This article is more than 5 years old. Information may no longer be current.
Ebola survivors experience increased neurologic symptoms decades after outbreak
Click Here to Manage Email Alerts
Ebola virus disease survivors had lower cognitive scores and more symptoms of depression and anxiety compared with close contacts more than 20 years after a 1995 outbreak in Kikwit, Democratic Republic of Congo, according to study results published in Clinical Infectious Diseases.
“Clinical sequelae of Ebola virus disease (EVD) have not been described more than 3 years post-outbreak,” Daniel Kelly, MD, MPH, an infectious disease fellow at the University of California, San Francisco, told Infectious Disease News. “We conducted a cross-sectional study of EVD survivors and close contacts in Kikwit, Democratic Republic of Congo, over 2 decades after the EVD outbreak.”
Kelly and colleagues conducted the study between August and September 2017. They recruited EVD survivors and close contacts from the 1995 Ebola outbreak, and conducted physical examinations and culturally adapted versions of the Folstein mini-mental status exam (MMSE) and Goldberg Anxiety and Depression Scale (GADS). They compared survivors with close contacts through the use of linear regression models to estimate the strength of relationships between EVD survivorship and health outcomes.
The case fatality rate of the 1995 outbreak was 81%, with 61 EVD survivors. During the time of the study, 42 survivors were listed as part of the Kikwit Ebola Survivor Association. The researchers recruited 20 of these survivors with (mean age, 53.2 years) and 187 close contacts (mean age, 53.5 years). Twenty percent of the survivors reported at least one abnormal neurological symptom including headache, vertigo, paresthesia, weakness in any limbs, tremor and ataxia; and 15% experienced an abnormal neurological examinations, including findings of tremor, gait/balance disturbance, speech abnormality, cranial nerve abnormality, focal weakness and sensory deficit. Eleven percent of close contacts reported at least one abnormal neurological symptom, including headache, vertigo, paresthesia, weakness in any limbs, ataxia and memory loss; and 5% experienced an abnormal neurological exam that included findings of abnormal reflexes, cranial nerve abnormality, gait/balance disturbance, tremor, sensory deficit and focal weakness.
When compared with the close contacts, the EVD survivors were more likely to have a lower mean MMSE (adjusted coefficient: –1.85; 95% CI, –3.63 to –0.07) and higher mean GADS score (adjusted coefficient: 3.91; 95% CI, 1.76-6.04).
“This study highlights general cognition and symptoms of depression and anxiety as areas where there may be long-term health needs of more than 10,000 EVD survivors from the 2013-2016 West Africa [epidemic] and for the EVD survivors of more than 33 other EVD outbreaks,” Kelly said. “More studies are needed to understand other long-term health outcomes of EVD survivors, but our findings are a call to action for the scientific community as well as international and government agencies to work in collaboration to understand and address the long-term needs of EVD survivors no matter the size of the outbreak.” – by Bruce Thiel
Disclosures: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts