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Ebola is one of the world’s most feared infectious diseases, known for causing severe illness and high death rates during outbreaks. The Bundibugyo ebolavirus (BDBV) is spreading in the Democratic Republic of the Congo (DRC) and Uganda, leading the World Health Organization (WHO) to declare it a Public Health Emergency of International Concern. This rare strain is not affected by vaccines or treatments for the more common Zaire strain. Most cases are in the provinces of Ituri, North Kivu, and South Kivu in the DRC, with some in Kampala, Uganda.
The risk to travellers in Europe, Asia, and the Americas is very low, as transmission requires direct contact with bodily fluids. Yet despite its dangerous reputation, doctors say Ebola can sometimes be difficult to identify in its earliest stages. The reason is simple: the first symptoms often resemble those of common viral infections, such as the flu or malaria, or even food poisoning. This overlap can delay diagnosis and increase the risk of viral spread.
Ebola virus disease is caused by a virus transmitted through direct contact with infected bodily fluids, contaminated surfaces, or infected animals. While outbreaks are relatively rare, they can spread quickly in areas with limited healthcare resources. “Early detection is critical because patients are most likely to survive when supportive treatment begins quickly. The initial symptoms of Ebola are usually nonspecific,” Dr Neha Rastogi, Senior Consultant, Infectious Diseases, Fortis Memorial Research Institute, Gurugram, tells Health Shots.
A person infected with the virus may first experience fever, fatigue, weakness, headache, muscle pain, and sore throat. These signs are common in many illnesses, which makes it easy for both patients and healthcare providers to overlook Ebola during the early phase.
Doctors explain that Ebola symptoms typically appear between two and 21 days after exposure, with most cases developing symptoms within eight to 10 days. “During this early period, there may be no obvious signs that distinguish Ebola from seasonal infections”, says the doctor. In regions where diseases like malaria or dengue are common, physicians may first suspect those illnesses instead.
As the disease progresses, symptoms become more severe. “Patients can develop vomiting, diarrhoea, stomach pain, skin rashes, and impaired kidney or liver function. In some cases, internal or external bleeding may occur, though doctors note that bleeding is not always present,” shares the expert. Contrary to popular belief, not every Ebola patient experiences dramatic haemorrhaging.
One major challenge in identifying Ebola early is the lack of travel history. Doctors stress that asking patients where they have recently travelled is essential. “Someone returning from an area experiencing an Ebola outbreak may require immediate testing and isolation, even if their symptoms appear mild”, says the doctor. Without this context, the illness could initially be mistaken for influenza, Covid-19, typhoid, or other tropical diseases.

Healthcare professionals also warn that early Ebola cases can sometimes be missed because patients may delay seeking treatment. Many people initially assume they have a routine viral illness and try to recover at home. By the time severe symptoms appear, the disease may already have spread to family members or caregivers through close contact.
Laboratory testing is the only reliable way to confirm Ebola. Doctors cannot diagnose the disease based on symptoms alone because the early signs are too similar to other infections. Blood tests performed in specialised laboratories can detect the virus and help health officials respond quickly to prevent further transmission.
Public health experts emphasise that awareness plays a major role in preventing outbreaks. Training healthcare workers to recognise warning signs, especially in high-risk regions, can help reduce missed cases. Hospitals also use screening protocols for patients with fever and a history of recent travel to outbreak zones.
Despite the seriousness of Ebola, experts say there is no need for panic in countries without active outbreaks. The virus does not spread through the air like the flu or Covid-19. Transmission requires direct contact with infected bodily fluids. Modern infection-control measures, rapid testing, and contact tracing have improved the ability to contain outbreaks more effectively than in the past.
“Ebola can indeed be missed initially because its early symptoms mimic many common illnesses. However, careful attention to travel history, exposure risk, and symptom progression can help healthcare providers identify cases sooner. Early recognition remains one of the most powerful tools in stopping the spread of this deadly disease,” concludes the doctor.
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