Ebola is a viral infection. There is no vaccine or cure for Ebola. Over half of all infected people die as a result of the infection. However, the risk of becoming infected with Ebola in the UK is very small.
Ebola is only spread by close contact with an infected person. The risk of Ebola is therefore for people who have had close contact with someone already infected with Ebola, either by:
- Travel to a country affected by Ebola; or
- Close contact with someone who has returned from an infected country and has Ebola infection.
People who are infected only spread the infection to other people when they become ill. People who have Ebola infection but have not yet developed Ebola symptoms will not spread the infection.
What is Ebola?
Ebola is a viral infection. Ebola infection was first recognised in 1974, with outbreaks in the Democratic Republic of the Congo and Sudan. Since 1994 there have been further outbreaks of Ebola infection in Central Africa. The current outbreak in West Africa is the largest recorded outbreak and was first confirmed in Guinea in March 2014.
How can I become infected with Ebola?
People can become infected with the Ebola virus if they come into contact with the blood, body fluids or organs of an infected person. Most people are infected either by directly touching the victim's body or by cleaning up an infected person's body fluids (eg, blood, poo (stools), urine, sick (vomit), saliva, sweat, breast milk or semen). A person is infectious as long as their blood, urine, stools or secretions contain the virus.
Ebola is much harder to catch than some other viral infections such as flu. You need to have close contact with a person infected with Ebola to be at risk of infection. People infected with Ebola do not pass on infection (become infectious) until shortly before they develop symptoms. Therefore, infected people do not spread the disease for long periods before they know they are infected.
Traditional African burial rituals have also played a part in its spread. The Ebola virus can survive for several days outside the body, including on the skin of an infected person. It is common practice for mourners in Africa to touch the body of the dead person.
People can also become infected by having sex with an infected person without using a condom. Ebola virus can stay in semen for up to seven weeks after the infected person has recovered.
Am I at risk of Ebola infection?
The risk of becoming infected with Ebola is extremely low for anyone living in the UK. However, there is a risk of Ebola infection for anyone travelling to an infected country or anyone who comes into close contact with an infected person.
Anyone who cares for an infected person or handles their blood or fluid samples is at risk of becoming infected. Hospital workers, laboratory workers and family members are at greatest risk.
Although the UK might see cases of imported Ebola, this is extremely unlikely to result in a large outbreak in the UK. The UK has a very effective public health system and measures have been put in place to identify any infected person at the earliest opportunity. Healthcare staff have been made aware of how to deal with any person with possible Ebola infection. Special hospital isolation units have been made available.
How can Ebola infection be prevented?
Any person suspected of being infected with Ebola should be isolated to prevent any contact with other people.
Anyone in contact with an infected person should:
- Wear face masks, goggles (face visors may be preferred), gowns and gloves.
- Carefully and frequently wash hands with soap (or alcohol hand rub) and water.
- Wash disposable gloves with soap and water after use, dispose of them carefully, and then wash hands.
Healthcare staff will also need to make sure that any equipment is properly disinfected and sterilised. Extreme care must also be taken when disposing of needles and any body fluids from the infected person.
To reduce the risk of Ebola infection, travellers to affected countries should very carefully keep to the following advice:
- Don't handle dead animals or their raw meat.
- Don't eat 'bush meat' (meat from wild animals).
- Avoid contact with any person who may have any symptoms of Ebola infection.
- Avoid having sex with any person in a risk area (always use a condom if you do have sex).
- Make sure fruit and vegetables are washed and peeled before eating.
- Wash hands frequently using soap and water to destroy the virus.
There is currently no proven vaccine to prevent Ebola infection but a great deal of research is currently trying to develop an effective vaccine.
What are the symptoms?
An infected person will usually develop a high temperature (fever), severe headache, joint and muscle pain, sore throat, and severe muscle weakness. These symptoms begin suddenly, and start between 2 and 21 days after becoming infected (usually after 5-10 days).
An infected person may then develop diarrhoea, sickness (vomiting), a rash, stomach pain and reduced kidney and liver function. Bleeding inside the body and also bleeding from the ears, eyes, nose or mouth may occur.
What if I think I might have Ebola in the UK?
If you feel unwell with any of the symptoms mentioned above within 21 days of coming back from any infected area of the world (but especially West Africa), you should:
- Stay at home; and
- Immediately telephone 111 (or 999 if it is an emergency) and explain that you have recently visited that country.
These services will provide advice and arrange for you to be seen in a hospital if necessary to find out what is causing your illness. It is essential to call 111 or 999 and not to just turn up at a hospital or your GP surgery.
How is Ebola diagnosed?
If Ebola is considered a possibility then tests will include samples of blood or body fluid sent to a laboratory to be tested for Ebola virus. A diagnosis can be made very quickly. If the test is positive then the infected person will be transferred to an approved hospital isolation unit.
How is Ebola treated?
People infected with Ebola need to be placed in isolation in intensive care.
There is currently no proven treatment to cure Ebola infection but potential treatments are being developed and tested. One promising medicine that has been used is called ZMapp but this medicine has not yet been properly tested in humans for safety or effectiveness.
There is a great deal of supportive care that can be provided. For example, fluids introduced into the body through a vein (intravenously), and use of oxygen. Reduced water in the body (dehydration) is common and may be severe. Intravenous fluids are usually required. The sooner supportive care is provided, the better the chances of survival.
What is the outcome (prognosis)?
Ebola virus disease is fatal in more than half of those infected but people can recover from Ebola infection. Some people who have recovered from Ebola have developed long-term complications, such as joint or vision problems.
Dr Colin Tidy
Dr Colin Tidy
Dr Hayley Willacy