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Information about Ebola Virus
Ebola Virus Disease (EVD)
[ref: WHO]
Ebola virus disease (formerly known as Ebola haemorrhagic fever) is a severe, often fatal illness
caused by Ebola virus. EVD has a case fatality rate of up to 90%. It is one of the world's most virulent
diseases.
The virus is transmitted by direct contact with the blood, body fluids and tissues of infected animals or
people. Severely ill patients require intensive supportive care. During an outbreak, those at higher risk
of infection are health workers, family members and others in close contact with sick people and
deceased patients. Ebola virus is not airborne, but may be spread via droplets that are
coughed or sneezed from a sick person and enter the eyes, nose, or mouth of another
person who is less than two metres away. More information about airborne and droplet
transmission...
Between August 6 and 7, 2014, an Emergency Committee met and after discussion and deliberation
on the information provided, the Committee advised that the current EVD outbreak in West Africa
constitutes an 'extraordinary event' and is a public health risk to other countries. It was agreed that
the conditions for a Public Health Emergency of International Concern (PHEIC) have been met. They
called on a coordinated international response to stop and reverse the international spread of EVD.
The entire statement, including a list of temporary recommendations, can be found at
http://who.int/mediacentre/news/statements/2014/ebola-20140808/en/.
Surveillance
[Ref: PHAC]
EVD has been nationally notifiable in Canada since 2000. As a nationally notifiable disease, ebolavirus
cases are reported to the Public Health Agency of Canada through national surveillance systems. The
Agency also works closely with its national and international partners, including the World Health
Organization, to track EVD outbreaks.
Health care workers in Canada should be vigilant for persons with symptoms compatible with EVD and
who have returned from affected countries within 21 days of symptom onset.
Case Classification: [Ref: PHAC]
Confirmed: A person with laboratory confirmation of EVD infection.
Laboratory testing for Ebola virus may only be done through
laboratory testing at the Agency's National Microbiology Laboratory
(NML).
Probable: A probable case is defined as a person with EVDcompatible symptoms (see Sign and Symptoms, below) not
attributed to another medical condition AND at least one of the
following high-risk exposures within the 21 days before the onset of
symptoms:

Percutaneous or mucous membrane exposure or direct skin contact
with body fluids of a confirmed or probable case of EVD AND/OR

Sexual contact with a probable or confirmed EVD case AND/OR

Laboratory worker processing body fluids of probable or confirmed
EVD cases without appropriate PPE or standard biosafety precautions
AND/OR

Health care worker (HCW) not wearing personal protective equipment
(PPE) and/or not adhering to appropriate infection prevention and
control precautions, who directly or indirectly cared for a probable or
confirmed case of EVD (e.g. direct patient care or contact with
environment or fomites of a case) AND/OR

Direct exposure to human remains (e.g. through participation in
funeral or burial rites) in the geographic area where the outbreak is
occurring without appropriate PPE
Person Under Investigation (PUI): A PUI is a person with EVDcompatible symptoms (see Signs and Symptoms, below) not
attributed to another medical condition AND at least one of the
following epidemiologic risk factors within the 21 days before the
onset of symptoms:

Residence in or travel to an area where EVD transmission is active

Healthcare worker (HCW) wearing personal protective
equipment (PPE) and adhering to appropriate infection prevention
and control precautions with no safety breaches, who directly or
indirectly cared for a probable or confirmed case of EVD (e.g. direct
patient care or contact with environment or fomites of a case)

Other patient or visitor without high risk exposures, as defined
below, who spent time in a healthcare facility where probable or
confirmed cases of EVD are being treated

Household member of a probable or confirmed case of EVD without
high-risk exposures, as defined below

Laboratory worker processing body fluids of probable or confirmed
cases of EVD with appropriate PPE and standard biosafety
precautions and no safety breaches

Direct exposure to human remains (e.g. through participation in
funeral or burial rites) in a geographic area where the outbreak is
occurring with appropriate PPE and no safety breaches

Direct unprotected contact with bats or primates from EVD-affected
country
Persons under investigation for EVD should be reported immediately
as per jurisdictional protocols in the respective province or territory in
Canada. Requests from provinces and territories for diagnostic or
confirmatory laboratory services for EVD should be directed to the
Public Health Agency of Canada's National Microbiology Laboratory at
1-866-262-8433.
For more information on EVD surveillance:

National Case Definition: Ebola virus disease (EVD) (23 August 2014)

Case definitions of Ebola virus and Marburg virus diseases (WHO 9 April 2014)
Signs and Symptoms
EVD is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness,
muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney
and liver function. Bleeding from gums, nose, injection sites and gastrointestinal tract occurs in about
50% of patients. Dehydration and significant wasting occur as the disease progresses. Laboratory
findings include low white blood cell and platelet counts and elevated liver enzymes.
People are infectious as long as their blood and secretions contain the virus. The incubation period is 2
to 21 days.
Other diseases that should be ruled out before a diagnosis of EVD can be made include: malaria,
typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis,
hepatitis and other viral haemorrhagic fevers.
There is no effective antiviral treatment for ebolavirus infections. Treatment is supportive, and is
directed at maintaining renal function and electrolyte balance, and at combatting haemorrhage and
shock.

Symptoms of Ebola virus disease (PHAC 23 May 2014)

Ebola clinical care guidelines (Canadian Association of Emergency Physicians, 29 August 2014)

Ebola virus disease information for clinicians in U.S. healthcare settings (CDC 10 August 2014