Ebola (disease): what is it? Symptoms, transmission and prevention

What is Ebola?

Ebola is a serious disease, which mobilizes several health agencies concerned with containing transmission and preventing epidemics.

The humanitarian organization Doctors Without Borders (MSF), for example, the body with the most experience in the treatment of Ebola patients in the world, worked during the 2014 epidemic in West Africa to help contain the disease, even before the outbreak was officially declared.

During the first seven months of the epidemic, it set up six Ebola treatment centers: two in Guinea, two in Liberia and two in Sierra Leone, mobilizing more than 3,300 professionals.

These centers received more than 4,900 patients, of which about 3,200 were confirmed with the disease. Among these people, approximately 1,100 survived. MSF also shipped more than 877 tons of medical supplies in that period.

Médecins Sans Frontières had also treated hundreds of people affected by Ebola in Uganda, Congo, Democratic Republic of Congo, Sudan, Gabon and Guinea. In 2007, they completely contained an Ebola epidemic in Uganda.

Aside from the 2014-2016 epidemic, more than 24 outbreaks of Ebola have been reported in Central and West Africa, in addition to Sudan and Uganda.

The situation today is also worrying, according to the World Health Organization. In 2019, the disease again became an epidemic threat in Congo, where 79 new cases were registered, from December 2018 until then.

Continue reading and understand how Ebola virus transmission occurs and how it is possible to prevent this disease.

New Ebola outbreak in Congo

Ebola, which has already caused an extremely worrying epidemic between 2014 and 2016, in West African countries, is a reason for yet another warning.

After the outbreak of the disease in April and May 2018, the disease again proved to be a concern in the Democratic Republic of Congo (DRC).

According to the World Health Organization (WHO) and the Ministry of Health of the DRC, between December 2018 and mid-January this year, 79 new cases were reported in 11 different regions of the country. The most affected region was the city of Katwa, with 36 recorded cases.

According to the country’s health authorities, what is happening is a continuation of the outbreak in dispersed areas.

Since April 2018, there have been 614 confirmed cases and 49 suspected cases. Of that number, 407 people died and 237 were discharged.

For WHO, the risk of a global epidemic is low, but that of national and regional spread is high and must be contained.

Cause of Ebola

This disease, as seen, is caused by the Ebola virus, which causes viral hemorrhagic fever . It is a virus considered dangerous, as it commonly leads to death, and can infect humans and other animals, such as chimpanzees.

The Ebola virus is a filovirus (the other member of this family is the Marburg virus) in a filamentous form, 14 micrometers in length and 80 nanometers in diameter. Its genome is single-stranded negative RNA strand (it is complementary to the coding strand). The genome is protected by capsid, is enveloped and encodes seven proteins .

The incubation period for the Ebola virus lasts from 5 to 7 days if the transmission is parenteral (via blood) and from 6 to 12 days if the transmission is from person to person through other fluids.

In some cases, between the fifth and seventh day of the disease, a rash appears, announcing hemorrhagic manifestations: hemorrhagic conjunctivitis , bloody ulcers on the lips and mouth, gingival bleeding, hematemesis (vomiting with blood) and melena (intestinal hemorrhage, where the stool contains blood).

In the epidemics observed, all cases with a hemorrhagic form evolved to death. In epidemic and outbreak periods, the lethality rate ranged from 50% to 90%. Its contagion can be through breathing or contact with bodily fluids of an infected person.

Virus strains

There are 5 types of strains of the Ebola virus, but the disease is caused by only 4 of them. They belong to the genus ebolavirus, of the family Filoviridae.

Each was named according to the place of origin:

  • Ebola-Bundibugyo;
  • Ebola-Ivory Coast;
  • Ebola-Sudan (EBO-S);
  • Ebola-Zaire (EBO-Z);
  • Ebola-Reston.

The mortality rate is more worrying when it comes to Ebola-Zaire, which represents 83%. Second is Ebola-Sudan, with a 54% risk of mortality.

Of these five types of strain, only Ebola-Reston has no record of having caused the disease or any case of death.

It was found in 1989 in monkeys Macaca fascicularis and imported from the Philippines to the United States. There, he infected some keepers via the respiratory route, but with no record of an outbreak.

What is the origin of the Ebola virus?

This disease was first identified in 1976 in two simultaneous outbreaks: one in a village near the Ebola River, in the Democratic Republic of Congo; and the other in a remote area of ​​Sudan. But the source of the virus is still unknown, with fruit bats being the likely hosts.

