Sunday 1 November 2015

Evidence for sexual transmission of the Ebola Virus.

In December 2013 cases of Ebola, a viral haemorrhagic fever with an extremely high mortality rate, began to emerge in Guinea, West Africa, marking the beginning of the most severe outbreak of the disease ever recorded. The epidemic rapidly spread to several neighbouring countries, including Sierra Leone and Liberia where if became established and killed large numbers of people before being eradicated. Liberia was officially declared free of Ebola on 3 September 2015, though cases were still being reported in Guinea and Sierra Leone, albeit at a much lower rate than during the peak of the epidemic.

Areas affected by the 2013-5 West African Ebola Virus outbreak. Digital Data Services.

Sexual transmission of the Marburg Virus, which is related to the Ebola Virus, has been known to occur at least once, and Ebola has been detected in other bodily fluids after blood samples have been shown to be clear of the Virus. For this reason Ebola survivors are advised to abstain from unprotected sex for at least three months after being diagnosed clear of the Virus.

In a paper published in the New England Journal of Medicine on 14 October 2015, a team of scientists led by Suzanne Mate and Jeffrey Kugelman of the Center for Genome Sciences at the U.S. Army Medical Research Institute of Infectious Diseases, Tolbert Nyenswah of the Ministry of Health and Social Welfare of the Republic of Liberia and Jason Ladner, also of the Center for Genome Sciences at the U.S. Army Medical Research Institute of Infectious Diseases report the first known case of sexual transmission of the Ebola Virus.

On Friday 20 March 2015 a 44-year-old woman from Montserrado County, Liberia, was diagnosed to be infected with the Ebola Virus. The woman died a week later on 27 March. Before dying she reported having had unprotected virginal sex with an Ebola survivor on 7 March 2015. This man had been diagnosed clear of the Virus (a test based upon blood samples) on 3 October 2014, and discharged from the unit where he was treated on 7 October. This man was contacted and voluntarily provided blood and semen samples on 27 March 2015. The blood was tested and shown to be clear of the Virus, but the semen sample proved to be Ebola positive, 175 days after after the patient’s blood was found to be clear. Subsequent tests of the male patients semen collected on 28 April and 2 May 2015 were shown to be clear of the Virus.

Electron micrograph of an Ebola Virus particle. Frederick Murphy/Centers for Disease Control and Prevention/Wikimedia Commons.

A genetic analysis of Virus samples taken from the two patients showed that they were very closely related, and no other plausible cause of transmission could be identified, leading Mate et al. to conclude that in this case the Ebola Virus had been transmitted sexually.

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