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 By Valentine's Day, nearly three months later, the 23-year-old had
not yet returned to Hannah, his girlfriend and mother of his young
son.
"I don't want to be tempted by her ... It would be a problem," he
said in the capital Monrovia, where he spent his self-imposed exile,
afraid that he could still infect her through sexual contact despite
his clean bill of health.
Research has shown traces of Ebola in semen of some survivors for at
least 82 days after the onset of symptoms and in vaginal secretions
for a much shorter period.
Scientists say testes are a reservoir for Ebola because white blood
cells, which protect the body against disease, are unable to
effectively destroy the virus there.
Although there is no conclusive scientific proof these traces are
infectious, anecdotal evidence of several cases in West Africa and
confirmed transmission of Marburg, another viral hemorrhagic fever,
have led experts to warn of the potential risk of sexually
transmitted Ebola.
With the disease typically taking 15 to 21 days to run its course,
this means traces of Ebola can remain in semen for around two months
after recovery.
This has raised the prospect of new infections, even in areas free
of the disease, just as the year-long epidemic appears to be
receding across the region.
Health officials declare Ebola outbreaks officially over after
countries complete 42 days -- twice the incubation period for Ebola
-- without recording new infections.
"We are saying that the outbreak is over after 42 days but
technically it could be longer because of the risk of sexual
transmission through contaminated semen," said Philippe Maughan, at
the humanitarian branch of the European Commission.
The World Health Organization (WHO) advises Ebola survivors to
abstain from sex during a 90-day period following recovery, or,
failing that, to practice safe sex.
"CONCENTRATION CAMPS"
Worries over sexual transmission risk adding to the stigmatization
Ebola survivors already face, and are protracting the emotional
burden of families often struggling to overcome the deaths of
relatives.
While men like Pabai have taken the WHO's advice a step further by
separating themselves from their loved ones, some traumatized
communities have imposed more draconian measures.
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"We've got people being treated horrendously," said Margaret Harris,
a spokeswoman on Ebola for the WHO. "In Sierra Leone particularly
male survivors have been put in a form of concentration camp."
Harris said men had been detained in Bombali, a district northeast
of the capital Freetown, highlighting how public hysteria had become
a real danger.
"This will further stigmatize anyone with symptoms of Ebola and is
likely to drive infections underground just at a time when we're
getting the upper hand," she said.
Infections are now receding, potentially freeing up resources to
test the semen of male survivors for the virus.
A positive test result would still not confirm if the traces of
Ebola remain infectious, but a negative result could bring welcome
relief.
"It's entirely possible to do this," said Michel Van Herp, an
epidemiologist with medical charity Medecins Sans Frontieres. "At
least we could reassure an individual that his semen is negative and
he is not contagious."
Late last week Musa Pabai finally went home to Walakor, his village
just outside Monrovia. He flirted, somewhat hesitantly, with Hannah
but still worried for her health.
"They told me three months (of abstinence), but I am going to make
it five months," he said. "That's my decision."
(Additional reporting by Derrick Snyder in Monrovia and Emma Farge
in Dakar; Editing by David Lewis and Robin Pomeroy)
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