Ebola: category 4 contact information
Advice for people who have come into direct contact with someone who has the Ebola virus, or material contaminated with a virus that causes Ebola disease.
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You have been given this information sheet because you have had contact with someone with Ebola disease, or material contaminated with a virus that causes Ebola disease. You should follow the advice in this information sheet and check yourself for symptoms for 21 days after you had possible contact with Ebola. If you develop symptoms of Ebola disease within 21 days of your last exposure to Ebola, you should stay at home and call your designated contact immediately.
About Ebola disease
Ebola disease is a rare but serious disease caused by orthoebolaviruses. There are 6 identified species of orthoebolavirus, 4 of which cause disease in humans.
Outbreaks of Ebola disease have previously occurred in the Democratic Republic of the Congo (DRC, formerly Zaire), Sudan, Gabon, Uganda, and the Republic of Congo.
In 2014, Ebola disease outbreaks occurred for the first time in West Africa, in Guinea, Liberia and Sierra Leone, and in these countries there was intense transmission in urban areas.
How Ebola spreads
The viruses that cause Ebola disease can spread by:
- direct contact with the organs, blood, secretions, or other bodily fluids of an infected person (including sexual transmission)
- contact with objects, such as needles or soiled clothing, that have been contaminated with infected secretions
- contact with an infected animal, such as chimpanzees, gorillas or fruit bats, either if they are found ill or dead, or collected as bushmeat
Ebola viruses are not spread through routine, social contact (such as shaking hands or sitting next to someone) with people who do not have symptoms. There is no evidence that Ebola viruses can spread through the air.
It can take up to 21 days from when someone is exposed to the virus for symptoms to appear.
Symptoms of Ebola disease
The onset of illness is sudden, with:
- high fever
- severe headache
- intense weakness
- muscle pain
A few days later symptoms can include:
- severe watery diarrhoea
- abdominal pain
- abdominal cramping
- nausea
- vomiting
Some patients with severe illness may develop internal and external bleeding.
Ebola disease is fatal in between 25% to 90% of all clinically ill cases, depending on the virus strain, the person’s age, and other factors including immunocompromise. Starting supportive treatment promptly after symptoms begin can improve the likelihood of surviving the disease.
Preventing and treating Ebola disease
There are currently 2 licensed vaccines that offer protection from Zaire orthoebolavirus, which is the species of orthoebolavirus that has caused most of the large outbreaks. Vaccines are used to protect high risk individuals (for example, frontline workers and those reporting high risk contacts with confirmed cases) during outbreaks. There are no licensed vaccines for the other strains of orthoebolaviruses that affect humans.
To avoid orthoebolaviruses spreading between people, those caring for individuals with possible or suspected Ebola disease should avoid contact with the patient’s bodily fluids and should wear personal protective equipment (PPE).
Treatment for Ebola disease is with supportive care, including balancing fluids and electrolytes, maintaining a person’s oxygen status and blood pressure, and treating any co-infections. Supportive care improves survival, particularly if started early.
Currently, there are 2 approved antiviral treatments that can be used for Ebola disease caused by Zaire orthoebolavirus, known as monoclonal antibodies. These are available in the UK as well as supportive care.
Your risk of developing Ebola disease
You reported that you were in the same room as, and within 2 metres of, someone who had Ebola disease, but you did not have direct contact with them, their body fluids or objects that they may have contaminated.
We would like to monitor you for a period of 21 days from when you were last exposed to Ebola. This will mean that we can act quickly in the unlikely event that you develop symptoms, reducing the risks to you and to others close to you.
What you need to do
Your family and household contacts are not at risk of catching Ebola disease from you if you do not have any symptoms.
You should take the following actions for 21 days after you had possible contact with Ebola:
- record your temperature and monitor yourself for other symptoms suggestive of Ebola disease (as listed above) twice per day at the same times each day
- report to your designated contact (see below for their details) if you develop a temperature of 37.5°C or higher, or other symptoms suggestive of Ebola disease, so that they can arrange for you to be assessed. They will explain the local arrangements for accessing healthcare
- there are no restrictions on work, travel or social activities as long as you have no symptoms
- do not share towels, bed linen, toothbrushes or razors
- use barrier contraception or avoid unprotected sexual contact with other people
- postpone any non-essential medical or dental treatment including vaccination. If you need essential medical or dental treatment, inform your healthcare provider about your possible contact with Ebola
If you are a healthcare worker, you should tell your line manager that you have been identified as a contact of Ebola, but that you are still able to attend work as long as you remain asymptomatic.
Use of medicines such as aspirin, paracetamol or ibuprofen
Certain medicines, such as paracetamol, ibuprofen and aspirin, can reduce your body temperature during a fever (antipyretic) for up to 8 hours. Thermometer measurements may therefore show a lower temperature than would be expected for up to 8 hours after taking an antipyretic.
You must call your designated contact for further advice if you need to take an antipyretic medicine.
Please take your temperature before you take paracetamol, ibuprofen or aspirin. If your temperature is 37.5°C or higher, you must call your contact immediately.
A temperature of 37.5°C or higher is always significant, whether you are taking one of these medicines or not, and must be reported urgently.
What to do if you become ill
It is unlikely that you have caught Ebola disease. However, if you are feeling unwell or develop any of the symptoms of Ebola disease (including a temperature of 37.5°C or higher) within 21 days from when you had contact with Ebola, stay at home. Take your temperature if you have not done this already. Phone your designated contact immediately (see below for details), who will arrange for you to be assessed by an appropriate clinician. In an emergency, you should call 999 and tell them about your symptoms and possible contact with Ebola.
You will get your designated contact number from the UK Health Security Agency (UKHSA).
Further information
More information about Ebola disease can be found on the following websites: