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(CNN) -- A man boards a plane in Liberia with a slight fever. As the jet nears an airport in New York, his temperature rises; his throat grows sore.

It's the flu, he thinks after he lands, but he's wrong. He's caught the deadly Ebola virus.

He soon dies of hemorrhagic fever while surrounded by family. Some of them catch it, and it's like a flame hitting a fuse.

The United States erupts in its first Ebola pandemic as health care workers fight an uphill battle to contain it.
The facts about Ebola Ebola: How at risk is the U.S.? Doc.: Ebola unlikely to spread to cities How easily can Ebola spread to the U.S.?
Could what sounds like the plot of a Hollywood pestilence thriller really happen here?

Well, yes and no.

Yes, Ebola can come to the United States.

But no, there's no reason to panic.

"This is not an epidemic; it's not the kind of disease that can sweep through New York," said Dr. Alexander van Tulleken of Fordham University.
What is the risk of catching Ebola on a plane? The 'yes' part:
Given that international air travel is commonplace, it's realistic that an infected passenger could land in the country.

One nearly did.

Patrick Sawyer, a U.S. citizen working in Liberia, fell violently ill while on a plane to Nigeria this month. He was planning on returning to his family in Minnesota but died before he could.

"It's going to happen at some point," CNN Chief Medical Correspondent Dr. Sanjay Gupta said.

A person can be infected and not show symptoms for up to three weeks. So it's possible for someone to fly to the United States who has the virus but is feeling fine.

"Just observing the whole process, it's almost impossible to prevent from happening," Gupta said.

Then, the person could develop symptoms of Ebola hemorrhagic fever, which would make the patient capable of passing the virus.

To catch it, one has to come into contact with a sick person's bodily fluids: sweat, saliva, blood or excrement.
The 'no' part:
Experts agree that the disease would not spread far like it has in Sierra Leone, Guinea and Liberia, where health officials believe it has killed more than 700 people in the largest Ebola outbreak in recorded history.

There are two reasons for this:

* Though Ebola is aggressively infectious, which means that those infected are highly likely to get sick, it's not very contagious, meaning that it doesn't spread easily.

* Public health educators and medical professionals in the United States and other highly industrialized countries would deal with it swiftly. It's an advantage the poor affected countries in West Africa don't have.

"It certainly is feasible that someone could come to the United States who is infected and gets sick here. No one's denying that," said Dr. Anthony Fauci of the National Institutes of Health. But the health care system in the United States gives it the ability "to do the kind of isolation that apparently is very difficult to do within the health care infrastructure in the African countries that we are talking about."

To answer that, consider the following:

That's one of the big advantages that industrialized nations, such as the United States, have in fighting Ebola's spread.

First, teach health care workers to recognize Ebola cases. Then quarantine them. Then keep people out of contact with their bodily fluids while it runs its course.
A healthcare worker diagnosed with Ebola after returning from Sierra Leone is wheeled in a quarantine tent onto an airplane at Glasgow International Airport in Scotland on Tuesday, December 30, bound for The Royal Free hospital in London. Health officials say the Ebola outbreak in West Africa is the deadliest ever. More than 6,000 people have died there, according to the World Health Organization. Photos: The Ebola epidemic Map: The Ebola outbreak Map: The Ebola outbreak Doc.: Ebola unlikely to spread to cities Ebola victim 'holding her own'
The CDC has alerted health workers in the United States to keep an eye out for symptomatic patients who have recently traveled to West Africa.

If a case does turn up, public health officials will work to rapidly track down other people the patient has come into contact with and screen them for the virus.

They are currently looking for anyone who may have come into contact with Sawyer.
2. There's little superstition surrounding Ebola here.
"Epidemics of disease are often followed by epidemics of fear and epidemics of stigma," said Dr. Marty Cetron of the Centers for Disease Control and Prevention. "All these kinds of things occur in a social context that can make containment very, very challenging."

In many parts of West Africa, rumors have spread that eating raw onions will protect from the disease while mangoes may promote it, the World Health Organization has said.

Villagers carry out their usual burial of the dead, coming into contact with bodily fluids and infecting themselves.

