Post-Ebola syndrome in Sierra Leone

Researchers from the University's Institute of Translational Medicine have conducted a study of Ebola survivors to describe the medical problems they continue to have after recovering from the acute disease. The results of which have been published in the journal Emerging Infectious Diseases.

This week it was widely reported that a British Nurse, Pauline Cafferkey, who was thought to have made a full recovery from Ebola, has been taken to a hospital for a third time due to what health officials described as delayed complications from the virus—raising further questions about the long-term impact of the disease on survivors. Cafferkey is one of thousands of survivors who have reported suffering from issues that appear to be related to late effects of the virus.

Symptoms persisting

To find out more about the symptoms that persist or develop after hospital discharge Dr Janet Scott and Dr Calum Semple from the University's Institute of Translational Medicine, and their colleagues at the 34th Regiment Military Hospital, Freetown, Sierra Leone examined and interviewed every survivor discharged from the Ebola Treatment Unit at that hospital.

During December 1, 2014-March 30, 2015, they treated 84 persons with Ebola, of whom 44 (52%) survived. Survivors were interviewed and examined at their first follow-up appointment three weeks after discharge, which followed two negative blood tests for Ebola.

Of the 44 people studied:

• 70% reported musculoskeletal pain
• 48% reported having headaches
• 14% reported having problems with their eyesight

Mounting evidence

Dr Janet Scott, said: "The phenomenon of 'Post-Ebola Syndrome' is still not very well understood. This is due in part to the fact that, in the past, the disease's high fatality rate has meant there haven't been many survivors. Due to the scale of the last outbreak we now have access to more survivors who can help us understand more about the damage that this virus causes and the long term problems it causes.

"There has been mounting evidence of both mental and physical health problems in Ebola survivors after the virus is cleared from the bloodstream. In some cases these health problems, such as damage to joints, brain and eyes, may be caused by Ebola virus persisting and causing damage in some of the compartments of the body that are less accessible to the immune system.

"Currently, there is a lot of anecdotal evidence of Post-Ebola Syndrome. The continued study of survivors is necessary if we are to learn more about how the Ebola virus works and how it affects them. The Ebola epidemic is waning, but the effects of the disease will remain."

Dr Semple, said "Ebola has revealed to the world the fragility of the health systems in West Africa. The impact of Ebola has been profound with 28639 cases and 11316 deaths. As interest in Ebola wanes, we must not overlook that most of the 17 thousand survivors in West Africa are experienced on-going health problems and that 12 thousand children have been orphaned. There has also been shocking secondary impact on other health and education services."