Ebola was first seen in Africa in 1976. Since then, at least seven Ebola outbreaks have occurred, all originating in Africa. Ebola virus likely emerged due to zoonotic spillover from a natural host to humans, such as wild bat(s). Deforestation and the build-up of wildland-urban interfaces may have increased the chances of human contact with the Ebola virus. The Ebola virus causes outbreaks in West Africa because that appears to be where the Ebola virus is endemic in the bat(s) population. Further Ebola outbreaks will likely occur in West Africa and possibly expand geographically with climate change. Although with the availability of the Ebola vaccine, ring vaccination campaigns may lessen the extent of future outbreaks. Healthcare-related or nosocomial infections are a significant transmission mode with Ebola due to the excessive production of body fluids in symptomatic individuals. In addition to Africa, the Ebola virus may be present in Germany, the United States, the Philippines, according to serologic survey data. However, we have not seen Ebola outbreaks originating in Germany, the United States, and the Philippines. The assumption that Ebola is only a problem for Africa is false as Ebola outbreaks have been seen to spread to other continents. The Ebola virus may also be endemic in different regions of the world, possibly leading to outbreaks that originate outside of Africa in years to come. Ebola has a long incubation period (2 - 21 days), but symptoms come on quickly when infection develops. Symptoms and signs are fever/ chills, muscle pain, headache, lack of appetite, abdominal pain/ nausea/ diarrhea/ vomiting, sore throat and cough with pharyngeal erythema, and conjunctivitis. As Ebola progresses, patients develop a rash and bleeding, most commonly to the gastrointestinal tract. Treatment is mainly supportive. However, there are several monoclonal antibody medications and a triple monoclonal antibody medication, ZMapp, that have been shown to decrease mortality during Ebola outbreaks. In addition to treating patients, other measures of containing Ebola outbreaks include:

-Identifying new cases quickly.

-Performing contact tracing (possibly with ring vaccination).

-Surveillance of high-risk populations (possible vaccination as primary prevention).

References:

Kaner J, Schaack S. Understanding Ebola: the 2014 epidemic. Global Health. 2016;12(1):53. Published 2016 Sep 13. doi:10.1186/s12992-016-0194-4

Feldmann H, Klenk HD. Filoviruses. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 72