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Health Alert: Ebola Outbreak in the Democratic Republic of Congo - May 22, 2018
The California Department of Public Health (CDPH), in collaboration with the U.S Centers for Disease Control and Prevention (CDC), is closely monitoring the current Ebola virus disease (EVD) outbreak in the Democratic Republic of Congo (DRC). As of May 21, 2018, 49 suspected, probable, and confirmed EVD cases, including 26 deaths, from the DRC have been reported to the World Health Organization (WHO). Currently, neither CDC nor WHO recommend any restrictions for travel in relation to this current outbreak. The risk of importation of EVD into California is very low. Nevertheless, infectious diseases are regularly imported into California. CDPH reminds all healthcare providers in hospitals, emergency departments, clinics, and other outpatient settings to routinely ask patients with acute, possibly infectious illness about recent travel, including international travel to Africa. Click here to read the full Health Alert.
Ebola Virus Disease (EVD), previously known as Ebola hemorrhagic fever, is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees). Ebola is a rare and deadly disease caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five identified Ebolavirus species, four of which have caused disease in humans: Zaire ebolavirus; Sudan ebolavirus; Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus; and Bundibugyo ebolavirus. The fifth, Reston ebolavirus, has caused disease in nonhuman primates but not in humans.
Ebola is found in several African countries. The first Ebola species was discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.
The natural reservoir host of Ebola remains unknown. However, on the basis of available evidence and the nature of similar viruses, researchers believe that the virus is animal-borne with bats being the most likely reservoir. Four of the five subtypes occur in an animal host native to Africa.
The 2014 Ebola outbreak is the largest Ebola outbreak in history and the first Ebola outbreak in West Africa. This outbreak is the first Ebola epidemic the world has ever known — affecting multiple countries in West Africa. Although the risk of an Ebola outbreak in the United States is very low, health officials are taking precautions to prevent this from happening.
Signs and Symptoms
Symptoms of Ebola typically include:
- Fever (greater than 38.6°C or 101.5°F)
- Severe headache
- Muscle pain
- Stomach pain
- Unexplained bleeding or bruising
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola but the average is 8 to 10 days. Recovery from Ebola depends on the patient’s immune response. Among those infected during the current West Africa outbreak, 1 in 2 have died. People who recover from Ebola infection develop antibodies that last for at least 10 years.
Ebola is an infectious disease. It is transmitted by direct contact with blood and body fluids from an infected, symptomatic person or from contact with blood and body fluids from an infected animal. It is not passed through the air like the flu. You cannot get it from casual contact. The virus is not carried in food or water. Standard and droplet precautions (gloves, gowns, and surgical masks) are sufficient to protect healthcare workers from infection in most healthcare situations that would be found in the United States. Proper removal of protective equipment and disposal of infectious waste, using procedures already in place in most U.S. healthcare facilities, will prevent spread of the virus. Ebola virus spreads in developing African countries due to the need to hunt wild animals that serve as virus reservoirs, lack of soap and clean water, limited access to disinfectants, poor or nonexistent medical facilities, scarce disposable medical supplies, and cultural practices that involve extensive direct contact with the bodies of deceased family members.
Testing and Treatment
Diagnosis of Ebola is based on a variety of laboratory tests and clinical symptoms.
Currently there are no specific vaccines or medicines (such as antiviral drug) that have been proven to be effective against Ebola. Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival:
- Providing intravenous(IV) fluids and balancing electrolytes (body salts)
- Maintaining oxygen status and blood pressure
- Treating other infections if they occur
Timely treatment of Ebola is important but challenging since the disease is difficult to diagnose clinically in the early stages of infection. Because early symptoms such as headache and fever are not specific to Ebolaviruses, cases of Ebola may be initially misdiagnosed.
Experimental treatment has been tested and proven effective in some animals but has not yet been evaluated in humans.
There is no FDA-approved vaccine available for Ebola.
If you travel to or are in an area affected by an Ebola outbreak, make sure to do the following:
- Practice careful hygiene. Avoid contact with blood and body fluids.
- Do not handle items that may have come in contact with an infected person’s blood or body 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 is often able to provide advice on facilities.
- After you return, monitor your health for 21 days and seek medical care immediately if you develop symptoms of Ebola.
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