Video:Post-Ebola virus syndrome

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Definition

Post-Ebola virus syndrome or post-Ebola syndrome is a post-viral syndrome affecting those who have recovered from infection with Ebola.[1] Symptoms include joint and muscle pain, eye problems, including blindness, and various neurological problems, sometimes so severe that the person is unable to work.[2]

Signs and symptoms

Post Ebola syndrome may manifest as joint pain, muscle pain, chest pain, fatigue, hearing loss, hair loss, cessation of menstruation, and poor long term health. Some survivors report neurological issues including memory problems and anxiety attacks. Vision loss is also frequently reported, along with eye pain, inflammation, and blurred vision.[3]


Mechanism 1

Studies from outbreaks reveal that the virus is able to survive for months after recovery in some parts of the body such as the eyes and testes, where the immune system cannot reach. It is not known if the neurologic symptoms seen in survivors are a direct result of the virus or, instead, triggered by the immune system’s response to the infection. [4]

Mechanism 2

It is known that Ebola can trigger a massive cytokine storm that can cause bleeding throughout the body, including the brain, which may explain various neurological symptoms that have been reported.[4]

Diagnosis

In terms of diagnosis, a physical exam of the individual may show sensitivity to light or eye redness when ocular problems are suspected. Neurologically the individual's coordination, gait and frontal release signs should be observed.[5] In general, survivors indicate problems with multiple organ systems that continue for years, including arthralgia and psychiatric complaints.[6]

Management

Management depends on the symptoms displayed, for example, if the individual indicates muscular-skeletal pain then paracetamol may be used. If there are eye problems, then prednisone and cyclopentolate may be given.[5]

Viral persistence and transmission 1

A 2017 study found the virus in the semen of some men after more than two years following the recovery from the virus infection[7] and in one case, Ebola viral RNA was identified up to 40 months after illness.[8]

Viral persistence and transmission 2

At the start of 2021 an outbreak of EVD that caused 18 cases and 9 deaths in Guinea is thought to have been due to a West Africa Ebola outbreak survivor. This individual apparently infected a woman more than 5 years after he himself had incurred the infection.[9]


History 1

The most significant Ebola outbreaks records of Ebola virus disease, that have afflicted humans and animals have occurred primarily in equatorial Africa.[10]The pathogens responsible for the disease are the five ebolaviruses recognized by the International Committee on Taxonomy of Viruses are Ebola virus , Sudan virus , Reston virus , Taï Forest virus , and Bundibugyo virus .[11][12][13]Bombali ebolavirus [14] is also a species of the genus Ebolavirus, first reported on 27 July 2018.[15]

History 2

Among the countries with the most survivors of Ebola virus disease are those of the West African Ebola virus epidemic, which were Liberia, Guinea, Sierra Leone, Nigeria, Spain, U.S., U.K., Senegal, Italy, and Mali, that total 16,000 to 17,000 survivors.[16] There is also the second largest Ebola outbreak which occurred in the Democratic Republic of the Congo and Uganda in 2018 that yielded 1,171 survivors.[17]

