Ebola virus disease for Healthcare Providers

What is Ebola virus disease? Ebola virus disease (EVD) is a severe illness caused by the Ebola virus. EVD is one of many viral hemorrhagic fevers that can affect humans and other primates. The case fatality rate for Ebola ranges between 25 and 90% in low-resource settings; case-fatality in well-resourced settings remains unknown.

EVD begins with a sudden onset of fever, weakness, muscle pain and headache. These symptoms may be followed by vomiting, diarrhea, abdominal pain, rash and bleeding or bruising. Hemorrhagic findings may occur in 50% of cases. Leukopenia, thrombocytopenia and elevation of transaminases are common laboratory findings.

Please ensure that patients suspected of having Ebola Virus Disease (EVD) are asked about recent travel for themselves and their close contacts as well as contact with anyone who was ill with EVD. Please contact the Health Unit should EVD be suspected in a patient (Monday - Friday 8:30 a.m.- 4:30 p.m. at 519-663-5317 ext 2330; after hours, weekends and holidays: 519-663-5317 and select option 2 and ask for the infectious disease pager).

What is the route of transmission?

EVD is spread through direct contact with the blood, vomit, diarrhea or body fluids of an infected person. It may also spread by contact with contaminated surfaces and objects. There is no evidence that EVD is spread through the airborne route. People are not infectious during the incubation period.

What is the incubation period?

The incubation period for EVD is two to 21 days.

Why are there concerns currently about EVD?

The World Health Organization has declared an EVD outbreak in West Africa. While new cases of EVD-related illness and deaths continue to emerge, to date, all have originated in Africa.

Public Health Ontario

For more Ebola information and resources, please visit
Public Health Ontario.

Steps to take if you suspect EVD in a patient

If a patient presents with a fever AND positive travel history (travel to any country where EVD outbreaks are occurring http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html) or epidemiological exposure within the preceding 21 days of illness onset:

Isolate patient to a closed, single room with dedicated washroom (if possible).
Follow precautions and use of PPE as directed by Ebola Virus Disease Directive #1 for Hospitals, when providing care to a suspect/confirmed EVD patient.
If any aerosol generating medical procedures (AGMP) are going to be undertaken, place the patient in a negative pressure room and use a fit-tested, seal-checked N95 respirator in addition to contact and droplet PPE as outlined in Ebola Virus Disease Directive #1 for Hospitals.
Notify the hospital’s Infection Prevention and Control team and the Middlesex London Health Unit.
For laboratory sample collection, please follow PHO’s Sample Collection and Submission guidelines, found at: http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/Pages/Viral-Hemorrhagic-Fevers.aspx#.VR1Qy_nF9CA

For Ebola guidance documents as well as testing information, please refer to Public Health Ontario.

Date of creation: September 3, 2014
Last modified on: April 2, 2015

Resources

References

¹Centers for Disease Control and Prevention (2014). Ebola Hemorrhagic Fever. Retrieved from
http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html

²Ontario Agency for Health Protection and Promotion (Public Health Ontario). Infection prevention and control guidance for patients with suspected or confirmed Ebola virus disease (EVD) in Ontario health care settings. Toronto, ON: Queen's Printer for Ontario; 2014. Retrieved from
http://www.publichealthontario.ca/en/eRepository/EVD_IPAC_Guidance.pdf

³Public Health Agency of Canada (2014). Ebola virus disease in Guinea, Liberia and Sierra Leone. Retrieved from
http://www.phac-aspc.gc.ca/tmp-pmv/notices-avis/index-eng.php

⁴World health Organization (2014). Ebola virus disease Retrieved from
http://www.who.int/mediacentre/factsheets/fs103/en/