Ebola RNA Can Persist in Semen Two Years After Acute Infection Period

Researchers are calling on the World Health Organization (WHO) to revise guidelines for the prevention of Ebola via sexual transmission. Results from a recent study conducted by researchers from the University of North Carolina at Chapel Hill, Ohio-based Clinical Research Management, and the Eternal Love Winning Africa (ELWA) Hospital in Liberia, show that Ebola virus RNA can remain in the genital tract for more than 2 years following the acute infection period.

Regulations released by WHO in 2016 suggest that men practice abstinence and use condoms for a year following infection or until semen has tested negative for Ebola virus RNA twice. However, the study results indicated that it is possible for Ebola virus RNA to reappear in the semen of men who had previously tested negative.

The results, published in Open Forum Infectious Diseases, do not indicate that sexual transmission of Ebola is necessarily occurring 2 years postinfection, but present the possibility. The researchers gathered data from participants over time using a longitudinal cohort study in Monrovia, Liberia. The subject pool consisted of 149 males who survived Ebola virus disease (EVD). The participants donated semen over a period of time of 260 to 1016 days postinfection. From the subject pool, 13 men (9%)) tested positive for the presence of Ebola virus RNA. Eleven of the 13 men (8%) tested positive for Ebola RNA in their semen after 2 years.

“Our finding of long term persistence and intermittent detection of viral RNA in semen suggests we need to change how we think about Ebola as it is no longer only an acute illness, but also one with potential long-term effects," said William A. Fischer II, MD, assistant professor of pulmonary and critical care medicine at the University of North Carolina at Chapel Hill, in a press release.

The researchers were also able to recognize consistencies in some of the participants. Results concluded that men who tested positive for longer periods of time were generally older than those who tested negative. The individuals with positive test results also reported more vision problems than men who tested negative.

The researchers said that future studies should be designed to determine if the presence of Ebola RNA indicates the presence of the virus. The country of Liberia is relevant due to the fact that in 2015 a Monrovian woman died after being infected with EVD after having sexual contact with a male survivor. Following her death, research determined that the strain of Ebola was almost identical to the strain that had infected the man. The man’s semen also tested positive for Ebola, nearly 200 days after the acute period.

This study is not the first of its kind, but provides key information in an area recovering from an epidemic. With increased numbers of survivors of the Ebola virus, the researchers also indicate the importance of determining how long the virus can sustain itself in the body in order to prevent further infection and futur outbreaks.