CORONA New Ebola outbreak likely sparked by a person infected 5 years ago

jward

passin' thru


The Ebola virus may cause latent infections in survivors that could spark new outbreaks.
National Institute of Allergy and Infectious Diseases/National Institutes of Health/Flickr (CC BY-NC 2.0)
New Ebola outbreak likely sparked by a person infected 5 years ago
By Kai KupferschmidtMar. 12, 2021 , 1:15 PM

An Ebola outbreak in Guinea that has so far sickened at least 18 people and killed nine has stirred difficult memories of the devastating epidemic that struck the West African country between 2013 and 2016, along with neighboring Liberia and Sierra Leone, leaving more than 11,000 people dead.
But it may not just be the trauma that has persisted. The virus causing the new outbreak barely differs from the strain seen 5 to 6 years ago, genomic analyses by three independent research groups have shown, suggesting the virus lay dormant in a survivor of the epidemic all that time. “This is pretty shocking,” says virologist Angela Rasmussen of Georgetown University. “Ebolaviruses aren’t herpesviruses”—which are known to cause long-lasting infections—“and generally RNA viruses don’t just hang around not replicating at all.”

Scientists knew the Ebola virus can persist for a long time in the human body; a resurgence in Guinea in 2016 originated from a survivor who shed the virus in his semen more than 500 days after his infection and infected a partner through sexual intercourse. “But to have a new outbreak start from latent infection 5 years after the end of an epidemic is scary and new,” says Eric Delaporte, an infectious disease physician at the University of Montpellier who has studied Ebola survivors and is a member of one of the three teams. Outbreaks ignited by Ebola survivors are still very rare, Delaporte says, but the finding raises tricky questions about how to prevent them without further stigmatizing Ebola survivors.

The current outbreak in Guinea was detected after a 51-year-old nurse who had originally been diagnosed with typhoid and malaria died in late January. Several people who attended her funeral fell ill, including members of her family and a traditional healer who had treated her, and four of them died. Researchers suspected Ebola might have caused all of the deaths, and in early February they discovered the virus in the blood of the nurse’s husband. An Ebola outbreak was officially declared on 13 February, with the nurse the likely index case.
The Guinea Center for Research and Training in Infectious Diseases (CERFIG) and the country’s National Hemorrhagic Fever Laboratory have each read viral genomes from four patients; researchers at the Pasteur Institute in Dakar, Senegal, sequenced two genomes. In three postings today on the website virological.org, the groups agree the outbreak was caused by the Makona strain of a species called Zaire ebolavirus, just like the past epidemic. A phylogenetic tree shows the new virus falls between virus samples from the 2013–16 epidemic.

Until recently, scientists assumed Ebola epidemics start when a virus jumps species, from an animal host to humans. Theoretically, that could have happened in Guinea, says virologist Stephan Günther of the Bernhard Nocht Institute for Tropical Medicine, who worked with one of the three teams. But given the similarity between viruses from the epidemic and the new ones, “It must be incredibly unlikely.”
Outside scientists agree but say it hasn’t been proved that Ebola lay dormant in one person for 5 years. “From the tree, you’d conclude that it is a virus that persisted in some way in the area, and sure, most likely in a survivor,” says Dan Bausch, a veteran of several Ebola outbreaks who leads the United Kingdom’s Public Health Rapid Support Team. But it is hard to rule out scenarios such as a small, unrecognized chain of human to human transmission, Bausch adds: “For example, a 2014 survivor infects his wife a few years after recovery, who infects another male, who survives and carries virus for a few years, then infecting another women, who is then seen by a nurse who dies”—the index case in the new outbreak.

The nurse was not known to be a survivor herself, but she could have had contact with a survivor privately or through her job, or she might have been infected herself years ago with few symptoms. “Figuring out what exactly happened is one of the biggest questions now,” Bausch says.
Another ongoing outbreak of Ebola in North Kivu, in the Democratic Republic of the Congo, was also started by transmission from someone infected during a previous outbreak, Delaporte notes. (The survivor had tested negative for Ebola twice after his illness in 2020.) Taken together, that suggests humans are now as likely to be the source of a new outbreak of Ebola as wildlife, he says. “This is clearly a new paradigm for how these outbreaks start.” Outbreaks sparked by survivors may even become more likely, now that increasing mobility and other factors have caused each eruption of Ebola to become bigger, resulting in more survivors, says Fabian Leendertz, a wildlife veterinarian who was involved in the sequencing.

This is clearly a new paradigm for how these outbreaks start.
Eric Delaporte, University of Montpellier
The cases raise important new research questions, Bausch says: “How do we need to change our response to escape from the cycle of outbreak-response-reintroduction-outbreak?” he asks. “Can we use new therapeutics to clear virus from survivors?”
But the most immediate question is what these results mean for Ebola survivors, who face a lot of hardship already. Many have not only lost friends and family to the virus, but also struggle with long-term aftereffects, such as muscle pains and eye problems. In a study published in February, Delaporte found that about half of more than 800 Ebola survivors in Guinea still reported symptoms 2 years after their illness, and one-quarter after 4 years.

