Ebola

The infectious agent of Ebola Virus Disease (EVD) is Ebolavirus, part of the virus family Filoviridae. Only four of the identified species cause disease in humans (Zaire, Sudan, Taï Forest, and Bundibugyo). 

 
Transmission  

Ebola has been found in certain mammals (primates, bats) in Africa. Fruit bats of the Pteropodidae family may be natural Ebola virus hosts. Ebola enters humans through close contact with the blood, secretions, organs, or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines found ill or dead. 

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 risk of transmission is highest during the late stages of the illness when the infected person has very high levels of the virus in their body and is vomiting, having diarrhea, or hemorrhaging. The risk of transmission is also high at death through unprotected contact with the body of the deceased. This can occur after preparing the body for burial and other related activities. 

The Ebola virus CANNOT spread to others if there are no signs or symptoms of EVD. It is not typically transmitted by food, except through handling or consumption of contaminated bush meat (wild animals hunted for food). 

 
Symptoms  

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 more commonly found, 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, the first FDA-approved vaccine for the prevention of Ebola virus disease (EVD), caused by Zaire ebolavirus in individuals 18 years of age and older.  

Data 

In 2014, there were three cases of Ebola reported in Texas that were associated with the 2014-2016 West Africa Ebola Epidemic. The initial case was the first travel-associated case of EVD diagnosed in the United States. Two nurses who cared for the sick Ebola patient (initial case) contracted EVD, marking the first known transmission of EVD in the United States. The patient died, and both nurses recovered. Since that point, there have been no new cases of Ebola reported in Texas. 

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. 

Several Texas laws (Tex. Health & Safety Code, Chapters 81, 84, and 87) require specific information about notifiable conditions to be provided to the Texas Department of State Health Services (DSHS). Healthcare providers, hospitals, laboratories, schools, and others are required to report patients who are suspected or confirmed of having 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) 

HCID and Ebola Webinar – October 9, 2015 

High-consequence infectious disease (HCID) is a public health issue with the potential to affect the health and livelihoods of Texans. Governments, healthcare institutions, and public health organizations recognize the potential threat such diseases pose and have increased efforts to prepare for them. Informed citizens are better prepared to participate in a calm and effective response in the event of an HCID outbreak. 

This webinar presents information from the 2014 Texas Ebola incident as well as the Texas Preparedness Strategy for High-Consequence Infectious Diseases. It also outlines the State’s HCID/Ebola preparedness projects. 

• Presentation Slides (1,551 kb, pdf) 

• Presentation Audio (6,347 kb, mp3) 

• Presentation Transcript (171 kb, pdf) 

• Texas Preparedness Strategy for High Consequence Infectious Diseases: Ebola and Other Pathogens (527 kb, pdf