With the present level of international travel and increased intercontinental movement, the risk of EVD spreading beyond West Africa is substantial. Ebola virus is spread by direct or indirect contact with the mucosa, nonintact skin, or bodily fluids of a person who is both infected and symptomatic.18,25 The virus is not known to spread from an infected person who is asymptomatic, though virus may persist in some body fluids, including semen and eye fluid, for weeks to months.3,17,23,26 Ebola virus is able to survive on the skin for several hours and can be transferred to mucosal surfaces at a later time. The risk of transmission increases with the length of illness and is highest during the late stages of infection.3 Airborne transmission has not been demonstrated in humans; however, there is speculation that it may be a mode of transmission in nonhuman primates.3,25
Within the African population, close family contact, funeral rituals that involve handling corpses with bare hands, and lack of adequate medical care lead to higher rates of transmission.
Healthcare workers are particularly at risk for contracting EVD. As seen in Liberia (which had the largest rate of nosocomial infection), limited availability of protective equipment and lack of knowledge regarding its proper use, as well as failure to recognize EVD, led to amplification of the spread of infection.6 The importance of personal protective equipment (PPE) and proper infection control measures cannot be overemphasized. For more details on the use of proper PPE, See the "Management" section.
Marlie Dulaurier, MD;Katherine Moyer, DO;Rebecca Wallihan, MD
July 2, 2016
August 2, 2019
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits