Ebola virus disease: epidemiology, clinical feature and the way forward


  • Lawan Gana Balami Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
  • Suriani Ismail Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
  • Saliluddin S. M. Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
  • Garba S. H. Department of Human Anatomy, College of Medical Sciences, University of Maiduguri, P.M.B 1069, Maiduguri, Borno state, Nigeria




The Ebola virus disease is a zoonotic, acute viral syndrome which occurs by infection with one the strains of the Ebola virus. It is primarily endemic in Africa however the recent outbreak in the year 2014 spanned from West Africa all the way to Europe and America. This shows the virus possess a global threat and should not be considered localized to only certain parts of the world. The social and economic impact of zoonotic diseases today is high as 80% of human pathogens are of zoonotic origin. Human to human transmission happens when there is contact with bodily fluids of infected humans during the infectious phase of the disease. This spread could be through nosocomial means or community spread. Poor knowledge of the syndrome among health care workers coupled with lack of funding and deficient resources has crippled their ability to diagnose and break the chain of transmission of the disease at its early stages. The virus undergoes pathogenesis by immune evasion, immune suppression, coagulopathy, and hypovolemic shock, multiple organ failure and death in up to 90% of cases. The unavailability of a cure or vaccine for this syndrome makes it a recurrent threat due to high risk behavior practiced in endemic countries such as bush meat consumption. Thus this study gives the reader a review of current literature on this deadly disease with the aim of increasing knowledge and aiding its prevention and control. 


Rajak H, Jain DK, Singh A, Sharma AK, Dixit A. Ebola virus disease: past, present and future. Asian Pac J Trop Biomed. 2015;5(5):337-43.

Lorente JÁ, Blanch L, Esteban A. Ebola Virus: Understanding the 2014 Outbreak. Arch Bronconeumol English Ed. 2015;51(2):59-60.

Shrivastava SR, Shrivastava PS, Ramasamy J. Ebola disease: an international public health emergency. Asian Pacific J Trop Dis. 2015;5(4):253-62.

Moghadam SRJ, Omidi N, Bayrami S, Moghadam SJ, Seyed Alinaghi S. Ebola viral disease: A review literature. Asian Pac J Trop Biomed. 2015;5(4):260-7.

Lefebvre A, Fiet C, Belpois-Duchamp C, Tiv M, Astruc K, Aho Glélé LS. Case fatality rates of Ebola virus diseases: A meta-analysis of World Health Organization data. Médecine Mal Infect. 2014;44(9):412-6.

Camacho A, Kucharski AJ, Funk S, Breman J, Piot P, Edmunds WJ. Potential for large outbreaks of Ebola virus disease. Epidemics. 2014;9(2014):70-8.

Wang L, Yang G, Jia L, Li Z, Xie J, Li P, et al. Epidemiological features and trends of Ebola virus disease in West Africa. Int J Infect Dis. 2015;38:52-3.

WHO. Ebola Situation Reports Ebola. WHO. 2015. Available at: http://apps.who.int/ebola/ebola-situation-reports. Accessed on 13 March 2017.

Wong SS-Y, Wong SC-Y. Ebola virus disease in nonendemic countries. J Formos Med Assoc. 2015;114(5):384-98.

Preparation G, Force T. Global Health Security: The Lessons from the West African Ebola Virus Disease Epidemic and MERS Outbreak in the Republic of Korea. Osong Public Heal Res Perspect. 2015;6(6):S25-7.

Ross AGP, Olveda RM, Yuesheng L. Are we ready for a global pandemic of Ebola virus? Int J Infect Dis. 2014;28:e217-8.

CDC. Ebola Virus Disease Outbreak — Nigeria, July–September 2014. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6339a5.htm. Accessed on 12 March 2017.

Shittu RO. Awareness, Knowledge and Misconceptions about Ebola Virus Disease (EVD) in a Family Practice Setting in Nigeria, West Africa. J Antivir Antiretrovir. 2015;7(1):10-4.

Oguntimehin O, Musa E, Nzuki C, Nguku P, Nwangwu IG, Waziri NE, et al. Public Knowledge, Perception and Source of Information on Ebola Virus Disease – Lagos, Nigeria; September, 2014. PLoS Curr. 2015;7.

Morens DM, Fauci AS. Emerging infectious diseases: threats to human health and global stability. PLoS Pathog. 2013;9(7):e1003467.

Shears P, O’Dempsey TJD. Ebola virus disease in Africa: epidemiology and nosocomial transmission. J Hosp Infect. 2015;90(1):1-9.

African Development Bank. Open Data for Nigeria. Borno State. 2015. Available at: http://nigeria. opendataforafrica.org/search?query=borno bush meat consumption. Accessed on 3 March 2017.

Matua GA, Van der Wal DM, Locsin RC. Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control. Braz J Infect Dis. 2015;19(3):308-13.

WHO. WHO | Unprecedented number of medical staff infected with Ebola. World Heal Organ. 2014. Available at: http://www.who.int/mediacentre/ news/ebola/25-august-2014/en/. Accessed on 7 February 2017.

Buseh AG, Stevens PE, Bromberg M, Kelber ST. The Ebola epidemic in West Africa: Challenges, opportunities, and policy priority areas. Nurs Outlook. 2015;63(1):30-40.

Gostin LO, Friedman EA. A retrospective and prospective analysis of the west African Ebola virus disease epidemic: robust national health systems at the foundation and an empowered WHO at the apex. Lancet. 2015;385(9980):1902-9.

Fazekas B, Fazekas J, Moledina M, Fazekas B, Karolyhazy K. Ebola virus disease: awareness among junior doctors in England. J Hosp Infect. 2015;90(3):260-262.

