Ebola risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: Michael Maddaleni, B.S.;Guillermo Rodriguez Nava, M.D. [2]; Rim Halaby, M.D. [3]

Overview

The main risk factors for Ebola virus disease (EVD) include a recent travel to endemic regions, provision of direct care or exposure/processing of blood of body fluids of a symptomatic patient with Ebola virus disease, and direct contact with a dead body in an endemic region without personal protective equipment (PPE).

Exposure Risk Levels

Levels of exposure risk are defined as follows:

• High risk
• Some risk
• Low (but not zero) risk
• No identifiable risk

Risk Factors

The following epidemiologic risk factors should be considered when evaluating a person for Ebola virus disease (EVD), classifying contacts, or considering public health actions such as monitoring and movement restrictions based on exposure.

High Risk

High risk includes any of the following:

• Percutaneous (e.g., needle stick) or mucous membrane exposure to blood or body fluids of EVD patient while the patient was symptomatic
• Exposure to the blood or body fluids (including but not limited to feces, saliva, sweat, urine, vomit, and semen) of a person with Ebola while the person was symptomatic without appropriate personal protective equipment (PPE)
• Processing blood or body fluids of a person with Ebola while the person was symptomatic without appropriate PPE or standard biosafety precautions
• Direct contact with a dead body without appropriate PPE in a country with widespread Ebola virus transmission
• Having lived in the immediate household and provided direct care to a person with Ebola while the person was symptomatic

Some Risk

Some risk includes any of the following:

• In countries with widespread Ebola virus transmission: direct contact while using appropriate PPE with a person with Ebola while the person was symptomatic
• Close contact in households, health care facilities, or community settings with a person with Ebola while the person was symptomatic. Close contact is defined as being for a prolonged period of time while not wearing appropriate PPE within approximately 3 feet (1 meter) of a person with Ebola while the person was symptomatic

Low Risk

Low (but not zero) risk exposure includes any of the following:

• Having been in a country with widespread Ebola virus transmission within the past 21 days and having had no known exposures
• Having brief direct contact (e.g., shaking hands) while not wearing appropriate PPE, with a person with Ebola while the person was in the early stage of disease
• Brief proximity, such as being in the same room for a brief period of time, with a person with Ebola while the person was symptomatic
• In countries without widespread Ebola virus transmission: direct contact while using appropriate PPE with a person with Ebola while the person was symptomatic
• Traveled on an aircraft with a person with Ebola while the person was symptomatic

No Identifiable Risk

No identifiable risk includes:

• Contact with an asymptomatic person who had contact with person with Ebola
• Contact with a person with Ebola before the person developed symptoms
• Having been more than 21 days previously in a country with widespread Ebola virus transmission
• Having been in a country without widespread Ebola virus transmission and not having any other exposures as defined above