Mahendra Pal^1,, Mahek Desai², Dhwani Upadhyay², Sônia de Avila Botton³

Ebola virus disease (EVD) is a zoonotic disease of great public health importance. It is characterized by a high case fatality rate, causes outbreaks, and can lead to major social and economic disruption. First recognised in 1976 in Sudan and the Democratic Republic of the Congo, the disease has since emerged in different parts of Africa. The most significant outbreak occurred between 2014 and 2016 in West Africa. EVD is caused by species of the genus Orthoebolavirus, including Ebola virus, Sudan virus, and Bundibugyo virus. These viruses differ in fatality rates and in the availability of medical countermeasures. Fruit bats are believed to be the natural reservoir. Transmission to humans occurs through contact with infected animals, body fluids of infected persons, and contaminated environments, including during unsafe burial practices. The early stages present with non-specific symptoms, followed by gastrointestinal and hemorrhagic symptoms. Laboratory confirmation involves molecular, antigen-based, serological, and virological methods. Treatment options include supportive care, monoclonal antibodies for cases caused by Orthoebolavirus zaire, and vaccination. However, major gaps remain in the treatment and prevention of Sudan and Bundibugyo virus infections. Despite progress in EVD management, further research is needed to improve preparedness, diagnosis, treatment, and control. Therefore, this review discusses the etiology, epidemiology, transmission, pathogenesis, clinical spectrum, diagnosis, treatment, control, and One Health implications of Ebola virus disease, while highlighting existing knowledge gaps and future research needs.

Ebola virus, Orthoebolavirus, One Health, Zoonotic disease, Africa