It has been nearly 40 years since the first outbreak of a mystery disease began near the Ebola River in Zaire. Since then, more than 30,000 cases have been confirmed (most in the West African outbreak the past two years) and more than 12,000 people have died. There is years’ of data and experience dealing with those infected with the deadly virus. However, scientists continue to learn more about the illness and its aftermath, particularly from those who have survived the latest Ebola virus disease (EVD) outbreak but continue to be plagued with physical ailments and health problems.
While only a handful of new Ebola cases have been diagnosed in the last month or two, those cases have raised new questions since they appear to have stemmed from contact with a survivor who has tested negative twice. Other survivors suffer from joint pain, potentially blinding problems with their eyesight, hearing loss and other after-effects, according to public health experts who have treated and surveyed the population.
A new study, published in The Lancet Infectious Diseases, is possibly the most detailed yet looking into post-Ebola complications and their prevalence. Survivors of the West African outbreak that affected large numbers in Sierra Leone, Liberia and Guinea have significant long-term after-effects and potentially long-term or permanent disabilities. For example, 277 survivors were examined at a clinic in Sierra Leone and nearly 80 percent were experiencing joint pain about four months after they were supposedly virus-free, according to experts. The study also found that patients with a higher “viral load” at the height of their illness had worse complications later.
Other findings reported include evidence that the Ebola virus may live on some parts of the body — including the eyes, which may be the cause of the vision problems many patients had reported. One of the authors of the study was an American doctor, Ian Crozier, who contracted the disease while treating patients and recovered; however, the virus was found in fluids around his eyes months after he was deemed to have recovered, which adds concerns that the reported 21 day incubation period may be incorrect.
Another recent example that illustrates the lingering presence in the body of the virus involves a mother in Liberia whose two children and their father became infected with Ebola two months after the country was declared by the World Health Organization (WHO) and other public health officials to be rid of the epidemic. The mother had cared for her Ebola-stricken brother in the summer of 2014. She subsequently fell ill with EVD-like symptoms, but she was never tested before recovering. The woman had a baby in September, became ill again in October, and got better again. During that period, she tested negative for the virus twice. Her system did contain the antibodies indicating that her body had fought the disease at some point. Then, in November, her 15-year-old son was hospitalized with a high fever and bleeding from the mouth and nose. He tested positive for Ebola and eventually succumbed. Since then, the father and another son have been come down with the virus, which no one else in the community reportedly has. The case has experts wondering if the woman was somehow still contagious and how the disease was transmitted.
While the EVD itself is no longer present in the bloodstream weeks after recuperating, the WHO believes it may persist for a full year in patients’ eyes, semen, and, for women infected while pregnant, breast milk. However, the WHO maintains presently that transmission by survivors, sexually or otherwise, “appears to be rare.” That does not explain the situation with the Liberian family.
More than 17,000 people survived after getting ill in the dwindling outbreak in West Africa. Hopefully, the research done on these survivors will arm health officials for future outbreaks and result in information on how to treat those still plagued with post-Ebola ailments.
Written and edited by Dyanne Weiss
CBC News: Ebola complications in Sierra Leone ‘more staggering’ than thought
NPR: Ebola Mystery: Did A Mom Who Tested Negative Infect Her Family?
Daily Mail: Health troubles persist for Ebola survivors: study
World Health Organization: Ebola virus disease outbreak
Photo by Athalia Christie, courtesy of the U.S. Centers for Disease Control and Prevention – Creative Commons license