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MEDSCAPE: Reinfection, Reemergence Unknown (Ebola)

MHSC

Senior Moderator
Reinfection, Reemergence Unknown
http://www.medscape.com/viewarticle/833730
Larry Hand October 23, 2014

In response to a question from a webcast participant, experts discussed the possibilities of reinfection and reemergence of disease after initial clearance.

"We know that patients who have survived do have specific antibodies in their blood," said Armand Sprecher, MD, from M?decins Sans Fronti?res. "Of course, what we don't know is the threshold at which antibodies give you a surrogate marker of protection. It's possible we may gather that over the course of this epidemic, as we hopefully move toward vaccination."

Paul Farmer, MD, PhD, from Partners in Health, Boston, Massachusetts, added, "In Monrovia, a couple of children under 5 who had negative [polymerase chain reactions (PCRs) after treatment] then returned some weeks later with positive PCR.

"These are children who had a normal course of illness...and had a clinical recovery, and both of these children became ill in a day or two," Dr Sprecher continued. "They came back and were found to be febrile and [PCR-]positive again. Both children had some neurologic signs. The feeling amongst the virologists is...the virus gets into some parts of the body with immunologic protection, like the central nervous system. The immune response clears the virus from the periphery, the patient has a clinical recovery, while the viral infection progresses in the [central nervous system] and eventually returns and reemerges as a renewed positivity. At least one of the children became negative again."
 
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