Ebola
Information on Ebola for health professionals, including symptoms and advice on managing suspected cases.
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Symptoms
The onset of Ebola symptoms is sudden and includes intense weakness, muscle pain, headache, nausea and sore throat.
This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding progressing to shock and multi-organ failure.
The case-fatality ratio for the Zaire strain of Ebola virus is estimated to be between 50% and 90%.
The incubation period varies from 2 to 21 days (although is usually between 8 and 10 days).
Case definitions
It is important that health professionals phone their local public health unit for advice for any person whose history and symptoms raise concern.
Suspected case
Given the lack of specificity of initial symptoms, a person will be defined as a suspected case only after a clinical assessment by an Infectious Diseases physician.
A person with a clinical illness compatible with Ebola
Fever (temperature 38°C or above) with or without additional symptoms such as intense weakness, severe headache, myalgia, abdominal pain, sore throat, marked vomiting, marked diarrhoea or unexplained haemorrhage. Initial symptoms are usually not specific, but onset is sudden and intense with symptoms worsening over a few days, often with prostration, rash, evidence of capillary leak, bleeding/haemorrhage, shock and impaired consciousness.
And, within 21 days before onset of illness, a history of travel to the affected areas or a contact with an identified potential source of Ebola virus elsewhere,
With either:
- direct contact with a probable or confirmed case OR
- exposure to Ebola-infected blood or other body fluids or tissues OR
- direct handling of bats, rodents or primates, from Ebola-affected countries OR
- preparation or consumption of ‘bushmeat’ from Ebola-affected countries.
Probable case
A suspected case with no possibility of laboratory confirmation for Ebola either because the patient or samples are not available for testing.
Confirmed case
A suspected case with laboratory confirmation (positive serology or PCR).
Notes
- Fever may be absent at presentation if the person is taking antipyretic medication.
- Direct contact includes:
- direct physical contact with the case during the illness (without the appropriate infection prevention and control measures)
- direct physical contact with the case post mortem (without the appropriate infection prevention and control measures)
- having touched case’s blood or body fluids during the illness (without the appropriate infection prevention and control measures)
- having touched case’s clothes or linens during the illness (without the appropriate infection prevention and control measures)
- having been breastfed by the case.
- This includes the semen of a recovered male patient. The presence of virus has previously been demonstrated in semen for up to three months after recovery.
- Bushmeat is the meat of African wild animals used as food.
For suspected cases of EVD
- Implement transmission-based precautions immediately (contact and droplet), including the use of personal protective equipment. Airborne transmission precautions apply to aerosol generating procedures and in the laboratory.
- Notify the local Medical Officer of Health immediately. They will notify the Ministry of Health.
Contact details for public health units
More information for primary care facilities and clinicians:
Patient management guideline for primary care: Ebola virus disease (DOCX, 263KB)
Latest updates
Latest updates on Ebola outbreaks.
11 January 2023
11 January 2023
The World Health Organisation (WHO) declares the latest Ebola outbreak in Uganda is now over - four months after the first cases there were reported.
While the latest outbreak in Uganda is at an end, the response and commitment to ending Ebola around the globe continues.
19 October 2022
19 October 2022
Ugandan health authorities declared an outbreak of Ebola virus disease (EVD) caused by Sudan virus in Uganda on 20 September 2022.
In this outbreak, as of 12 October 2022 there have been 54 confirmed cases reported.
Mubende District is the epicentre of the outbreak, with sporadic cases reported in Kyegegwa, Kasanda, Kagadi, Bunyangabu districts.
As of 12 October 2022, there have been 19 deaths. This means there is a case fatality rate of 35% among confirmed cases in this outbreak.
This is the first EVD outbreak caused by Sudan virus in Uganda since 2012. As of 12 October, there is no evidence that the disease has spread outside of Uganda.
Risk assessment
The likelihood of importation to New Zealand is deemed very low based on the small number of cases, the limited spread of disease within Uganda and geographic remoteness of affected areas to New Zealand. If importation does occur, risk of widespread community transmission is deemed very low.
