Ebolavirus disease (EVD)

• Ebolavirus disease, often called Ebola, is a serious and often fatal disease caused by Ebolavirus.
• People who are living in or travelling to affected areas of Africa may be at risk of infection.
• It is diagnosed by a test that detects the virus in blood or bodily fluids.

What is Ebolavirus disease?

Ebolavirus disease (EVD), commonly called Ebola, is a serious and often fatal disease caused by Ebolavirus.

The virus can cause disease in humans, other primates (apes and monkeys) and some other animal species. Since Ebolavirus was first identified in 1976, there have been occasional small outbreaks of disease in humans in rural areas of sub-Saharan and central Africa. The previous outbreak in West Africa, which commenced in 2013, was the largest ever recorded and the first to spread to major urban areas and to multiple countries.

Scientists have identified six species of Ebolavirus across the central part of Africa and believe that it occurs naturally in fruit bats, and sometimes causes disease in other animals such as primates (apes and monkeys), forest antelope and porcupines.

There is no evidence that Ebolavirus occurs in bats or other animals in Australia.

How is Ebolavirus disease spread?

Humans may become infected with Ebolavirus through direct contact with the blood, bodily fluids or tissues of an infected animal, usually during hunting or preparation of ‘bushmeat’.

Once a human is infected, the virus can then spread to other people via contact with the blood or other bodily fluids of a sick or dead person, or via contact with contaminated objects such as needles and syringes and unsterilized medical instruments.

The virus has been found in blood, saliva, vomit, faeces, urine, semen, tears, breast milk and nasal secretions of infected people.

The virus in the blood and other bodily fluids is transmitted to another person through broken skin or mucous membranes, such as the mouth, eyes or nose. Ebolavirus can also be transmitted from person-to-person during sexual contact (oral, vaginal or anal sex).

People who participate in traditional burial rituals conducted in some areas of Africa are at high risk of getting infected because the virus can survive in bodily fluids of the deceased for several days.

What are the signs and symptoms of Ebolavirus disease?

Humans are not infectious until they develop symptoms.

Symptoms of EVD begin between 2 to 21 days (average 8 to 10 days) after exposure to the virus. Initially, symptoms may be difficult to distinguish from other more common infectious diseases that occur in Africa such as malaria, typhoid fever and meningitis.

The first symptoms typically include “dry symptoms” such as fever, severe headache, fatigue, muscle and joint aches and weakness.

The illness progresses with other symptoms like sore throat, stomach pain, rash and “wet symptoms” such as vomiting, diarrhoea and in some cases internal and external bleeding which can progress to multi-organ failure and death.

Between 40 and 90 per cent of EVD cases in Africa die of the disease.

Who is at risk of Ebolavirus disease?

People who live in, or travel to, affected areas of Africa may be at risk of exposure to Ebolavirus. However, the risk of infection is extremely low unless there has been direct contact with the bodily fluids of an infected person or animal, whether alive or dead.

Healthcare workers and carers in contact with infected people are at risk of infection, particularly those in resource-poor settings where there may be limited access to hand-washing facilities and protective equipment. Protective clothing and equipment (including: a fluid resistant P2/N95 mask/respirator and face shield/goggles, or a powered air-purifying respirator (PAPR); double gloves; a fluid resistant gown; fluid-repellent boots that cover to mid-calf; and a head cover that covers the head and neck (unless protection is provided by using a PAPR)) is recommended when caring for a sick person.

How can Ebolavirus disease be prevented?

There are two Ebola vaccines available globally; both have been licensed in Europe and one in the United States. Neither vaccine is currently available in Australia. No vaccines are available for Sudan ebolavirus, a species of Ebolavirus.

The best prevention is to avoid contact with infected animals and people, including bodies of the deceased.  

Hunting and contact with ‘bushmeat’ in affected areas of Africa should be avoided.

How is Ebolavirus disease diagnosed?

EVD is confirmed by a blood test or testing of other body fluids. Testing for EVD is only performed at designated laboratories with special biosafety facilities.

How is Ebolavirus disease treated?

The World Health Organization recommends the use of two treatment options, Ebanga and Inmazeb. There are currently no treatments available in Australia. Early diagnosis and prompt supportive therapy, such as intravenous fluid replacement, can be lifesaving. In WA, people with EVD are managed in designated hospitals.

What is Western Australia’s public health response?

There are national and state plans and guidelines for identification, investigation and management of suspected or confirmed cases of EVD, should the disease be imported into Australia.

Public health measures include implementing border measures and screening procedures as required.

Doctors and laboratories are required to immediately report any suspected or confirmed EVD cases to the Department of Health.

A person with suspected or confirmed Ebolavirus infection would be managed in designated hospitals in WA and follow strict infection prevention and control precautions to prevent infection.

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