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Ebola FAQs 2

What is Ebola?

Ebola is a “viral hemorrhagic fever”, an illness that may have symptoms of fever and severe bleeding which can progress to organ failure and death. The average fatality rate is around 50%. The virus is thought to reside in bats, and can spread to non-human primates. Humans can be infected after contact with infected animals, through contact with an infected person’s body fluids, or via contaminated objects.

What viruses cause Ebola?

Ebola is caused by a group of viruses known as orthoebolaviruses (formerly ebolavirus). There are six identified types of orthoebolaviruses, four of which are known to cause illness in humans. Each is named after the region where it was first detected:

  • Zaire or Ebola virus (Orthoebolavirus zairense): First identified in 1976 in Congo (DRC), formerly Zaire. It has caused multiple outbreaks, primarily in Central Africa. It emerged in West Africa in 2014, causing a large outbreak that affected Liberia, Guinea and Sierra Leone, which took over two years to control.
  • Sudan virus (Orthoebolavirus sudanense): First identified in 1976 in southern Sudan. This virus has caused at least six outbreaks in Uganda and Sudan.
  • Bundibugyo virus (Orthoebolavirus bundibugyoense): First identified in 2007 in the western region of Uganda. It has led to two outbreaks: one in Uganda and one in Congo (DRC).
  • Taï Forest virus (Orthoebolavirus taiense): This virus has only caused one known human infection in 1994.

Two additional orthoebolaviruses have been identified but are not known to cause illness in humans:

  • Reston virus (Orthoebolavirus restonense): First identified in 1989, this virus is found in monkeys and pigs from the Philippines. While some people in contact with these animals developed antibodies, none exhibited symptoms, suggesting possible asymptomatic infections.
  • Bombali virus (Orthoebolavirus bombaliense): First identified in 2018, this virus has been found in bats in Sierra Leone, including near households. No human infections have been reported, and its pathogenicity in humans remains unclear.

What illness does it cause (symptoms)?

The early symptoms of Ebola infection are usually sudden and non-specific, including:

  • Fever
  • Severe headache
  • Muscle pain
  • Weakness
  • Fatigue
  • Sore throat

Vomiting, diarrhoea, rash and abdominal pain usually appear as the disease progresses. Some people may develop redness of the eyes and hiccups. The disease can progress to cause organ failure and bleeding, both internally and externally, which may lead to death. The average fatality rate is around 50%. However, in past outbreaks, fatality rates have varied from 25% to 90%.

How is it spread?

There are three primary routes of transmission for Ebola:

  • Animal to Human: through direct contact with the blood, secretions, organs or other bodily fluids of an infected animal, which may include chimpanzees, gorillas, fruit bats, monkeys, forest antelopes and porcupines. This may happen during butchering, handling or cooking bush meat (meat of wild animals). Humans can also become infected by consuming undercooked meat from an infected animal.
  • Person to Person: through direct unprotected contact (through broken skin or mucous membranes) with an infected person’s body fluids. Once someone has symptoms of illness, their blood, vomit, faeces, mucus, urine and other body fluids become infectious. The bodies of people who died from Ebola are highly infectious.
  • Objects or Environment: via objects contaminated with body fluids from sick people, such as dirty clothing or bed linens, gloves and medical waste. Ebola does not spread through the air the way colds and flu viruses do.

How long are infected people contagious?

People infected with Ebola are contagious once they develop symptoms and are infectious as long as body fluids contain the virus, which can be many months. Generally, the more severe the symptoms are, the more infectious the person is. The dead body of an Ebola victim is highly contagious.

Even after the virus is undetectable in the blood it can linger in some body fluids, such as semen, breast milk, and other “immune privileged” sites such as inside the eye and the central nervous system.

What locations are at risk for Ebola?

Most Ebola-causing viruses are believed to reside in bats and non-human primates, such as monkeys and apes, in Africa. Countries that have experienced recurrent Ebola outbreaks include the Republic of Congo, the Democratic Republic of Congo, Gabon, South Sudan and Uganda. Other countries reporting outbreaks include Guinea, Liberia, Sierra Leone, South Africa and Côte d’Ivoire.

