1. What is Ebola?

The Ebola virus causes a hemorrhagic fever that is very often fatal. This filamentous virus (or filovirus) is a classic example of an infectious disease poorly adapted to humans and accidentally transmitted from animal to man (also called a ‘zoonotic’ disease).

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2. What are the symptoms?

If you are infected with the virus, the first symptoms resemble those of influenza:

  • Sudden fever
  • Nausea
  • Weakness
  • Headache
  • Muscle pain
  • Sore throat

This is followed a few days later by:

  • Vomiting
  • Diarrhea
  • Rash
  • Impaired kidney and liver function

In some cases, both internal and external bleeding ensue.

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4. How do you become infected with the virus?

Ebola is a very dangerous but not very contagious disease. Infection occurs mainly through direct contact with blood or body fluids: 

  • Saliva
  • Sweat
  • Faeces,
  • Vomit
  • Semen
  • Urine
  • Vaginal secretions
  • Menstrual blood

In theory, one can get infected through secondary sources such as body fluid from an Ebola patient left on packaging. As was observed in West-Africa, this rarely happens. The virus survives only briefly on inanimate objects. There is no risk of airborne infection or infection through insect bites.

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5. Can I get Ebola through my skin even if I have no cuts or scratches?

Intact skin protects us from viral infections including Ebola. An infected body fluid droplet that lands on your arm will not cause contamination. However, if you have a cut or a scratch on your arm this may present a risk. Please note that some injuries are so tiny that they are not visible to the naked eye.

If someone’s body fluids come into contact with those of a patient who is in an advanced stage of infection, the risk is much higher because the number of viruses in the blood is a lot higher.

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6. How is Ebola diagnosed?

Each suspected Ebola case has first to be examined by a doctor. The doctor establishes a diagnosis, based on the patient’s file and by taking into account any stay in areas where infections occur.

Only analysis can confirm the presence of an Ebola infection. There are very few specialised laboratories where safety standards are sufficiently high (BSL4 laboratories) to analyse the Ebola virus. In Belgium, the Institute of Tropical Medicine carries out Ebola diagnoses in its own laboratories. The institute has received approval to diagnose Ebola virus infections in its BSL3+ laboratory because the virus is not cultivated on its premises.

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7. When is Ebola most contagious?

Infected patients who do not yet have symptoms cannot transmit the virus. The risk of infection is moreover rather low at the onset of symptoms. The risk of infection increases as the disease becomes more serious and the number of viruses in the body fluids is high.  When the patient dies, his body remains highly contagious. This explains why many infections occur during funerals.

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8. Why is this virus so often fatal?

The fatality rate lies between 70 and 90% and is high because the virus has not adapted to humans. Contrary to most other viruses that depend upon a host organism for replication, the Ebola virus poisons humans and makes them die more quickly, thus eliminating itself. Because Ebola evades the natural defence system, the body does not know how to react to the virus and thus Ebola can quickly multiply in the human organism.

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9. Who is at risk of being infected?

The following people are at risk:

  • Travelers who during the last three weeks stayed in an affected country and who were in contact with or took care of infected patients
  • Health workers who had contact with patients infected with the Ebola virus or with the body fluids of those patients, without adequate protection.
  • Relatives or friends of a deceased person who took care of that person during his illness or who were involved in the burial rites.
  • People who have been in contact with or who have eaten potentially infected animals (bats, monkeys, …).
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10. Is Belgium at risk of an Ebola epidemic?

Although it is possible that an infected person ends up in Belgium, it is highly unlikely that the disease will take on epidemic proportions. The (few) possible import cases can easily be isolated and followed up in countries with an efficient health system, such as Belgium. The disease will be stopped in its tracks and won’t be able to spread.

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11. Why did Belgium appoint a national Ebola coordinator?

Dr. Erika Vlieghe of the Institute of Tropical Medicine coordinates all Ebola measures in Belgium. She also advises the Minister of Public Health and works closely together with the different public health actors. Dr. Daniel Reynders of the Federal Service of Public Health was appointed assistant-coordinator. He and Dr. Vlieghe coordinate the information flow to professionals and the general public.

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12. Is there a vaccine or a treatment against Ebola?

At present, there is neither a vaccine nor a medication against Ebola. Patients are now treated for their symptoms: they are administered, among other things, fluids, salts and antipyretics. The sooner they are treated, the greater their chances of survival.

Given the gravity of the epidemic, the World Health Organisation has announced that experimental treatments and vaccines may be used provided that certain ethical criteria are met.

At the moment, two vaccines are being tested in humans. Ebola patients also receive experimental treatment and medicines are being tested. Not only new medicines are concerned: existing medicines are also used to treat Ebola (more information can be found at: http://www.who.int/medicines/emp_ebola_q_as/en/).

Provisional data of a research study conducted in Guinea and using the antiviral product favipiravir show a fall in mortality rates. This was mainly observed in patients in an early stage of illness, with a limited amount of virus particles in their blood.

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