Infektionsschutz; Beratung Ebola

Below you will find numerous facts about the infectious disease "Ebola fever" and further information.

Ebola is a rare and life-threatening infectious disease. It belongs to the so-called viral hemorrhagic fever diseases (AF) and is caused by the Ebola virus (EV).

Ebola is subject to the reporting obligation.

• Name and age of the patient
• Detailed information about complaints/symptoms and their onset and severity
• Indication of pre-existing conditions and medication intake, e.g. vaccinations and malaria prophylaxis (does not exclude malaria in principle)
• Exact period of stay in an Ebola outbreak area
• Type and location of accommodation
• Exact itinerary
• Stay in (bat) caves
• Professional activities in laboratories
• Further information about the stay, e.g. tourism, visiting relatives, professional activity in the outbreak area
• Contact with wild animals, consumption of wild animal meat
• Sick persons in the environment, participation in funerals

A reasonable suspicion of Ebola fever illness is only present in persons who have entered from areas with Ebola fever in the last 21 days, have at least fever or elevated temperature with Ebola fever-typical accompanying symptoms AND have had local contact with Ebola fever patients or deceased persons, with their bodily fluids or with sick wild animals.
The RKI has published a guide for doctors to clarify whether a suspicion of Ebola fever is justified (infographic measures in case of suspected Ebola fever). The infographic is also available at www.rki.de/ebola.

It is a benefit of the (statutory and private) health insurance.

The patient should contact a doctor by telephone (supplement: a doctor, a doctor's office or the telephone service of the statutory health insurance on-call service telephone 116117), point out the suspicion of Ebola fever and describe the symptoms that have occurred, as well as name the travel locations and travel time.

Then the doctor will discuss the further procedure with the patient. Even if you travel to an Ebola fever outbreak area within the last three weeks, the likelihood of Ebola virus infection is very low if there has been no close contact with a person who has contracted or died of Ebola fever.

How is Ebola transmitted?

The Ebola virus can be transmitted from person to person. Transmission occurs through direct physical contact with Ebola fever patients or deceased persons, in particular through direct contact with their body fluids, e.g. blood, saliva, sweat, urine, stool or vomit. Before symptoms appear, people infected with the Ebola virus are not contagious.

Transmission through the air has not yet been detected.

Transmission is also possible via objects that have come into contact with infectious fluids, e.g. needles, surgical instruments, clothing or bed linen.

The Ebola virus can also be transmitted to humans in contact with infected animals or infectious animal products, e.g. during hunting, meat preparation or the consumption of undercooked meat (so-called "bushmeat") derived from animals from affected areas.

How long is the incubation period?

The incubation period is at least two, but usually eight to ten days, and after 21 days it can be assumed that a disease is no longer to be expected.

How high is the risk of infection in sick people?

There is only a very high risk of infection in the case of unprotected direct contact with bodily fluids and body excretions of Ebola fever patients and deceased, e.g. blood, saliva, sweat, urine, stool or vomit. Therefore, sufficient protective measures must be taken during care, treatment and funeral activities. General hygiene measures, especially hand hygiene, are also of particular importance.

How long is the risk of infection?

A few days after the symptoms subside, patients are no longer considered contagious.

Transmission through sperm during sexual intercourse is still possible for several weeks. Those affected must be informed about this and advised on necessary preventive measures.

Which risk groups are there in Germany?

Mainly people who had direct physical contact with Ebola fever patients or deceased persons or their bodily fluids belong to the risk group. In addition to medical personnel, this risk mainly affects family caregivers of Ebola fever patients without adequate protection. Laboratory personnel who have worked with samples from Ebola fever patients may also be affected if protective measures against Ebola viruses were not sufficient.

Symptoms

The early symptoms are non-specific and resemble a flu-like infection: fever, headache, musculoskeletal pain, vomiting, diarrhoea and abdominal pain.

In the course of other symptoms may be added, but not all of them must always occur: Internal and external bleeding (hemorrhages), which can be very severe, rash of the skin (exanthema), redness of the conjunctiva, sore throat, chest pain, difficulty swallowing and shortness of breath.

