The word “Ebola” immediately creates fear, and for good reason. Few diseases in modern history have carried such a terrifying reputation. In some outbreaks, the Ebola virus has killed close to 90 percent of those infected. Although modern medical care and vaccines have improved survival rates, Ebola remains one of the deadliest infectious diseases known to mankind.

The Ebola virus was first identified in 1976 during simultaneous outbreaks in what is now South Sudan and the Democratic Republic of Congo. The disease was named after the Ebola River in the Congo region near one of the outbreaks. 

Since then, Ebola has appeared periodically in several African countries, usually beginning in remote villages before spreading through human contact.

The largest outbreak occurred between 2014 and 2016 in West Africa, primarily in Guinea, Liberia, and Sierra Leone. More than 28,000 people were infected, and over 11,000 died. The outbreak shocked the world because Ebola spread into crowded cities and even reached Europe and the United States through infected travelers.

Ebola is caused by a virus belonging to the filovirus family. Scientists believe fruit bats are the natural host of the virus. Humans may become infected after contact with infected bats or animals such as monkeys and antelopes. Once a human becomes infected, the virus spreads rapidly from person to person.

Unlike airborne viruses such as influenza or COVID-19, Ebola is not spread through casual breathing or simply being near an infected individual. Transmission occurs through direct contact with the blood or body fluids of an infected person. This includes saliva, vomit, diarrhea, sweat, urine, semen and other bodily secretions. The virus can also spread through contaminated needles, bedding, clothing or medical equipment.

One of the reasons Ebola outbreaks become so deadly is that the symptoms often resemble more common illnesses in the early stages. The incubation period—the time between exposure and symptoms—ranges from 2 to 21 days.

Early symptoms usually include:

• Sudden high fever 
• Severe fatigue 
• Muscle pain 
• Headache 
• Sore throat 

As the disease progresses, patients may develop:

• Vomiting 
• Severe diarrhea 
• Abdominal pain 
• Rash 
• Liver and kidney failure 
• Internal and external bleeding 

Contrary to Hollywood portrayals (e.g., the movie “Outbreak "), massive bleeding does not occur in every case, but hemorrhaging can occur in severe infections. Patients often become critically dehydrated and go into shock.

Historically, some Ebola outbreaks had mortality rates approaching 90 percent. Today, survival has improved significantly when patients receive rapid medical care, including intravenous fluids, oxygen, blood pressure support and treatment of secondary infections. Even so, Ebola remains an extremely dangerous disease.

A breakthrough came with the development of the Ebola vaccine, known as Ervebo. This vaccine was developed to protect against the Zaire strain of Ebola, the deadliest form. It has been widely used in African outbreaks, especially in the Democratic Republic of the Congo and neighboring countries.

Health workers often use a “ring vaccination” strategy. When a person is diagnosed with Ebola, doctors vaccinate family members, health care workers and anyone who had close contact with the patient. This creates a protective “ring” around the infected individual and helps stop further spread.

In addition to vaccines, newer treatments have improved survival rates. Two antibody-based therapies, Imnazeb and  Ebanga,  have shown effectiveness in treating Ebola infections. These medications help the immune system attack the virus more effectively.

One concern Americans often ask is: “Could Ebola spread widely in the United States?”

The risk of a large outbreak in the U.S. remains very low. American hospitals have strong infection-control procedures, isolation units, advanced sanitation and protective equipment. In addition, the Centers for Disease Control and Prevention (CDC) monitors travelers from outbreak regions and works closely with international health agencies.

However, Ebola could still enter the country through an infected traveler during the incubation period before symptoms appear. A person exposed overseas might board a plane feeling perfectly healthy and become ill days later after arriving in the United States.

If someone develops symptoms consistent with Ebola and has recently traveled from an outbreak area, hospitals immediately isolate the patient. Health care workers use full-body protective gear to prevent exposure. Contact tracing begins quickly to identify anyone who may have been exposed.

The 2014 U.S. Ebola cases demonstrated that while transmission in America is possible, it can usually be contained rapidly through aggressive public health measures.

Perhaps the greatest lesson from Ebola is that infectious diseases anywhere in the world can become global concerns. Modern air travel allows viruses to cross continents within hours. Continued investment in vaccines, rapid diagnosis, surveillance and international cooperation remains essential.

Although Ebola is rare, it reminds us how dangerous emerging viruses can be, and how critical science, public health, and preparedness are in protecting the world from future outbreaks.

Michael Kossove is professor emeritus and an adjunct professor of microbiology at Touro University’s School of Health Sciences. He is a polio researcher, international polio lecturer and polio survivor. He can be reached at Professormike2@aol.com.