Ebola exists in certain mammals (primates, bats) in Africa. Fruit bats of the Pteropodidae family may be natural Ebola virus hosts. Ebola can get into people's bodies when they have close contact with the blood, fluids, organs, or other bodily fluids of infected animals. Examples include sick or dead chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines.

Once infection occurs in humans, Ebola spreads through direct contact (through broken skin, mucous membranes -eyes, nose, mouth, etc.) with: 

• Blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with or has died from Ebola 

• Objects contaminated with the virus (e.g., surfaces, bedding, needles, syringes) 

• Semen from a man who recovered from EVD through oral, vaginal, or anal sex 

The chance of spreading the disease is greatest when the person who has it is in the later stages of the illness. During this time, their body contains a lot of the virus. The person may be vomiting, having diarrhea, or bleeding. The chance of spreading the disease is also high if you come into contact with the body of someone who has died from the disease, without proper protection. This can happen when you prepare the body for burial or do other similar things.

If a person does not have any signs or symptoms of Ebola virus disease, then they cannot spread it to others. Usually, the virus is not passed on through food, unless someone handles or eats contaminated bush meat (wild animal meat).

EVD is a severe acute illness, usually with sudden onset of: 

• Fever 

• Fatigue 

• Malaise 

• Muscle pain 

• Severe headache 

• Sore throat 

• Vomiting 

• Diarrhea 

• Abdominal pain 

• Rash 

• Symptoms of impaired liver or kidney function 

• Bruising and bleeding 

Symptoms may appear anywhere from 2 to 21 days after contact with the virus, with an average of 8 to 10 days. Many common illnesses can have these same symptoms, including influenza (flu) or malaria. EVD is a rare but severe and often deadly disease. Recovery from EVD depends on good supportive clinical care and the patient’s immune response. Some survivors may have long-term complications, such as joint and vision problems. It is not known if people who recover are immune for life or if they can later become infected with a different species of Ebola virus. 

In the United States, EVD is a very rare disease. In other parts of the world, especially in sub-Saharan Africa, the Ebola virus is more common (endemic).  

When living in or traveling to a region where the Ebola virus is common, there are many ways to protect yourself and prevent the spread of EVD. Practicing good hand hygiene is an effective method of preventing the spread of dangerous germs like the Ebola virus. Proper hand hygiene means washing hands often with soap and water or an alcohol-based hand sanitizer. 

While in an area affected by Ebola, it is important to avoid the following: 

• Contact with blood and body fluids (such as urine, feces, saliva, sweat, vomit, breast milk, semen, and vaginal fluids). 

• Items that may have come in contact with an infected person’s blood or body fluids (such as clothes, bedding, needles, and medical equipment). 

• Funeral or burial rituals that require handling the body of someone who died from EVD. 

• Contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals (bushmeat) or meat from an unknown source. 

• Contact with semen from a man who had EVD until you know the virus is gone from the semen. 

These same prevention methods apply when living in or traveling to an area affected by an Ebola outbreak. After returning from an area affected by Ebola, monitor your health for 21 days and seek medical care immediately if you develop symptoms of EVD. 

In December 2019, the U.S. Food and Drug Administration (FDA) approved Ervebo. This is the first FDA-approved vaccine for the prevention of EVD caused by Zaire Ebola virus in individuals 18 years of age and older. 

Reporting 

Ebola virus disease (EVD) cases are immediately reportable upon suspicion. Report suspected or confirmed cases of EVD immediately to the local health department or health service region by using the contact information provided by the link or calling 800-705-8868. 

There are several laws in Texas (Tex. Health & Safety Code, Chapters 81, 84, and 87) that require doctors, hospitals, schools, and labs to inform the Texas Department of State Health Services (DSHS) if they think someone has a notifiable condition (25 Tex. Admin. Code §97.2).

Investigation Guidance 

See a list of diseases and guidelines on the Investigation page. 

• CDC Ebola Virus Disease 
• WHO Ebola Virus Disease 
• Identify, Isolate, Inform (PDF revised 01.03.20) 
• DSHS approval and testing process for Ebola (01.30.20)