The first known cases of Ebola occurred in 1976 in Zaire, a Democratic Republic of Congo. Prior to very recently, all human cases of illness or death from Ebola have occurred in Africa, except for some laboratory contamination cases. Until recently, we had not seen any cases of Ebola in the US and those individuals traveled to the US from Africa.

Who's at risk for Ebola?

People who come in close contact with Ebola patients, and their blood, body fluids are most at risk.  In other words, healthcare workers. Other risk categories are those who come in contact with the infected wildlife (infected meat), clothing or linens with the body fluids, or needles from an infected patient.

How is Ebola transmitted?

According to the Centers for Disease Control (CDC), you can't get the Ebola virus through air, water, or food. It is believed that Ebola outbreaks start with someone coming in contact with an infected animal (bats, non-human primates). From there, an infected person can spread the Ebola virus through direct contact via broken skin, or mucous membranes (eyes, nose, mouth) with blood or body fluids (urine, saliva, sweat, feces, vomit, breast milk, and semen). Since needles and syringes come in contact with blood and body fluids, they can be a source of transmission, too. While food is not a source of transmission, if the animal is infected with Ebola, their meat can then be a source for transmission.

The key is close personal contact, for transmission, therefore, healthcare providers, like the RN caring for the patient recently in Texas, and close family and friends are most at risk.

What are the symptoms of Ebola?

Symptoms of Ebola infection can occur anywhere from 2-21 days after exposure. Early symptoms of Ebola are difficult to pinpoint, as they are similar to other viral infection symptoms. However, if there is a known exposure to Ebola with the emergence of symptoms, the patient should be immediately isolated to avoid spreading the virus.

Symptoms include:

• Fever (over 101.5)
• Muscle aches
• Weakness
• Diarrhea
• Vomiting
• Abdominal pain
• Severe headache
• Unexplained bleeding or bruising.

How is Ebola infection diagnosed?

Ebola infection is diagnosed through bloodwork tests such as antigen-capture enzyme-linked immunosorbent, IGM Elisa, polymerase chain reaction (PCR), and virus isolation testing. Later in the illness, or after recovery, IgM or IgG antibodies can be measured as well.

How is Ebola infection treated?

First, the infected individual is isolated to decrease the chance of spreading the virus. Since there isn't an FDA-approved vaccine or medication for treating Ebola, patients are treated supportively as symptoms appear. For example, IV fluids, oxygen, medication to support blood pressure, and prevention of a secondary infection. Research is underway for the development of a vaccine and medication for Ebola, however they have not yet been fully tested for safety or effectiveness.

ZMapp is an experimental treatment that has been used recently, however it has not gone through clinical trials, and is in limited supply. It is not known if ZMapp played a role in the recovery of the patients who received it.

A patient's ability to recover from Ebola infection depends largely on their immune response, and any pre-existing conditions, which may complicate their clinical presentation.

Can Ebola infection be prevented?

While no vaccine is available to prevent Ebola, there are steps one can take if they are traveling to an area where there is an Ebola outbreak.

• Careful hygiene (handwashing, for example)
• Avoid contact with blood or body fluids
• Do not handle items of infected individuals where you could come in contact with blood or body fluids (clothing, bed linens, medical equipment)
• Don't participate in funeral rituals where handling the body of someone who died from Ebola takes place.
• Avoid contact with bats and non-human primates, blood, fluids and raw meat from these animals.
• Avoid hospitals where Ebola patients are being treated. (Contact the US embassy or consulate in the region, if needed)
• After returning from a region where there was an Ebola outbreak, monitor your health for 21 days, and seek medical care immediately if symptoms appear.