Persistence of Ebola virus in various body fluids during convalescence: evidence and implications for disease transmission and control
The persistence of Ebola virus (EBOV) in various body fluids (around 800 specimens in total) was studied in this review. There is a need for more research on persistence, and a uniform approach to infection control guidelines in convalescence in EBOV and viral RNA.
The systematic review found 12 studies of patients who had recovered clinically from the disease. Fluids studied included semen, vaginal, faecal and conjunctival fluids, blood, tears, sweat, urine and saliva. Specimens were tested by ELISA and reverse transcriptase-polymerase chain reaction (RT-PCR).
The samples showed that the virus can certainly persist in body fluids after clinical recovery but current evidence is based on a very small number of patients and larger, statistically robust studies are needed to inform better infection control guidelines in convalescence. The mechanism of survival of EBOV in recovered patients is not clear, nor consistent, and may be linked to the possibility of infection by asymptomatic patients. Precautionary guidance about avoiding sexual intercourse or using barrier contraception is given, and a need for further research reinforced.