References

  1. Scott JT, Sesay FR, Massaquoi TA, Idriss BR, Sahr F, Semple MG (April 2016). "Post-Ebola Syndrome, Sierra Leone". Emerging Infectious Diseases. 22 (4): 641–6. doi:10.3201/eid2204.151302. PMC 4806950. PMID 26983037.
  2. Burki TK (July 2016). "Post-Ebola syndrome". The Lancet. Infectious Diseases. 16 (7): 780–781. doi:10.1016/S1473-3099(15)00259-5. PMID 27352759.
  3. Carod-Artal FJ (3 October 2015). "Post-Ebolavirus disease syndrome: what do we know?". Expert Review of Anti-Infective Therapy. 13 (10): 1185–7. doi:10.1586/14787210.2015.1079128. PMID 26293407.
  4. 4.0 4.1 Clark DV, Kibuuka H, Millard M, Wakabi S, Lukwago L, Taylor A, et al. (August 2015). "Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study". The Lancet. Infectious Diseases. 15 (8): 905–12. doi:10.1016/S1473-3099(15)70152-0. PMID 25910637.
  5. 5.0 5.1 "Clinical care for survivors of Ebola virus disease" (PDF). WHO. World Health Organization. Retrieved 5 August 2016.
  6. Bond, Nell G; Grant, Donald S; Himmelfarb, Sarah T; Engel, Emily J; Al-Hasan, Foday; Gbakie, Michael; Kamara, Fatima; Kanneh, Lansana; Mustapha, Ibrahim; Okoli, Adaora; Fischer, William; Wohl, David; Garry, Robert F; Samuels, Robert; Shaffer, Jeffrey G; Schieffelin, John S (2 April 2021). "Post-Ebola Syndrome Presents With Multiple Overlapping Symptom Clusters: Evidence From an Ongoing Cohort Study in Eastern Sierra Leone". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. pp. 1046–1054. doi:10.1093/cid/ciab267. Retrieved 4 February 2022.
  7. Fischer WA, Brown J, Wohl DA, Loftis AJ, Tozay S, Reeves E, et al. (2017). "Ebola Virus Ribonucleic Acid Detection in Semen More Than Two Years After Resolution of Acute Ebola Virus Infection". Open Forum Infectious Diseases. 4 (3): ofx155. doi:10.1093/ofid/ofx155. PMC 5897835. PMID 29670927.
  8. Sneller MC, Reilly C, Badio M, Bishop RJ, Eghrari AO, Moses SJ, et al. (March 2019). "A Longitudinal Study of Ebola Sequelae in Liberia". The New England Journal of Medicine. 380 (10): 924–934. doi:10.1056/NEJMoa1805435. PMC 6478393. PMID 30855742.
  9. Kupferschmidt, Kai (12 March 2021). "New Ebola outbreak likely sparked by a person infected 5 years ago". Science. doi:10.1126/science.abi4876. Retrieved 19 March 2021.
  10. "Outbreaks Chronology: Ebola Virus Disease". Centers for Disease Control and Prevention (Division of High-Consequence Pathogens and Pathology; Viral Special Pathogens Branch), National Center for Emerging and Zoonotic Infectious Diseases. 20 October 2016 [Last updated 14 April 2016]. Retrieved 15 May 2017.
  11. "Filoviridae: Current Taxonomy (2015)". International Committee on Taxonomy of Viruses. 2015. Retrieved 15 May 2017.
  12. "End of Ebola outbreak in Uganda" (Press release). World Health Organization. 20 February 2008. Archived from the original on 1 March 2008. Retrieved 29 November 2009.
  13. Schoepp, Randal J.; Olinger, Gene G. (2014). "Chapter 7: Filoviruses". In Liu, Dongyou (ed.). Manual of Security Sensitive Microbes and Toxins. CRC Press. p. 66. Retrieved 15 May 2017.
  14. "Genus: Ebolavirus" (html). International Committee on Taxonomy of Viruses. Retrieved 15 October 2019. Related, unclassified viruses Bombali virus MF319185 BOMV (Goldstein et al., 2018)
  15. "Ministry of Health Sierra Leone" (PDF). Retrieved 27 July 2018.
  16. "Researching Ebola in Africa | NIH: National Institute of Allergy and Infectious Diseases". www.niaid.nih.gov. Retrieved 7 February 2022.
  17. Guetiya Wadoum, Raoul Emeric; Sevalie, Stephen; Minutolo, Antonella; Clarke, Andrew; Russo, Gianluca; Colizzi, Vittorio; Mattei, Maurizio; Montesano, Carla (10 December 2021). "The 2018–2020 Ebola Outbreak in the Democratic Republic of Congo: A Better Response Had Been Achieved Through Inter-State Coordination in Africa". Risk Management and Healthcare Policy. 14: 4923–4930. doi:10.2147/RMHP.S327616. ISSN 1179-1594. Retrieved 7 February 2022.