China updates Ebola diagnosis & treatment protocols for 2026 outbreak - says no cases yet - June 1, 2026

[sharon sanders]

The diagnosis and treatment guidelines for Ebola virus disease have been released; no locally transmitted or imported cases have been reported in my country.

Author: June 1, 2026, 23:11



The National Health Commission and the State Administration of Traditional Chinese Medicine have released the "Ebola Virus Disease Diagnosis and Treatment Protocol (2026 Edition)". The protocol describes Ebola virus disease, formerly known as Ebola hemorrhagic fever, as an acute infectious disease caused by the Ebola virus. It is highly pathogenic and has a high mortality rate, primarily transmitted through direct contact with the blood, bodily fluids, secretions, excrement, and contaminated items of patients, the deceased, or infected animals. Clinical manifestations mainly include sudden onset of fever, extreme fatigue, headache, muscle pain, frequent vomiting, and severe diarrhea, which may be accompanied by bleeding and multiple organ dysfunction. The average mortality rate is approximately 50%, with some strains reaching 90%. It is mainly prevalent in sub-Saharan Africa, and there have been no reported local or imported cases in my country.

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Notice from the General Office of the National Center for Disease Control and Prevention on Issuing the Ebola Virus Disease Prevention and Control Plan (2026 Edition)

Date: 2026-06-16 Source: Emergency Response Department

National Center for Disease Control and Prevention Emergency Response Letter [2026] No. 144

Disease control bureaus of all provinces, autonomous regions, municipalities directly under the Central Government, and Xinjiang Production and Construction Corps; Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine):

To guide local authorities in carrying out Ebola virus disease prevention and control work scientifically and effectively, and to protect the health of the people, the National Center for Disease Control and Prevention has formulated the "Ebola Virus Disease Prevention and Control Plan (2026 Edition)". It is hereby issued to you for your earnest implementation.

Attachment: Ebola Virus Disease Prevention and Control Plan (2026 Edition)

General Office of the National Center for Disease Control and Prevention
June 12, 2026

(Information disclosure format: proactive disclosure)

Ebola Virus Disease Prevention and Control Plan (2026 Edition)

Ebola virus disease is an acute infectious disease caused by the Ebola virus. It is primarily transmitted through contact with the blood, bodily fluids, secretions, excrement, and contaminated materials of infected patients or animals. Clinical manifestations mainly include fever, extreme fatigue, vomiting, diarrhea, bleeding, and multi-organ damage, with a mortality rate as high as 50%-90%. The disease was first discovered in Africa in 1976, mainly occurring in the Democratic Republic of Congo, Uganda, Gabon, Sudan (South Africa), Guinea, Liberia, Sierra Leone, Nigeria, Côte d'Ivoire, and South Africa. Imported cases have been reported in several countries worldwide. Currently, only the Zaire Ebola virus vaccine and antiviral drugs have been successfully developed and approved for emergency use in epidemic prevention and control. Early detection, early diagnosis, strict isolation, standardized management, and scientific management of close contacts remain crucial for the prevention and control of Ebola virus disease.

I. Disease Overview

(a) Etiology

Ebola virus is an enveloped, single-stranded, negative-sense RNA virus belonging to the genus *Ebolavirus* in the family Filoviridae. The virus is a long, filamentous structure, which can be rod-shaped, filamentous, or L-shaped. Viral particles vary in length, with typical filamentous particles ranging from several hundred to 1000 nm in length and approximately 80 nm in diameter. The virus is covered by a lipid envelope, with brush-like projections composed of viral glycoproteins distributed on its surface. Its genome is approximately 18.9 kb in size, encoding seven structural proteins and one non-structural protein. The viral surface is studded with spikes approximately 10 nm long, formed by glycoproteins anchoring to the envelope; these spikes appear as brush-like projections under an electron microscope.

Based on differences in their gene sequences, Ebola viruses can be classified into six species: Zaire, Sudan, Bundibugyo, Tai, Reston, and Bombali. The nucleotide composition of the genomes of different Ebola virus species varies considerably, but the genes of the same virus species are relatively stable. Zaire, Sudan, Bundibugyo, and Tai Ebola viruses can cause Ebola virus disease in humans, exhibiting high pathogenicity and mortality. Reston and Bombali viruses primarily infect animals, and there is no clear evidence of human pathogenicity. Zaire Ebola virus has the widest distribution and has caused the most large-scale outbreaks, followed by Sudan Ebola virus.

