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Symptoms and Signs of Ebola Virus Disease (Ebola Hemorrhagic Fever)

Doctor's Notes on Ebola Virus Disease (Ebola Hemorrhagic Fever)

Ebola virus disease (EVD), also referred to as Ebola hemorrhagic fever, is a severe and often fatal disease in humans and nonhuman primates such as monkeys, chimpanzees, and gorillas. Ebola virus disease outbreaks occur mainly in villages in Central and West Africa and have a mortality rate up to 90%. Wild animals transmit the Ebola virus to people, and the Ebola virus spreads in the human population through human-to-human contact.

Symptoms of Ebola occur suddenly from two to 21 days after exposure and include fever, headache, sore throat, joint and muscle aches and pain, weakness, and loss of appetite, followed by diarrhea, vomiting, and stomach pain. Some patients may develop symptoms such as a skin rash, red eyes, hiccups, cough, difficulty breathing, and chest pain. Late symptoms of Ebola include bleeding from inside and outside the body (eyes, ears, and nose), vomiting and/or coughing up blood, mental confusion, seizures, shock, and coma.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Ebola Virus Disease (Ebola Hemorrhagic Fever) Symptoms

Symptoms may appear anywhere from two to 21 days after exposure to Ebola virus, but eight to 10 days is most common. Typical signs and symptoms of Ebola virus disease include

The will then develop increasingly severe problems, such as

Some patients may develop

Late signs include the following:

Health researchers do not know why some people survive from an infection with the Ebola virus. However, researchers have found that those who die from the disease are not able to develop an adequate immune response to the virus.

Ebola Virus Disease (Ebola Hemorrhagic Fever) Causes

An infection with the Ebola virus causes Ebola virus disease. The Ebola virus is a member of the Filoviridae family. Researchers have found the Ebola virus in African monkeys, chimpanzees, and other nonhuman primates. The natural reservoir (normal habitat) of Ebola viruses is unknown. However, researchers believe that the virus is zoonotic (animal-borne) with bats being the most likely reservoir.

There are five identified species (types) of Ebola virus. Four of the five have caused disease in humans:

  • Zaire ebolavirus
  • Sudan ebolavirus
  • Taï Forest ebolavirus
  • Bundibugyo ebolavirus
  • Reston ebolavirus (has not caused illness in humans)

The risk of getting Ebola virus disease is low for most people. All cases of illness or death have occurred in Africa, with the exception of laboratory contamination in Russia and England. The risk increases if a person travels to or lives in Africa where Ebola virus disease outbreaks have occurred. Those at highest risk include the following:

  • Health care workers and family and friends who have cared for an infected person with Ebola virus disease (any health workers in the outbreak area)
  • Laboratory personnel working with bodily fluids of an Ebola virus disease patient
  • Animal researchers with direct handling of bats, rodents, or primates from an area where Ebola virus disease has occurred
  • Individuals participating in funeral rites in which there is direct exposure to human remains where an Ebola virus disease outbreak is occurring

Ebola Virus Outbreak, Symptoms, and Treatment Slideshow

Ebola Virus Outbreak, Symptoms, and Treatment Slideshow

Ebola is a viral hemorrhagic (bleeding) illness that has a high fatality rate. The virus was discovered in 1976 near the Ebola River in the present day Democratic Republic of Congo. There are five strains of the Ebola virus -- Tai Forest, Sudan, Bundibugyo, Zaire, and Reston. Four of the strains (Reston is the exception) are responsible for outbreaks in humans. The Ebola virus is harbored by fruit bats, gorillas, monkeys, forest antelope, chimpanzees, and porcupines. Humans can contract the virus by coming into close contact with the body or bodily fluids (including blood) of an infected animal. Once the virus spreads to a human, person-to-person transmission is possible.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.