With too few people to mount a tough battle against the spread of the disease itself, aid workers have said they are putting a lot of emphasis on education.

They are teaching local residents to stay out of contact with the virus while they treat the sick. But locals often view them with suspicion, some accusing them of bringing the disease to the country.
3. There's ready access to basic care.
"We don't have a vaccine, and we don't have any drugs that work on it at the moment," van Tulleken said. "The treatment is entirely what we call supportive care."

Much of the treatment involves simple nursing, things such as proper hydration and nutrition.

In places where aid workers in West Africa have done so, they have been able to save about 45% of those infected.

Without treatment, the death rate can run as high as 90%, Medecins sans Frontieres has said.

A pretty good way not to catch the virus is not to come into unprotected contact with sick patients.

That's why Ebola caregivers dress in head-to-toe protective gear with masks and patients are isolated in tent-like structures, making it look like the scene of a chemical spill.

How the United States and the West can help is to devote money and staff to contain the virus in West Africa.
Ebola outbreak cripples West Africa, threatens beyond Deadliest-ever outbreak: What you need to know Ebola doctor in Sierra Leone dies
"We're not doing a brilliant job of containing the epidemic in terms of the resources we've devoted to it so far," van Tulleken said.

CNN's Jacque Wilson contributed to this report.

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Could the Ebola outbreak come to the United States?

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(CNN) -- A man boards a plane in Liberia with a slight fever. As the jet nears an airport in New York, his temperature rises; his throat grows sore. It's the flu, he thinks after he lands, but he's wrong. He's caught the deadly Ebola virus.

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What you need to know about the outbreak.

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What you need to know about the outbreak.

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Q & A

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Note: On Sept. 30, officials with the federal Centers for Disease Control and Prevention said Mr. Duncan first went to the hospital on Sept. 26. On Oct. 1, the Texas Health Presbyterian Hospital issued a statement that he first arrived there after 10 p.m. on Sept. 25.

By Jeremy Ashkenas, Larry Buchanan, Joe Burgess, Hannah Fairfield, Denise Grady, Josh Keller, K.K. Rebecca Lai, Patrick J. Lyons, Heather Murphy, Haeyoun Park, Sergio Peçanha, Archie Tse and Karen Yourish

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How Many Ebola Patients Have Been Treated Outside of Africa?

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Note: On Sept. 30, officials with the federal Centers for Disease Control and Prevention said Mr. Duncan first went to the hospital on Sept. 26. On Oct. 1, the Texas Health Presbyterian Hospital issued a statement that he first arrived there after 10 p.m. on Sept. 25.

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Includes a timeline and map of the source of the outbreak

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At the center of the Ebola crisis in Sierra Leone, the villagers in Njala Ngiema are afraid to return to homes where so many died. Published On Credit Credit Image by Tommy Trenchard for The New York Times

NJALA NGIEMA, Sierra Leone - The signs of a deadly struggle remain: Scattered around the houses of the Ebola dead lie empty pill packages, their plastic casings punched through. Nearby in the mud are used packets of oral rehydration salts. The pills did not work, and the hurried trip to the hospital, if there was one, came too late.

Inside house after house, Ebola has claimed its victims: Here, 10 people died; over there, four, including three children. A few yards away, an old man lives alone, his wife now dead. In another, seven people are dead, the village teacher said. In a long low house nearby, 16 died, all from the same family. Outside yet another, two tiny girls, one age 6 and her sister, 7, sit pensively in front, their parents gone.

And there are more. "So many," said Sheku Jaya, the 35-year-old village teacher, clutching his little daughter's hand. "We lost too many people."

Here in the nation most afflicted by Ebola, in the hardest-hit part of the country, this may well be the most devastated village, local and international officials say. Some 61 people have died here, out of a population of perhaps 500. Njala Ngiema, a mud-brick community of rice and cassava farmers deep in the forest, is quiet now.

"We wanted to abandon this village," Mr. Jaya said.