Olowookere SA, Abioye-Kuteyi EA, Adepoju OK, Esan OT, Adeolu TM, Adeoye TK, et al. Knowledge, Attitude, and Practice of Health Workers in a Tertiary Hospital in Ile-Ife, Nigeria, towards Ebola Viral Disease. J Trop Med. 2015;2015:1-6.

Monasch R. Study on Public Knowledge, Attitudes, and Practices Relating to Ebola Virus Disease ( EVD) Prevention and Medical Care in Sierra Leone. Unicef. 2014.

Ministry of Health Liberia. National Knowledge, Attitudes and Practices (KAP) Study on Ebola Virus Disease in Liberia. 2015.

Kobayashi M, Beer KD, Bjork A, Chatham-Stephens K, Cherry CC, Arzoaquoiet S, et al. Community Knowledge, Attitudes, and Practices Regarding Ebola Virus Disease - Five Counties, Liberia, September-October, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(26):714-8.

Meyers L, Frawley T, Goss S, Kang C. Ebola Virus Outbreak 2014: Clinical Review for Emergency Physicians. Ann Emerg Med. 2015;65(1):101-8.

Andreas A, Egom CBA, Kruzliak P, Egom EE. Is there a way out for the 2014 Ebola outbreak in Western Africa? Asian Pac J Trop Med. 2015;8(10):773-8.

To KKW, Chan JFW, Tsang AKL, Cheng VCC, Yuen K-Y. Ebola virus disease: a highly fatal infectious disease reemerging in West Africa. Microbes Infect. 2015;17(2):84-97.

Darawad MW, Al-Hussami M. Jordanian nursing students’ knowledge of, attitudes towards, and compliance with infection control precautions. Nurse Educ Today. 2013;33(6):580-3.

Ftika L, Maltezou HC. Viral haemorrhagic fevers in healthcare settings. J Hosp Infect. 2013;83(3):185-92.

Yasri S, Wiwanitkit V. Spermatogenic transmission of Marbug and ebola virus. Asian Pacific J Reprod. 2015;4(1):83-4.

MacIntyre CR, Chughtai AA. Recurrence and reinfection-a new paradigm for the management of Ebola virus disease. Int J Infect Dis. 2016;43:58-61.

Tseng C-P, Chan Y-J. Overview of Ebola virus disease in 2014. J Chinese Med Assoc. 2015;78(1):51-5.

Li H, Ying T, Yu F, Lu L, Jiang S. Development of therapeutics for treatment of Ebola virus infection. Microbes Infect. 2015;17(2):109-17.

Sousa ZL. Key features of Ebola hemorrhagic fever: a review. Asian Pac J Trop Biomed. 2014;4(11):841-4.

Rewar S, Mirdha D. Transmission of Ebola Virus Disease: An Overview. Ann Glob Heal. 2014;80(6):444-51.

WHO.WHO_EVD_GUIDANCE_LAB_14.1_eng.pdf. WHO. 2014. Available at: http://apps.who.int/ iris/bitstream/10665/134009/1/WHO_EVD_GUIDANCE_LAB_14.1_eng.pdf. Accessed on 12 March 2017.

Cherpillod P, Schibler M, Vieille G, Cordey S, Mamin A, Vetter P, et al. Ebola virus disease diagnosis by real-time RT-PCR: A comparative study of 11 different procedures. J Clin Virol. 2016;77:9-14.

Park S-W, Lee Y-J, Lee W-J, Jee Y, Choi W. One-Step Reverse Transcription-Polymerase Chain Reaction for Ebola and Marburg Viruses. Osong Public Heal Res Perspect. 2016;7(3):205-9.

Kilgore PE, Grabenstein JD, Salim AM, Rybak M. Treatment of Ebola virus disease. Pharmacotherapy. 2015;35(1):43-53.

Yazdanpanah Y, Arribas JR, Malvy D. Treatment of Ebola virus disease. Intensive Care Med. 2014;41(1):115-7.

Bevilacqua N, Nicastri E, Chinello P, Puro V, Petrosillo N, Di Caro A, et al. Criteria for discharge of patients with Ebola virus diseases in high-income countries. Lancet Glob Heal. 2015;3(12):e739-e740.

CDC. U.S. Citizens Living Abroad | Viral Hemorrhagic Fevers | CDC. CDC. 2014. Available at: http://www.cdc.gov/vhf/abroad/vhf-manual.html. Accessed on 1 April 2017.

Greiner AL, Angelo KM, McCollum AM, Mirkovic K, Arthur R, Angulo FJ. Addressing contact tracing challenges-critical to halting Ebola virus disease transmission. Int J Infect Dis. 2015;41:53-5.

CDC. Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure, Ebola Hemorrhagic Fever, CDC. CDC. 2015. Available at: http://www.cdc.gov/vhf/ebola/ exposure/monitoring-and-movement-of-persons-with-exposure.html. Accessed on 2 March 2017.

CDC. Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE) Q&A | Ebola Hemorrhagic Fever, CDC. CDC. 2015. Available at: http://www.cdc.gov/vhf/ebola/strive/qa.html. Accessed on 3 March 2017.

Ohimain EI. Recent advances in the development of vaccines for Ebola virus disease. Virus Res. 2016;211:174-85.

Wong G, Richardson JS, Cutts T, Qiu X, Kobinger GP. Intranasal immunization with an adenovirus vaccine protects guinea pigs from Ebola virus transmission by infected animals. Antiviral Res. 2015;116:17-9.




How to Cite

Balami, L. G., Ismail, S., S. M., S., & S. H., G. (2017). Ebola virus disease: epidemiology, clinical feature and the way forward. International Journal Of Community Medicine And Public Health, 4(5), 1372–1378. https://doi.org/10.18203/2394-6040.ijcmph20171744



Review Articles