Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a serious and often fatal disease (fatal outcome in 50% of cases). The virus belongs to the Filoviridae family, which includes 3 genera (Cuevavirus, Marburgvirus and Ebolavirus). Five strains of the Ebola virus are known: the Zaire, Bundibugyo, Sudan, Reston and Taï Forest strains. The first 3 have been associated with major outbreaks in Africa. Although a sixth strain, Bombali, was identified in a bat in Sierra Leone in 2018, the extent to which this strain causes disease in humans (pathogenicity) is still unknown.

The name of the virus comes from the Ebola River in the Democratic Republic of Congo (DRC). There, in Yambuku (DRC), scientists first identified an outbreak of the disease in 1976, with a simultaneous outbreak in Nzara, South Sudan.

Humans can become infected through contact with infected animals, through contact with the bodily fluids of infected people (e.g. urine, saliva, sweat, faeces, vomit, breast milk, amniotic fluid and semen), or through contaminated surfaces and equipment (clothing, bedding, needles, etc.). The amount of virus in the body (viral load) remains high after death.

The incubation period ranges from 2 to 21 days. A person cannot transmit Ebola to other people until he or she has developed clinical symptoms of the disease.

The first symptoms are sudden fever and tiredness, headache, muscle pain and eye inflammation (conjunctivitis). This is followed by vomiting, diarrhea, rash, sore throat, abdominal and chest pain, symptoms of kidney and liver failure and, in some cases, internal and external bleeding.

Based on its symptoms Ebola virus disease is difficult to distinguish from other infectious diseases such as malaria, typhoid and meningitis. An Ebola virus infection may be suspected on the basis of the patient’s presentation and a recent stay in an area where infections are common. Laboratory tests can confirm the diagnosis definitively.

There is no medicine to combat an Ebola virus infection. Treatment is aimed solely at supporting the patient to fight the infection. Beginning rehydration and symptomatic treatment early improves the chance of survival.

However, there is a vaccine that protects against Ebola virus disease. This has been used during Ebola outbreaks in Guinea and the Democratic Republic of Congo since 2019. Other vaccines are used preventively to contain the spread of the disease, by vaccinating the people who are most likely to be infected (ring vaccination).

Ebola survivors often suffer from medical and psychosocial problems that require extensive support. They also need help to minimise the risk of continued transmission of the Ebola virus. After all, the Ebola virus can survive in certain bodily fluids, including semen, pregnancy fluids and breast milk. A targeted program to deal with the aftermath of the disease is therefore necessary.

Due to the dangers to public health, Ebola is an infectious disease that must be reported to the health inspectorate.

There have been several Ebola outbreaks since 1976, mainly in Central Africa. The 2014-2016 Ebola outbreak, which started in Guinea and spread to Sierra Leone and Liberia, was the biggest with 28,616 infections and 11,310 deaths.

No cases of the Ebola virus have been confirmed in Belgium so far.