Ebola

Overview

Ebola, also called Ebola virus disease, is a serious illness caused by a virus. It brings on fever and can damage several organs, including the liver and kidneys. Ebola outbreaks have mostly happened in parts of central and west Africa. It does not spread easily the way a cold or flu does. People catch it only through direct contact with the blood or body fluids of someone who is already sick with Ebola, or by touching objects that have those fluids on them. It is not spread through the air, through water, or through everyday contact with someone who has no symptoms.

No. Ebola is very rare worldwide. Cases are counted in outbreaks, and most outbreaks happen in areas of central and west Africa where the virus is known to circulate in animals. Outside outbreak areas, a single case is a public health emergency and is treated very seriously.

Anyone can catch Ebola if they have direct contact with an infected person's body fluids or with contaminated objects. People at highest risk are family members and friends caring for a sick person at home, health workers, people who prepare bodies for burial, and people who handle or eat infected wild animals. People who travel to an outbreak area and follow normal tourist activities, without contact with sick people, are at very low risk.

Symptoms

Common symptoms

• Sudden fever, often with chills
• Feeling very tired and weak
• Muscle pain and body aches
• Severe headache
• Sore throat
• Stomach pain and loss of appetite
• Vomiting and diarrhoea, which can lead to dehydration
• A rash, red eyes, or hiccups in some people
• Bruising, or bleeding from the gums, nose, or where a needle went in (this happens in some, not all, cases)

Symptoms in children

• Symptoms are broadly the same as in adults, but children may become dehydrated faster
• Young children may be irritable, sleepy, or refuse to feed or drink
• Children can get the same fever, vomiting, and diarrhoea, and may not describe pain clearly
• Children who recover may need follow-up for growth, eyesight, hearing, and general health

Symptoms in older adults

• Older adults can become seriously ill more quickly, especially with dehydration or confusion
• Existing conditions such as heart or kidney problems can make illness harder to manage
• Weakness, low blood pressure, and falls are more of a risk
• Recovery may take longer and needs close follow-up

Causes

Main causes

• The Ebola virus lives in bats, which are thought to be the natural source. It can also infect other animals such as monkeys and apes.
• People are infected through direct contact with the blood, body fluids, or organs of an infected animal, such as when hunting or preparing wild meat.
• The virus then spreads from person to person through broken skin or the mouth, nose, or eyes touching a sick person's blood or body fluids.
• Caring for a sick person at home without protective gloves or gowns is a major way the virus spreads.
• Touching a person who has died from Ebola is very risky, because the body still carries a lot of virus.
• Sharing needles or medical equipment that has not been properly cleaned can spread the virus.
• Ebola is not spread by air, water, or food, and not by mosquitoes or other insects.

Risk factors

• Living in or travelling to an area where there is an active outbreak
• Living in the same household as, or caring for, someone with Ebola
• Working as a health or lab worker in an outbreak area, especially without proper protective equipment
• Helping with burials or washing bodies of people who died from Ebola
• Working with wild animals, hunting, or handling wild meat in outbreak areas
• Being pregnant or breastfeeding can add risk for both mother and baby if infection happens

When to see a doctor

See a doctor urgently if:

• You have a fever and you have been in an area with an Ebola outbreak in the past 21 days
• You have had direct contact with someone who has, or may have, Ebola
• You have a fever with bleeding, bruising, or red eyes, especially after travel
• You are feeling very unwell with vomiting or diarrhoea and cannot keep fluids down

Book a routine appointment if:

• You are planning travel to an area with an outbreak and want advice on how to stay safe
• You have returned from an outbreak area and feel well, but want to check whether you need to watch for symptoms
• You have recovered from Ebola and need follow-up care or advice about close contact, sex, or breastfeeding
• You are feeling anxious or low after an outbreak or after caring for someone who was ill

Diagnosis

A doctor will ask about your symptoms, your recent travel, and any contact with someone who was sick or who died. Ebola is confirmed with blood tests done in a specialist laboratory. Because early Ebola symptoms look like many other illnesses, doctors usually test for other common causes at the same time, such as malaria. If Ebola is suspected, you will be cared for in a single room or specialist treatment unit while tests are done.

Tests that may be done

• A blood test that looks for the virus's genetic material (a PCR test) — this is the main test
• A blood test that looks for pieces of the virus (an antigen test)
• A blood test that looks for the body's immune response (antibodies), which is more useful later in illness
• Tests for other likely causes of fever, such as malaria, typhoid, and common infections
• Blood tests to check how well your kidneys, liver, and blood clotting are working
• Tests to check for dehydration and salt balance

What to expect at your appointment

If Ebola is suspected, you will be kept separate from other patients to protect them. Staff will wear protective clothing. You may be asked detailed questions by public health teams so they can check on people you have been in close contact with. Test results for Ebola usually come back within a day or two, though it can take longer in a busy outbreak. Waiting can be frightening, so ask staff to explain what is happening and to help you contact family. If the test is negative, the team will look for another cause of your illness.

