Dr. Ian Crozier survived Ebola, only to have his normally blue left eye turn green because of inflammation. Though the rest of his body was Ebola-free, his eye was teeming with the virus.
Emory Eye Center
“If there’s anything that this outbreak has taught me, it’s that I’m often wrong,” says Dr. Daniel Bausch.
He’s talking about Ebola. He’s one of the world’s leading experts on the virus — an infectious disease specialist at Tulane University and a senior consultant to the World Health Organization.
And as he makes clear, he’s still got a lot to learn.
The virus came roaring back into headlines this past week. A Scottish nurse who survived Ebola is back in isolation in London, being “treated for Ebola,” according tothe Royal Free Hospital. The hospital says the patient’s “condition has deteriorated and she is now critically ill.”
And two new research papers found that the virus can live in a male survivor’s semen for up to nine months, and that one man passed it to his sexual partner months after he was released from the Ebola ward.
“If you look back at the classic teaching about Ebola and survivors, it was that once you get better from this disease, even though it may take a while to recover, you made a full recovery and that kind of was the end of it,” says Bausch.
And now, with an estimated 17,000 survivors, researchers are discovering all kinds of twists and turns. The semen study is particularly puzzling to Ilhem Messaoudi.
“It’s an explosive virus. It replicates like crazy … and it destroys everything in its path,” says Messaoudi, a viral immunologist and professor of biomedical sciences at the University of California, Riverside, who is studying how the virus works in the human body. “So, how is it just hanging out in the testes for like nine months?”
There hasn’t been much research — in animals or humans — about what happens after survival. What we do know is mostly from past outbreaks of the virus, in particular, two studies looking at past survivors of the disease and comparing their health to Ebola-free friends and family.
Research on 19 survivors of a 1995 outbreak in Kikwit in the Democratic Republic of the Congo found that most had joint pain and vision problems after the virus. One lost sight. Studies from the 1970s and 1980s had, like recent research, found the virus persisting in the semen and eyes of survivors.
Researchers following 49 survivors of a 2007 Ebola outbreak in Uganda found that— even two years after the illness — they had eye problems like inflammation and blurred vision as well as joint pain, difficulty sleeping, difficulty swallowing and even hearing loss, memory loss and confusion.
A third study examining 105 survivors of the 2014-15 outbreak in Guinea found that about 90 percent had chronic joint pain and 98 percent had poor appetites or an aversion to food. They also reported difficulty with short-term memory, headaches, sleeplessness, insomnia, dizziness, abdominal pain, constipation, sexual dysfunction, and decreased libido and exercise tolerance.
Bausch says, aside from arthritis and eye inflammation, it’s still unclear which issues are directly related to the Ebola virus and which could be caused by the physical and emotional toll on the body. But something is going on.
“It’s clear that there is a post-Ebola syndrome,” he says.