Beyond 90 days |Sexually-transmitted Ebola

“With regards the development of a strange positive case of Ebola appearing in a 9-month-old baby in Kailahun, everyone should vigorously be concerned,” writes Sylvia Blyden. The former special executive assistant to President Koroma recently spoke on the impact, consequences, prospects and challenges facing young people because of Ebola. Blyden represented Sierra Leone as a global youth activist on a panel at Chatham House, the Royal Institute of International Affairs in London on January 20, 2015.

On Saturday, April 4, 2015, the chief executive officer in Kailahun, the eastern district where the 9-month-old baby reportedly died, confirmed that swab tests have shown the baby was positive for Ebola virus disease, but he expressed some reservation because both parents showed no signs of Ebola.

In a media group she manages on WhatsApp, Blyden, a medical doctor, asked whether the child had been breast fed and suggested that the mother’s milk be PCR tested.

Polymerase chain reaction (PCR) is a technique that is used to amplify trace amounts of DNA located in or on almost any liquid or surface where DNA strands may be deposited. The key to understanding PCR is to know that every human, animal, plant, parasite, bacterium, or virus contains genetic material such as DNA (or RNA) sequences (nucleotide sequences or pieces of DNA or RNA) that are unique to their species, and to the individual member of that species. 

“It appears after a patient is blood negative, the (Ebola) virus can also remain in breast milk. With a few asymptomatic (infected but showed no symptoms) cases being reported, let us hope the mother was not one. Or better still, let the alternative that it was a laboratory error causing false positive be the situation,” Blyden wrote.

The doctor urged that Sierra Leone pass on the relevant cautionary messages. “We have to balance between avoiding stigmatizing of victims on one hand and protecting the general populace on the other,” she said.

Blyden also responded to emerging reports of Ebola transmission through sexual contact with survivors.

She argued that the first case of such transmission probably happened some time last year. A 17-year-old housewife in Kissi Teng, Kailahun, died from Ebola-like symptoms and a swab test on her corpse proved positive.

“She had no travel history and no obvious epidemiological link to an Ebola transmission source except that her husband had Ebola symptoms weeks earlier,” Blyden said. “But he turned negative within days and got discharged. He confirmed he had been having unprotected sex with the 17-year-old wife.”

However, Blyden added that she did not follow-up on whether the male survivor’s semen ever got to be PCR tested for Ebola because she had just left State House at the time.

Blyden also noted a case last month in Liberia, where a 44-year-old woman died from Ebola.

She had reportedly caught the virus from her partner after he had been Ebola-free for six months.

“That man's semen was PCR tested and proved that he had active Ebola virus still surviving inside his semen, six months after he was Ebola free. Sexual transmission is too horrifying to contemplate!,” she wrote.

According to the VOA, Liberian authorities are urging Ebola survivors to refrain from unprotected sex beyond the recommended 90 days, after the country's first Ebola death in more than a month.

The female patient who died was married to a man who had the disease but survived, VOA said. Officials fear she may have gotten sick through sexual transmission.

The World Heath Organization recommends that Ebola survivors refrain from sex for 90 days. But Liberian officials urge former patents to at least use condoms beyond that time, until more information is known.

In Freetown, unconfirmed reports say a team comprising of Sierra Leone’s Ministry of Health and Sanitation, country representatives of the World Health Organization, and the United States Centers for Disease Control and Prevention left Freetown Saturday afternoon for Kailahun to conduct an investigation.

Kailahun had high hopes after being Ebola free for more than 100 days.

****UPDATE According to Dr. Blyden, making the situation even more complex is senior medical sources in Sierra Leone have confirmed to her that at Freetown's Connaught Hospital, an Ebola survivor tested positive for the virus disease within the fluid that covers the brain and spinal cord (Cerebro Spinal Fluid).

The survivor had been blood negative for some time, Blyden said. "The new vaccines are giving us hope for the future."


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