On top of this, survivors have faced intense stigmatization. Many conspiracy theories swirled in the aftermath of the epidemic, including the claim that survivors had sold family members to international organizations to save themselves, says Frederic Le Marcis, a social anthropologist at the École Normale Supérieure of Lyon and the French Research Institute for Development, who is working in Guinea. One man, he says, was the only one to survive out of 11 family members and when he came back, no one wanted to work with him. “He was seen as someone untrustworthy.” News that a survivor likely touched off the current outbreak could cause further problems for survivors, Le Marcis says: “Will they be highlighted as a source of danger? Will they be chased out of their own families and communities?”

Alpha Keita, a virologist who led the sequencing work at CERFIG, worries about stigmatization and even violence against survivors have occupied him since he first got the surprising results a week ago. One important message to the public should be that some people infected with Ebola show few symptoms, meaning people may be survivors without knowing it. “So don’t stigmatize Ebola survivors—you don’t know that you are not a survivor yourself,” Keita says.

Bausch calls for an educational campaign explaining that unprotected sex with an Ebola survivor may pose a risk, but casual contacts such as shaking hands and working together do not. And although there needs to be some medical monitoring of survivors, it cannot just be about testing them for Ebola virus, he says. “We need to recognize and assist with all the other challenges, physical, mental, and social, that survivors and their families face.” The key, Bausch says, is to “not just treat survivors as some hot potato risk of starting another outbreak.” It also presents a challenge to the country’s health care system if every patient with fever and diarrhea has to be a considered potential Ebola case, Le Marcis says.

Fortunately, Ebola vaccines and treatments have become available in recent years. Already, several thousand contacts of the new Ebola patients, and contacts of these contacts, have been vaccinated. Health care workers are being immunized as well. Vaccinating survivors might even help clear latent infections, Rasmussen says. And the fact that viral samples were sequenced in Guinea this time around shows the country’s scientific capabilities have improved, Delaporte says: “Seven years ago, when the epidemic started, there was no infrastructure in Guinea to be able to do this.”

Posted in:

doi:10.1126/science.abi4876


Posted For Fair Use
 

night driver

ESFP adrift in INTJ sea
This could become a MAIN post given thesituation developing in Oregon.

Two people who just came BACK from Guinea and the DR Congo are being CAREFULLY observed for "Ebola Symptoms".

Gimme a minit and i should be able to find a link.

Lynx :: Possible Ebola exposure leaves 4 in Oregon under monitoring post-travel, officials say - oregonlive.com

monitoring post-travel, officials say
Updated Mar 25, 3:42 PM; Posted Mar 25, 9:11 AM
Oregon News Oregonian/OregonLive

Breaking news from The Oregonian/OregonLive
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By Kale Williams | The Oregonian/OregonLive
Four people in Oregon are being monitored for the Ebola virus after travel to west African countries that have outbreaks of the disease, public health officials said Thursday.

The Oregon Health Authority has contacted all of the individuals, who traveled to Guinea and Democratic Republic of the Congo, and considers them to be “persons under monitoring,” the agency said in a statement.

All arrived in Oregon from the affected countries earlier this month, officials said, adding that risk to others in the state was low.


“We want to make sure these individuals have the support they need to monitor their health, stay in contact with public health officials and safely get help with medical services if it comes to that,” Richard Leman, the state’s chief medical officer for health security, preparedness and response, said in a statement.


Leman stressed that, unlike the coronavirus, people without symptoms cannot transmit the Ebola virus and none of the individuals being monitored had shown any signs of the illness.


He also said that Oregon has successfully implemented monitoring programs during past Ebola outbreaks.


“We’ve had to do this before,” he said. “These approaches we’re using have been successful in those instances and we’ve never had a case of Ebola in Oregon.”


As of Wednesday, Guinea has reported 18 Ebola cases and nine deaths. The outbreak is centered in the southern region of the country. Democratic Republic of Congo has seen 12 cases and six deaths in the eastern part of the country near the border with Uganda.


The outbreaks were limited to small areas in both countries and had not affected large population centers.


Still, the Centers for Disease Control has issued warnings for both countries and told people to avoid unnecessary travel.


Public health officials said they were in contact with community-based organizations in Oregon to provide aid to those being monitored in the state.


-- Kale Williams; kwilliams@oregonian.com; 503-294-4048; @sfkale
 

Faroe

Un-spun
Yep. I really don't want to go down this road again. Natural Ebola didn't "take" here, but like Corona, it can always be re-engineered (what's a Level 4 lab for, anyway?). The .gov response/overreach will make Covid look like a picnic.
 

packyderms_wife

Neither here nor there.
Yep. I really don't want to go down this road again. Natural Ebola didn't "take" here, but like Corona, it can always be re-engineered (what's a Level 4 lab for, anyway?). The .gov response/overreach will make Covid look like a picnic.
I guess it's time to make a run to Sam's Club for a few items, before we go into double lock down. For me this is just topping off, not stocking up. I need to stop at the dealership and pick up a couple of quarts of oil, since that's the only oil the original owner ran through my new beast, and then autozone for a wiper blade for the rear wiper.