There are still people here, but the village appears frozen. Inside the darkened houses, the scant belongings of the victims - ragged clothing, sandals, a rare radio - sit untouched weeks later. No new cases have surfaced here in nearly a month, but fear that the deadly virus still lurks has kept everything in place. Nothing appears to have moved since the deadly tide swept through.

The Sierra Leone government, desperate to contain an epidemic that has claimed about 300 lives in this nation alone, has effectively cordoned off this part of the country, deploying troops and setting up roadblocks in the hardest-hit areas. Two districts here in the east - an area with about one million people - were put under quarantine by the government late last week, shutting down much of the traffic on the muddy road cutting through the Ebola zone.

Now, a region roughly the size of Jamaica has been cut off from the rest of the country because of the roadblocks, warned a local leader, David Keili-Coomber, the paramount chief - raising worries that if the epidemic does not decimate the region, a subsequent shortage of food, trade and supplies will.

"Our fear now is that closing these roads risks having more people die of malnutrition and even starvation than by Ebola," Mr. Keili-Coomber said in an email message.

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The body of a man who died of Ebola, outside a morgue in Kailahun. Credit Tommy Trenchard for The New York Times

The sweeping quarantine, much like the one imposed on parts of Liberia across the border, underscores a basic reality in the battle against the epidemic: Neither the government nor the international health organizations on the front lines seem able to stop it from spreading. So many villages have been struck, with so few health workers and other resources to try to halt the advance, that governments have resorted to closing off entire regions in hopes of containing the damage.

"Every week, we get one or two new villages with infections," said Anja Wolz, the Doctors Without Borders physician who was running the organization's treatment center outside the town of Kailahun last week. "It is a disaster."

The government quarantine comes too late for Njala Ngiema, where the scourge's mark is everywhere along the wide muddy road that runs through the palm-fringed village. In front of a house where five people died hangs a pair of blue trousers, untouched since Ebola passed through. Inside a house where two elderly women lived, a plastic bag labeled "See the World," packed with clothes, sits on a bed for a trip to the hospital that never happened. Towels, trousers and underclothes still hang from the rafters in another house where Foday Joko lived with his wife and daughter. All three died.

At the back of Alhaji Abbah's house, where 16 people died, the stained and torn farming clothes he wore - bluejeans and T-shirts - still hang from a line. Nobody has dared to remove them.

A young resident of Njala Ngiema, Messi Boa, whose parents both died from the virus. Some 61 residents of Njala Ngiema, out of a population of about 500, have died of Ebola, making it one of the hardest-hit places in Sierra Leone. Credit Tommy Trenchard for The New York Times

"People are afraid; we asked them to burn them," said James Baion, a teacher from the area who is helping to organize an Ebola response on behalf of local officials.

The sheet on Mr. Abbah's bed is still rumpled and the pillow still askew. Poking out from the simple wood bed frame are his sandals. "He refused to go to the hospital," Mr. Baion said. "He was afraid to go." After Mr. Abbah died, he was found in a sitting position at the edge of his bed, hunched over, his head bowed.

So many of the farmers have died that the residents said this year's planting season was not likely to occur.

"This farming season, we can't do any work," said Mr. Jaya, the teacher. "We have lost too many people."

Villages all around here have been routed, and life has ground to a halt. Schools are closed, soccer matches have been called off, and food prices have shot up. In Bonbom, 24 are dead, along with 12 in Bendima, and 61 in Daru, a town of about 6,000 up the road from here, said the paramount chief in Daru, Musa Ngombu-kla Kallon II, ticking off the towns where his subjects have died.

"Some villages are deserted," the chief said. In Sierra Leone, the paramount chief, a powerful semi-elected position, upholds customary laws and collects some taxes. "People got scared," he said. "They ran away."

Mr. Kallon himself lost his wife and daughter. His wife, taking care of the initial case in the town, an infected nurse, told her husband: "Don't worry. Keep cool." At the nurse's burial, everybody wanted to "touch in abundance" the corpse, Mr. Kallon said, even dressing the deceased's hair. Infected corpses are highly infectious, presenting a common risk of infection.

