Diseases

Ebola Virus Disease (Ebola)

Last Updated: September 06, 2018
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An outbreak of Ebola, which likely began in a rural area of Guinea in December 2013, has spread to other countries in West Africa. The outbreak is contained in Guinea, Sierra Leone and Liberia. Cases have occurred in Senegal, Nigeria, Mali, Spain and the US. Over ten thousand suspected and confirmed cases of Ebola have been reported and many thousands have died.

Disease control in West Africa has been difficult due to lack of healthcare resources, poor living conditions, misinformation, local traditions that increase disease transmission, and people who do not seek medical care due to distrust.

Scientists believe the source of the virus is most likely bats, and other animals can also become infected. An outbreak in humans begins when an individual or small group of people become infected by eating or handling uncooked or undercooked meat from infected game animals, such as bats and monkeys, also known as "bushmeat."

Ebola is concentrated in West Africa, where disease control is more difficult due to lack of healthcare resources, poor living conditions, misinformation, local traditions such that increase disease transmission, and lack of medical care due to distrust.

Outbreaks have been reported sporadically in West African countries since Ebola was first recognized in1976. To date, the largest outbreak began in the country of Guinea in December 2013, and spread to surrounding West African nations, with isolated travel-related cases diagnosed in Spain, Italy, the UK, and the US. In August 2014 the WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC). It wasn't until June 2016, after more than 28,000 cases were reported with 11,325 deaths, that all affected countries were declared Ebola-free.

Although the spread of EVD in West Africa was contained in the affected areas, additional cases may occur. On 4 April 2018, the first Ebola case of an on-going outbreak was reported in the Equateur Province of the Democratic Republic of Congo (DRC). The WHO, CDC and other public health organizations are actively monitoring the situation and supporting local response efforts for which Ebola treatment centers have been established and vaccination campaigns utilizing a promising experimental vaccine have been launched. As of yet the outbreak is localized and does not constitute a PHEIC.  

General Information  


Deployment Information -

The National Center for Medical Intelligence and CDC assess that EVD represents a low risk to DoD personnel and the U.S. general public. Although the DoD has not been tasked to support the current DRC outbreak, in the event that the outbreak progresses to the point that it becomes a PHEIC as occurred in 2014, the DoD may be asked to participated in response efforts.

During the widespread 2014 outbreak, the US military supported Operation United Assistance (OUA), through provision of engineering, logistical and training support. The overwhelming majority of tasks U.S. military personnel performed in West Africa were deemed to pose no risk for infection given the absence of direct exposure to infected patients or contaminated articles. Information pertinent to the OUA response, EVD and other disease threats in the region is available through the links provided below.

 

Ebola Video Image

 
Ebola: What You Need to Know Video 
(updated 11/25/14)
YouTube (CC)External Link
milTubeExternal Link

To download: Right click and "Save target as"
Windows Media file
QuickTime Movie
MP4 Video



West Africa Medical Threat Briefing 
West Africa Medical Threat Briefing
AKO External Link - (restricted access)
milBook External Link(restricted access)
(updated 2/5/15)

 

 Hotlines
Army Medicine
24/7 EVD Information Line:
CONUS 800-984-8523, DSN 421-3700
OCONUS DSN 312-421-3700

U.S. Army Medical Research
Institute of Infectious Diseases
Emergency Response Line:
1-888-872-7443

 

            Top 10 Things to Know about Ebola

Predeployment Information

 

Military Treatment Facilities

Preparation

Patient Evaluation 

Treatment - There is no vaccination or specific treatment for EVD. Intensive supportive care is required to maintain fluid and electrolyte balance, oxygen status and blood pressure, and respond to complications. Outbreaks may have case fatality rates (CFR) as high as 90%, but some treatment centers in the current outbreak are reporting CFR of 35% or less.

Administration

Infection control - Ebola virus spreads from person to person by direct contact with blood, secretions, organs or other bodily fluids (such as sweat, vomit, and diarrhea) of infected people. Only people who have symptoms of EVD, or have recently died from EVD, can transmit the virus to others. The risk of spreading the infection to others increases as the disease progresses. CDC guidance for U.S. care settings includes initiating standard, contact and droplet precautions for suspected EVD.

 

Disinfection of Patient Belongings

 

Transportation - Infection control procedures should be used during the transport of EVD patients or individuals suspected of having EVD.

 

Case Reporting

  • Report suspected EVD cases to the APHC Disease Epidemiology Program telephonically at (410) 417-2377 or (800) 222-9698
  • Report suspected EVD cases as Viral Hemorrhagic Fever in DRSi
  • Inform the local health department 
     

Laboratory Testing - MTFs must ensure clinical Ebola specimen submission and testing on patients is coordinated with the MTF lab, MTF Preventive Medicine Department and the state/ local public health department.