In Africa, outbreaks probably originate when people have contact with or handle the raw meat of chimpanzees, infected gorillas, bats, monkeys, forest antelopes and hedgehogs found sick or dead in forests, as it is customary to feed on these animals in the region.

The Ebola virus has five strains, with Ebola-Zaire being the most lethal of them. This was the prevalent virus during the epidemic that hit West Africa between 2014 and 2016. The disease affected more than 22,000 people, causing 11,000 patients to die.

How does Ebola transmit?

Ebola is a disease considered to be highly infectious. Its transmission occurs through direct contact with the blood, secretions, organs or semen of people carrying the virus, or other body fluids of infected animals.

It is not transmitted by air, but it can be transmitted through inhalable droplets of 0.8 to 1.2 micrometers.

Infection can also occur if a healthy person’s skin or mucous membranes come into contact with objects contaminated with infectious fluids from an Ebola patient.

During the incubation period, the infected person is not able to transmit the disease. People can infect others as long as their blood and secretions contain the virus and after symptoms develop.

Objects such as dirty clothes, bedding or needles used by patients should be handled with great care. Through semen, transmission can occur for up to 7 weeks after clinical recovery from the disease.

For this reason, infected patients need to be surrounded by specific care to prevent health professionals or relatives and friends who visit them at the hospital from coming into contact with blood and / or secretions.

According to the WHO, it is also possible to acquire the virus when dealing with a sick or dead wild animal that has been infected.

Transmission by contact with animals

The appearance of the disease is related to reports of infection by the management of chimpanzees, gorillas, bats (fruit bats), monkeys, antelopes and infected porcupines found dead or sick in the forest.

Bats discard partially eaten fruit, which is then collected and eaten by land mammals, such as gorillas. This chain of events is a possible means of indirect transmission between the natural host and animal populations, so the investigation has focused on bat saliva.

Among other factors, fruit production and animal behavior vary between location and season, which can trigger occasional outbreaks among animal populations when conditions are right.

Transmission at funeral ceremonies

Funeral ceremonies in which, during the wake, people have direct contact with the body of the deceased, as is common in rural communities in some African countries, can also play an important role in the transmission of Ebola.

People who have died of Ebola should be handled only by those wearing protective clothing and gloves. In addition, the body must be buried immediately.

African populations are infected in large numbers due to the culture of the villages, where families are in the habit of washing the bodies of the dead manually and carefully before burial.

In the last hours before death, the virus becomes extremely contagious and, therefore, the risk of transmission from the corpse is much greater. For these reasons, ensuring the safety of funerals is a crucial part of managing an outbreak.

Thus, the individual killed by Ebola transmits the virus to all those who have contact with the body. After this person comes into contact with an animal that has Ebola, it can spread the virus in its community, passing it on to other individuals.

What is the action of the virus in the body?

Ebola, like other viruses, needs to lodge in some organism to multiply and survive. Alone, it has no ability to cause an outbreak.

For this survival, he finds ways to multiply in other bodies. In humans, the Ebola virus directly attacks the immune system, especially dendritic cells.

They are very important for our defense, so fundamental that they are known as the “brain of the immune system”.

However, when the virus binds to transport receptors it is able to invade dendritic cells.

Once inside these cells, it takes control over them, releasing their genetic material, nucleoproteins and enzymes.

Thus, not only is it able to block the action of the immune system, it is also able to reprogram it. This is how it manages to multiply.

When these cells become saturated by the ebola’s rampant replication, the membranes dissolve into thousands of viruses that are released into the body’s tissues.

The action of the virus also has the power to deceive other cells, as it is able to send messages to end their lives.

On the other hand, more defense cells are activated, such as macrophages, monocytes and cytokines. However, they are also not sufficient to block the action of the virus.

The reaction of these cells, when facing the invader, ends up causing hemorrhages, liver failure and all other symptoms. All of this happens at the same time and very fast.

The virus is capable of provoking a war against the immune system, which, with all its defense cells, tries to defend itself.

Groups and risk factors

During an outbreak, such as those in Liberia, Sierra Leone, Guinea and Nigeria, the people most at risk of infection are:

  • Health professionals who care for patients without the protection measures being adopted;
  • Family members or others who have close contact with infected people;
  • People who have direct contact with the bodies of the dead as part of funeral ceremonies;
  • Hunters who come into contact with dead animals found in the forest.

