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 Virologists said Friday's case of a Scottish nurse, Pauline
Cafferkey, who had recovered from Ebola but is now suffering
complications adds to signs that the virus is a long-term health
risk and can lead to a "post-Ebola syndrome".
"Over the past few years there has been mounting evidence of mental
and physical health problems in Ebola survivors that can last for
years after the virus is cleared from the bloodstream," said Ben
Neuman, an Ebola expert and lecturer in virology at Britain's
University of Reading.
"The newly discovered twist on this post-Ebola syndrome is that in
some cases the health problems - often including damage to the eyes
and joints - are caused by live Ebola virus growing in fluids in
some of the less accessible compartments of the body."
Ebola, one of the deadliest viruses known in humans, infected 28,000
people and killed more than 11,300 of them in an unprecedented
outbreak in West Africa which was declared in March 2014 and is only
now coming under control.
Partly because of the vast numbers involved in the epidemic, which
centered on Guinea, Sierra Leone and Liberia, infectious disease
experts say we are learning more every day about Ebola from cases
such as Cafferkey's and thousands more survivors.
Ebola experts said in August that around half of Ebola survivors in
West Africa were already reporting suffering from chronic problems,
including serious joint pain and eye inflammation that can lead to
blindness.
LARGE VIRUS RESERVOIR?
"Due to the sheer scale of this outbreak compared to previous ones
we are going to see aspects of Ebola virus infection that we have
not observed before," said Julian Hiscox, a professor of infection
and global health at Britain's Liverpool University.
He was concerned that Ebola's persistence in survivors, who have no
obvious symptoms of Ebola infection and so are often living and
working normally and not kept in isolation as a symptomatic patient
would be, means they are "a potential reservoir of the virus".
"It's why men who have had Ebola and recovered are advised to
abstain or wear condoms," he noted.
The World Health Organization's advice is that all male survivors
should be tested three months after the onset of symptoms and then
monthly until they know they have no risk of passing on the virus
through their semen.
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John Edmunds, an expert at the London School of Hygiene and Tropical
Medicine, said that while the risk of transmission from survivors
harboring the virus in their eye fluids and other organs "appears to
be very low", it still warrants attention.
"With so many survivors in West Africa now, there is a risk that
further outbreaks can be triggered, which is why authorities have to
remain very vigilant," he said.
Cafferkey, a 39-year-old nurse, was back in hospital in London on
Friday with doctors saying she would be treated in isolation as a
precautionary measure.
The hospital said in statement it had "identified a small number of
close contacts ... that we will be following up as a precaution",
but added: "The risk to the general public remains low."
Cafferkey was the first person to be diagnosed with Ebola on British
soil and was originally discharged in January after seemingly making
a full recovery.
Neuman said the likelihood of survivors spreading Ebola depends on
how much of the virus is present in the blood.
In Cafferkey's case, he said, "if her body was able to control the
virus once, the chances are she can do it twice."
(Reporting by Kate Kelland; editing by Giles Elgood)
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