Treatment

There is no simple cure that works for everyone, but Ebola can be treated. Care focuses on keeping the body strong while the immune system fights the virus. This means replacing lost fluids, keeping blood pressure steady, giving oxygen if needed, and treating other infections. Early treatment greatly improves the chance of survival, so quick assessment matters. In some outbreaks, specific antibody-based treatments have been used under medical supervision, and vaccines are used to protect people at high risk.

Self-care at home

• Do not try to manage suspected Ebola at home — get medical help the same day
• If you are recovering, rest as much as you need and build up activity slowly
• Drink fluids regularly and follow your care team's advice on food and hydration
• Keep all follow-up appointments, including eye, hearing, and joint checks
• Wash your hands often with soap and water
• Ask your care team when it is safe to resume close contact, sex, and breastfeeding after recovery
• Tell a doctor or nurse early if you feel low, anxious, or unable to sleep

Medical treatments

Treatment is given in a specialist unit with strict infection control. The main approach is supportive care: fluids given by mouth or into a vein, oxygen, medicines for pain and fever, treatment for other infections such as malaria, nutrition support, and careful monitoring of blood pressure, kidney function, and blood clotting. In some outbreaks, antibody-based treatments designed to target the Ebola virus have been used, and antiviral research continues. Vaccines are used to protect contacts of cases and health workers. You should discuss any treatment decisions with your treating team.

When is surgery considered?

Surgery is not a treatment for Ebola. Emergency surgery may only be considered in rare situations, such as a pregnancy complication, and would be done with very strict protective measures by a specialist team. Your doctors will explain any such decision carefully.

Living with this condition

Most people who survive Ebola go home after a period in hospital. Recovery can be slow, and tiredness is common for weeks or months. Many survivors are offered follow-up clinics that check eyes, hearing, joints, and mental health. It also helps to plan a gradual return to work, school, and family life, and to ask for practical help in the first weeks at home.

Lifestyle tips

• Build activity back up slowly and rest when you need to
• Keep up hand washing and household cleanliness
• Follow your care team's advice about condoms and safer sex for the recommended time after recovery
• Ask for advice before breastfeeding if you were infected while pregnant or breastfeeding
• Avoid heavy physical work until you feel stronger
• Stay connected with family, friends, and survivor groups where available

Diet and exercise

Eat regular, balanced meals with plenty of fluids to help your body rebuild strength. Start with short walks and gentle daily movement, and increase slowly over weeks. If eating is difficult, or you are losing weight, tell your care team. There is no special diet that cures Ebola, but good nutrition supports recovery.

Mental health and emotional wellbeing

Surviving a serious illness like Ebola can leave deep emotional effects. Many survivors have fear, vivid memories, trouble sleeping, low mood, or anxiety. Some face stigma, which can be very painful and may make people hide their history. These feelings are common and treatable. Talking to a counsellor, joining a survivor support group, and telling your doctor how you feel can help a lot. If you ever feel unable to cope or have thoughts of harming yourself, contact your local emergency number or a local crisis support line straight away — you deserve urgent help and you are not alone.

Prevention

Yes, Ebola can be prevented. The key is to avoid direct contact with blood and body fluids from people or animals that may be infected. In outbreak areas, wash your hands often with soap and water, avoid touching anyone who is sick or who has died, and follow public health advice. Health workers should use protective equipment and follow infection control steps. Safe and dignified burials, done by trained teams, protect families and communities.

Vaccines

Vaccines have been developed and approved to protect against one type of Ebola virus. They are mainly used during outbreaks for people at highest risk, such as close contacts of cases, health workers, and outbreak response teams. The vaccine is given as part of a public health strategy called ring vaccination. Ask your local health service whether vaccination is recommended for you if you live in or travel to an outbreak area.

Screening programmes

During outbreaks, airports and border points may screen travellers for fever and ask for health declarations. If you have been in an outbreak area, you may be asked to check your temperature for 21 days and report any fever straight away. Screening helps find cases early, but it does not replace good hand hygiene and avoiding contact with sick people.

Complications

If left untreated

• Severe dehydration from vomiting and diarrhoea
• Low blood pressure and shock, where blood cannot reach the organs properly
• Liver and kidney failure
• Problems with blood clotting, leading to bleeding
• Secondary infections such as pneumonia or malaria
• Pregnancy complications, including miscarriage
• Death in a significant number of cases, especially without early supportive care

Long-term outlook

Ebola is a serious illness, and survival rates vary widely between outbreaks, from about one in four to about nine in ten people recovering depending on the setting and how early care starts. Early treatment clearly improves the chance of survival, and outbreak teams now have better tools, including vaccines and supportive care. Many people recover fully. Some survivors have longer-term problems such as joint pain, eye inflammation, hearing changes, or tiredness, and these can be checked and treated. There is real hope, and support is available at every stage.

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