Even at the Doctors Without Borders treatment center outside Kailahun, the doctors say they are not keeping pace with the epidemic, despite a staff of over 300, 10 tents, more than 2,000 protective suits and a mathematically precise layout to reduce the risk of infection.

The unmade bed of a victim in Njala Ngiema. Credit Tommy Trenchard for The New York Times

"I think we are two steps behind," Dr. Wolz said.

"We are still discovering villages," she said, where Ebola victims are dying at home, rather than in isolation, risking new infections. There have been up to 140 new cases at the treatment center over the last three weeks, she said.

The standard protocols for containing the disease - isolating each patient, tracking the people he or she came in contact with, and monitoring all of those people for weeks to see if they develop any symptoms - seem an almost insurmountable task across the four West African nations that have reported about 1,800 cases so far: Sierra Leone, Guinea, Liberia and Nigeria.

International officials have said there were at least 500 contacts to trace just from the city in Guinea where the outbreak was first identified in March, and the World Health Organization says it will need to send hundreds of additional health workers to the region to try to contain the epidemic.

At the Doctors Without Borders center, a medical assistant flipped cans of sardines to grateful Ebola patients behind a barrier, several of whom were eager to demonstrate their healthiness. But one patient, struggling to his feet, held his head in his hands. "Hurting, hurting, hurting," said Mamou Samba, a 43-year-old mason, groaning and demanding painkillers.

Behind the tents, the morgue is full. A body arrived - a young man, his arm hanging limply from the stretcher, who appeared to have been in his prime. Most of the patients are breadwinners for their families, as one staff member put it. A team of five in full protective gear disinfected the corpse with a potent chlorine spray solution. Behind the morgue rose smoke from the latest incineration of protective gear, which is discarded after a single use.

Dr. Wolz said the outbreak would not end this year. "Everybody sends experts," she said. "They sit in offices and go to meetings. We need people to go into the field."

A version of this article appears in print on , on Page A1 of the New York edition with the headline: At Heart of Ebola Outbreak, a Village Frozen by Fear and Death. Order Reprints | Today's Paper | Subscribe

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At Heart of Ebola Outbreak, a Village Frozen by Fear and Death

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NJALA NGIEMA, Sierra Leone - The signs of a deadly struggle remain: Scattered around the houses of the Ebola dead lie empty pill packages, their plastic casings punched through. Nearby in the mud are used packets of oral rehydration salts. The pills did not work, and the hurried trip to the hospital, if there was one, came too late.

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1976-2014 stats

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Ebola Information - Fact sheet

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What is Ebola Virus Disease? | Ebola (Ebola Virus Disease) | CDC

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Ebola Virus Disease (EVD) is a rare and deadly disease most commonly affecting people and nonhuman primates (monkeys, gorillas, and chimpanzees). It is caused by an infection with one of five known Ebola virus species, four of which can cause disease in people.

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Description of Ebola - Fact sheet

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The Ebola virus causes an acute, serious illness which is often fatal if untreated. EVD first appeared in 1976 in 2 simultaneous outbreaks, one in what is now Nzara, South Sudan, and the other in Yambuku, DRC. The latter occurred in a village near the Ebola River, from which the disease takes its name.

The 2014-2016 outbreak in West Africa was the largest Ebola outbreak since the virus was first discovered in 1976. The outbreak started in Guinea and then moved across land borders to Sierra Leone and Liberia. The current 2018-2019 outbreak in eastern DRC is highly complex, with insecurity adversely affecting public health response activities.

The virus family Filoviridae includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. Within the genus Ebolavirus, six species have been identified: Zaire, Bundibugyo, Sudan, Taï Forest, Reston and Bombali. The virus causing the current outbreak in DRC and the 2014-2016 West African outbreak belongs to the Zaire ebolavirus species.

Transmission

It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as fruit bats, chimpanzees, gorillas, monkeys, forest antelope or porcupines found ill or dead or in the rainforest.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with:

Blood or body fluids of a person who is sick with or has died from Ebola

Objects that have been contaminated with body fluids (like blood, feces, vomit) from a person sick with Ebola or the body of a person who died from Ebola

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This occurs through close contact with patients when infection control precautions are not strictly practiced.

