In the Journals

Ebola RNA persists for months in breast milk, semen of survivors

Study findings demonstrated the long-term presence of Ebola RNA in breast milk and semen samples from survivors of the West African epidemic, including almost 10% of male survivors who tested positive in at least one semen sample.

Researchers detected Ebola RNA only rarely in breast milk and two other body fluids, saliva and urine. The presence of Ebola RNA was detected in the semen of one survivor for 512 days.

“The majority of data on persistence of Ebola virus or RNA are from semen. Here, we studied —for the first time — large numbers of samples from other body fluids, in addition to semen because very limited information was available,” Martine Peeters, PhD, research director at the French National Research Institute for Sustainable Development at Montpellier University, told Infectious Disease News. “The major outbreak in West Africa has led to a significant number of Ebola virus disease survivors, providing us a unique opportunity to study these aspects.”

Peeters and colleagues used molecular assays to study Ebola viral RNA shedding in semen, urine, cervico-vaginal fluid, saliva, breast milk and feces among survivors in Guinea from baseline until 40 months after study inclusion.

According to Peeters, semen seems to be the body fluid with highest number of positive tests, with a significant number of men still positive 6 months after discharge from Ebola treatment units. According to the study, 27 of 277 male survivors tested positive for Ebola RNA in at least one semen sample, and Peeters and colleagues calculated the probability of semen remaining positive for Ebola to be 93.02% and 60.12% after 3 and 6 months, respectively.

“RNA does not mean that virus is still infectious, but it has to be noted that the patient ... who was still positive at 512 days after [Ebola treatment unit] discharge, has been previously reported to be at the origin of a new cluster of [Ebola virus disease] in Guinea and Liberia after the declaration of the end of the outbreak,” Peeters and colleagues wrote.

The researchers reported detecting Ebola RNA in the breast milk of 2 of 168 tested survivors, the saliva of 1 out of 454 survivors and the urine of 2 of 593. They were surprised to find that Ebola RNA was detectable in breast milk from a woman 1 month after she gave birth, which was 500 days after she was discharged from the Ebola treatment unit.

Peeters added that the researchers were unable to perform viral isolations on the RNA positive samples and could not comment on whether the samples and individuals who provided them are infectious.

“There are still many uncertainties about how long the virus can stay in immune privileged sites and on how many patients are concerned by this,” Peeters said, adding that more studies and longer follow-up are needed. – by Caitlyn Stulpin

Disclosures: Infectious Disease News was unable to confirm relevant financial disclosures at the time of publication.

Study findings demonstrated the long-term presence of Ebola RNA in breast milk and semen samples from survivors of the West African epidemic, including almost 10% of male survivors who tested positive in at least one semen sample.

Researchers detected Ebola RNA only rarely in breast milk and two other body fluids, saliva and urine. The presence of Ebola RNA was detected in the semen of one survivor for 512 days.

“The majority of data on persistence of Ebola virus or RNA are from semen. Here, we studied —for the first time — large numbers of samples from other body fluids, in addition to semen because very limited information was available,” Martine Peeters, PhD, research director at the French National Research Institute for Sustainable Development at Montpellier University, told Infectious Disease News. “The major outbreak in West Africa has led to a significant number of Ebola virus disease survivors, providing us a unique opportunity to study these aspects.”

Peeters and colleagues used molecular assays to study Ebola viral RNA shedding in semen, urine, cervico-vaginal fluid, saliva, breast milk and feces among survivors in Guinea from baseline until 40 months after study inclusion.

According to Peeters, semen seems to be the body fluid with highest number of positive tests, with a significant number of men still positive 6 months after discharge from Ebola treatment units. According to the study, 27 of 277 male survivors tested positive for Ebola RNA in at least one semen sample, and Peeters and colleagues calculated the probability of semen remaining positive for Ebola to be 93.02% and 60.12% after 3 and 6 months, respectively.

“RNA does not mean that virus is still infectious, but it has to be noted that the patient ... who was still positive at 512 days after [Ebola treatment unit] discharge, has been previously reported to be at the origin of a new cluster of [Ebola virus disease] in Guinea and Liberia after the declaration of the end of the outbreak,” Peeters and colleagues wrote.

The researchers reported detecting Ebola RNA in the breast milk of 2 of 168 tested survivors, the saliva of 1 out of 454 survivors and the urine of 2 of 593. They were surprised to find that Ebola RNA was detectable in breast milk from a woman 1 month after she gave birth, which was 500 days after she was discharged from the Ebola treatment unit.

Peeters added that the researchers were unable to perform viral isolations on the RNA positive samples and could not comment on whether the samples and individuals who provided them are infectious.

“There are still many uncertainties about how long the virus can stay in immune privileged sites and on how many patients are concerned by this,” Peeters said, adding that more studies and longer follow-up are needed. – by Caitlyn Stulpin

Disclosures: Infectious Disease News was unable to confirm relevant financial disclosures at the time of publication.

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