The individuals who have been most frequently exposed to the virus are health professionals, when caring for Ebola patients in Africa.

Contamination by the virus occurs when they do not properly use personal protective equipment, such as gloves and masks.

These professionals must strictly follow the recommended infection control precautions.

Symptoms

The Ebola virus is serious and the complications it causes as well. Therefore, it is essential to pay attention to the symptoms. At the beginning of the onset of the disease, it can be difficult to diagnose it correctly, as the signs are not specific.

The first symptoms that the Ebola patient has are:

  • Sudden onset of fever;
  • Intense weakness;
  • Muscle aches;
  • Headache;
  • Pain and inflammation in the throat.

Subsequently, they are followed by:

  • Vomiting;
  • Itches;
  • Diarrhea;
  • Liver dysfunction;
  • Rash (common);
  • Renal insufficiency;
  • Reddish eyes (common);
  • Hemorrhage both internal and external, in only a few cases.

The incubation period, or the time interval between infection and the onset of symptoms, can vary from 1 to 21 days after exposure to the virus.

During this period, infected people do not transmit the disease. The risk of transmission happens only when the symptoms start to show.

When there is a risk of death, it usually occurs between 6 to 16 days after the onset of symptoms and, in most cases, is due to the decrease in blood pressure, resulting from blood loss.

Hemorrhagic Phase

All infected people show symptoms of involvement of the circulatory system, such as coagulopathy. During the hemorrhagic phase, the first internal or subcutaneous hemorrhages can appear through red eyes or by the presence of blood in the vomit.

In about 40% to 50% of cases, there are reports of hemorrhages in the folds of the skin and mucous membranes; for example, in the digestive system, nose, vagina and gums.

Among the types of hemorrhage associated with the disease are the presence of blood in vomit, cough and feces. Heavy bleeding is rare and usually restricted to the digestive system. Usually, progression to hemorrhagic symptoms is an indicator of worsening prognosis and blood loss can cause death.

Diagnosis

The diagnosis is not always simple, as the symptoms are not specific. A team of doctors may be needed to assess the patient, as they are not usually isolated cases.

During diagnosis, it is essential to know the patient’s history to investigate whether contact has occurred with dead and / or sick animals or people with suspected virus infection.

In addition, it is part of the differential diagnosis to eliminate the hypothesis of diseases with similar symptoms, such as viral hemorrhagic fever, malaria , typhoid fever , bacterial dysentery, epidemic typhus , cholera , sepsis and Lyme disease.

These diseases can manifest symptoms similar to the infection caused by the Ebola virus.

To confirm the diagnosis, the doctor needs to carry out blood tests to confirm the presence of viral antibodies, viral RNA or the Ebola virus itself.

The confirmation of Ebola cases is done by specific laboratory exams, after carrying out seven tests approved by WHO. These tests are of great biological risk and must be conducted under conditions of maximum containment.

Laboratory tests

Even at the beginning of the worrying epidemic of 2014-2016, the World Health Organization launched an emergency procedure so that the assessment of suspected cases of Ebola could be carried out more quickly in the affected countries.

In December 2014, seven laboratory tests were approved for the Emergency Use Assessment and Listing Procedure (EUAL). These tests are part of a project to accelerate the containment of outbreaks, with rapid tests adapted to the Ebola virus.

The seven tests are as follows:

  • OraQuick;
  • RealStar;
  • ReEBOV;
  • Liferiver;
  • Xpert;
  • FilmArray;
  • SD Q Line Ebola Zaire Ag.

Ebola in pregnant and lactating women

 

This disease is extremely worrying when it occurs in pregnant women, as it puts the life of the mother and baby at risk.

There is no evidence that pregnant women are more susceptible to infection than other people in general, as transmission occurs in the same way to the entire population.

However, in cases of Ebola in pregnant women, the prognosis can be more severe, with the risk of loss of the fetus caused by hemorrhage caused by the disease.

In previous cases within outbreaks in Africa, some children born to mothers who had the disease did not survive. However, the virus was not always the cause of death, which prevents it from being affirmed that the virus has full responsibility in the face of these fatalities.

Treatment in pregnant women

Medical treatment with pregnant women should follow the same procedure used in all cases of Ebola. However, obstetric care needs to be done with greater monitoring, acting on the treatment of hemorrhagic complications that can be caused by the virus.