Burial ceremonies that involve direct contact with the body of the deceased can also contribute in the transmission of Ebola.

People remain infectious as long as their blood contains the virus.

Pregnant women who get acute Ebola and recover from the disease may still carry the virus in breastmilk, or in pregnancy related fluids and tissues. This poses a risk of transmission to the baby they carry, and to others. Women who become pregnant after surviving Ebola disease are not at risk of carrying the virus.

If a breastfeeding woman who is recovering from Ebola wishes to continue breastfeeding, she should be supported to do so. Her breast milk needs to be tested for Ebola before she can start.
For more, read the guidelines on the management of pregnancy and breastfeeding in Ebola.

Symptoms

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is from 2 to 21 days. A person infected with Ebola cannot spread the disease until they develop symptoms.

Symptoms of EVD can be sudden and include:

This is followed by:

Vomiting

Diarrhoea

Rash

Symptoms of impaired kidney and liver function

In some cases, both internal and external bleeding (for example, oozing from the gums, or blood in the stools).

Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Diagnosis

It can be difficult to clinically distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis. Many symptoms of pregnancy and Ebola disease are also quite similar. Because of risks to the pregnancy, pregnant women should ideally be tested rapidly if Ebola is suspected.

Confirmation that symptoms are caused by Ebola virus infection are made using the following diagnostic methods:

antibody-capture enzyme-linked immunosorbent assay (ELISA)

antigen-capture detection tests

serum neutralization test

reverse transcriptase polymerase chain reaction (RT-PCR) assay

electron microscopy

·virus isolation by cell culture.

Careful consideration should be given to the selection of diagnostic tests, which take into account technical specifications, disease incidence and prevalence, and social and medical implications of test results. It is strongly recommended that diagnostic tests, which have undergone an independent and international evaluation, be considered for use.

Current WHO recommended tests include:

Automated or semi-automated nucleic acid tests (NAT) for routine diagnostic management.

Rapid antigen detection tests for use in remote settings where NATs are not readily available. These tests are recommended for screening purposes as part of surveillance activities, however reactive tests should be confirmed with NATs.

The preferred specimens for diagnosis include:

Whole blood collected in ethylenediaminetetraacetic acid (EDTA) from live patients exhibiting symptoms.

Oral fluid specimen stored in universal transport medium collected from deceased patients or when blood collection is not possible.

Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All biological specimens should be packaged using the triple packaging system when transported nationally and internationally.

Treatment

Supportive care - rehydration with oral or intravenous fluids - and treatment of specific symptoms improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated.

In the ongoing 2018-2019 Ebola outbreak in DRC, the first-ever multi-drug randomized control trial is being conducted to evaluate the effectiveness and safety of drugs used in the treatment of Ebola patients under an ethical framework developed in consultation with experts in the field and the DRC.

Pregnant and breastfeeding women with Ebola should be offered early supportive care, like general population. Likewise experimental treatment should be offered under the same conditions as for non-pregnant population.

Vaccines

An experimental Ebola vaccine proved highly protective against EVD in a major trial in Guinea in 2015. The vaccine, called rVSV-ZEBOV, was studied in a trial involving 11 841 people. Among the 5837 people who received the vaccine, no Ebola cases were recorded 10 days or more after vaccination. In comparison, there were 23 cases 10 days or more after vaccination among those who did not receive the vaccine.

The rVSV-ZEBOV vaccine is being used in the ongoing 2018-2019 Ebola outbreak in DRC. Pregnant and breastfeeding women should have access to the vaccine under the same conditions as for the general population.

Initial data indicates that the vaccine is highly effective.

WHO's Strategic Advisory Group of Experts has stated the need to assess additional Ebola vaccines.

Prevention and control

Good outbreak control relies on applying a package of interventions, including case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures (including vaccination) that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:

Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats, monkeys, apes, forest antelope or porcupines and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.

Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.

Outbreak containment measures, including safe and dignified burial of the dead, identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days, the importance of separating the healthy from the sick to prevent further spread, and the importance of good hygiene and maintaining a clean environment.

