WHO advises male Ebola survivors to abstain from sex; Reports of sexually transmitted cases in Liberia

[nola_mnr]

http://www.reuters.com/article/2014/11/28/us-health-ebola-sex-idUSKCN0JC0UP20141128

(Reuters) - Men who recover from Ebola should abstain from sex for three months to minimize the risk of passing the virus on in their semen, the World Health Organization (WHO) said on Friday.
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http://allafrica.com/stories/201411271561.html

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But Dr. Omurutu alarmed over one disturbing trend where male Ebola survivors are infecting their partners and putting entire families at risk. "Almost all the wives of male Ebola survivors is coming to the ETU as patients," Dr. Omurutu stressed and appealed to President Sirleaf to see how the Ministry of Health can freely distribute condoms in the various communities to avoid this disturbing trend.

The Ugandan doctor confirmed that once a person survives Ebola, they still have the virus in the semen for up to three months, and it's extremely important that one abstains from sex during that period or use a condom to avoid infecting one's partner.
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[sharon sanders]

Re: WHO advises male Ebola survivors to abstain from sex; Reports of sexually transmitted cases in Liberia

Ebola virus in semen of men who have recovered from Ebola virus disease

Key messages

26 November 2014

WHO/Winnie Romeril
Survivors of Ebola working with WHO, Sierra Leone

• Sexual transmission of Ebola virus disease (EVD) has not been documented
• In four studies that investigated persistence of Ebola virus in seminal fluid from convalescent patients (a total of 43 patients), three men who had recovered from Ebola virus disease were reported to shed live virus in semen 40 days, 61 days and 82 days after onset of symptoms, respectively.
• In two studies, Ebola virus was isolated from semen, but subsequent infections were not identified in household contacts.
• Men who have recovered from Ebola virus disease should be aware that seminal fluid may be infectious for as long as three months after onset of symptoms.
• Because of the potential to transmit the virus sexually during this time, they should maintain good personal hygiene after masturbation, and either abstain from sex (including oral sex) for three months after onset of symptoms, or use condoms if abstinence is not possible.
• WHO does not recommend isolation of male convalescent patients whose blood has been tested negative for EVD.

The Ebola virus is shed in bodily fluids such as blood, vomit, faeces, saliva, urine, tears, and vaginal and seminal fluids. There is evidence that seminal fluids of convalescing men can shed the Ebola virus for at least 82 days after onset of symptoms. Although the scientific evidence is limited, it is clear that semen is a potential source of infection and could therefore cause transmission of the virus through delivery of the infectious virus on a mucosal surface.

1. How long is Ebola virus present in semen?

In a study performed during the Ebola outbreak in Gulu, Uganda, in 2000, the authors tested the semen of a single convalescent patient and were able to isolate Ebola virus up to 40 days after the onset of illness. One study in 1977 (Edmond et al., laboratory infection in England) detected live Ebola virus in semen of one convalescent man 61 days after onset of symptoms. One study in1995 (Rodriguez et al. Ebola outbreak in Kikwit, Democratic Republic of Congo) also detected live Ebola virus in semen in one convalescent man 82 days after disease onset. Therefore, it is possible for Ebola virus to be present in semen for 3 months after disease onset.

2. Is semen that tests positive for Ebola virus infectious?

The evidence is inconclusive. One study (Rowe et al.) that followed four men recovering from Ebola virus disease and their sexual partners found that no sexual partner developed symptoms.

References

• Bausch, D. et al. (2007) Assessment of the risk of Ebola virus transmission from bodily fluids and fomites, The Journal of Infectious Diseases, 196, pp. S142-7.
• Emond, R. et al. (1977) A case of Ebola virus infection, British Medical Journal, 2, pp. 541-544.
• Rodriguez, L. et al. (1999) Persistence and genetic stability of Ebola virus during the outbreak in Kikwit, Democratic Republic of Congo, 1995, The Journal of Infectious Diseases, 179(1), pp. S170-6.
• Rowe, A. et al. (1999) Clinical, Virologic, and Immunologic Follow-up of Convalescent Ebola Hemorrhagic Fever Patients and their Household Contacts, Kikwit, Democratic Republic of the Congo, The Journal of Infectious Diseases, 179(1), pp.S28-35.

http://www.who.int/reproductivehealth/topics/rtis/ebola-virus-semen/en/