Persistence of Ebola Virus in Convalescence

Abstract

The recent Ebola epidemic in West Africa has had a global impact of unprecedented dimension. It resulted in a large survivor population, many of whom have suffered from lingering systemic complications during convalescence. A growing body of literature strongly suggests that the virus persists in immune privileged organs and body fluids even after clearance of the virus from plasma, and may represent a continued transmission risk during this time. Much is yet to be discovered regarding Ebola and its potential to persist in human organs after plasma clearance. The response to this public health epidemic has merged the efforts of national and international organizations working towards elucidating novel information about the virus, developing of therapeutic options, and discovering a cure and/or vaccine. Most critically, future studies evaluating the persistence and transmissibility of the virus during convalescence is required to delineate the management of complications in survivors and prevent further transmission of virus. While the overall risk of transmissibility appears to remain low during convalescence, it is our recommendation that healthcare providers take a precautionary approach in treating and counseling survivors and their close contacts. Until future research can provide adequate evidence based guidelines for prevention of virus transmission, it would be prudent for survivors and contacts to be counseled regarding the potential for transmission, especially with regards to sexual intercourse or breastfeeding; and for providers to utilize personal protective equipment in the course of caring for convalescent survivors particularly if there is a risk of contact with body fluids.