Primary prevention
The following preventive measures are recommended for people living in or traveling to an area affected by an outbreak.[1]
Avoid contact with body and body fluids from people who are sick.
Avoid contact with semen from someone who has recovered from Ebola disease until testing shows the virus is no longer present.
Avoid contact with clothes, bedding, medical equipment, or other items that may have touched an infected person’s body fluids.
Avoid contact with the body of someone who is suspected or confirmed to have Ebola disease (e.g., during a funeral or burial practice).
Avoid contact with bats, forest antelopes, and primates, and blood, fluids, or raw meat from these animals (or other unknown animals).
Wear protective equipment when in contact with people who are sick or have died from Ebola disease, their body fluids, or objects covered with their body fluids.
Monitor health for 21 days after returning from an area with an ongoing outbreak and seek immediate medical care if symptoms develop.
If infection is suspected based on initial screening, immediate isolation is warranted before any further workup is carried out. This is crucial to reduce contact with other patients and healthcare workers while the patient is being investigated. Isolation measures should be continued until the patient has tested negative.[91]
The highest risk facing healthcare workers when looking after infected patients is inadvertently touching their own faces or neck under the face shield during patient care, and removing (doffing) personal protective equipment (PPE). Healthcare workers should understand the following basic principles of using PPE:[91]
Donning: PPE must be donned correctly in proper order before entry into the patient care area. Because PPE cannot be modified while in the patient care area, caution should be taken to ensure it is as comfortable as possible before entering the area. No skin should be exposed. Donning activities must be directly observed by a trained observer, and a final check performed before entering the patient care area.
During patient care: PPE must remain in place and be worn correctly for the duration of exposure to potentially contaminated areas. PPE should not be adjusted during patient care. Healthcare workers should perform frequent disinfection of gloved hands using an alcohol-based hand rub or chlorine solution, particularly after handling body fluids. If there is a partial or total breach in PPE (e.g., gloves separate from sleeves leaving exposed skin, a tear develops in an outer glove, a needlestick) during patient care, the healthcare worker must move immediately to the doffing area to assess the exposure and implement the facility exposure plan, if indicated. The immediate action drills to take in the event of a high-risk exposure (needlestick injury and mucous membrane splash) should be clear to all healthcare workers. After safe doffing, a rapid risk assessment and consideration of postexposure prophylaxis (PEP) should be undertaken.[92]
Doffing: removal of used PPE is a high-risk process that requires a structured procedure, a trained observer, and a designated area for removal to ensure protection. PPE must be removed slowly and deliberately in the correct sequence to reduce the possibility of self-contamination or other exposure. A stepwise process should be developed and used during training and daily practice. [Figure caption and citation for the preceding image starts]: Healthcare worker in personal protective equipment at an Ebola treatment center in Sierra Leone, 2014From the personal collection of Chris Lane, MSc (Public Health England/World Health Organization); used with permission [Citation ends].
The importance of a "buddy" when inside the patient care area and during donning and doffing, to ensure safe practice, cannot be overstated, together with guidance from independent monitors if available.
The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) produce detailed guidance on PPE:
CDC: viral hemorrhagic fevers - guidance for personal protective equipment (PPE) Opens in new window
WHO: infection prevention and control guideline for Ebola and Marburg diseases Opens in new window
Vaccines: Ebola virus
A vaccine, commercially known as Ervebo®, is available for the prevention of disease caused by the Ebola virus (Orthoebolavirus zairense species).
It is a live attenuated vaccine that contains vesicular stomatitis virus that has been modified to contain a protein from Orthoebolavirus zairense.
Administered as a single intramuscular dose.
The WHO has prequalified the vaccine, and several African countries have approved it for the prevention of disease caused by Orthoebolavirus zairense.[93]
It is recommended by WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization as part of a broader set of outbreak response tools.
The Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have also approved the vaccine for the prevention of disease caused by the Orthoebolavirus zairense species in at-risk individuals age ≥1 year.
In the US, the CDC’s Advisory Committee on Immunization Practices (ACIP) recommends pre-exposure vaccination for adults age ≥18 years who are at highest risk for potential occupational exposure to Orthoebolavirus zairense because they are responding to an outbreak, work as healthcare personnel at a federally designated Ebola treatment center in the US, or work as laboratorians or other staff members at biosafety level 4 facilities in the US.[94]
It is also recommended for healthcare personnel involved in the care and transport of patients with suspected or confirmed Ebola disease at special pathogens treatment centers, and people who work in Laboratory Response Network facilities that handle specimens that might contain replication-competent Orthoebolavirus zairense.
