How is Ebola transmitted?

The Ebola virus can be transmitted from person to person. Transmission occurs through direct physical contact with Ebola fever patients or deceased persons, in particular through direct contact with their bodily fluids, e.g. blood, saliva, sweat, urine, stool or vomit. Before symptoms appear, people infected with the Ebola virus are not contagious.

Transmission through the air has not yet been proven.

Transmission is also possible via objects that have come into contact with infectious fluids, e.g. needles, surgical instruments, clothing or bed linen.

The Ebola virus can also be transmitted to humans through contact with infected animals or infectious animal products, e.g. when hunting, preparing meat or eating undercooked meat (so-called "bushmeat") from animals in affected areas.

How long is the incubation period?

The incubation period is at least two, but usually eight to ten days, and after 21 days it can be assumed that the disease is no longer likely to occur.

How high is the risk of contracting the disease from a sick person?

There is only a very high risk of infection through unprotected direct contact with bodily fluids and excretions of Ebola fever patients and deceased persons, e.g. blood, saliva, sweat, urine, stool or vomit. Therefore, adequate protective measures must be taken during care, treatment and burial activities. General hygiene measures, especially hand hygiene, are also of particular importance.

How long is the risk of infection?

A few days after the symptoms have subsided, patients are no longer considered contagious.

Transmission through semen during sexual intercourse is still possible for several weeks. Those affected must be informed about this and advised on the necessary preventive measures.

Which risk groups are there in Germany?

Mainly people who have had direct physical contact with Ebola fever patients or deceased persons or their bodily fluids belong to the risk group. In addition to medical staff, this risk primarily affects family members caring for Ebola fever patients without adequate protection. Laboratory staff who have worked with sample material from Ebola fever patients can also be affected if protective measures against Ebola viruses were inadequate.

Symptoms

The early symptoms are non-specific and resemble a flu-like infection: fever, headache, musculoskeletal pain, vomiting, diarrhea and abdominal pain.

Further symptoms may occur during the course of the disease, although not all of them are necessarily present: Internal and external bleeding (hemorrhages), which can be very severe, rash on the skin (exanthema), redness of the conjunctiva, sore throat, chest pain, difficulty swallowing and shortness of breath.

Direct contact with an Ebola patient should be avoided. Medical staff caring for a confirmed case must adhere to strict hygiene and isolation rules.

What should a patient who suspects they have Ebola do?

It is very important to remain calm. A doctor should be contacted by telephone with information about the suspected Ebola fever, a more detailed description of the symptoms, the places traveled to and the duration of the trip. The doctor will then discuss the next steps with the patient.

However, even if you have traveled to one of the affected areas within the last three weeks, the probability of an Ebola virus infection is very low if you have had no contact with a person who has contracted or died from Ebola fever.

Doctor's procedure: If the doctor can confirm a suspected Ebola virus infection, the responsible health authority should be informed and a specialized center should be contacted. However, apparent suspected cases can often be ruled out during a telephone call to a specialized center.

If the patient's condition allows, they should remain on site until Ebola has been confirmed or ruled out, e.g. at home, in the doctor's surgery or in isolation on the hospital ward. The patient should not be admitted to an emergency room. Transportation should also be avoided as far as possible to prevent infection.

What preventive measures can be taken?

Unprotected direct contact with an Ebola fever patient or deceased person must be strictly avoided. Medical staff caring for a suspected case or a patient with a confirmed Ebola virus infection must adhere to strict hygiene and isolation regulations.

There is no approved vaccine.

Is there a specific therapy?

There is no approved specific therapy. Treatment is therefore exclusively symptomatic, and the quality of medical care has an influence on mortality. The few specific therapeutic approaches are experimental.

What should travelers be aware of?

The Federal Foreign Office provides information on its website about medical risks abroad. It provides information on countries and information sheets on diseases. The Federal Association of Public Health Services and the ECDC also provide information for travelers in several languages.

Individual advice for travelers is offered by specialist doctors in private practice as well as tropical institutes and, in some cases, health authorities.

How likely is it that Ebola fever will occur in Germany?

The risk of travelers bringing the disease to Germany or Europe is low, but it cannot be ruled out. People in the closest environment of the infected person would be at risk of infection due to human-to-human transmission. However, there is no risk to the population because Germany is well prepared to treat people who have contracted Ebola fever. There is a network of special isolation wards that are equipped with both the medical expertise and the technical requirements to treat such illnesses (Working Group of Competence and Treatment Centers, STAKOB, www.stakob.rki.de). The staff there are specially trained for this situation and regularly train in the care of patients under isolation conditions.

What happens if a case of Ebola fever is brought to Germany?

There is only a low risk of a person infected with the Ebola virus entering Germany. Should a patient nevertheless enter the country, the spread of the Ebola virus in Germany is practically impossible due to the good medical care and preparations for such events.

If air travelers experience symptoms typical of Ebola during the flight, the pilot should inform the relevant airport, which must have the status of a medical airport, in accordance with international health regulations. There, the patient would be isolated and questioned by a doctor from the responsible health authority. If the suspicion of Ebola fever is confirmed, the traveler would be taken to a special isolation ward for diagnosis and treatment. At the same time, people who have been in close contact with such patients (neighbors and people who have directly cared for the patient) would be registered by the public health department and asked to watch out for symptoms typical of Ebola over the next 21 days (maximum incubation period).

If a person infected with the Ebola virus first falls ill in Germany, they would also be admitted to a special isolation ward as soon as there is reasonable suspicion of Ebola fever. All persons who have had close contact with them are identified and registered by the responsible health authority by interviewing the patient and their relatives or caregivers, informed about the possible infection and monitored in their everyday environment for 21 days for symptoms typical of Ebola.

Before symptoms appear, people infected with the Ebola virus are not contagious.

As the National Public Health Institute, the RKI works closely with the federal states on infection control. Federal states with an international airport have experience in dealing with diseases imported from the tropics.

• Information on infectious and tropical diseases - Federal Foreign Office
• Information for passengers about Ebola - Public Health Service (ÖGD)
• STAKOB working group