Ebola Virus Disease (Ebola)

Last Updated: November 03, 2022
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​​​​Ebola Virus Disease (EVD) is a rare and deadly disease in people and nonhuman primates. The viruses that cause EVD are located mainly in sub-Saharan Africa. People can get EVD through direct contact with an infected animal (bat or nonhuman primate) or a sick or dead person infected with Ebola virus.

The U.S. Food and Drug Administration (FDA) approved the Ebola vaccine rVSV-ZEBOV (called Ervebo®) on December 19, 2019. This is the first FDA-approved vaccine for Ebola.

This vaccine is given as a single dose vaccine and has been found to be safe and protective against Zaire ebolavirus, which has caused the largest and most deadly Ebola outbreaks to date.

On February 26, 2020, the Advisory Committee on Immunization Practices (ACIP) recommended pre-exposure prophylaxis vaccination with rVSV-ZEBOV for adults age 18 years or older in the U.S. population who are at potential occupational risk of exposure to Zaire ebolavirus. This recommendation includes adults who are:

  • Responding or planning to respond to an outbreak of EVD;
  • Laboratorians or other staff working at biosafety-level 4 facilities that work with live Ebola virus in the United States; or
  • Healthcare personnel working at federally designated Ebola Treatment Centers in the United States​

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 September 20, 2022, the Ugandan Ministry of Health confirmed an outbreak of Ebola virus disease (EVD) (Sudan virus) in Mubende District, in western Uganda. Outbreaks have been reported in 8 districts (Mubende, Kyegegwa, Kassanda, Kagadi, Bunyangabu, Mityana, Kampala, Wakiso).  Outbreaks were reported in outbreaks reported in Democratic Republic of the Congo in August & April of 2022. 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.

West Africa Preventative Medicine Briefing

Predeployment Information

Military Treatment Facilities

Patient Evaluation 
  • Ebola symptoms can start 2 to 21 days after becoming infected with the virus, but typically symptoms begin in 8-10 days. The most common symptoms of Ebola infection are fever, tiredness, loss of appetite, vomiting, diarrhea, headache and stomach pain.
  • Persons presenting with a subjective fever or a temperature of ≥100.4°F (≥38°C) and other symptoms compatible with Ebola, such as headache, muscle pain, weakness, diarrhea, vomiting, abdominal (stomach) pain or unexplained bleeding or bruising should be asked about recent travel and exposure to persons with Ebola.
  • Evaluation should also include work-up for more common travel-related illnesses, such as malaria, influenza and other febrile diseases.
  • CDC: Emergency Preparedness and Response - Health Alert Network Message (archived 2015) HAN 381 - Clinical Considerations for the Evaluation of Ill Travelers from Liberia to the United StatesExternal Link
  • MEDCOM: Ebola Virus Disease Screening Questionnaire Template (updated 11/9/14) If asked for a password, select Cancel each time and the document will open. Note that the popup window may be under this screen.
  • Control of Communicable Diseases Manual: APHA's Ebola-Marburg virus chapter External Link is available free of charge
  • C​DC: Detailed Hospital Checklist for Ebola Preparedness External Link 

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.

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

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 Branch 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.