Incubation period days

Period of communicability From start of symptoms and for up to 10 weeks for seminal fluid. Healthcare workers are particularly liable to become infected, especially during the phase of vomiting and diarrhoea. Contact with blood is invariably fatal.

Occurrence and distribution The main focus of infection is the rain forest of Central Africa, outbreaks having occurred in Sudan, Congo (formerly Zaire), Gabon and Uganda. Another focus of an Ebola-related virus has been found in monkeys in the Philippines exported for experimental purposes. The focal nature suggests a zoonosis, but despite extensive search, no reservoir has been found. Bats have been infected experimentally, but do not die, so might be responsible for maintaining the virus in the wild.

Control and prevention The strictest level of barrier nursing is required taking particular care to avoid contact with blood and all secretions. Patients who die must be buried or cremated immediately using the same precautions, with relatives being forbidden to take the body away for burial. Patients who recover must be counselled about the dangers of sexual intercourse and the infective nature of semen.

All contacts of a case and accidental contacts by healthcare workers must be quarantined and the temperature checked twice a day. Surveillance should continue for 3 weeks from the date of contact.

Treatment There is no specific therapy and hyper-immune serum does not offer any long-term protection.

Surveillance Outbreaks should be reported to WHO, neighbouring countries and those with air connections so that surveillance can be mounted on travellers.

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