Preliminary study finds that Ebola virus persists in the semen of some survivors
A growing volume of data from careful clinical observation and testing of people who have recovered from acute Ebola virus disease indicates that the Ebola virus can persist at various sites in the body for many months in some people. Such sites include the inside of the eye, semen, amniotic fluid, the placenta, breast milk and the central nervous system.
A preliminary study on Ebola virus persistence in the semen of male survivors in Sierra Leone, has found that some men still produce semen that test positive on real time – polymerase chain reaction (RTPCR), a test used to detect Ebola virus genetic material (RNA) – for nine months or longer.
The study, published 15 October 2015 in the New England Journal of Medicine, provides the first results of a long-term study being jointly conducted by the Sierra Leone Ministry of Health and Sanitation, Sierra Leone Ministry of Defence, the World Health Organization and the US Centers for Disease Control and Prevention.
The first phase of this study has focused on testing for Ebola virus in semen because of past research showing persistence in that body fluid. Better understanding of viral persistence in semen is important for supporting survivors to recover and to move forward with their lives.
“These results come at a critically important time, reminding us that while Ebola case numbers continue to plummet, Ebola survivors and their families continue to struggle with the effects of the disease. This study provides further evidence that survivors need continued, substantial support for the next 6 to 12 months to meet these challenges and to ensure their partners are not exposed to potential virus,” said Bruce Aylward, WHO Director-General’s Special Representative on the Ebola Response.
Based on current results, the presence of virus in semen decreases in the months after recovery from Ebola virus disease. However, one participant was still positive 9.5 months after his illness began. It is still not known how long the virus can persist in semen but this study will yield more information about how long it takes for men to clear Ebola virus from semen.
While it is now clear that virus persists longer in semen than previously thought, the risk of people being infected with Ebola by those who have survived the disease is probably low. Although sexual transmission by survivors with persistent virus is a possibility, it appears to be rare. “EVD survivors who volunteered for this study are doing something good for themselves and their families and are continuing to contribute to the fight against Ebola and our knowledge about this disease,” said Yusuf Kabba, National President of the Sierra Leone Association of Ebola Survivors.
Why some study participants had cleared the fragments of Ebola virus from semen earlier than others remains unclear. The US Centers for Disease Control and Prevention in Atlanta is conducting further tests of the samples to determine if the virus is live and potentially infectious.
“Ebola survivors face an increasing number of recognized health complications,” said CDC Director Tom Frieden, M.D., M.P.H. “This study provides important new information about the persistence of Ebola virus in semen and helps us make recommendations to survivors and their loved ones to help them stay healthy.” Until more is known, the more than 8,000 male Ebola survivors across the three countries need appropriate education, counselling and regular testing so they know whether Ebola virus persists in their semen; and the measures they should take to prevent potential exposure of their partners to the virus. Until a male Ebola survivor’s semen has twice tested negative, he should abstain from all types of sex or use condoms when engaging in sexual activity. Hands should be washed after any physical contact with semen.
In the current West African outbreak, continued vigilance to identify, provide care for, contain and stop new cases, are key strategies on the road to achieving zero cases.
Date of upload: 16th Nov 2015
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