longer.⁷ Proper cleaning, disinfection and infection prevention practices are essential to help reduce transmission.

In healthcare settings, Ebola viruses can spread quickly during an outbreak. Ensuring proper infection control practices are in place and being used is very important. Extra care should be taken with the body fluids and contaminated materials soiled by patients suspected of having Ebola disease.¹ The use of dedicated (and preferably disposable) medical equipment and instrumentation is critical. If instruments are not disposable, they must be thoroughly cleaned and sterilized before using again.

People at higher risk of infection include:⁸

• Healthcare workers who are not using proper infection prevention practices, such as hand hygiene and personal protective equipment (PPE) while caring for infected patients
• Friends and family in close contact with infected individuals
• Individuals handling the body of someone who has died from Ebola disease

Ebola does not spread through casual contact, food, or water, and it is not airborne. There is no evidence that mosquitoes or other insects can transmit Ebola viruses.⁵

Like all infectious diseases, the key to preventing the spread of Ebola disease is by breaking the chain of infection through strong prevention practices. Increasing awareness of how Ebola viruses spread can help reduce person to person transmission. This includes:

• Stay informed and follow local, regional and national public health recommendations
• Avoid contact with individuals who are sick or suspected of having Ebola disease
• Follow protective measures when handling the body of a deceased infected person
• Use appropriate PPE, such as gloves, gowns and eye protection
• Provide training on symptoms and risk factors, especially in high-risk settings
• Practice frequent handwashing using soap and water or an alcohol-based hand rub if soap and water aren’t available
• Ensure needles and sharps are disposed of properly

Cleaning and disinfection recommendations:

• Clean and disinfect frequently touched surfaces and any areas contaminated with body fluids
• Use disinfectants approved by local regulatory authorities or recommended by national public health organizations, such as the World Health Organization (WHO)
   
  • In the US, use an EPA-registered disinfectant with a claim against Ebola or a product listed as having an emerging viral pathogen claim⁹
  • In the EU, use a disinfectant labeled with either ‘Virucidal’, ‘Limited Spectrum Virucidal’ or ‘Virucidal Activity against enveloped viruses’ activity
• Follow manufacturer instructions, including proper concentration and contact time

Vaccines have been developed for Ebola virus, but do not exist or are in development for Sudan virus and Bundibugyo virus.¹

For more information, contact your Ecolab representative or visit ecolab.com/contact-us.