Man’s Ebola relapse spawned dozens of new cases in Africa
By MARILYNN MARCHIONE, AP Chief Medical Writer
A man in Africa who developed Ebola despite receiving a vaccine recovered but suffered a relapse nearly six months later that led to 91 new cases before he died. The report adds to evidence that the deadly virus can lurk within the body long after symptoms end which survivors need monitoring for his or her own welfare and stop the spread.
Relapses like this one from the 2018-2020 outbreak within the Democratic Republic of Congo are thought to be rare. this is often the primary one clearly shown to possess spawned an outsized cluster of latest cases. The New England Journal of drugs published details on Wednesday.
Earlier this month, scientists said a separate outbreak that’s happening now in Guinea seems associated with one in West Africa that ended five years ago. A survivor may have silently harbored the virus for years before spreading it.
“The most vital message is, someone, can get the disease, Ebola, twice and therefore the second illness can sometimes be worse than the primary one,” said Dr. Placide Mbala-Kingebeni of the University of Kinshasha, who helped research the Congo cases.
As more Ebola outbreaks occur, “we are becoming more and more survivors” and therefore the risk posed by relapses is growing, he said.
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Ebola outbreaks usually start when someone gets the virus from wildlife and it then spreads person to person through contact with bodily fluids or contaminated materials. Symptoms can include sudden fever, muscle pain, headache, pharyngitis, vomiting, diarrhea, rash, and bleeding. Fatality rates range from 25% to 90%.
The case within the medical journal involved a 25-year-old motorcycle taxi driver vaccinated in December 2018 because he’d been in touch with someone with Ebola. In June 2019, he developed symptoms and was diagnosed with the disease.
For some reason, the person never developed immunity or lost it within six months, said Michael Wiley, an epidemic expert at Nebraska center who helped investigate the case.
The man was treated and discharged after twice testing negative for Ebola in his blood. However, semen can harbor the virus for quite a year, so men are advised to be tested periodically after recovery. the person had a negative semen test in August but didn't return then.
In late November, he again developed symptoms and sought care at a clinic and from a standard healer. After worsening, he was sent to a specialized Ebola treatment unit but died the subsequent day.
Gene tests showed the virus from his new illness was nearly just like his original one, meaning this was a relapse, not a replacement infection from another person or an animal, Wiley said. Tests showed the person had spread the virus to 29 others and that they spread it to 62 more.
Previously, two doctors who got Ebola while treating patients in Africa were found to possess the virus long after they recovered — a Scottish nurse in her cerebrospinal fluid and American physician Ian Crozier in his eyes. But those relapses were discovered quickly and didn't spawn new outbreaks.
They and therefore the man in Africa all were treated with antibodies during their initial infections. Antibodies are substances the body makes to fight the virus but it can take weeks for the foremost effective ones to make. Giving them to Ebola patients is assumed to spice up the system, and studies suggest they improve survival. But the relapses have doctors concerned that such patients won't develop a robust enough immune reaction on their own and could be susceptible to recurrences once antibodies fade. It’s just a theory at now, the researchers stressed.
A few other viruses can lurk for long periods and cause problems later, like the one liable for chickenpox, which may reactivate and cause shingles decades after initial infection.
The news about latent Ebola tells us “absolutely nothing” about the prospect of something similar happening with the bug that causes COVID-19 because “they’re totally different viruses,” Wiley said.
Dr. Ibrahima Soce Fall, a World Health Organization scientist, agreed.
“We haven’t seen yet this type of latency from people that survived coronavirus,” he said. Even with Ebola, “after six months, most of the patients completely clear the virus.”
The biggest concern is the best monitoring for survivors -- there are quite 1,100 within the Congo alone, and therefore the WHO recommends monitoring for a minimum of two years.
“We got to confirm that survivors aren't stigmatized” and obtain the assistance they have so any relapses are treated quickly, Fall said.
The Associated Press Health and Science Department receives support from the Hughes Medical Institute’s Department of Science Education. The AP is solely liable for all content.
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