Ebola Disease

  • Ebola virus Ebola disease (EBOD) is a serious illness caused by an Ebola virus.
  • Ebola viruses do not spread easily from person to person. They spread by contact with body fluids, primarily blood, vomit and feces of infected people; by contact with some animals (bats, monkeys and apes in Central or West Africa); or by contact with medical equipment that was in contact with infected body fluids, like needles. It is not spread through casual contact and is not transmitted until the infected person shows signs of illness.
  • Occasionally, there are outbreaks of EBOD, which have historically occurred mostly on the African continent.
  • Travel to a country actively affected by an outbreak may put a person at risk.
  • Risk from travel to any other country is very low unless the individual has been in contact with a person with EBOD.
  • The risk of a case of EBOD in Manitoba is low.

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Symptoms

Ebola disease (EBOD) is a serious illness that was first discovered in a remote part of Central Africa in 1976. Symptoms of EBOD include fever, tiredness, muscle aches, weakness, severe headache, red eyes, sore throat, vomiting and diarrhea that can be bloody, and hemorrhaging (bleeding). Symptoms develop rapidly. Fever is usually the first symptom of EBOD. This is followed by the sudden onset of flu-like symptoms followed by worsening gastrointestinal (i.e. vomiting and diarrhea) symptoms. EBOD can also cause kidney and liver problems. When the disease progresses, there may be a rash and bleeding from inside and outside the body. EBOD can cause death but early medical care increases the chances of survival.

Symptoms start between two to 21 days after contact with the virus. Infected persons are not considered contagious before symptoms start.

Before seeking health care, it is important to call ahead to the hospital or call Health Links-Info Santé at 204-788-8200 or 1-888-315-9257 (toll-free) if you or a household member has any of symptoms of EBOD and has travelled to an area with EBOD in the last 21 days. Describe your symptoms over the phone, tell them where you have been travelling or living and mention any possible exposure risks. They will be able to advise you on next steps to get assessed and ensure precautions are taken to limit exposure to others by following protocols designed to minimize risk. In addition, if you suspect you have been exposed to EBOD, you should immediately isolate from household members and pets, wash your hands frequently and ensure no one comes in contact with your bodily fluids or items that may have touched your bodily fluids (e.g. bedding, toiletries).

Causes

Outbreaks of EBOD have occurred from time to time in sub-Saharan Africa. There are five recognized species of Ebola viruses:

  • Zaire ebolavirus (EBOV)
  • Sudan ebolavirus (SUDV)
  • Taï Forest ebolavirus (TAFV, formerly Côte d'Ivoire)
  • Bundibugyo ebolavirus (BDBV)
  • Reston ebolavirus (RESTV)

Of the five species, only the first four are known to cause illness in people. The EBOV and SUDV are considered especially virulent, and associated with higher fatality rates. These viruses can cause disease in humans and non-human primates (e.g. monkeys, gorillas, chimpanzees) and can infect other animals (e.g. fruit bats, forest antelope, pigs). While the natural reservoir of EBOD is unknown, some bat species are suspected to carry the virus. Additionally, non-human primates have been identified as incidental hosts (not reservoirs).

Transmission

EBOD is not easily spread to other people. It spreads:

  • from person to person by:
    • direct contact with blood and/or other bodily fluids such as feces, urine, vomit, saliva, sweat, breast/chestmilk and semen from an infected, symptomatic person or dead body and/or;
    • unprotected sexual contact with a person who is recovering from EBOD for up to 12 months following infection with an Ebola virus.
  • through indirect contact with surfaces or equipment (e.g. needles) that are contaminated with these fluids, and
  • through contact with animals that are reservoirs or incidental hosts of the virus.

Cases can spread the virus as long as their blood and/or other bodily fluids contain the virus, including after death.

EBOD is not spread through the air, by water, or in general, by food. However, in Africa, EBOD may be spread by handling bushmeat (wild animals hunted for food).

You can't get EBOD from people who have no symptoms, even if they were recently in an affected country.

Just because someone who has recently been to an affected country is sick, it doesn't mean they have EBOD.

Risk Groups

The following activities have a higher risk of exposure to EBOD:

  • Caring for an EBOD case who is symptomatic without proper and consistent appropriate use of personal protective equipment (PPE)
  • Unprotected sexual contact with a person infected with EBOD who is ill or after recovery for up to 12 months
  • Pregnancy (from birth parent with EBOD to the child)
  • Breast/chestfeeding, if the parent has EBOD
  • Participating in unsafe burial practices, including preparing the body for burial and,
  • Handling and/or consuming wild animals (i.e. bushmeat) in affected areas
Treatment

EBOD is diagnosed by a laboratory test, usually a blood test. It is important to have an early diagnosis because people can recover from EBOD when they receive proper and timely medical care for their symptoms. The average case fatality rate for EBOD is 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.

In Canada, there are currently no approved vaccines or therapeutics available for EBOD. Cases receive care in specialized centres and receive supportive care, such as intravenous fluids, oxygen, blood products, and treating other infections if they occur.  A number of investigational treatments and vaccines are currently under development for some of the different species of Ebola virus. If a case occurs in Canada, the Public Health Agency of Canada (PHAC), in coordination with the province or territory, will provide guidance and access to investigational products as required and appropriate for the situation.

Prevention

EBOD prevention measures include: 

  • avoiding direct contact with blood and body fluids from a person infected with EBOD
  • avoiding non-essential travel to regions affected by ongoing EBOD outbreaks.
  • avoiding contact with items that may have come in contact with an infected person's blood or body fluids (such as clothes, bedding, needles, and medical equipment).
  • avoiding funeral or burial practices that involve touching the body of someone who died from confirmed or suspected EBOD.
  • avoiding contact with bats, forest antelopes, and nonhuman primates (such as monkeys and chimpanzees) blood, fluids, or raw meat prepared from these or unknown animals (bushmeat).

After returning from an area experiencing an EBOD outbreak, people should monitor their health for 21 days. Individuals who are known to be exposed are monitored by public health for 21 days.

Current Risk Status

Updated: December 21, 2022

On September 20, 2022, the Ministry of Health of Uganda declared an EBOD outbreak in the Mubende District, which has since spread to other districts. This outbreak has been linked to the Sudan ebolavirus (SUDV) species. A travel advisory was issued by the Government of Canada on October 7, 2022. The public health risk in Canada and Manitoba remains very low. Canada has a number of border measures in place to mitigate the potential risk of the introduction and spread of communicable diseases into Canada, including EBOD.

Further information on outbreaks, including maps of affected areas, are available at cdc.gov/vhf/ebola/outbreaks/index-2018.html.

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