Post-Ebola virus syndrome

Post-Ebola syndrome
Classification and external resources
ICD-10 B94.8

Post-Ebola virus syndrome (or post-Ebola syndrome) is a post-viral syndrome affecting those who have recovered from infection with Ebola.[1] Symptoms include joint and muscle pain, eye problems, including blindness, various neurological problems, and other ailments, sometimes so severe that the person is unable to work.[2] Although similar symptoms had been reported following previous outbreaks in the last 20 years, health professionals began using the term in 2014 when referring to a constellation of symptoms seen in people who had recovered from an acute attack of Ebola disease.

Signs and symptoms

Researchers have been aware of a group of symptoms that frequently followed Ebola virus disease for 20 years, but it became more widely reported with the large number of survivors of the deadly epidemic in West Africa in 2014.[1][3][4][5][6] Post Ebola syndrome may manifest as joint pain, muscle pain, chest pain, fatigue, hearing loss, hair loss, cessation of menstruation, and poor long term health. Some survivors report neurological issues including memory problems and anxiety attacks. Vision loss is also frequently reported, along with eye pain, inflammation, and blurred vision.[7] The New England Journal of Medicine reports that symptoms include lethargy, joint pains, hair loss, and vision loss, frequently to the point of near blindness, and uveitis.[8][9]

Cause

Although there is some progress that may potentially help Ebola survivors, adequate funding and further research is required to help provide more answers about post-Ebola Syndrome.[10] Studies from previous outbreaks reveal that the virus is able to survive for months after recovery in some parts of the body like eyes and testes, where the immune system cannot reach. It is not known if the neurologic symptoms seen in survivors are a direct result of the virus or, instead, triggered by the immune system’s response to the infection. It is known that Ebola can trigger a massive cytokine storm that can cause bleeding throughout the body, including the brain, which may explain various neurological symptoms that have been reported.[11]

Viral persistence

According to a review by Brainard, et al., Ebola virus was identified in almost 3 out of 4 seminal fluid samples ( 18 survivors) almost 4 months after initial infection, with the last positive samples being more than 6 months (203 days) after infection had occurred.[12] Another aspect of survivors of the Ebola virus, is that it could become sexually transmitted, as the virus is present in semen nine months after the individuals are declared free of Ebola.[13]

Diagnosis

In terms of diagnosis the individual may show sensitivity to light or eye redness when ocular problems are suspected. Neurologically the individual's coordination, gait and frontal release signs should be observed.[6]

Management

Prednisone

In terms of management,it depends on the specific case by case diagnosis, if the individual indicates muscular-skeletal pain then paracetamol may be administered. If the individual presents with ocular problems, then prednisone and cyclopentolate may be used for treatment, according to WHO.[6]

See also

References

  1. 1 2 "Post-Ebola Syndrome, Sierra Leone - Volume 22, Number 4—April 2016 - Emerging Infectious Disease journal - CDC". wwwnc.cdc.gov. Retrieved 2016-03-29.
  2. ↑ Burki, Talha Khan (July 2016). "Post-Ebola syndrome". The Lancet Infectious Diseases. 16 (7): 780–781. doi:10.1016/S1473-3099(15)00259-5. ISSN 1474-4457. PMID 27352759. – via ScienceDirect (Subscription may be required or content may be available in libraries.)
  3. ↑ Neporent, Liz (2014-09-03). "'Post-Ebola Syndrome' Persists After Virus Is Cured, Doctor Says". ABC news. Retrieved 12 May 2015.
  4. ↑ Farge, Emma; Giahyue, James Harding (2015-02-04). "Free from Ebola, survivors complain of new syndrome". Dakar, Monrovia. Reuters. Retrieved 12 May 2015.
  5. ↑ Grady, Denise (2015-05-07). "After Nearly Claiming His Life, Ebola Lurked in a Doctor's Eye". The New York Times. Retrieved 12 May 2015.
  6. 1 2 3 "Clinical care for survivors of Ebola virus disease" (PDF). WHO. World Health Organization. Retrieved 5 August 2016.
  7. ↑ Carod-Artal, Francisco Javier (3 October 2015). "Post-Ebolavirus disease syndrome: what do we know?". Expert Review of Anti-infective Therapy. 13 (10): 1185–1187. doi:10.1586/14787210.2015.1079128. ISSN 1478-7210. Retrieved 5 August 2016.
  8. ↑ Varkey, Jay B.; Shantha, Jessica G.; Crozier, Ian; Kraft, Colleen S.; Lyon, G. Marshall; Mehta, Aneesh K.; Kumar, Gokul; Smith, Justine R.; Kainulainen, Markus H.; Whitmer, Shannon; Ströher, Ute; Uyeki, Timothy M.; Ribner, Bruce S.; Yeh, Steven (7 May 2015). "Persistence of Ebola Virus in Ocular Fluid during Convalescence". New England Journal of Medicine. 372: 150507125510001. doi:10.1056/NEJMoa1500306. PMID 25950269.
  9. ↑ Epstein, Lauren; Wong, Karen K.; Kallen, Alexander J.; Uyeki, Timothy M. (17 December 2015). "Post-Ebola Signs and Symptoms in U.S. Survivors". New England Journal of Medicine. 373 (25): 2484–2486. doi:10.1056/NEJMc1506576. ISSN 0028-4793. Retrieved 5 August 2016.
  10. ↑ "Ebola survivors: What happens next?". Foundation for Biomedical Research. Retrieved 8 July 2015.
  11. ↑ Clark, Danielle V; Kibuuka, Hannah; Millard, Monica; Wakabi, Salim; Lukwago, Luswa; Taylor, Alison; Eller, Michael A; Eller, Leigh Anne; Michael, Nelson L; Honko, Anna N; Olinger, Gene G; Schoepp, Randal J; Hepburn, Matthew J; Hensley, Lisa E; Robb, Merlin L (August 2015). "Long-term sequelae after Ebola virus disease in Bundibugyo, Uganda: a retrospective cohort study". The Lancet Infectious Diseases. 15 (8): 905–912. doi:10.1016/S1473-3099(15)70152-0. – via ScienceDirect (Subscription may be required or content may be available in libraries.)
  12. ↑ Brainard, Julii; Pond, Katherine; Hooper, Lee; Edmunds, Kelly; Hunter, Paul (2016-02-29). "Presence and Persistence of Ebola or Marburg Virus in Patients and Survivors: A Rapid Systematic Review". PLOS Negl Trop Dis. 10 (2): e0004475. doi:10.1371/journal.pntd.0004475. ISSN 1935-2735. PMC 4771830Freely accessible. PMID 26927697.
  13. ↑ "Preliminary study finds that Ebola virus fragments can persist in the semen of some survivors for at least nine months". WHO. Workd Health Organization. Retrieved 5 August 2016.

Further reading

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