Reducing the risk of possible sexual transmission, based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of EVD practice safer sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for Ebola virus.

Reducing the risk of transmission from pregnancy related fluids and tissue, Pregnant women who have survived Eboa disease need community support to enable them to attend frequent antenatal care (ANC) visits, to handle any pregnancy complications and meet their need for sexual and reproductive care and delivery in a safe way. This should be planned together with the Ebola and Obstetric health care expertise. Pregnant women should always be respected in the sexual and reproductive health choices they make.

Controlling infection in health-care settings

Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Ebola virus should apply extra infection control measures to prevent contact with the patient's blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with EVD, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).
Healthcare staff working with ANC or obstetric care should be informed about risks of persisting virus in pregnancy related fluids and encouraged to follow protocol for their own safety and the safety of the women they are caring for.
Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Ebola infection should be handled by trained staff and processed in suitably equipped laboratories.

Care for people who recovered from EVD

A number of medical complications have been reported in people who recovered from Ebola, including mental health issues. Ebola virus may persist in some body fluids, including semen, pregnancy-related fluids and breast milk.

Ebola survivors need comprehensive support for the medical and psychosocial challenges they face and also to minimize the risk of continued Ebola virus transmission. To address these needs, a dedicated programme can be set up for care for people who recovered from Ebola.

Ebola virus is known to persist in immune-privileged sites in some people who have recovered from Ebola virus disease. These sites include the testicles, the inside of the eye, and the central nervous system. In women who have been infected while pregnant, the virus persists in the placenta, amniotic fluid and fetus. In women who have been infected while breastfeeding, the virus may persist in breast milk.

Relapse-symptomatic illness in someone who has recovered from EVD due to increased replication of the virus in a specific site is a rare event, but has been documented. Reasons for this phenomenon are not yet fully understood.

Studies of viral persistence indicate that in a small percentage of survivors, some body fluids may test positive on reverse transcriptase polymerase chain reaction (RT-PCR) testing for Ebola virus for longer than 9 months.

More surveillance data and research are needed on the risks of sexual transmission, and particularly on the prevalence of viable and transmissible virus in semen over time. In the interim, and based on present evidence, WHO recommends that:

All Ebola survivors and their sexual partners should receive counselling to ensure safer sexual practices until their semen has twice tested negative. Survivors should be provided with condoms.

Male Ebola survivors should be offered semen testing at 3 months after onset of disease, and then, for those who test positive, every month thereafter until their semen tests negative for virus twice by RT-PCR, with an interval of one week between tests.

Ebola survivors and their sexual partners should either:

abstain from all types of sex, or

oobserve safer sex through correct and consistent condom use until their semen has twice tested negative.

Having tested negative, survivors can safely resume normal sexual practices without fear of Ebola virus transmission.

Based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of Ebola virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus.

Until such time as their semen has twice tested negative for Ebola, survivors should practice good hand and personal hygiene by immediately and thoroughly washing with soap and water after any physical contact with semen, including after masturbation. During this period, used condoms should be handled safely, and safely disposed of, so as to prevent contact with seminal fluids.

All survivors, their partners and families should be shown respect, dignity and compassion.

Interim advice on the sexual transmission of the Ebola virus disease
WHO response

WHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus disease and supporting at-risk countries to develop preparedness plans. This document provides overall guidance for control of Ebola and Marburg virus outbreaks:

When an outbreak is detected WHO responds by supporting community engagement, disease detection, contact tracing, vaccination, case management, laboratory services, infection control, logistics, and training and assistance with safe and dignified burial practices.

WHO has developed detailed advice on Ebola infection prevention and control:

Table: Chronology of previous Ebola virus disease outbreaks

* Include Suspect, Probable and Confirmed EVD cases.

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The Ebola virus causes an acute, serious illness which is often fatal if untreated. EVD first appeared in 1976 in 2 simultaneous outbreaks, one in what is now Nzara, South Sudan, and the other in Yambuku, DRC. The latter occurred in a village near the Ebola River, from which the disease takes its name.