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Ebola Virus Disease-2

Controlling infection in health-care settings

Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Ebola virus should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with EVD, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Healthcare staff working with ANC or obstetric care should be informed about risks of persisting virus in pregnancy related fluids and encouraged to follow protocol for their own safety and the safety of the women they are caring for.Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Ebola infection should be handled by trained staff and processed in suitably equipped laboratories.

Care for people who recovered from EVD

A number of medical complications have been reported in people who recovered from Ebola, including mental health issues. Ebola virus may persist in some body fluids, including semen, pregnancy-related fluids and breast milk.A number of medical complications have been reported in people who recovered from Ebola, including mental health issues. Ebola virus may persist in some body fluids, including semen, pregnancy-related fluids and breast milk.Ebola survivors need comprehensive support for the medical and psychosocial challenges they face and also to minimize the risk of continued Ebola virus transmission. To address these needs, a dedicated programme can be set up for care for people who recovered from Ebola.

For more, read the Guidance on clinical care for survivors of Ebola virus disease Ebola virus is known to persist in immune-privileged sites in some people who have recovered from Ebola virus disease. These sites include the testicles, the inside of the eye, and the central nervous system. In women who have been infected while pregnant, the virus persists in the placenta, amniotic fluid and fetus. In women who have been infected while breastfeeding, the virus may persist in breast milk.   

For more information on pregnant and breastfeeding women recovering from Ebola virus disease please read the GuidelineRelapse-symptomatic illness in someone who has recovered from EVD due to increased replication of the virus in a specific site is a rare event, but has been documented. Reasons for this phenomenon are not yet fully understood.

Studies of viral persistence indicate that in a small percentage of survivors, some body fluids may test positive on reverse transcriptase polymerase chain reaction (RT-PCR) testing for Ebola virus for longer than 9 months.More surveillance data and research are needed on the risks of sexual transmission, and particularly on the prevalence of viable and transmissible virus in semen over time. In the interim, and based on present evidence, 

WHO recommends that:   

All Ebola survivors and their sexual partners should receive counselling to ensure safer sexual practices until their semen has twice tested negative. Survivors should be provided with condoms.    Male Ebola survivors should be offered semen testing at 3 months after onset of disease, and then, for those who test positive, every month thereafter until their semen tests negative for virus twice by RT-PCR, with an interval of one week between tests.    Ebola survivors and their sexual partners should either: abstain from all types of sex, or observe safer sex through correct and consistent condom use until their semen has twice tested negative. Having tested negative, survivors can safely resume normal sexual practices without fear of Ebola virus transmission.   

Based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of Ebola virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus.   

Until such time as their semen has twice tested negative for Ebola, survivors should practice good hand and personal hygiene by immediately and thoroughly washing with soap and water after any physical contact with semen, including after masturbation. During this period, used condoms should be handled safely, and safely disposed of, so as to prevent contact with seminal fluids. All survivors, their partners and families should be shown respect, dignity and compassion.Interim advice on the sexual transmission of the Ebola virus disease.

WHO response

WHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus disease and supporting at-risk countries to develop preparedness plans. This document provides overall guidance for control of Ebola and Marburg virus outbreaks:WHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus disease and supporting at-risk countries to develop preparedness plans. This document provides overall guidance for control of Ebola and Marburg virus outbreaks:   

Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation When an outbreak is detected WHO responds by supporting community engagement, disease detection, contact tracing, vaccination, case management, laboratory services, infection control, logistics, and training and assistance with safe and dignified burial practices.

WHO has developed detailed advice on Ebola infection prevention and control: Infection prevention and control guidance for care of patients with suspected or confirmed Filovirus haemorrhagic fever in health-care settings, with focus on Ebola.

NewsStatement on the 5th meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 14 April 2020 14 April 2020WHO Director-General’s Statement on IHR Emergency Committee on Ebola Virus Disease in the Democratic Republic of the Congo 14 April 2020New Ebola case confirmed in the Democratic Republic of the Congo 10 April 2020.

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Reference:: World Health Organization