In addition, doctors must be aware of the risk of miscarriage and intrapartum abortion.

Care during breastfeeding

Lactating women infected by the virus or who are already cured can present the virus in breast milk.

However, the data on this manifestation are still not conclusive. The recommendation, according to the Center for Disease Control and Prevention (CDC) is that women who have recently had the disease or are infected should not breastfeed.

The time when breastfeeding will be safe for the baby should be stipulated by doctors, after safe tests to confirm the possibility.

Is Ebola curable?

There is still no treatment to guarantee the cure of Ebola. There are vaccines and experimental treatments, but they are not yet available for clinical use.

The patient diagnosed with this pathology must undergo some standard procedures and intensive supportive treatments.

The improvement in symptoms varies from patient to patient. Thus, the cure of the disease is not guaranteed, as it depends on the immune system of each infected individual, the hospital procedure, early diagnosis and other factors.

Treatment

The treatment carried out in patients with Ebola requires intensive support, which must be carried out in referral hospitals for the treatment of serious infectious diseases.

Generally, patients become dehydrated and need intravenous fluids or oral rehydration with solutions that contain electrolytes. Although the cure is uncertain, some patients may recover after receiving appropriate medical treatment.

The standard treatment for the disease is limited to supportive therapy, which consists of hydrating the patient, maintaining their oxygen and blood pressure levels and treating any infections that may appear.

Therapies

Supportive care involves two types of therapy:

  • Oral rehydration therapy : the patient, due to dehydration, receives oral rehydration therapy with saline as treatment.
  • Intravenous therapy: intravenous therapy is used to improve the prognosis of the disease.

Medicines

The drugs that exist for the treatment are still experimental. In the United States, during the 2014 outbreak, the Food and Drug Administration allowed two drugs, ZMapp and an interfering RNA called “TKM-Ebola”, to be used on people infected with ebola, under very strict conditions.

Animal tests are also being carried out with an experimental drug called BCX4430, in order to become a possible therapy in humans.

Some of these medications are ZMapp, Favipiravir and TKM-Ebola.

ZMapp

This is an experimental drug based on three monoclonal antibodies. Despite its limited availability, it has been used to treat a small number of people infected with the Ebola virus. Although some of these people have recovered, the results are not considered statistically significant. However, ZMapp has been shown to be highly effective in clinical trials with Rhesus monkeys.

Favipiravir

Favipiravir, an antiviral approved in Japan for prevention storage for influenza pandemics , appears to have some effectiveness in models of Ebola mice. The estrogen receptors used to treat infertility and breast cancer (clomiphene and toremifene) inhibit the progression of the ebola virus in infected rats.

From a study of rats treated with clomiphene, about 90% had good responses and were cured. With the use of toremifene as well, but in a percentage of 50%.

Another 2014 study looked at the effects of amiodarone, an ion channel blocker, used in cases of patients with cardiac arrhythmia . It was noted in this research that amiodarone is able to block the entry of the Ebola virus into cells in vitro .

TKM-Ebola

TKM-Ebola is a drug formed by a combination of RNAs that interfere with the action of three among the seven proteins of the Ebola virus.

This interference inhibits the replication of the virus and consequently contributes for the infection to be eliminated.

Blood transfusion

Treatment with blood transfusion from cured patients to infected patients has long been studied as an alternative.

Although there is still no scientific confirmation that this treatment is a viable option for all people who have been infected by the virus, there have been positive results in small groups.

In 1976, when the virus first appeared, this type of treatment was tested on an affected woman. She demonstrated less intense clinical bleeding after transfusion than other patients with the same disease.

However, the blood used for the transfusion was not that of a patient with Ebola, but that of a person cured of the Marburg virus, a virus that also causes hemorrhagic fever and causes symptoms similar to that of the Ebola virus. Unfortunately, this patient did not survive.

However, this attempt was promising in opening up a new possibility. In 1995, in Kikwit, Democratic Republic of Congo, the treatment was tested in a group of eight people and seven were recovered.

However, studies cannot yet be understood as a 100% safe solution, as it is not possible to state that these recoveries occurred exclusively with this procedure.

Because it was used in small groups, it is not possible to support conclusions about this treatment.

Vaccine

There is still no vaccine that is used clinically as a form of prevention or treatment. However, there are vaccines in tests that have shown good results, such as rVSV-ZEBOV, announced by the WHO and tested on more than 16,000 volunteers.

