An outbreak of Ebola Virus Disease1 has been ongoing in West Africa since March 2014. It is the largest outbreak known to date. Although low, the threat of importing Ebola virus disease cannot be excluded. Ebola Virus Disease has a fatality rate of 50% to 90%.
This fact sheet sets out the recommendations of the Comité sur les infections nosocomiales du Québec (CINQ)2
for Ebola virus disease prevention and control measures for Québec hospitals. Notwithstanding the transmission of the disease through contact and droplets, the CINQ recommends more important measures to take into account possible airborne transmission, significant environmental contamination by blood, body fluids, secretions or excretions, and high Ebola virus disease fatality.
Hospitals must implement the measures necessary to prevent the transmission of the Ebola virus disease.
Last, it is important to remind clinicians and prevention and control teams of Québec hospitals that other infectious diseases can occur upon return from travel, which may require additional prevention and control measures and investigations.
Epidemiological Characteristics of Ebola Virus Disease
- Sudden disease onset consistent with a non-specific flu-like syndrome: fever, chills, fatigue, myalgia,
arthralgia, malaise, headache, cough, and sometimes sore throat (average 8-10 days post-exposure).
- Frequently, other signs or symptoms approximately 5 days after the initial symptoms:
- maculopapular erythematous rash on face, neck, trunk, and limbs;
- gastrointestinal symptoms (e.g. nausea, vomiting, diarrhea, abdominal pain);
- respiratory symptoms (e.g. cough, chest pain);
- neurological symptoms (e.g. prostration, confusion).
- Delayed-onset hemorrhagic manifestations in a third of patients: petechiae, ecchymosis, oozing at vein
puncture sites, mucous membranes bleeding (hematemesis, melena, gingival bleeding, epistaxis,
- 50% to 90% fatality rate.
- Of support.
- Experimental vaccine: a combination of three monoclonal antibodies that bind to the virus protein.
- Member of the Filoviridae family, RNA virus with a lipid membrane.
- Low infectious dose: 10 virus particles can cause infection.
- Immunosuppression following infection. Impairment of the coagulation system.
- Survival time in the environment: several days (in liquid or dried material), with infectivity remaining stable at
room temperature or at 4 °C.
- Sensitive to sodium hypochlorite, liquid solvents, phenol-based disinfectants, peracetic acid, methanol,
ether, sodium deoxycholate, 2% glutaraldehyde, 25% Triton X-100, -propiolactone, 3% acetic acid (pH 2.5),
formaldehyde and paraformaldehyde, and detergents.
Period of incubation
- 2 to 21 days, with an average of 4 to 10 days.
Modes of transmission
- Direct contact (through broken skin or mucous membranes) with the blood, body fluids, secretions or
excretions (e.g. stool, vomit, urine, sweat, saliva, sperm, breast milk, tears, etc.) of an infected person (living
- Indirect contact, through objects, surfaces, clothing or bedding contaminated by the blood, body fluids,
secretions or excretions of an infected person (living or deceased).
- Possibly airborne (opportunistic infection), in cases of pulmonary disease and when performing aerosol-generating procedures.
- Transmission reported among family members and friends who took care of infected persons or their
remains and in staff not wearing appropriate personal protective equipment.
Period of contagiosity
- As soon as symptoms appear. Not contagious during the incubation period, when the patient is
- Contagiousness increases as the disease progresses, particularly with the onset of hemorrhagic
- Contagious as long as blood, body fluids, secretions, or excretions contain the virus. There are documented
cases of viral shedding in sperm up to 90 days after illness onset.