Outside the African continent, imported infections have occurred in several countries during large outbreaks in Africa, including Italy, Spain, the U.K., and the U.S. Additionally, one type of orthoebolavirus, the Reston virus, has been found in monkeys and pigs from the Philippines, though it is not believed to cause symptomatic infections in humans.

See the U.S. Centers for Disease Control and Prevention Ebola Disease Outbreaks Map for more information on geographical distribution of Ebola: https://www.cdc.gov/ebola/outbreaks/index.html.

How is it treated?

The management of Ebola-infected patients focuses on supportive therapy. This may include intravenous fluids, supplemental oxygen, blood transfusions, medications to support blood pressure and reduce gastrointestinal symptoms, and antibiotics for any secondary bacterial infections. Early supportive medical interventions improve the chance of survival.

There are currently two drugs approved for the treatment of Ebola caused by the Zaire species, Inmazeb and Ebanga. Both of these treatments were evaluated in a clinical trial during the 2018-2020 Ebola outbreak in Congo (DRC). Neither of these has so far been evaluated for the treatment of Ebola caused by other species.

There are no approved treatments for the Sudan type of Ebola, which is currently causing an outbreak in Uganda, though clinical trials are underway.

Is there a vaccine?

There currently are two licensed vaccines against the Zaire type of Ebola. Animal studies indicate that these vaccines do not provide protection against the other types of Ebola. They are used in outbreak situations and are not commercially available.

  • The Ervebo vaccine was licensed in 2019 and is safe and recommended for use as part of Ebola outbreak response measures. It is a single-dose vaccine approved for individuals 18 years and older.
  • A vaccine consisting of two components, Zabdeno and Mvabea, administered approximately 8 weeks apart is recommended for individuals 1 year and older. Due to the two-dose requirement, this vaccine is not a suitable response measure for an outbreak where immediate protection is necessary.

There are currently no approved vaccines for the Sudan type of Ebola. However, vaccine candidates are being used in clinical trials during the 2025 outbreak in Uganda to assess their efficacy.

Who is most at risk?

The risk of getting Ebola is low for most people. However, people who have direct unprotected contact with infected people and their contaminated items are at highest risk of infection. This typically includes:

  • Healthcare workers taking care of patients infected with Ebola.
  • Family members and other people who are in direct contact with sick people, or dead bodies at funerals.
  • People who have direct contact with infected animals.

Are there any travel restrictions?

There are currently no travel restrictions for the outbreak in Uganda. However, enhanced screening measures have been implemented in Uganda and some neighbouring countries.

How can I protect myself?

  • Defer non-essential travel to the affected area until outbreak control measures have been definitively established.
  • Pay strict attention to hygiene.
  • Do not participate in high-risk activities such as funerals in outbreak areas (do not touch / wash dead bodies).
  • Avoid hospitals that are treating suspected Ebola cases.
  • Avoid direct contact with sick people and their body fluids; this includes items that may have been contaminated with fluids like bedding and clothing.
  • Avoid direct contact with animals, including bats; both dead and live animals pose a risk.
  • Do not eat bats or "bush meat" from gorillas, monkeys and other primates.
  • Avoid sexual transmission of Ebola by using condoms consistently and correctly during sexual contact or abstaining from sex for at least 12 months or until semen has tested negative twice for the virus (pertinent to survivors of Ebola).

If someone is suspected/confirmed to have Ebola, can International SOS evacuate them?

International SOS is highly experienced in evacuating patients with infectious diseases, having safely and successfully transported patients with infectious diseases requiring in-transport isolation in many regions of the world.

Considerations

International evacuation of patients exposed to, or with confirmed Ebola or another viral haemorrhagic fever is highly complex. Patients with confirmed Ebola would only be considered suitable for movement with the use of patient isolation transport units and the patient clinical picture being suitable for safe transport in these isolation units.

  • Generally, the more serious the condition of the patient, the more unlikely transport will be possible or realistic in patient isolation transport units.
  • Patients with exposure or suspected exposure without symptoms are transportable, provided relevant health authority support is in place.