In the current outbreak affecting the Democratic Republic of Congo, WHO has obtained authorization to import the vaccine against the virus into the country.

It was developed by the Public Health Agency of Canada and belongs to the Merck laboratory. In human tests, called the “Ebola Ça Suffit” experiment (Ebola, enough!), The vaccine proved to be safe, but it is still considered experimental because it does not have a license.

The vaccine tests were carried out in Guinea in 2015, during the great Ebola outbreak in West Africa. During this phase of experimentation with the vaccine, the approach used was that of ring vaccination .

The rVSV-ZEBOV vaccine, although it has optimistic expectations, still needs care focused on transport and storage logistics, since it must be kept at temperatures from -60 ºC to -80 ºC.

According to experts, what we can consider as failures in the action of the rVSV-ZEBOV vaccine is the fact that we do not have knowledge about its long-term effects on the patient.

In addition, there is no confirmation of the vaccine’s action on all 5 types of virus strains. Until then, the vaccine was tested only on the most lethal virus, Zaire.

Ring vaccination approach

Ring vaccination refers to the approach given when there is a patient diagnosed with Ebola and all people with whom he has had recent contact are identified and vaccinated.

In this way, it is possible to have greater control over the transmission of the disease and try, in some way, to prevent an outbreak from occurring.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Prognosis

The prognosis of this disease is still considered to be deficient. There is not enough scientific evidence to suggest a treatment that is able to guarantee the cure of all patients.

In addition, infection with this virus is still associated with a very high percentage of mortality. With the exception of the Reston strain, which does not cause disease in humans, the other types of strain can cause up to 90% mortality.

Early diagnosis is also a process yet to be improved, considering the non-specific symptoms of Ebola. Treatments, vaccines and medications are being developed, but they still remain in the experimental phase, with little knowledge of their long-term effects for people.

Thus, the prognosis of this disease remains worrying, as the complications of this infection can be long-lasting or lethal.

Complications

The disease has a high mortality rate, often between 50% and 90% of cases. The reason viruses are so deadly is that they interfere with the immune system’s ability to mount a defense.

In the event that an infected person survives, recovery is usually quick and complete. However, in cases of longer duration, complications with long-term problems, such as:

  • Inflammation of the testicles;
  • Joint pain;
  • Convulsions;
  • Delirium;
  • With the;
  • Shock;
  • Muscle aches;
  • Multiple organ failure;
  • Exfoliation of the skin;
  • Severe bleeding;
  • Hair loss.

Eye symptoms have also been observed, such as:

  • Sensitivity to light;
  • Epiphora;
  • Uveitis;
  • Chorioretinitis;
  • Blindness.

Ebola viruses are able to persist in the semen of some survivors for up to seven weeks, which makes it possible to spread it through sexual intercourse. People who survive have slow recovery, and it may take months to regain strength and weight, and may experience:

  • Sensory changes;
  • Headaches;
  • Hepatitis;
  • Weakness;
  • Fatigue;
  • Inflammation of the eyes;
  • Testicular inflammation;
  • Hair loss.

How to prevent?

Ebola, despite its severity and infectious potential, can be prevented (or contained). For this, it is necessary to avoid any contact with body fluids or blood of any infected person, especially in the most advanced stage, when the disease is even more contagious.

Some of these forms of prevention include the following proposals:

Reduce the risk of transmission from animals to humans

One way to prevent Ebola is to reduce contact with infected animals.

Therefore, contact with fruit bats and primates that may be infected should be avoided.

Contact with the flesh of infected dead animals should be made with the utmost care, when it is not possible to avoid it. For this, it is necessary to use gloves and masks.

Reduce the risk of transmission between people

In the containment of Ebola or any infectious disease, it is necessary to adopt preventive measures between the relationships of healthy people and patients.

For this to happen, some recommendations must be made and information about the risks needs to reach people.

Some simple ways to avoid this risk include:

  • Avoid direct contact with people infected by the virus, particularly with their body fluids;
  • Health professionals should wear personal protective equipment when in contact with patients;
  • Hand hygiene always after contact with patients in hospitals;
  • Seek information about the forms of transmission;
  • Search for information about symptoms;
  • Seek medical help when in contact with a patient or when the disease is suspected;
  • Health professionals should inform the entire medical team of a suspected Ebola virus-infected patient, so that procedures can be done safely, such as handling blood tests.