The vaccine is not commercially marketed in the US, but is stockpiled in the Strategic National Stockpile and is made available through the CDC.
Evidence supports the use of the vaccine.
The Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE) trial, a combined phase 2 and 3 clinical trial to assess the safety and efficacy of the vaccine, found that no cases of Ebola disease were reported in the 7998 participants who were vaccinated.[95]
An open-label, cluster-randomized, ring vaccination trial in which contacts of a suspected Ebola disease case were vaccinated with a single intramuscular dose of the vaccine was conducted in Guinea. Patients in the treatment arm received the vaccine immediately, while vaccination was delayed by 21 days in the control arm. The study found that the vaccine had high protective efficacy. No patients who received the vaccine developed Ebola disease 10 days or more after randomization in the immediate-treatment arm; however, cases occurred in unvaccinated patients in the comparison group.[96]
Pregnant and breastfeeding women should be offered vaccination with the vaccine during an active outbreak caused by Orthoebolavirus zairense in affected areas, in the context of rigorous research or in accordance with a compassionate use protocol, with informed consent.[97]
Common adverse reactions include injection-site reactions, arthralgia, myalgia, rash, headache, fever, and fatigue.
The Zabdeno®/Mvabea® vaccines, originally approved by the EMA in 2020, were removed from the market in May 2026 due to commercial reasons, and are no longer available.
Vaccines: other Orthoebolavirus species
There are currently no licensed vaccines available for the prevention of disease caused by Orthoebolavirus sudanense (Sudan virus), Orthoebolavirus bundibugyoense (Bundibugyo virus), or Orthoebolavirus taiense (Tai Forest virus) species.[98]
Candidate vaccines are in development and may be used during outbreaks.
Evidence for the use of Ervebo® (a vaccine licensed specifically for the prevention of disease caused by the Orthoebolavirus zairense species) for the prevention of disease caused by other species of the Orthoebolavirus family, such as the Sudan and Bundibugyo viruses, is limited and inconclusive.
Ervebo® should only be used in carefully designed research settings during the current 2026 Ebola outbreak. There is insufficient evidence to determine whether it provides cross-protection against the Bundibugyo virus, and no human vaccine efficacy data are available.[34]
Vaccine candidates for Sudan and Bundibugyo viruses are still in clinical trials.
The most promising candidates for the Bundibugyo virus are the rVSV Bundibugyo vaccine and the ChAdOx1 Bundibugyo vaccine. However, these vaccines are still in development and are not likely to be available for clinical trials for several months.[33]
Secondary prevention
Ebola disease is a notifiable disease.
If infection is suspected, the patient should be put in isolation and all healthcare workers in contact with the patient should wear personal protective equipment. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) produce detailed guidance on infection prevention and control in healthcare settings:
CDC: viral hemorrhagic fevers - guidance for personal protective equipment (PPE) Opens in new window
WHO: infection prevention and control guideline for Ebola and Marburg diseases Opens in new window
Contact tracing (e.g., family, friends, work colleagues) is essential. People who have been exposed to the virus within the last 21 days and who are asymptomatic need to be monitored for the duration of the incubation period in order to ensure rapid recognition of symptoms followed by immediate isolation. The WHO has produced guidance on contact tracing:
Healthcare workers suspected of being infected should be isolated and treated the same as any other patient until a negative diagnosis is confirmed.[166] If exposure to body fluids from a patient with suspected infection has occurred, the person should immediately wash affected skin surfaces with soap and water and irrigate mucous membranes with copious amounts of water.
Safe burial practices are essential but are not always culturally accepted, and this continues to be a challenge.[87]
Postexposure prophylaxis (PEP):
This is a rapidly changing field.[230] A useful framework that takes a stratified approach to exposure risk has been proposed.
PEP is recommended in high-risk patients (e.g., people with broken skin or mucous membrane contact with an infected patient [alive or deceased] or their body fluids, a penetrating sharps injury, or contact with contaminated gloves or clothing). It may also be considered in patients with intact skin-only contact with an infected patient (alive or deceased) or their body fluids. Options to consider include passive immunotherapy with monoclonal antibodies, antiviral agents, or vaccination depending on specific patient circumstances.[231]
Obeldesivir (a prodrug that delivers the same active metabolite as remdesivir) has shown antiviral activity against Bundibugyo virus, and efficacy in nonhuman primate models for other filoviruses. It is currently being investigated as a priority candidate for PEP during the current 2026 Ebola outbreak.[32]
In addition to these interventions, psychological support is needed for healthcare workers exposed to dangerous pathogens.[232]
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