This risk assessment is consistent to others completed internationally including:
- the UKHSA risk assessment for this event on 06 October 2022 considers the risk to the public in the UK as very low
- the ECDC risk assessment for this event on 08 October 2022 considers the risk of infection for EU/EEA citizens in relation to this event to be very low.
Updates and additional information can be found at:
19 July 2019
19 July 2019
On 17 July 2019 the World Health Organization (WHO) announced a Public Health Emergency of International Concern in relation to the ongoing Ebola epidemic in the Democratic Republic of Congo.
At 17 July 2019 there have been over 2500 confirmed or probable cases of Ebola resulting in over 1600 deaths since the outbreak began in August 2018. The outbreak is predominantly affecting two provinces in the DRC, North Kivu and Ituri.
Risk assessment
The risk to New Zealand has been identified as low, and no action is required. The WHO has made recommendations for countries that are not directly affected and do not neighbour an affected country:
- No country should close its borders or place any restrictions on travel and trade. Such measures are usually implemented out of fear and have no basis in science. They push the movement of people and goods to informal border crossings that are not monitored, thus increasing the chances of the spread of disease. Most critically, these restrictions can also compromise local economies and negatively affect response operations from a security and logistics perspective.
- National authorities should work with airlines and other transport and tourism industries to ensure that they do not exceed WHO’s advice on international traffic.
- The Committee does not consider entry screening at airports or other ports of entry outside the region to be necessary.
More information is available on the World Health Organization website.
1 August 2018
1 August 2018
The World Health Organization was notified by the Ministry of Health of the Democratic Republic of the Congo (DRC) of Ebola Virus Disease (EVD) in North Kivu province.
Cases have also been subsequently found in the Ituri Province. Between 4 May and 15 October 2018, 216 EVD cases have been reported, of which 181 are confirmed and 35 are probable. The global case fatality rate stands at 64% overall, and at 57% among confirmed cases.
This is the tenth outbreak of EVD over the last four decades in the country.
24 May 2018
24 May 2018
The WHO, the Democratic Republic of Congo (DRC) and international partners are responding to an outbreak of Ebola virus disease (EVD) in the DRC using a model that was successful in resolving a similar outbreak in 2017.
The risk to New Zealand from EVD in the DRC is low due to the mode of transmission of the virus, the distance from New Zealand, the low number of travellers coming to New Zealand from the DRC, increased exit screening occurring in the DRC, and the rapid response of the DRC Government and the WHO to manage the outbreak.
29 December 2015
29 December 2015
WHO declared Guinea free of Ebola virus transmission, as 42 days have passed since the last confirmed case had a second negative blood test.
9 November 2015
9 November 2015
On 7 November 2015, WHO declared Sierra Leone free of Ebola virus transmission, as 42 days have passed since the last confirmed case had a second negative blood test.
11 May 2015
11 May 2015
On 9 May 2015, WHO declared Liberia free of Ebola virus transmission, as 42 days have passed since the last laboratory-confirmed case was buried.
Personal protective equipment (PPE)
For a video demonstration for the procedures for donning and doffing (removal) of PPE when treating a person identified as suspected or confirmed EVD, go to the CDC website.
Note that the CDC training video is based on PPE being used at Johns Hopkins Hospital in the US, and there are likely to be variations in local PPE equipment.
If you have any queries, please discuss these with your IPC nurse specialist.
Patient management guidelines for Primary Care
Viral haemorrhagic fevers chapter of Communicable Disease Control Manual
- Viral haemorrhagic fevers chapter of the Communicable Disease Control Manual
Resources
Publications
Download: Response to Suspected Ebola Virus Disease Cases in NZ - PDF, 264 KB
Key themes from sector and Ministry debriefs, July 2015
Download: Response to Suspected Ebola Virus Disease Cases in NZ - DOCX, 201 KB
Key themes from sector and Ministry debriefs, July 2015