Ebola disease for health professionals

If you get unwell within 21 days of arriving in Australia from the Democratic Republic of the Congo or Uganda:

  • call your healthcare professional immediately — tell them about your symptoms and travel history.
  • do not visit a clinic or hospital in person without calling ahead — they might take extra steps to protect others.
  • dial 000 in an emergency and tell them about your symptoms and travel history.

Ebola disease is caused by infection with an orthoebolavirus, of which there are six species: Ebola virus, Sudan virus, Bundibugyo virus,  Taï Forest virus, Reston virus and Bombali virus.

Ebola is a type of viral haemorrhagic fever (VHF), which are potentially life threatening infections. The death rate of Ebola depends on the species and the setting. 

Outbreaks of Ebola disease in humans have occurred only in Africa, specifically in, the Democratic Republic of Congo, Gabon, the Sudan, South Sudan, Uganda, Guinea, Sierra Leone, Liberia and Nigeria. There has never been a case in Australia. For up to date information on current outbreaks see World Health Organization Disease Outbreak NEWS.

Clinical presentation

Sudden onset of an influenza-like illness symptoms including:

  • fever
  • myalgia
  • fatigue
  • headache.

The patient may subsequently develop:

  • respiratory symptoms such as a sore throat and cough
  • gastrointestinal symptoms such as vomiting and diarrhoea
  • neurological symptoms such as confusion and coma
  • vascular symptoms such as conjunctival injection, postural hypotension and oedema
  • maculopapular rash
  • prostration.

After approximately one week, patients may develop a septic shock-like syndrome and progress to multi-organ failure, sometimes accompanied by profuse internal and external bleeding.

Mode of transmission

Ebola disease causing viruses are introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals.

It can then spread from person-to-person via contact with the blood, secretions or other bodily fluids of infected people (living or deceased), and indirect contact with environments or fomites contaminated with such fluid.

Incubation period

Usually 8 to 10 days (range 2 to 21 days)

Infectious period

The infectious period starts with onset of symptoms. People are infectious while their blood and body fluids contain the virus. Infectivity is highest at the point of death or after death.

The virus can persist for long periods in immunologically protected sites, such as the eyes and testes. Sexual transmission can occur during this period.

Diagnosis

Consider Ebola disease in patients with:

  • fever (>38°C)

and

  • history of travel to an endemic/epidemic area within 21 days of illness onset OR contact with a person with Ebola disease, their blood, or bodily fluids, or objects contaminated with these. 

Contact Communicable Disease Control Branch (CDCB) 1300 232 272 (24 hours, 7 days) immediately and seek urgent infectious diseases and/or clinical microbiology advice for any suspected case.

Do not send patients to a pathology collection centre for testing. See Laboratory testing.

Remember, patients returning from affected areas with fever are still more likely to have other causes for their illness, particularly malaria.

Infection prevention and control

Patients with suspected or confirmed Ebola disease will be managed in a tertiary hospital with standard and transmission based precautions (contact, droplet and airborne).

See the following fact sheets for management of Ebola disease:

Laboratory testing

  • Prior to taking any specimens contact your local infectious diseases team or SA Pathology clinical microbiologist, and CDCB.

Treatment

Supportive care. Monoclonal antibody therapies may be recommended depending on the virus causing the Ebola disease.

Notification

The Communicable Disease Control Branch, South Australia, should be notified on suspicion of Ebola disease on 1300 232 272 (24 hours, 7 days) to enable prompt public health follow up.