Ebola Can Persist in the Semen of Male Survivors

A recent press release by the Centers for Disease Control and Prevention (CDC) showed that data provided by Liberia’s Men’s Health Screening Program (MHSP) have shown that out of 429 males who survived the Ebola virus, 38, or 9%, still had fragments of the virus within their semen. Even a year after recovery, semen samples taken from those individuals tested positive for Ebola. Furthermore, in one particular case, the virus was present in the semen of an Ebola survivor 565 days after he had recovered. The data also showed that men who were more likely to have semen test positive for the virus were over the age of 40.

Operated by the Liberian Ministry of Health in collaboration with the CDC, the World Health Organization (WHO), and the Academic Consortium Combating Ebola in Liberia, the MHSP is the first national program that provides semen testing for the Ebola virus. However, the tests do have limitations. According to the CDC, the tests “detect Ebola virus genetic material but cannot tell if live virus is present and capable of spreading disease.” The preliminary results of the MHSP can be viewed in a report published in Lancet Global Health.

The MHSP also provides individuals in Liberia with education and counseling on Ebola preventive measures, such as safe sex practices. Through the program, researchers were provided with insight into the current safety measures being taken, with men reporting whether or not they use condoms during sexual intercourse. The CDC states that of those who reported having sexual intercourse without condoms at the time of enrollment, about 75% reported to have started using protection at a later date.

CDC Director Tom Friedan, MD, MPH, commented, “This program provides important insights into how long Ebola remains in semen, a key component to preventing flare-ups of the disease and protecting survivors and their loved ones. It also shows how investments in public health capacity can save lives.”

Male individuals who have survived Ebola and are older than 15 years of age can become a part of the Liberia MHSP and have their semen tested on a monthly basis, as well as receive counseling on safe sex practices and free condoms. In addition, those whose semen tests negative for the virus two times in a row will then “graduate” from the program, according to the CDC.

In March 2015, there was a case in Monrovia, Liberia where a woman had become infected with the Ebola virus and died. At the time, Liberia had recently been “declared free of Ebola,” according to the CDC, and it was proven that she was exposed to the virus through unprotected sexual intercourse with a man that had survived Ebola. His semen proved to still be positive for the virus 199 days after initial onset of illness. This case is an example of how unprotected sexual contact can be a contributing factor to inciting Ebola epidemics.

The Ebola epidemic in West Africa was the largest the world had ever seen, according to the CDC, and since then, there have been efforts to control the virus through learning more about it. Prior to the MHSP report, researchers knew that in certain body sites, such as the eyes and the testes, the virus could persistent even after recovery. However, the data from this report has provided researchers with insight into the length of time that the virus can persist, as well as how this duration of viremia is subjective, according to the CDC.

When speaking of the implications of their findings, Moses J. Soka, MD, coordinator, Ebola Virus Disease Survivor Clinical Care at the Liberian Ministry of Health and first director of the MSPH program, said, “Before this outbreak, scientists believed that Ebola virus could be found in semen for three months after recovery. With this study, we now know that virus may persist for a year or longer. We now have many more Ebola survivors than ever before. This work demonstrates the importance of providing laboratory testing and behavioral counseling to empower survivors to make informed decisions to protect their intimate partners.”