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Questions and Answers on Ebola

The 2014 Ebola outbreak is the largest Ebola outbreak in history and the first Ebola outbreak in West Africa. This outbreak is the first Ebola epidemic the world has ever known — affecting multiple countries in West Africa. Although the risk of an Ebola outbreak in the United States is very low, CDC and partners are taking precautions to prevent this from happening. A small number of cases in Nigeria have been associated with a man from Liberia who traveled to Lagos and died from Ebola, but the virus does not appear to have been widely spread.

CDC is working with other U.S. government agencies, the World Health Organization, and other domestic and international partners and has activated its Emergency Operations Center to help coordinate technical assistance and control activities with partners. CDC has also deployed teams of public health experts to West Africa and continues to send public health experts to the affected countries.

For general information about Ebola, please use the links below:

General

How do I protect myself against Ebola?

If you must travel to an area affected by the 2014 Ebola outbreak, protect yourself by doing the following:

  • Wash hands frequently or use an alcohol-based hand sanitizer.
  • Avoid contact with blood and body fluids of any person, particularly someone who is sick.
  • Do not handle items that may have come in contact with an infected person’s blood or body fluids.
  • Do not touch the body of someone who has died from Ebola.
  • Do not touch bats and nonhuman primates or their blood and fluids and do not touch or eat raw meat prepared from these animals.
  • Avoid hospitals where Ebola patients are being treated. The U.S. Embassy or consulate is often able to provide advice on medical facilities.
  • Seek medical care immediately if you develop fever (temperature of 101.5°F/ 38.6°C) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
    • Limit your contact with other people until and when you go to the doctor. Do not travel anywhere else besides a healthcare facility.

CDC has issued a Warning, Level 3 travel notice for three countries. U.S. citizens should avoid all nonessential travel to Guinea, Liberia, and Sierra Leone. CDC has issued an Alert, Level 2 travel notice for Nigeria. Travelers to Nigeria should take enhanced precautions to prevent Ebola. CDC has also issued an Alert, Level 2 travel notice for the Democratic Republic of the Congo (DRC). A small number of Ebola cases have been reported in the DRC, though current information indicates that this outbreak is not related to the ongoing Ebola outbreaks in Guinea, Liberia, Nigeria and Sierra Leone. For travel notices and other information for travelers, visit the Travelers’ Health Ebola web page.

Has the first patient to become sick in this outbreak, know as “patient zero” been identified?

Reports in the medical literature and elsewhere have attempted to identify the patient who might have been the initial person infected in the West Africa Ebola outbreak. It’s important for CDC to learn as much as it can about the source and initial spread of any outbreak.

With regard to the West Africa Ebola outbreak, tracing the lineage of how Ebola has spread thus far can help CDC apply that knowledge toward better prevention and care techniques. The knowledge gained in this work might entail details about specific patients. CDC generally refrains, however, from identifying particular patients in any aspect of an outbreak.

Infection Control

Can hospitals in the United States care for an Ebola patient?

Any U.S. hospital that is following CDC’s infection control recommendations and can isolate a patient in their own room‎ with a private bathroom is capable of safely managing a patient with Ebola.

Travelers

What is being done to prevent ill travelers in West Africa from getting on a plane?

In West Africa

CDC’s Division of Global Migration and Quarantine (DGMQ) is working with airlines, airports, and ministries of health to provide technical assistance for the development of exit screening and travel restrictions in the affected areas. This includes:

  • Assessing the ability of Ebola-affected countries and airports to conduct exit screening,
  • Assisting with development of exit screening protocols,
  • Training staff on exit screening protocols and appropriate PPE use, and
  • Training in-country staff to provide future trainings.
During Travel

CDC works with international public health organizations, other federal agencies, and the travel industry to identify sick travelers arriving in the United States and take public health actions to prevent the spread of communicable diseases. Airlines are required to report any deaths onboard or ill travelers meeting certain criteria to CDC before arriving into the United States, and CDC and its partners determine whether any public health action is needed. If a traveler is infectious or exhibiting symptoms during or after a flight, CDC will conduct an investigation of exposed travelers and work with the airline, federal partners, and state and local health departments to notify them and take any necessary public health action. When CDC receives a report of an ill traveler on a cruise or cargo ship, CDC officials work with the shipping line to make an assessment of public health risk and to coordinate any necessary response.

In the United States

CDC has staff working 24/7 at 20 Border Health field offices located in international airports and land borders. CDC staff are ready 24/7 to investigate cases of ill travelers on planes and ships entering the United States.

CDC works with partners at all ports of entry into the United States to help prevent infectious diseases from being introduced and spread in the United States. CDC works with Customs and Border Protection, U.S. Department of Agriculture, U.S. Coast Guard, U.S. Fish and Wildlife Services, state and local health departments, and local Emergency Medical Services staff.

While possible, it is unlikely that an infected person who traveled from an area with Ebola to the United States on an airline would spread the disease to fellow passengers. First, relatively few of the approximately 350 million travelers who enter the United States each year come from these countries. Secondly, most people who become infected with Ebola are those who live with or care for people who have already caught the disease and are showing symptoms. CDC and healthcare providers in the United States are prepared for the remote possibility that a traveler could get Ebola and return to the U.S. while sick.

What do I do if I’m returning to the U.S. from the area where the outbreak is occurring?

After you return, pay attention to your health.

