Ebola virus disease (EVD), also known as Ebola, is a severe illness that starts with the abrupt onset of fever, usually with headache, malaise and myalgia and can lead to severe multisystem illness in which the vascular system is damaged. Ebola has been associated with historical outbreaks in several Central African countries, including a large outbreak in West Africa from 2014 to 2016.

On September 20, 2022, an outbreak of Sudan virus disease (SVD), a type of Ebola disease caused by the Sudan virus (SUDV), was announced by Uganda health authorities. As such, Canada has put into place enhanced health screening measures for Ebola. No confirmed cases related to this outbreak have been reported outside of Uganda to date. See the World Health Organization’s Situational Reports for the most up-to-date Ebola-affected areas.

 

Symptoms may include

  • Fever
  • Headache
  • Feeling tired
  • Muscle pain and weakness
  • Sore throat
  • Nausea and vomiting
  • Diarrhea
  • Hemorrhaging (bleeding)
  • Pharyngitis and conjunctival injection
  • A non-pruritic, erythematous, maculopapular rash that involves neck, trunk, and arms, may develop in 25% to 52% of patients by days 5 to 7

Incubation period

Symptoms can begin 2 to 21 days after exposure and usually start with the sudden onset of fever followed by other symptoms.

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Person to person

  • Unprotected contact with the blood, body fluids or tissues of an infected person with EVD symptoms. Infected individuals have not been shown to transmit the disease before they develop symptoms.
  • Unprotected sexual contact with a person who is recovering from EVD for up to 12 months following infection with an Ebola virus.
  • In health care settings, if staff who are caring for a person infected with the virus:
    • Do not use appropriate infection prevention and control measures such as hand washing, safe use of needles, and isolating patients.
    • Do not consistently and correctly use proper personal protective equipment such as masks, gowns, and gloves.

Contact with contaminated objects

  • Unprotected contact with soiled surfaces, materials (such as bedding) or medical equipment (such as needles) contaminated with an Ebola virus.

Animals to humans

  • Close contact (e.g., handling or eating), with infected animals (alive or dead) or their body fluids, including:
    • Gorillas
    • Monkeys
    • Chimpanzees
    • Fruit bats
    • Porcupines
    • Forest antelope
    • Pigs

No animals in Canada have been found to be naturally infected with an Ebola virus. Only infected animals pose a risk of EVD.

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Acute Care Settings

If a Viral Haemorrhagic Fever (VHF) including Ebola is suspected, immediately:

Note: Do not collect specimens for a microbiological examination before consulting with a PHO Laboratory Microbiologist. PHO Laboratory Customer Service Centre can be reached at 416-235-6556/1-877-604-4567, and after-hours 416-605-3113.

Non-Acute Care Settings (e.g. walk-in clinic, family physician)

  • Immediately place the individual with suspect, probable or confirmed EVD infection in a single patient room, with the door closed.
  • Call the Health Care Provider Hotline at 1-866-212-2272 to initiate a coordinating call to assess the risk and exposures of the patient and the need for testing.
  • Inform your local public health unit.

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Appropriate patient screening, risk assessment, patient placement and use of Personal Protective Equipment (PPE) is vital in healthcare settings when caring for suspect and confirmed patients.

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Humanitarian Aid Workers and individuals who recently returned from travel to an Ebola-affected area are asked to monitor for EVD symptoms for 21 days.

As of November 14, 2022, Public Health Ontario’s (PHO) laboratory will perform the Ebolavirus PCR assay to detect the Sudan ebolavirus species. PHO’s laboratory will provide a preliminary result for specimens received from patients with suspected Sudan ebolavirus infection; specimens will also be referred to the National Microbiology Laboratory (NML) in Winnipeg for parallel testing.

Note: Do not collect specimens for a microbiological examination before consulting with a PHO Laboratory Microbiologist. PHO Laboratory Customer Service Centre can be reached at 416-235-6556/1-877-604-4567, or after-hours at 416-605-3113.

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There is currently no approved treatment specifically for EVD. Early diagnosis is important. Ebola cases are very difficult to care for because the symptoms can get worse very quickly.

Cases should receive care in highly specialized centres, in order to ensure appropriate supportive care (maintaining blood pressure, electrolyte balance and organ systems function) under strict infection prevention control management. Provincial and territorial public health authorities can provide information regarding whether a treatment facility has been designated for this purpose in their jurisdiction.

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There is currently no approved vaccine for EVD in Canada. An investigational vaccine (rVSV-ZEBOV-GP, Merck) for the Zaire ebolavirus species has completed early stage investigational trials, and has been available on compassionate grounds in recent outbreaks (West Africa 2014 to 2016, DRC 2018). The vaccine may also be offered to front-line health care and humanitarian workers in EVD-affected areas as part of an outbreak management strategy.

The vaccine is not approved or marketed in Canada. In the event of a Canadian case, the vaccine may be deemed helpful for outbreak control purposes. Under these circumstances, access to this unapproved product, will be facilitated by PHAC through the appropriate regulatory mechanism.

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All suspected and confirmed cases of Ebola must be reported to TPH by:

  • Completing TPH’s Reportable Disease Form and faxing it to 416-392-0047, OR
  • Calling 416-392-7411 during regular business hours (8:30 a.m. to 4:30 p.m., Monday to Friday) or 311 outside these hours.