Ebola resurgence can happen well after transmission is controlled
Ebola virus can last in semen, perhaps up to 2 years. Ebola after recovery likely waxes and wanes in some in immunologically protected areas(testes, also eyes) leading to sexual transmission cdc.gov/media/releases…
Ebola virus can last in semen, perhaps up to 2 years. Ebola after recovery likely waxes and wanes in some in immunologically protected areas(testes, also eyes) leading to sexual transmission cdc.gov/media/releases…
In July 2015, there was a death from Ebola in Liberia after transmission had been halted. Many theories raised then, including sexual transmission but also zoonotic transmission from meat rather than from bats or standard reservoirs thelancet.com/journals/lanre…
Most sexual transmission has been associated with male partners and semen. It is not thought that female partners transmit the virus. cdc.gov/vhf/ebola/tran…
However, pregnancy can lead to unexpected and persistent reservoir of viral activity, while the mother has recovered and done well (and given vomiting in pregnancy may not have known she was even infected).
In January 2015, a healthy woman in Bo, Sierra Leone gave birth to a stillborn. The attentive midwife swabbed the stillborn as all deaths were to be swabbed (but stillborns, miscarriages often not)...
The stillborn result was quite positive (Ct value 16) but the mother's blood tested negative and only recalled what she thought were pregnancy related. Her husband though was known to have Ebola the month before ncbi.nlm.nih.gov/pmc/articles/P…
This all points to pregnancy creating a protected reservoir for Ebola, though usually pregnant women are at the highest risk for severe Ebola, severity can vary.
This brings us to what was likely the most unusual cluster in Liberia in November 2015 when a 15 year old boy arrived at a clinic, found to have Ebola, long after transmission stopped. Father then found ill, as well as 8 year old brother
nytimes.com/2015/11/21/wor…
nytimes.com/2015/11/21/wor…
With further history and viral lineage analysis, it looks like the mother likely was infected in 2014 (when her brother was) and the virus persisted/resurged, which may be related to her pregnancy and birth of the 3rd baby sibling in the family thelancet.com/journals/lanin…
Immunologic protected sites like the testes and eyes are known sites of intermitten Ebola replication post recovery. Sexual transmission from men is documented. This immune protection and transmission may also occur w/pregnancy in rarely, though pregnant women face high mortality
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