Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Ebola: Facts for Healthcare Providers
The 2016 Ebola outbreak in Westboth consistent symptoms and theAfrica generated considerable media
following risk factors:
Education about Ebola is an important step
attention. This type of intense media■ Fever > 101.5ºF and additionalin ensuring optimal care for patients andcoverage can understandably increase
symptoms such as severe
fear and stress for patients, theirmanaging the stress and anxiety.
headache, muscle pain, vomiting,families, and other healthcare workers
diarrhea, abdominal pain, oraffected by an Ebola outbreak.
unexplained hemorrhage.
Education about Ebola is an important step in ensuring■ Epidemiologic risk factors within the past 21 days before
optimal care for patients and managing the stress and anxiety
onset of symptoms, such as:
for our patients, colleagues, and ourselves.
x Residence in — or travel to — an area where Ebola
virus transmission is active; all patients presentingClinical Presentation and Coursewith a fever should be screened for travel history.
Severe early symptoms are associated with increased
x Contact with blood, body fluids, or human remains ofmortality, which typically results from multi-organ failure anda patient infected with or suspected to have Ebola.
septic shock. Mortality rates range from 55-75 percent.
x Direct handling of bats or non-human primates from■ Abrupt onset, generally 8-10 days after exposure
disease-endemic areas.
■ Fever, anorexia, asthenia/weakness■ Chills, myalgias, and malaise; this can result in Ebola being

confused with other more common infectious diseases likemalaria, typhoid, meningococcemia and others, so a highdegree of suspicion is needed■ Diarrhea, nausea, vomiting, abdominal pain, andaerythematous maculopapular rash can occur by day five
■ Chest pain, shortness of breath, headache, confusion,conjunctival injection, hiccups, seizures, bleeding

Pathogenesis and Spread of Disease
Risk for transmission is low in the initial stages of patientswith symptoms. The virus is not transmitted in the air. Ebola
virus is spread by direct contact with:■ Blood and other body fluids such as vomit, urine, diarrhea,
sweat, semen, and breast milk of an infected person orsomeone who has recently died from Ebola.
■ Surfaces or objects contaminated by body fluids of an
infected person. This includes clothing and/or bedding.
■ Handling dead wild animals or “bushmeat” in Africa.
■ Unprotected sexual contact with a person who has recently
recovered from Ebola. The virus may be present in semen
up to 3 months after recovery.
Patient Evaluation and Diagnosis
The Centers for Disease Control and Prevention (CDC)
recommend further investigation for a person who has

Caring for Patients with Ebola
Treatment is supportive. The U.S. has developed a vaccinethat was approved for use in December 2019. Research into
other vaccine candidates and drug therapies is ongoing.
Talking with Patients Concerned about Ebola■ Listen without judgment to patients’ fears/concerns.
■ Avoid simple reassurances or dismissing patient concernswith statements such as “There’s nothing to worry about.” or“Everything will be fine.”■ Educate patients that, although Ebola virus can causeserious illness, it is extremely rare.
■ Inform people to seek health care as soon as symptoms
appear. This also protects those close to the person fromcoming in contact with blood and body fluids.
■ Avoid contact with patients who are infected or traveling toareas with Ebola outbreaks.
■ Encourage hand washing regularly as a general infection
control precaution.
Additional Resources:
Centers for Disease Control and Prevention Ebola Website:
http://www.cdc.gov/vhf/ebola/