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Possible sexual transmission of Ebola reported months after illness
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Unprotected sex between a man discharged from an Ebola treatment unit 5 months earlier and a Liberian woman appears to have resulted in transmission of the virus, according to a case study published in MMWR.
“It is not possible to definitively ascribe Ebola infection in patient A to transmission from survivor A,” Athalia Christie, MIA, of the CDC, and colleagues wrote. “However, the timing of intercourse between survivor A and patient A, the subsequent illness in patient A, the presence of viral RNA in survivor A’s semen, matching genetic sequences (where coverage has been obtained) in isolates from survivor A and patient A, and the lack of other known exposures suggest possible sexual transmission.”
The woman was lab-confirmed with Ebola on March 20, researchers wrote, 30 days after the most recent confirmed Ebola patient in Liberia was isolated. Since Jan. 21, all newly confirmed cases of Ebola in Liberia have been epidemiologically linked to a single transmission chain. Ebola viral RNA from three of the patients in this chain were sequenced and compared with the genetic material from the patient. None of the sequences shared the mutations observed in the patient’s isolate.
Published reports from previous outbreaks have demonstrated that Ebola survivors can continue to harbor virus in immunologically privileged sites during convalescence. Ebola virus has been isolated from semen for as much as 82 days after symptom onset, and viral RNA has been detected in semen up to 101 days after symptom onset, the researchers wrote.
In this case, the patient reported unprotected vaginal intercourse with an Ebola virus disease survivor on March 7, 5 months after he was discharged from the Ebola treatment unit. He reported no subsequent illness or symptoms, according to the study.
“Based on information gathered in this investigation, CDC now recommends that contact with semen from male Ebola survivors be avoided until more information regarding the duration and infectiousness of viral shedding in body fluids in known,” the investigators wrote. “If male survivors have sex, a condom should be used correctly and consistently every time.”
Researchers said sufficient supplies of condoms and counseling to promote their correct and consistent use should be part of the response in Ebola-infected countries. – by David Jwanier
Disclosure: The researchers report no relevant financial disclosures.
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