- Male Ebola survivors can have traces of the deadly virus in their semen for up to nine months after onset of the disease, but it remains unclear whether the virus can be sexually transmitted.
In a study of 93 male Ebola survivors in Sierra Leone, West Africa, a team of international researchers found that nearly half - 49 - had levels of Ribonucleic acid (RNA) from the Ebola virus in their semen. But those numbers slowly declined as their recovery progressed.
The study, published in today’s New England Journal of Medicine, was conducted jointly by the U.S. Centers for Disease Control and Prevention, the Sierra Leone Ministry of Health and Sanitation and the World Health Organization.
Each of the study participants enrolled within two to ten months after showing symptoms of the virus. In initial samples taken from nine men within two to three months after they became ill, all nine tested positive for the virus.
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Ebola fragments found in genetic material like semen months after symptoms have developed and the virus is no longer detectible in the blood suggests the “continuing , or at least very recent, presence of live and potentially transmissible Ebola virus,” the WHO noted in an advisory issued in May 2015.
The CDC is testing the semen samples from the study to see if the virus is live and possibly infectious.
Understanding Ebola’s viral persistence in semen helps survivors plan and manage their lives and relationships.
“This study provides further evidence that survivors need continued, substantial support for the next 6 to 12 months to meet these challenges and to ensure their partners are not exposed to potential virus, ” said Bruce Aylward, WHO Director-General’s Special Representative on the Ebola Response.
Participants in the study were given counseling and condoms.
“Survivors who volunteered for this study are doing something good for themselves and their families and are continuing to contribute to the fight against Ebola and our knowledge about this disease,” said Yusuf Kabba, National President of the Sierra Leone Association of Ebola Survivors.
Experts who believe Ebola can be sexually transmitted through infected semen cite the lone reported case of male-to-female transmission of the related Marburg virus during an outbreak in 1967, according to the WHO. Marburg and Ebola viruses are both native to Africa and live in animals, but both can be contracted by humans and spread through contact with contaminated body fluids.
According to the WHO, traces of Ebola virus RNA were found in vaginal fluid of a woman 33 days after she became ill from the disease. But the live virus has never been found in vaginal fluid. With limited data and research, it’s unclear how long the virus can remain in vaginal fluids and whether Ebola can be sexually transmitted from women to men.
Until more is known about the risks of transmission, the WHO recommends safe-sex counseling for Ebola survivors and their partners and abstinence or consistent safe sex practices until semen has twice tested negative for the Ebola virus.
For survivors whose semen has not been tested, WHO recommends that safe sex be practiced for at least six months after onset of the disease.