Thread by @Rpshahmemorial1

Short 🧵 On Persistence of #Ebola - Patient infective over 500 days & spreads infection by Sex- So with the risk of spill over we may see repeated outbreaks. In 2016, Guinea had recorded 3 probable, 7 confirmed cases, of which 6 were admitted at an Ebola treatment unit ctd)

2/n 4 patients died in the community ,4 patients in the ETU.Fatality ratio among probable & confirmed cases in this cluster in Guinea was 80% (8/10).They were closely related to viruses from the 2014–2016 outbreak, ruling out a new introduction from an animal reservoir ctd)

3/n Epi investigation revealed that case 1 had sexual intercourse with a male #Ebola survivor who reported sexual abstinence after discharge from Nov 2014 -August 2015 as recommended. From Sep 2015, he had occasional intercourse with various partners, including case 1 ctd)

4/n HIV-1/2 was negative. The PCR and sequencing data strongly suggest that EBOV persisted in the survivor from 26 October 2014 (date of onset) to 9 April 2016 (last EBOV RNA–positive semen sample)—that is 504 days .Ctd)

5/n the sample had just 5 novel mutations in the 504 days which was roughly 6 times slower than the average evolutionary rate seen during human-to-human transmission in that outbreak .EBOV persistence in seminal fluid is a known phenomenon ctd)

6/n The reduced evolutionary rate of the virus during persistence is plausible, given presumed low level of replication in immune-privileged sites such as the testes in the absence of detectable viremia. So add #Ebola to #Covid , #HIV, #monkeypox & Epstein Barr Virus list ctd)

7/n All of these viruses and so many others are coexisting in a particular geographic region with poor health care delivery and poor vaccination rates .With global travel we are sitting on a gun powder keg ready to explode HOWEVER we aren't paying attention.🤦‍♂️😢

For the reference
doi: 10.1093/cid/ciw601