Reduce the risk of transmission through sexual intercourse

Transmission of the Ebola virus during sexual intercourse should also be treated as an alert. From the suspicion process to the total treatment of the patient, some care must be followed so that there is no risk.

According to the WHO, more surveillance and research data is still needed to have a more viable analysis of the risks of sexual transmission, especially with regard to the prevalence of the virus in semen over time.

Based on the evidence, up to then, WHO recommends that:

  • All surviving Ebola patients and their sexual partners should receive medical advice that can ensure that their relationships are safe until tests show that there is no risk;
  • Condom use should be encouraged and, if possible, distributed to hospitals and organizations;
  • Men who have had Ebola should be tested for semen 3 months after the onset of the disease. If the test is positive, it will be necessary to perform the test monthly until the result is negative. Two tests with a negative result are necessary for the patient to be considered as not transmitting the disease. From one negative exam to the next, the interval should be one week;
  • Ebola patients should avoid all types of sex, as there is a risk of transmission through any body fluid;
  • Doctors should advise patients on the correct and safe use of condoms.

Although the guidelines listed refer to the transmission of the Ebola virus, it is important to emphasize the importance of good education in relation to sex education in any situation, in order to avoid the transmission of various sexual diseases, as serious as Ebola.

Outbreak containment measures

As for travel in times of outbreaks, WHO does not recommend travel restrictions for countries with transmission because the risk of infection for travelers is very low, since person-to-person transmission only occurs through direct contact with body fluids or secretions from an infected patient.

Also, transmission occurs mainly in towns and villages in rural areas. People traveling for business to the capitals or cities of these countries should avoid any contact with animals or sick people.

Health professionals traveling to areas at risk of transmission in these countries must strictly follow the measures recommended by WHO for infection control.

Brazilians residing in countries where Ebola is transmitted (Liberia, Sierra Leone, Guinea and Nigeria) should avoid traveling to rural areas and villages where the cases are occurring, be alert to the information and recommendations provided by the Ministries of Health of those countries and also avoid contact with animals or sick people.

In countries where Ebola is transmitted, the best way to prevent it is to avoid contact with the blood or secretions of animals or sick people or with the body of people who died as a result of this disease, during wake rituals.

Containment measures for health professionals

In addition to the usual care, healthcare workers should strictly apply the recommended infection control measures to avoid exposure to infected blood, fluids or contaminated environments or objects, such as a patient’s dirty clothes or used needles:

  • They must wear personal protective equipment, such as: aprons, gloves, masks and goggles or face shields;
  • They must not reuse protective equipment or clothing unless they have been properly disinfected;
  • They must change their gloves when passing from one patient to another.

Invasive procedures that can expose doctors, nurses and others to infection must be carried out under strict conditions of safety. Infected patients should be kept as separate from other patients and healthy people as possible.

The difficulty in maintaining these adequate standards in the health services of the affected African countries has led to a large number of infections in professionals in the area.

Common questions

Know some of the most common doubts related to this disease:

Ebola cases are possible in Brazil?

Due to the characteristics of the Ebola virus infection, the possibility of a global spread of the virus is very low. Since its discovery in 1976, the virus has occasionally produced outbreaks in one or more African countries, always very serious due to high lethality, but self-limited.

The seriousness of the outbreak lies in its ability to extend and the delay in control. This is due to the precariousness of health services in the areas where transmission occurs, which do not have basic protective equipment for health professionals and other patients.

In Brazil, there is no natural circulation of the Ebola virus in wild animals, as in several regions of Africa.

Cases of suspected Ebola recorded in Brazil are rare. There is no record of any confirmed case of the disease in the country.

According to the Ministry of Health, the risk of an Ebola outbreak in Brazil is considered low. And, according to WHO, the chances of the virus causing a pandemic are also small.

The recommendation to prevent the country from suffering a possible outbreak includes the identification of people who have traveled to countries in areas at risk and who have any symptoms.

Based on the identification that this is a suspicious case, measures are taken to protect the health professionals involved in handling the case, as well as to prevent the infection from being transmitted to other people.

The Ministry of Health receives daily information from WHO to assess the situation of Ebola outbreaks in West Africa and to recommend appropriate measures for the protection of our country.

