Ebola Virus Disease (EVD)

Ebola Virus Disease (EVD), previously called Ebola Haemorrhagic Fever, is a rare and often fatal disease in humans. The term Ebola is often used to refer to both the virus and the severe disease is causes.

The virus which causes the disease has many strains and was first identified in 1976. Since then there have been multiple outbreaks of Ebola in humans in Central, West and East Africa, including a large outbreak affecting over 28,000 people in 2014-2016.

Fruit bats are considered the natural host of the Ebola viruses. Outbreaks have occurred amongst other species such as chimpanzees, gorillas, monkeys and forest antelope.

The risk of Ebola in Australia

There have not been any human cases of Ebola in Australia and there is no evidence that the Ebola virus is present in Australian bats or other animals in Australia.

The risk of Ebola spreading to Australia is extremely low and Australia is very well prepared for an imported case of EVD.

How Ebola is spread

Humans may acquire Ebola from animals (fruit bats, chimpanzees, gorillas, monkeys and forest antelope) through close contact with blood, secretions, organs or other bodily fluids of infected animals (for example, hunting animals for food).

A person with Ebola is infectious to others only once he or she has developed symptoms.

Once in the human population, Ebola then spreads from person-to-person via contact with the blood and other bodily fluids of infected people (including sweat, vomit, diarrhoea, and other secretions), and with surfaces and materials (for example, bedding and clothing) contaminated with these fluids. Ebola is not airborne and cannot be caught by breathing air near a person with Ebola. Transmission through sexual contact may occur for as long as 12 months after the person feels well.

Traditional burial ceremonies conducted in affected areas of Africa are a known high-risk activity for transmission.

Who is at risk of infection

The Ebola virus is naturally found in animals in several African countries. The Australian Government Department of Foreign Affairs and Trade operates the Smart traveller website which provides country-specific advice and should be consulted before travelling overseas. People who are living in or travelling to affected areas may be at risk of infection.

However, the risk of infection is extremely low, unless there has been direct contact with the bodily fluids of an infected person or animal (alive or dead).

Health professionals travelling to African countries should ensure they are familiar with and adhere to strict hygiene and isolation recommendations, and ensure personal protective equipment is used during the care of any suspected Ebola cases.

Symptoms

It can take up to 21 days for symptoms to appear after contact with the virus. The Ebola virus can cause a serious illness, with a sudden onset of fever, muscle and joint aches, weakness, and headache.

The next stage is characterised by vomiting, diarrhoea, rash, as well as liver and kidney problems. Some people may develop internal and external bleeding, and progress to multi-organ failure.

Diagnosis

Ebola is diagnosed by a blood test that detects the virus. Testing for Ebola is done in a public health laboratory with special biosafety facilities.

Treatment

There is currently no specific proven treatment for people who are sick with Ebola. Intensive supportive medical care and early intervention improves survival.

With ongoing outbreaks overseas, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated.

Prevention

Practising good hand hygiene and implementing good infection control measures are the most effective way of preventing the spread of Ebola. There is no vaccine for Ebola available for use in Australia.

Following the 2014-16 West African Ebola outbreak, experimental vaccines have been developed and trialled for use in emergency situations and in at-risk populations, but these experimental vaccines are not yet widely available and have not been licensed for general use.

If you become unwell after travel in areas affected by Ebola

If you become ill or feel unwell while travelling in areas affected by Ebola, you should not wait until you arrive back in Australia to seek medical assistance. Instead you should see a doctor or go to the local emergency department.

If you have returned from travelling in areas affected by Ebola within the last 21 days and develop a fever, vomiting, diarrhoea and other symptoms, you should see your doctor or go to the emergency department to work out why you are ill. It is important that you mention your symptoms and which countries you have visited when you first arrive at the medical practice or hospital emergency department.

You may be separated from others to prevent further spread of infection.

Public health response

Special procedures to prevent the spread of Ebola are in place to manage the situation in the event there is a case of Ebola in Australia.

These procedures include:

• Notification – doctors and laboratories are required to urgently notify state/territory health departments of any suspect cases.
• Isolation – suspected cases must be isolated away from other people and visitors will be restricted.
• Contact tracing – public health authorities will identify people who have been in contact with the case by so that these people are given information about the risk of infection and monitored for any signs or symptoms of the disease.
• Infection control – special safety guidelines must be implemented to prevent the spread of Ebola to healthcare workers managing the patient and laboratory staff handling specimens. These guidelines require individuals to wear personal protective equipment and implement specialised disposal of contaminated waste.

In the ACT, staff from the Communicable Disease Control Section will investigate all cases to find out how the infection occurred, identify other people at risk of infection, implement control measures and provide other advice, as required.

Contact

For more information or advice about Ebola, contact your doctor or call ACT Health on 02 5124 9213 (during business hours) or page 02 9962 4155 after hours.

Acknowledgement

Australian Government Department of Health, Ebola Virus Disease (EVD) CDNA National Guidelines for Public Health Units (December 2018).