Signs and Symptoms

What are the signs and symptoms of Ebola?
Signs and symptoms of Ebola include fever (greater than 38.6°C or 101.5°F) and severe headache, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising. Signs and symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, although 8 to 10 days is most common.

How Ebola Spreads

How is Ebola spread?
The virus is spread through direct contact (through broken skin or mucous membranes) with blood and body fluids (urine, feces, saliva, vomit, and semen) of a person who is sick with Ebola, or died from Ebola, or with objects (like needles) that have been contaminated with the virus. Ebola is not spread through the air or by water or, in general, by food; however, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats and nonhuman primates .

Who is most at risk of getting Ebola?

Healthcare providers caring for Ebola patients and family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in direct contact with the blood or body fluids of sick patients.

In some places affected by the current outbreak, care may be provided in clinics with limited resources (for example, no running water, no climate control, no floors, inadequate medical supplies), and workers could be in those areas for several hours with a number of Ebola infected patients.

Additionally, certain job responsibilities and tasks, such as attending to dead bodies, may also require different Personal Protective Equipment (PPE) than what is used when providing care for infected patients in a hospital.

Can I get Ebola from a person who is infected but doesn’t have fever or any symptoms?
No. A person infected with Ebola is not contagious until symptoms appear.

If someone survives Ebola, can he or she still spread the virus?
Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. People who recover from Ebola are advised to abstain from sex or use condoms for 3 months.

Can Ebola be spread through mosquitos?
There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys and apes) have shown the ability to spread and become infected with Ebola virus.

Could Ebola be brought in through imported animals?
Because of restrictions the government has in place for importing animals, it is highly unlikely for Ebola to be brought in through imported animals.

The animals most commonly associated with Ebola are nonhuman primates (for example, apes and monkeys) and bats. Fish and Wildlife Service regulate importation of nonhuman primates and bats. These animals, products made from these animals, and research samples from these animals may only be imported with a permit. The permit specifies that the animals, animal products, or research samples are arriving ONLY for scientific, educational, or exhibition purposes. It is illegal to import these animals as pets or bushmeat.

Treatment

How is Ebola treated?
No specific vaccine or medicine has been proven to cure Ebola. Signs and symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can increase the chances of survival.
• Providing fluids and electrolytes
• Maintaining oxygen status and blood pressure
• Treating other infections if they occur

Early recognition of Ebola is important for providing appropriate patient care and preventing the spread of infection. Healthcare providers should be alert for and evaluate any patients suspected of having Ebola.

Prevention 

How do I protect myself against Ebola?
If you are in or traveling to an area affected by the Ebola outbreak, protect yourself by doing the following:
• Wash hands frequently.
• Avoid contact with blood and body fluids of any person, particularly someone who is sick.
• Do not handle items that may have come in contact with an infected person’s blood or body fluids.
• Do not touch the body of someone who has died from Ebola.
• Do not touch bats and non-human primates or their blood and fluids and do not touch or eat raw meat prepared from these animals.
• Avoid hospitals where Ebola patients are being treated.
• Seek medical care immediately if you develop fever (temperature of 101.5oF/ 38.6oC) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding and have been exposed to any Ebola or suspected case/country.
• Limit your contact with other people until and when you make contact with your general physician or a house doctor.

WHO has issued travel warning, stating that all nonessential travel should be avoided to the identified countries with Ebola outbreak. For travel notices and other information for travelers, visit the Travelers’ Health Ebola web page http://www.cdc.gov/vhf/ebola/.

How can healthcare providers protect themselves?
Healthcare providers can take several infection control measures to protect themselves when dealing with Ebola patients.
• Anyone entering the patient’s room should wear at least gloves, a gown, eye protection (goggles or a face shield), and a facemask.
• Additional personal protective equipment (PPE) might be needed in certain situations (for example, when there is a lot of blood, vomit, feces, or other body fluids).
• Healthcare providers should frequently perform hand hygiene before and after patient contact, contact with potentially infectious material, and before putting on and after removing PPE, including gloves.

Travelers

What is being done to prevent ill travelers in West Africa from getting on a plane?
Collaborating with local ports of entry to help prevent infectious diseases from being introduced and spread in St. Maarten. Communication lines have been set up to ensure follow up to investigate cases of ill travelers on planes and ships.  A person infected with Ebola is not contagious until symptoms appear.
Healthcare providers need to be prepared for the remote possibility that a traveler could get Ebola and return while sick. Ebola information is provided to partners, such as Customs and Border Protection and airlines, on signs and symptoms to look for in travelers arriving from Ebola outbreak-affected countries that should be reported to Collective Prevention Services. 

What do I do if I’m returning from the area where the outbreak is occurring?
After you return, pay attention to your health.
• Monitor your health for 21 days if you were in an area with an Ebola outbreak, especially if you were in contact with blood or body fluids, items that have come in contact with blood or body fluids, animals or raw meat, or hospitals where Ebola patients are being treated or participated in burial rituals.
• Seek medical care immediately if you develop fever (temperature of 101.5oF/ 38.6oC) and any of the following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
• Tell your doctor about your recent travel and your symptoms before you go to the office or emergency room. Advance notice will help your doctor care for you and protect other people.


What do I do if I am traveling to an area where the outbreak is occurring?
If you are traveling to an area where the Ebola outbreak is occurring, protect yourself by doing the following:
• Wash your hands frequently.
• Avoid contact with blood and body fluids of any person, particularly someone who is sick.
• Do not handle items that may have come in contact with an infected person’s blood or body fluids.
• Do not touch the body of someone who has died from Ebola.
• Do not touch bats and nonhuman primates or their blood and fluids and do not touch or eat raw meat prepared from these animals.
• Seek medical care immediately if you develop fever (temperature of 101.5oF/ 38.6oC) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
Limit your contact with other people until and when you go to the doctor. Do not travel anywhere else besides a healthcare facility. 

Should people traveling to Africa be worried about the outbreak? 
Avoid unnecessary travel to the identified areas although spread to other countries is possible. Ebola is a very low risk for most travelers – it is spread through direct contact with the blood or other body fluids of a sick person, so travelers can protect themselves by avoiding sick people and hospitals where patients with Ebola are being treated.

Are there any cases of people contracting Ebola? 
No confirmed Ebola cases have been reported on St. Maarten.

What is happening locally?
The Ministry of Public Health Social Development and Labour has activated its Emergency Services Function 6 (ESF-6) to help coordinate technical assistance and control activities with partners. They are presently working on protocols and awareness information to protect against further spread of disease. These protocols include having airline crew notify the identified authority of ill travelers on a plane before arrival, evaluation of ill travelers, and isolation and transport to a medical facility if needed.