Direct contact with an Ebola patient should be avoided. Medical personnel who are caring for a confirmed case must comply with strict hygiene and isolation regulations.

What should a patient who suspects Ebola do?

It is very important to keep calm. A telephone contact with a doctor should be made with reference to the suspicion of Ebola fever, a more detailed description of the symptoms, the travel locations and the duration of the trip. Then the doctor will discuss the further procedure with the patient.

However, even if you travel to one of the affected areas within the last three weeks, the probability of Ebola virus infection is very low if there has been no contact with a person who has contracted or died of Ebola fever.

Doctor's procedure: If the doctor can confirm a suspicion of infection with the Ebola virus, the responsible health authority should be informed and contact should be made with a specialized center. Often, however, apparent suspected cases can already be ruled out in a telephone call with a specialized center.

Contact details of specialised centres can be found under www.stakob.de.

If the condition allows, the patient should remain in isolation, e.g. at home, in the doctor's office or on the hospital ward, until confirmation or exclusion of a suspicion of Ebola occurring. No instruction in a rescue center should be made. Transports should also be avoided as far as possible in order to prevent infections.

What preventive measures are there?

Unprotected direct contact with an Ebola fever patient or deceased person must be strictly avoided. Medical personnel caring for a reasonable suspicion or a patient with confirmed Ebola virus infection must comply with strict hygiene and isolation regulations.

There is no approved vaccine.

Is there a specific therapy?

There is no approved specific therapy. Treatment is therefore exclusively symptomatic, the quality of medical care has an influence on mortality. The few specific therapeutic approaches are experimental.

What do travelers have to consider?

On its website, the Federal Foreign Office provides information on medical risks abroad. It provides information on countries and leaflets on diseases . Information for travellers in several languages is also provided by the Federal Association ÖGD and the ECDC .

In addition to specialized doctors, tropical institutes and some health authorities offer individual advice for travellers.

How likely is it that Ebola fever will occur in Germany?

The risk of travellers bringing the disease to Germany or Europe is low, but it cannot be ruled out. Persons in the closest environment of the patients would have a risk of infection due to the person-to-person transmission. However, there is no danger to the population because Germany is thoroughly prepared for the treatment of people suffering from Ebola fever. There is a network of special isolation wards, which are designed for the treatment of such diseases both in terms of medical expertise and technical requirements (Working Group of Competence and Treatment Centres, STAKOB, www.stakob.rki.de). The staff there is specially trained for this situation and regularly trains the care of patients under isolation conditions.

What happens if an Ebola fever case is brought to Germany?

There is only a small risk that a person infected with the Ebola virus will enter Germany. Should a patient nevertheless enter, the spread of the Ebola virus in Germany is practically impossible due to good medical care and preparations for such events.

If passengers experience symptoms typical of Ebola during the flight, the pilot should inform the relevant airport, which must have the status of a medical airport, in accordance with international health regulations. There, the patient would be isolated and questioned by a doctor from the responsible health authority. If the suspicion of Ebola fever is confirmed, the traveler would be taken to a special isolation ward for diagnosis and treatment. At the same time, people who have been in close contact with such patients (seat neighbors and people who have cared for the patient directly) would be registered by the health department and asked to pay attention to Ebola-typical symptoms in the next 21 days (maximum incubation period).

If a person infected with the Ebola virus falls ill in Germany, he or she would also be admitted to a special isolation ward as soon as the reasonable suspicion of Ebola fever is established. All persons who have had close contact with her are identified and registered by the responsible health authority by interviewing the patient and his relatives or caregivers, informed about the possible infection and monitored for Ebola-typical symptoms in their everyday environment for 21 days.

Before symptoms appear, people infected with the Ebola virus are not contagious.

As the National Public Health Institute, the RKI works closely with the federal states on infection control. Federal states with an international airport have experience in dealing with diseases that are imported from the tropics.

Ebola is a rare and life-threatening infectious disease. It belongs to the so-called viral hemorrhagic fever diseases (AF) and is caused by the Ebola virus (EV).

Ebola is subject to the reporting obligation.

responsible health authority