Ebola outbreak in other countries

The Ebola virus is recurrent in several West African countries, where it has already caused outbreaks in some countries:

  • Democratic Republic of Congo (DRC);
  • Gabon;
  • Southern Sudan;
  • Costa do Marfim;
  • Uganda;
  • Republic of the Congo (RC);
  • South Africa (broadcast by foreigners).

Is any health facility capable of treating a patient with suspected Ebola?

No. Ebola is a disease of great concern because of its potential for outbreaks and mortality. In the presence of a patient with suspected virus infection, it is recommended that the person be kept isolated from other patients and be referred to a referral unit.

Blood collection, for diagnostic tests, must be done with a specific preparation, to contain the risks of contamination of patients and professionals who work in hospitals.

In addition, ebola is considered a disease of immediate notification to the Ministry of Health and the State Department of Health.

If an infected person sneezes near me, am I at risk of being infected?

No, the risks are minimal. Ebola is not transmitted by air. In this situation, contamination would only happen with direct contact with possible inhalable droplets.

Can the virus be transmitted by sweat?

There is no scientific evidence that this is possible in cases where the person has no cut on the skin.

However, claiming that such a chance does not exist can be imprudent. When it comes to this disease, more care needs to be taken.

Is it safe to travel during an outbreak?

According to WHO recommendations, it is not necessary to restrict access of people to countries with Ebola outbreaks, as it considers the risk of transmission to be low when there is no direct contact with fluids from the infected person.

Another factor considered is that epidemics occur more frequently in towns and villages in more rural areas.

Thus, the guidance for travelers is to avoid contact with animals and sick people. For health professionals who need to travel to the outbreak site, they must follow the recommendation established by WHO for infection control.

In the case of people living in areas with a history of an outbreak or who are experiencing any, they should follow the prevention recommendations.

Can Ebola be eradicated?

It is not yet possible to say when Ebola will be an eradicated disease or if this is, in fact, possible.

Because it is a disease caused by a virus, even though it recognizes the areas and risk factors, it is difficult to know when and where a new outbreak will happen.

What can be done to prevent these outbreaks are containment measures, incentives for research into medicines and vaccines, improvements in the structure of hospitals to receive these cases and good awareness campaigns to promote information about the risks of the disease.

The virus hosts bats and even though contact with these animals is unlikely for most people, the virus is able to reach people in different ways.

Thus, it is not possible to eradicate all host animals and contaminated animals. Therefore, as long as there is this risk of transmitting animals to people, this disease will be a concern. However, transmission between humans can be mitigated.

Why are bats more resistant to the Ebola virus?

Bats are the most likely hosts for the Ebola virus. Involuntarily, they are related to the onset of outbreaks in humans. However, the same virus that can cause thousands of people to die does not affect these animals to the same extent.

Even if infected, the risk of death from the virus is significantly lower when compared to the action of the disease in humans and other species.

In addition to the Ebola virus, bats are reported to carry many other viruses, such as rabies virus , Severe Acute Respiratory Syndrome (SARS), Nipah virus and MERS-CoV.

This resistance of bats to so many viruses aroused the curiosity of researchers. Some theories emerged from this:

Body temperature

During long-haul flights, bats experience some variations in body temperature and metabolic rate. The theory compares this oscillation of temperature as if it were a kind of “flying fever”.

Fever can mean the presence of an infection. Thus, this symptom acts as a way for our body to warn that there is something wrong and that the immune system needs to do something about it. And it happens, our body tends to demonstrate immune responses.

Therefore, these variations that bats show, when compared to humans, may indicate that immune responses are more efficient, making them more resistant to pathogens.

However, it is still a hypothesis. To confirm or rule out this possibility, more investment in research is needed.

Genome construction

Another theory questions the evolutionary loss of specific genes that encode immune response proteins in bats. Therefore, this species may be more resistant to viruses precisely because it does not have the genes that recognize them.

Immune system signaling molecules

Scientists have observed that bats continuously express IFN-a, a protein produced by the body to stop the replication of viruses, fungi, bacteria and tumor cells.

The presence of this protein occurs even when there is no presence of a viral infection. In this way, the immune systems of these animals become active and potent constantly, preventing viruses like Ebola from getting sick.


From the emergence of the virus to the present day, Ebola is a disease that causes concern in all corners of the world. With such high mortality rates, it is impossible not to be touched by the countries that suffer and have suffered from outbreaks of this disease.

In this article, we seek to clarify what the virus is and how this disease behaves. There is still a long way to go for more effective treatments and research to achieve safer forms of prevention.

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