The Ebola virus is moderately resistant to heat; its infectivity remains largely unchanged after one month of storage at room temperature and 4°C. It can be inactivated by heating at 60°C for one hour or at 100°C for five minutes. The virus is sensitive to physical factors such as ultraviolet light and gamma rays, as well as disinfectants such as formaldehyde, hypochlorous acid, and phenols, and lipid solvents such as alcohol.

(II) Epidemiological characteristics

1. Source of infection

Patients infected with the Ebola virus and non-human primates are the main sources of infection for this disease. Wild animals infected with the Ebola virus, such as gorillas, chimpanzees, monkeys, antelopes, porcupines, and fruit bats, are often the source of infection for the first cases. After an outbreak, patients with Ebola virus disease are the main source of infection; no infectious agents have been found in patients during the incubation period.

Currently, fruit bats of the family Pteropodidae are considered the natural host of the Ebola virus, and infected fruit bats can transmit the virus to humans and animals.

2. Transmission routes

Contact transmission is the most common route of transmission for this disease, occurring through direct contact with the blood, bodily fluids, secretions, excrement, carcasses, and contaminated materials of infected patients and animals. Studies have shown that Ebola virus can still be detected in the semen of some male Ebola virus disease survivors up to three months after recovery, suggesting that sexual transmission is possible. Furthermore, Ebola virus can be isolated from breast milk, indicating a risk of mother-to-child transmission. There is no evidence that Ebola virus can be transmitted through the air, but there is a risk of close-range transmission via aerosols formed from contaminated materials. The highest risk of infection is primarily found in medical facilities and patients' homes. Healthcare workers, family members of patients, or other close contacts are easily infected without strict protective measures during the treatment and care of patients or the handling of their bodies.

3. Population susceptibility

Humans are generally susceptible to the Ebola virus. There is no data to suggest differences in the incidence of the disease among different genders, races, or ethnicities.

Antibody levels in infection survivors can persist for 10 years or even longer, providing immune protection against the same virus, but the cross-protective effect between different species is still unclear.

(III) Clinical Manifestations

The incubation period for this disease is 2-21 days, generally 5-12 days. No infectiousness has been found during the incubation period.

The patient presents with an acute onset, initially manifesting as fever, extreme fatigue, sore throat, headache, muscle pain, and joint pain—symptoms of infection and poisoning. Dry cough and dyspnea may also occur, and some patients may experience conjunctival congestion, facial edema, and relative bradycardia. The acute phase typically begins 4-5 days into the illness, with a sudden worsening of the condition, prominently featuring gastrointestinal symptoms including nausea, vomiting, abdominal pain, and copious watery diarrhea. Extreme fluid loss can lead to severe dehydration, electrolyte imbalance, acidosis, and hypovolemic shock. Some patients develop petechiae and ecchymoses on the skin, bleeding from mucous membranes and cavities (such as the nasal cavity, oral cavity, respiratory tract, gastrointestinal tract, urethra, and vagina), and internal organ bleeding. Central nervous system manifestations include dizziness, severe headache, eye pain, emotional abnormalities or aggressive behavior, convulsions, altered consciousness, and even coma. Some patients develop measles-like or maculopapular rashes on the trunk and extremities on days 5-7 of the illness. It often leads to complications such as acute kidney injury, severe hepatitis, and myocarditis. If treatment is not timely, it can cause death due to refractory shock, severe bleeding, DIC, and multiple organ dysfunction syndrome (MODS).

After being infected with the Ebola virus, most people exhibit the above obvious clinical manifestations, but there are also mild cases and asymptomatic infections.

II. Case Discovery and Reporting

(a) Diagnostic criteria

The diagnosis is made based on a comprehensive analysis of epidemiological history, clinical manifestations, and laboratory tests.
Epidemiological history is based on any one of the following within 21 days prior to the onset of illness:

1. History of residence or travel in areas affected by Ebola virus disease;

2. In the absence of appropriate personal protective equipment, direct contact with the blood, bodily fluids, secretions, excrement, or contaminated environment or object surfaces of suspected, confirmed, or deceased Ebola virus disease patients; direct contact or handling of the blood or organs of sick or dead bats or non-human primates (such as fruit bats, chimpanzees, gorillas, monkeys, forest antelopes, porcupines, etc.) from endemic areas; or consumption of raw wild animal meat; or unprotected sexual intercourse with patients recovering from Ebola virus disease.

(II) Case Definition

1. Cases under observation.

Those who have the first item of the above epidemiological history and have a body temperature ≥37.3℃.

