What Happens to You When You Have Ebola?

I've been staying in North Africa for work, and there was a resurgence in Ebola virus infections in the country where I was working. Lately I've been having headaches and feeling fatigued. It's probably just a cold, but now I'm paranoid about Ebola. What happens to you when you have Ebola? How does Ebola start? How do you know if someone has Ebola?

Unfortunately, early symptoms of Ebola virus disease are nonspecific and include

• fever,
• headache (severe),
• weakness,
• vomiting,
• diarrhea,
• stomach discomfort or pain in the abdomen,
• decreased appetite, and
• joint and muscle discomfort.

As the disease progresses, patients may develop other symptoms and signs such as

• a rash or red spots on the skin,
• eye redness,
• hiccups,
• sore throat,
• cough and/or coughing or vomiting up blood,
• chest pain,
• mental confusion,
• bleeding both inside and outside the body (for example, mucosal surfaces, eyes), and
• difficulty breathing and swallowing.

Ebola hemorrhagic fever often has many complications; organ failures, severe bleeding, jaundice, delirium, shock, seizures, coma, and death (about 50%-100% of infected patients). Those patients fortunate enough to survive Ebola hemorrhagic fever still may have complications that may take many months to resolve. Survivors may experience weakness, fatigue, headaches, hair loss, hepatitis, sensory changes, and inflammation of organs (for example, the testicles and the eyes). Some may have Ebola linger in their semen for months and others may have the virus latently infect their eye(s).

Male patients may have detectable Ebola viruses in their semen for as long as six months after they survive the infection. Researchers consider the chance of being infected with Ebola from semen is very low; however, they recommend utilizing condoms for six months; some experts suggest a longer time.

It is apparent that we don't know everything about how to cure Ebola infections. A physician thought to be cured of Ebola, Dr. Ian Crozier, in fall 2014 developed burning light sensitivity in his eyes. He returned to Emory University where he was treated and after several tests he was found to have Ebola infection in his eyes. However, only the fluid removed by needle from his eyes showed viable virus; his tears and the outer membrane of his eyes had no detectable virus. Consequently, health care professionals considered the patient not to be able to spread the virus. One of the complications was that his blue eye color turned green. Fortunately, for Dr. Crosier, treatment with steroids and antiviral agents allowed his eyes to return to normal. This unusual circumstance has suggested that follow-up eye exams are likely to be important in patients who survive Ebola infections.

The risk factors for Ebola hemorrhagic fever are travel to areas with reported Ebola infections. In addition, association with animals (mainly primates in the area with reported Ebola infections) is potentially a health risk factor according to the Centers for Disease Control and Prevention. Another potential source of the virus is eating or handling "bush meat." Bush meat is the meat of wild animals, including hoofed animals, primates, bats, and rodents. Evidence for any airborne transmission of this virus is lacking. During Ebola hemorrhagic fever outbreaks, health care workers and family members and friends associated with an infected person (human-to-human transfer) are at the highest risk of getting the disease. Researchers who study Ebola hemorrhagic fever viruses are also at risk of developing the disease if a laboratory accident occurs. Caring for infected patients who are near-death or disposing of bodies of individuals that have recently died of Ebola infection is a very high risk factor because in these situations, the Ebola virus is highly concentrated in any blood or bodily secretions. Caregivers should wear appropriate personal protective equipment.

For more information, read our full medical article on the Ebola virus.

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