Medicines for Ebola virus disease

What it is

Ebola virus disease (often just called Ebola) is a rare but serious and often severe viral illness. It occurs in outbreaks, mainly in certain parts of Africa, and does not occur naturally elsewhere; the risk to people outside affected areas is very low, and it is not a risk in the UK except in the very rare situation of someone becoming infected in an outbreak area and travelling. Ebola is caused by a virus, and is spread through direct contact with the blood or body fluids (such as vomit, faeces, urine, saliva, or other fluids) of an infected person who has symptoms, or with objects or surfaces contaminated with these fluids, or through contact with infected animals; it is not spread through the air like a cold or flu. Because of how it spreads, those most at risk in an outbreak are people caring for or in close contact with infected people (including healthcare workers without adequate protection) and family members. The symptoms of Ebola usually begin within about 2 to 21 days of exposure, and can include: a sudden fever, severe headache, muscle and joint pain, weakness and tiredness, sore throat, and then, as the illness progresses, vomiting, diarrhoea, a rash, tummy pain, and, in severe cases, problems with bleeding (both internal and external) and failure of the body’s organs. Ebola is a severe illness that can be fatal, though outcomes have improved with better supportive care and, more recently, specific treatments and vaccines developed for use in outbreaks. Because Ebola is so rare and geographically limited, the main relevance for most people is awareness and, for those travelling to or returning from an outbreak area, being alert to symptoms and seeking urgent medical advice (mentioning the travel) if they become unwell. Public health authorities monitor and respond to outbreaks, and there are established procedures for the very rare situation of a suspected case in the UK. The key messages are that Ebola is a rare but serious viral illness occurring in outbreaks in parts of Africa, spread through contact with body fluids (not through the air), and that the risk to people outside affected areas is very low.

How it is treated

The approach to Ebola centres on outbreak control, care and treatment of affected people in outbreak areas, and, for people outside affected areas, awareness and prompt action for the very rare relevant situation; the risk to most people is very low. For the general public outside affected areas, the practical relevance of Ebola is awareness: because it occurs in outbreaks in specific areas and is spread through direct contact with the body fluids of an infected person (not through the air), the risk to people not in or travelling to affected areas is very low. For anyone travelling to an area affected by an Ebola outbreak, following public health and travel advice (which may include avoiding contact with sick people and infected animals, and good hygiene) reduces the already low risk; and, importantly, anyone who has been in an outbreak area and develops symptoms (such as a fever) within about three weeks of returning should seek urgent medical advice and mention the travel, so they can be assessed safely — this is important both for their care and to protect others, and there are established procedures for handling such situations. In outbreak areas, the response involves public health measures to control the outbreak — such as identifying and isolating cases, tracing and monitoring contacts, safe care and infection control, safe handling of the deceased, community engagement, and, increasingly, the use of vaccines (which have been developed and are used to help control outbreaks and protect those at risk, such as contacts and healthcare workers). For people with Ebola, care is provided in specialist facilities with strict infection control, and includes supportive care — which is very important and improves survival, such as fluids, maintaining the body’s salts and functions, and treating complications — and, importantly, specific treatments (including certain antibody-based treatments developed for Ebola) that have improved outcomes and are used where available. With good supportive care and these treatments, survival has improved, though Ebola remains a serious illness. The reassuring messages are that Ebola is rare and geographically limited (occurring in outbreaks mainly in parts of Africa), that the risk to people outside affected areas is very low, that it is spread through contact with body fluids rather than through the air, and that outbreak control, vaccines, supportive care, and specific treatments have improved the response and outcomes; so awareness, following travel and public health advice, and — for anyone unwell after being in an outbreak area — seeking urgent medical advice and mentioning the travel are the key points for the public.