2. Suspected cases

It meets one of the following three conditions:

(1) Having any of the conditions in item 2 of the epidemiological history, body temperature >37.3℃ or having the above-mentioned Ebola virus disease related symptoms.

(2) Having the epidemiological history of item 1, body temperature >37.3℃, and at least one of the following symptoms: headache, muscle or joint pain; extreme fatigue; nausea, vomiting, abdominal pain, diarrhea; drowsiness, difficulty breathing, etc.

(3) Meeting any of the above epidemiological histories, and accompanied by unexplained bleeding or sudden unexplained death.

3. Confirmed cases

Suspected cases meet any of the following criteria:

(1) The patient’s blood, tissue or autopsy specimens tested positive for Ebola virus nucleic acid by methods such as RT-PCR.

(2) Blood samples tested positive for Ebola virus antigen using methods such as ELISA;

(3) Ebola virus is isolated from blood or tissue specimens;

(4) During the recovery period, serum specific IgG antibodies turn positive or increase by 4 times or more compared to the acute period.

(III) Case Reporting

When medical and disease control institutions at all levels and customs discover cases of Ebola virus disease requiring observation, suspected cases, or confirmed cases, they should promptly report the relevant information. Observational cases, suspected cases, and confirmed cases should be reported online within 2 hours through the Infectious Disease Reporting Information Management System. The disease name should be selected as "Ebola Virus Disease" under "Other Infectious Diseases," and the nationality and the name of the epidemic area from which the case originated should be noted in the remarks column. Observational cases discovered by customs should be reported online by the receiving medical institution. Disease control institutions at all levels should complete the three-level review of the reported information online within 2 hours. Reported observational cases and suspected cases should be corrected promptly after further diagnosis. The requirements and methods for reporting relevant information shall be implemented in accordance with the "Infectious Disease Information Reporting Management Standards." Confirmed cases should also be reported through the Public Health Emergency Information System.

(iv) Multi-channel monitoring

Building upon existing port entry quarantine and domestic disease surveillance, monitoring channels will be further expanded to include: notifications from international organizations; detection by domestic testing and inspection institutions, universities, research institutes, and other laboratories with biosafety and pathogen detection qualifications; and monitoring of wastewater from inbound aircraft. Upon receiving or detecting abnormal monitoring signals, disease control institutions at all levels should promptly organize investigations, risk assessments, and response measures.

III. Laboratory Testing

Laboratory pathogen and serological tests were conducted on blood and other relevant specimens from observed cases, suspected cases, and confirmed cases. The specific testing protocol was based on the "Laboratory Testing Protocol for Ebola Virus Disease" issued by the Chinese Center for Disease Control and Prevention.

Laboratory activities related to pathogen and serological testing are strictly conducted in accordance with the requirements of the "List of Human Infectious Pathogens" and in laboratories of the corresponding biosafety level. Virus culture is performed in a BSL-4 laboratory, animal infection experiments in an ABSL-4 laboratory, handling of uncultured infected materials in a BSL-3 laboratory, and handling of inactivated materials in a BSL-2 laboratory.

IV. Prevention and Control Measures

(a) Tracking and management of people from epidemic areas

Provincial-level disease control departments should strengthen monitoring and improve information communication with relevant departments. Based on information provided by relevant departments regarding individuals from epidemic areas or those with a travel history to epidemic areas within the past 21 days, and referring to the requirements of the "Health Monitoring and Management Plan for Individuals Arriving in (Returning to) China from Ebola Virus Disease Epidemic Areas" (Annex 1), they should coordinate with relevant departments to conduct tracking and follow-up visits. The follow-up period should end 21 days after leaving the epidemic area. Relevant information should be entered into the relevant module of the Infectious Disease Reporting Management Information System.

(II) Management of close contacts

Close contacts are individuals who have had direct contact with the blood, bodily fluids, secretions, excrement, or contaminated materials of confirmed or suspected Ebola virus disease cases. This includes those who live with or care for patients, and those who have not strictly adhered to protective measures during diagnosis, treatment, patient transport, or handling of corpses. Close contacts will be traced and placed under quarantine for medical observation. The medical observation period is 21 days from the date of the last contact with a case or contaminated item. During the medical observation period, if a close contact develops symptoms such as acute fever, fatigue, sore throat, headache, joint or muscle pain, vomiting, diarrhea, or bleeding, they will be sent to a designated hospital for treatment, and specimens will be collected for laboratory testing and screening. See the "Ebola Virus Disease Case Close Contact Identification and Management Plan" (Annex 1-2) for details.

