With Ebola spreading in DR Congo, cases in Kenya, an imported case in Nigeria and Uganda on high alert, every nurse in the region needs to recognise it early and care for patients safely. This guide covers the essentials. Always follow your national guidelines (NCDC, Kenya MOH and others) and your facility’s protocol.
How Ebola spreads
- Through direct contact with blood or body fluids (vomit, stool, urine, saliva, sweat, breast milk, semen) of a sick or dead person, through broken skin or mucous membranes.
- Through contaminated objects: needles, linen, clothing.
- It is not airborne in normal settings. People are not considered infectious before symptoms start.
- Bodies of people who died of Ebola are highly infectious, which is why unsafe burials spread outbreaks.
Incubation period
Between 2 and 21 days from exposure to the first symptoms. That is why contacts are monitored for 21 days.
Signs and symptoms
| Early (“dry” phase) | Later (“wet” phase) |
|---|---|
| Sudden fever, severe weakness and fatigue, muscle and joint pain, headache, sore throat | Vomiting, profuse diarrhoea, abdominal pain, rash, signs of kidney and liver failure, and in some patients unexplained bleeding or bruising |
Bleeding is not always present and is a late sign. Early Ebola looks like malaria, typhoid, Lassa fever or gastroenteritis, so the travel and contact history is your most important tool.
Nursing priorities for a suspected or confirmed case
- Isolate in a single room or designated unit. Restrict entry to essential trained staff and keep a log of everyone who enters.
- Protect yourself with full PPE, put on and taken off under observation. See our PPE guide.
- Fluid and electrolyte replacement is the core of supportive care. Patients can lose many litres a day through vomiting and diarrhoea. Use oral rehydration where possible and IV fluids as prescribed. Monitor input, output and vital signs closely.
- Treat symptoms as ordered: fever, pain, nausea, and other infections such as malaria.
- Minimise sharps. Take blood only when essential, use safety devices and never recap needles.
- Handle waste and linen as infectious, following your facility’s protocol.
- Support the patient and family. Isolation is frightening, so explain what is happening and use phones or windows for family contact.
Vaccines and treatment
Approved vaccines and antibody treatments exist for the Zaire strain only. The 2026 outbreak is Bundibugyo, so care depends on early, high-quality supportive treatment. See Bundibugyo vs Zaire explained.
Based on WHO and NCDC Ebola guidance. This is educational content and does not replace your national or facility protocol.