Pathogenicity Ebola can be transmitted through direct contact with body fluids or contact with the skin or mucous membranes of patients. The incubation period of the virus can be 2 to 21 days, but usually only 5 to 10 days. Symptoms vary from person to person and can appear suddenly. Initial symptoms include high fever (at least 38.8 degrees Celsius or 101 degrees Fahrenheit), severe headache, muscle, joint or abdominal pain, severe weakness and fatigue, sore throat with pharyngitis, vomiting and dizziness. Before an outbreak is suspected, early symptoms can be incorrectly diagnosed as malaria, typhoid, dysentery, colds or other bacterial infections, all of which are more common. Ebola can cause diarrhea, dark or bloody stools, coffee-like vomiting of blood, red eyes due to distended blood vessels, red patches of skin due to subcutaneous bleeding, maculopapular rash, purple spots, and internal bleeding. Bleeding can occur from any hole in the body, including the nose, mouth, anus, genital organs, or pinholes. Other symptoms include hypotension (below 90 mmHg), hypovolemia, palpitations, severe organ damage (especially to the kidneys, spleen, and liver) leading to diffuse systemic necrosis, and proteinuria. The time from the onset of the disease to death (usually due to hypovolemic shock and/or organ failure) is usually 7 to 14 days. In the second week after infection, the patient either has a reduced fever or multiple organ failure. The mortality rate of Ebola infection is as high as 50-70%, and since the 2014 outbreak in West Africa, 8997 people have been diagnosed with Ebola worldwide by October 15, 2014, with 4493 deaths, a mortality rate of 49.94%. Some patients die 24-48 hours after contracting Ebola, and they all “die a horrible death” as the virus spreads rapidly through the body, multiplying and attacking multiple organs, causing them to degenerate, necrosis, and slow decomposition. The patient first bleeds internally, then bleeds from all seven organs and vomits out the necrotic tissue from the organs in the body, and finally dies from extensive internal bleeding and brain damage. Doctors and nurses or family members who care for the patient can be infected after close contact with the patient. Sometimes the infection rate can be high, such as 23% for those in contact with the patient in the same room and sleeping with the patient and 81% for those caring for the patient during an epidemic in Sudan. There have also been several cases of infection and morbidity among laboratory personnel in hospitals. Two nurses who cared for imported cases of Duncan in the United States have recently been confirmed to be infected. Another nurse in Spain has also been infected by caring for an Ebola patient.