(III) Diagnosis, transfer and isolation treatment of cases

Once a medical institution discovers a case under observation or a suspected case, it should transfer the case to a qualified designated hospital for isolation and treatment. The transfer work should be carried out in accordance with the requirements of the "Notice on Issuing the Work Plan for the Transfer of Ebola Hemorrhagic Fever Cases" (National Health Commission Document No. 43 [2014]). After customs discovers a case under observation, it should cooperate with the local health and disease control departments to carry out the case transfer work in accordance with relevant regulations.

Health and disease control departments organize designated hospitals and disease control institutions to conduct diagnosis, treatment, and specimen testing for observed and suspected cases. Designated hospitals are responsible for the isolation and treatment management of cases and specimen collection. Personal protective equipment must be used during specimen collection. Specimens must be placed in Category A packaging materials compliant with ICAO regulations, packaged using a triple packaging system, and conform to UN2814 requirements, in accordance with the "Regulations on Biosafety Management of Pathogenic Microorganism Laboratories" and the "List of Pathogenic Microorganisms Transmissible to Humans." Containment containers and outer packaging must comply with IATA Dangerous Goods Regulations Packing System 620. The specimens must be transported to laboratories qualified to conduct Ebola virus-related experimental activities.
Local authorities should establish expert groups composed of clinical, epidemiological, and laboratory testing personnel to be responsible for case assessment. Based on the course of the disease and laboratory test results, diagnoses or exclusions should be made promptly according to the case definition.

Strict isolation and management measures must be implemented for all cases under observation, suspected cases, and confirmed cases. Hospital infection prevention and control must be carried out effectively, and disinfection work must be performed in accordance with the "Infectious Disease Disinfection Standard" (GB 19193—2025). In accordance with the requirements of the "Law on the Prevention and Control of Infectious Diseases," the "Regulations on Hospital Infection Management," the "Regulations on the Management of Medical Waste," the "Regulations on the Management of Medical Waste in Medical and Health Institutions," and the "Ebola Virus Disease Diagnosis and Treatment Protocol (2026 Edition)," personal protective measures must be strengthened, and attention should be paid to hand hygiene. Patients' blood, body fluids, secretions, and excrement should be disposed of as medical waste. Disposable medical devices should be used as much as possible in patient diagnosis and care, and all used devices should be disposed of as medical waste. Reusable medical devices should be disinfected in accordance with relevant regulations. Specimen collection, transportation, and testing, as well as the collection, transfer, temporary storage, and centralized disposal of medical waste, should be carried out in accordance with regulations.

After a patient's death, the handling and transportation of the body should be minimized. The body should be disinfected, double-wrapped in a sealed, leak-proof container, and cremated promptly. If an autopsy is necessary, it should be performed in accordance with the "Regulations on Autopsy Examination of Patients with Infectious Diseases or Suspected Infectious Diseases" and the "Notice on Strengthening Biosafety Management of Ebola Virus Laboratories" (National Health and Family Planning Commission Document No. 52 [2014]), and other relevant biosafety regulations.

(iv) Epidemiological investigation

County and district-level disease prevention and control institutions shall conduct epidemiological investigations on suspected and confirmed cases within their jurisdictions. The investigation shall include: basic information, onset and medical treatment, clinical manifestations, laboratory tests, epidemiological history, information on close contacts, diagnosis and outcome, etc. The specific epidemiological investigation plan shall refer to the "Ebola Virus Disease Epidemiological Investigation Plan (Third Edition)" issued by the Chinese Center for Disease Control and Prevention.

Epidemiological investigators must strictly adhere to relevant requirements for personal protective equipment. After completing the investigation, county and district-level disease control and prevention institutions should promptly submit the epidemiological case investigation forms, investigation reports, and other materials to the higher-level disease control and prevention institutions level by level.

(v) Conduct public awareness and education campaigns and ensure effective risk communication.

Actively promote knowledge about the prevention and control of Ebola virus disease, raise public awareness of self-protection, and respond to public concerns in a timely manner.

Attachment: 1. Health Monitoring and Management Plan for People Arriving in (Returning to) China from Ebola Virus Disease Epidemic Areas.pdf
2. Ebola Virus Disease Case Close Contact Identification and Management Plan.pdf


Related Link: Q&A on the "Ebola Virus Disease Prevention and Control Plan (2026 Edition)"

https://www.ndcpa.gov.cn/jbkzzx/c100014/common/content/content_2066765358108676096.html