  • Monitor your health for 21 days if you were in an area with an Ebola outbreak, especially if you were in contact with blood or body fluids, items that have come in contact with blood or body fluids, animals or raw meat, or hospitals where Ebola patients are being treated or participated in burial rituals.
  • Seek medical care immediately if you develop fever (temperature of 101.5°F/ 38.6°C) and any of the following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
  • Tell your doctor about your recent travel and your symptoms before you go to the office or emergency room. Advance notice will help your doctor care for you and protect other people who may be in the office.

What do I do if I am traveling to an area where the outbreak is occurring?

If you are traveling to an area where the Ebola outbreak is occurring, protect yourself by doing the following:

  • Wash your hands frequently or use an alcohol-based hand sanitizer.
  • Avoid contact with blood and body fluids of any person, particularly someone who is sick.
  • Do not handle items that may have come in contact with an infected person’s blood or body fluids.
  • Do not touch the body of someone who has died from Ebola.
  • Do not touch bats and nonhuman primates or their blood and fluids and do not touch or eat raw meat prepared from these animals.
  • Avoid hospitals where Ebola patients are being treated. The U.S. Embassy or consulate is often able to provide advice on facilities.
  • Seek medical care immediately if you develop fever (temperature of 101.5oF/ 38.6oC) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
    • Limit your contact with other people until and when you go to the doctor. Do not travel anywhere else besides a healthcare facility.

Should people traveling to Africa be worried about the outbreak?

Ebola has only been reported in multiple countries in West Africa (see Affected Countries). A small number of cases in Nigeria have been associated with a man from Liberia who traveled to Lagos and died from Ebola, but the virus does not appear to have been widely spread. CDC has issued a Warning, Level 3 travel notice for United States citizens to avoid all nonessential travel to Guinea, Liberia, and Sierra Leone. CDC has issued an Alert, Level 2 travel notice for travelers to Nigeria urging them to protect themselves by avoiding contact with the blood and body fluids of people who are sick with Ebola. CDC has also issued an Alert, Level 2 travel notice for the Democratic Republic of the Congo (DRC). A small number of Ebola cases have been reported in the DRC, though current information indicates that this outbreak is not related to the ongoing Ebola outbreaks in Guinea, Liberia, Nigeria, and Sierra Leone. You can find more information on these travel notices at http://wwwnc.cdc.gov/travel/notices.

CDC currently does not recommend that travelers avoid visiting other African countries. Although spread to other countries is possible, CDC is working with the governments of affected countries to control the outbreak. Ebola is a very low risk for most travelers – it is spread through direct contact with the blood or other body fluids of a sick person, so travelers can protect themselves by avoiding sick people and hospitals where patients with Ebola are being treated.

Why were the ill Americans with Ebola brought to the U.S. for treatment? How is CDC protecting the American public?

A U.S. citizen has the right to return to the United States. Although CDC can use several measures to prevent disease from being introduced in the United States, CDC must balance the public health risk to others with the rights of the individual. In this situation, the patients who came back to the United States for care were transported with appropriate infection control procedures in place to prevent the disease from being transmitted to others.

Ebola poses no substantial risk to the U.S. general population. CDC recognizes that Ebola causes a lot of public worry and concern, but CDC’s mission is to protect the health of all Americans, including those who may become ill while overseas. Ebola patients can be transported and managed safely when appropriate precautions are used.

What does CDC’s Travel Alert Level 3 mean to U.S. travelers?

CDC recommends that U.S. residents avoid nonessential travel to Guinea, Liberia, and Sierra Leone. If you must travel (for example, to do for humanitarian aid work in response to the outbreak) protect yourself by following CDC’s advice for avoiding contact with the blood and body fluids of people who are ill with Ebola. For more information about the travel alerts, see Travelers’ Health Ebola web page.

Travel notices are designed to inform travelers and clinicians about current health issues related to specific destinations. These issues may arise from disease outbreaks, special events or gatherings, natural disasters, or other conditions that may affect travelers’ health. A level 3 alert means that there is a high risk to travelers and that CDC advises that travelers avoid nonessential travel.

In the United States

Are there any cases of people contracting Ebola in the U.S.?

No confirmed Ebola cases have been reported in the United States, with the exception of four U.S. health workers who were infected with Ebola virus in West Africa and were transported to hospitals in the United States. Two of the patients have recovered and been released from the hospital after laboratory testing confirmed that they no longer have Ebola virus in their blood. CDC has advised the hospital that there is no public health concern with their release and that they do not pose a risk to household contacts or to the public.

CDC has received many calls from health departments and hospitals about suspected cases of Ebola in travelers from the affected countries. These calls have been triaged appropriately and samples have been sent to CDC for testing. All samples sent to CDC have tested negative for Ebola.

What is CDC doing about the outbreak in the U.S.?

CDC has activated its Emergency Operations Center (EOC) to help coordinate technical assistance and control activities with partners. CDC has deployed several teams of public health experts to the West Africa region and plans to send additional public health experts to the affected countries to expand current response activities.

On the remote possibility that an ill traveler arrives in the U.S., CDC has protocols in place to protect against further spread of disease. These protocols include having airline crew notify CDC of ill travelers on a plane before arrival, evaluation of ill travelers, and isolation and transport to a medical facility if needed. CDC, along with Customs & Border Patrol, has also provided guidance to airlines for managing ill passengers and crew and for disinfecting aircraft. CDC has issued a Health Alert Notice reminding U.S. healthcare workers about the importance of taking steps to prevent the spread of this virus, how to test and isolate patients with suspected cases, and how to protect themselves from infection.

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