Corona was the test run, ebola will be the real deal.
 

John Deere Girl

Veteran Member
I guess it's time to make a run to Sam's Club for a few items, before we go into double lock down. For me this is just topping off, not stocking up. I need to stop at the dealership and pick up a couple of quarts of oil, since that's the only oil the original owner ran through my new beast, and then autozone for a wiper blade for the rear wiper.

Corona was the test run, ebola will be the real deal.
That is a huge concern of mine.
 

packyderms_wife

Neither here nor there.
That is a huge concern of mine.
Keep your concerns to yourself, ie don't tell family and friends, and go get your stuff while the gettin is good! I need to restock my whiskey and vodka supplies. I'm giving this a week to two weeks tops before the sheep stampede the stores again.

With the incompetency of the biden administration this is going to get fugly and fast.
 

John Deere Girl

Veteran Member
Keep your concerns to yourself, ie don't tell family and friends, and go get your stuff while the gettin is good! I need to restock my whiskey and vodka supplies. I'm giving this a week to two weeks tops before the sheep stampede the stores again.

With the incompetency of the biden administration this is going to get fugly and fast.
We are very careful about what we say. I think I'm going to do inventory and top everything off.
 

TxGal

Day by day
This just won't go away. Fair use cited:

Man's Ebola relapse spawned dozens of new cases in Africa - ABC News (go.com)

Man's Ebola relapse spawned dozens of new cases in Africa
Researchers say a man in Africa who recovered from Ebola suffered a relapse nearly six months later that led to 91 new cases before he died

By MARILYNN MARCHIONE AP Chief Medical Writer
April 1, 2021, 3:16 AM • 4 min read

(there's a video here I can't bring over)

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 in the body long after symptoms end, and that survivors need monitoring for their own welfare and to prevent spread.

Relapses like this one from the 2018-2020 outbreak in the Democratic Republic of Congo are thought to be rare. This is the first one clearly shown to have spawned a large cluster of new cases. The New England Journal of Medicine published details on Wednesday.

Earlier this month, scientists said a separate outbreak that’s going on now in Guinea seems related to one in West Africa that ended five years ago. A survivor may have silently harbored the virus for years before spreading it.

“The most important message is, someone can get the disease, Ebola, twice and the second illness can sometimes be worse than the first one,” said Dr. Placide Mbala-Kingebeni of the University of Kinshasha, who helped research the Congo cases.

As more Ebola outbreaks occur, “we are getting more and more survivors” and the risk posed by relapses is growing, he said.

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, sore throat, vomiting, diarrhea, rash and bleeding. Fatality rates range from 25% to 90%.

The case in the medical journal involved a 25-year-old motorcycle taxi driver vaccinated in December 2018 because he’d been in contact with someone with Ebola. In June 2019, he developed symptoms and was diagnosed with the disease.

For some reason, the man never developed immunity or lost it within six months, said Michael Wiley, a virus expert at Nebraska Medical 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 more than a year, so men are advised to be tested periodically after recovery. The man had a negative semen test in August but did not return after that.

In late November, he again developed symptoms and sought care at a health center and from a traditional healer. After worsening, he was sent to a specialized Ebola treatment unit but died the next day.

Gene tests showed the virus from his new illness was nearly identical to his original one, meaning this was a relapse, not a new infection from another person or an animal, Wiley said. Tests showed the man had spread the virus to 29 others and they spread it to 62 more.

Previously, two health workers who got Ebola while treating patients in Africa were found to have the virus long after they recovered — a Scottish nurse in her spinal fluid and American physician Ian Crozier in his eyes. But those relapses were discovered quickly and did not spawn new outbreaks.

They and 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 most effective ones to form. Giving them to Ebola patients is thought to boost the immune system, and studies suggest they improve survival. But the relapses have doctors concerned that such patients might not develop a strong enough immune response on their own and might be vulnerable to recurrences once antibodies fade. It’s just a theory at this point, the researchers stressed.

A few other viruses can lurk for long periods and cause problems later, such as the one responsible for chickenpox, which can reactivate and cause shingles decades after initial infection.

The news about latent Ebola tells us “absolutely nothing” about the chance 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 kind of latency from people who survived coronavirus,” he said. Even with Ebola, “after six months, most of the patients completely clear the virus.”

The biggest concern is better monitoring for survivors -- there are more than 1,100 in the Congo alone, and the WHO recommends monitoring for at least two years.

“We need to make sure that survivors are not stigmatized” and get the help they need so any relapses are treated quickly, Fall said.
 
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