Ebola virus disease: symptoms, spread, risk to UK travellers and treatment

Ebola virus disease is a severe infection caused by a virus that originates in wild animals. The NHS explains that it passes between people through touching infected body fluids, and lists blood, semen, saliva, poo, pee and vomit among them. Outbreaks have occurred in Central, West and East Africa.

Most of what the public has heard about Ebola comes from the large outbreak in West Africa in 2014 to 2015. NHS inform records that this outbreak mainly affected Guinea, Liberia and Sierra Leone, with some cases in parts of central Africa, and that around 28,000 cases and more than 11,000 deaths were reported to the World Health Organization. It was the largest known outbreak, and it was officially declared over in June 2016.

Ebola is classed among the viral haemorrhagic fevers, a group of infections in which severe illness can include bleeding. That is a feature of advanced disease rather than a first sign, and many people at first simply feel as though they have flu.

The virus is spread in the blood, body fluids or organs of a person or animal with the infection. NHS inform gives several examples of how this can happen, and they all involve close physical contact rather than being in the same room.

• Directly touching the body of someone with the infection who has symptoms or has recently died. NHS inform notes that the virus can survive for several days outside the body.

• Cleaning up body fluids, or touching the soiled clothing of an infected person.

• Handling unsterilised needles or medical equipment used in the care of an infected person.

• Sex with an infected person without a condom. NHS inform says studies show traces of Ebola may remain in a man's semen many months after recovery, which is why the NHS advises using a condom if you have sex with someone who has recovered from Ebola in the last few months.

• Handling or eating raw or undercooked bushmeat.

The NHS says symptoms can start between 2 and 21 days after infection and can appear suddenly. They usually begin with a high temperature, extreme tiredness and a headache, much like many common infections. NHS inform adds joint and muscle pain, a sore throat and severe muscle weakness.

As the illness progresses the NHS lists further symptoms, which are not all present in every person.

• Being sick, diarrhoea and tummy pain.

• A skin rash.

• Yellowing of the skin and eyes.

• Blood in poo or vomit, and lots of bruises over the body.

• Bleeding from the ears, eyes, nose or mouth.

• Reduced kidney and liver function, which NHS inform lists among the later effects.

The NHS advises calling NHS 111 if you have travelled to a country where Ebola is found and have Ebola symptoms, or if you have been in contact with someone who has travelled to such a country and has symptoms. Stay at home and avoid close contact with other people, including sharing towels or bedding, until you have been told what to do. Because of the need to avoid exposing others, it is better to phone than to walk into a surgery or hospital unannounced.

If you become unwell while still travelling, the NHS says to get medical advice quickly. NHS inform stresses that it is extremely unlikely that a returning traveller with a fever has Ebola, and that the cause could be another serious condition such as cholera or malaria, so getting help matters in any case. Always mention your recent travel history, since it helps clinicians work out what could be happening. A doctor may take samples of blood, urine or stools to test for infections.

The NHS says Ebola is an emergency that needs to be treated quickly. People are usually cared for in isolation in hospital, with specialist care in an intensive care unit. Treatment centres on managing symptoms, including help with breathing and fluids given directly into a vein to stop dehydration.

NHS inform describes supportive care in more detail: blood oxygen levels and blood pressure are maintained at the right level and organs are supported while the body fights the infection. Healthcare workers use strict precautions, including protective equipment, to avoid contact with the body fluids of patients. Its page states that there was no licensed treatment or vaccine for Ebola at the time it was last updated and that new vaccines and drug therapies were being tested. Because that position can change, ask a clinician or check current UK Health Security Agency guidance if you need up-to-date information on specific medicines or vaccines.

NHS inform also says Ebola is sometimes fatal and that the sooner a person is given care, the better the chance of survival.

Before travelling, both NHS sources recommend checking the health risks for the country you are visiting on the TravelHealthPro website or GOV.UK foreign travel advice. The NHS suggests getting advice from a travel clinic at least 4 to 6 weeks before you go, although you can still get advice at the last minute.

• Wash your hands regularly and wash and peel fruit and vegetables before eating them.

• Avoid anyone who has symptoms of Ebola.

• Do not touch or eat raw or undercooked meat from wild animals in countries where Ebola is found.

• Do not handle wild animals, especially bats, monkeys, baboons and chimpanzees.

• Do not touch a person who might have died from Ebola, their body fluids or anything they have been in contact with, such as clothes and bedding.

NHS inform says the people who remain most at risk are those who care for infected people or handle their blood or fluids, such as hospital workers, laboratory workers and family members. This is why outbreak control in affected regions relies on protective equipment, safe burial practice and quarantine of affected areas. For an ordinary traveller who avoids contact with sick people and wild animals, the risk is much lower.

Because the situation in any individual country can change, the NHS points readers to current outbreak information on GOV.UK. When an outbreak is active, public health teams issue specific advice for travellers, which supersedes general guidance on pages like this.

Suspected Ebola in the UK is handled through the NHS and public health system, starting with a call to NHS 111, which can arrange the right assessment while protecting other people. The NHS says people with Ebola are usually treated in isolation in hospital.

Private travel clinics are widely used for pre-travel advice and vaccinations for other infections, and they can explain which risks apply to your destination. They are not set up to assess suspected Ebola, so anyone unwell after returning from an affected area should follow the NHS 111 advice above rather than booking a routine appointment.