Scientists and global health authorities are looking at whether the latest Ebola outbreak in Guinea was started by someone who was first infected with the virus during the region’s Ebola epidemic five years ago.
The World Health Organization (WHO) is doing further research into the individual who seems to have the virus dormant in their system.
This suggests that infections can linger after people heal, with the potential to spread in the future.
To better determine the cause, foreign experts, including a team from Guinea’s University of Conakry, sequenced the genomes of nine samples taken from people affected during the current outbreak and compared them to sequences from past outbreaks.
The findings indicate that the current epidemic “is the result of the return of a virus that previously circulated in the West African outbreak,” according to the authors’ report.
The researchers discovered that the Ebola virus strain circulating was identical to the Makano variant, which was responsible for the large-scale 2014-2016 epidemic in West Africa.
“The similarities are big enough for us to declare that this is the same family of the virus,” says Dr. Salam Gueye, director of the Emergency preparedness and Response Cluster at the WHO Regional Office for Africa.
But Dr. Alpha Keita, Deputy Director of the Centre de Recherche et de Formation en Infectiologie de Guinée (CERFIG) at the University of Conakry, who led the research, said his team have refrained from making any hasty conclusions.
They decided to be extremely careful and continue sequencing on additional samples to obtain more complete sequences that will provide a safer answer, he added.
Keita clarified in a separate article about the work that the consequences in terms of public health and people’s welfare, such as the dangers of stigmatization, physical and verbal abuse against past Ebola survivors, necessitated such a strategy.
Gueye mentioned that further inquiries are being conducted to determine what actually occurred.
On February 14, Guinea’s Ministry of Health announced a new Ebola virus epidemic in the country’s Nzérékoré area. There have been 18 cases registered as of March 25th, with 14 confirmed and four suspected cases. Nine people have disappeared, and 366 people have been contacted.
According to the experts, the new outbreak began just 200 kilometers from the epicenter of the previous epidemic.
Is this a sexually transmitted disease?
The first case of the latest epidemic was a nurse who died at the end of January 2021 in the Gouécké sub-county. According to Gueye, all of the other events concern individuals who missed the funeral on February 1, 2021.
The nurse was the sister-in-law of the survivor’s husband, who is believed to have borne the virus for five years. Following the death of the partner from Ebola virus disease, the nurse contracted the disease and is suspected of spreading it to those at the funeral. “That is how the outbreak may have started,” said Gueye.
CERFIG researchers then sequenced the nine samples from people who tested positive for Ebola, discovering the Makana mutation in all of them.
The virus may have been dormant and then sexually spread by one human to another, or the virus may have been present in the body but not causing infection, but a rebound occurred due to virus mutation or a decrease in host immunity. Gueye said
Long after a human was proclaimed Ebola-free, remnants of the virus were discovered in their sperm.
“We are continuing to do epidemiological and anthropological investigations in order to reinforce that hypothesis or exclude it but so far that is the strongest hypothesis we have,” said Gueye.
Wim Van Damme, a researcher and infectious disease expert at the Institute of Tropical Medicine, Antwerp, who was not involved in the research, cautions that this method of transmission would be a very rare event. “There are more than 10,000 Ebola survivors in West Africa, and this is the first case, after five years,” he said.
He went on to state that many people believe the virus was transmitted by sexual touch. “This isn’t clear since the virus will survive in other areas of the body (most importantly the central nervous system).” However, he adds that it’s still unclear how the infection can spread from one person to another’s nervous system.
e need to do supplemental investigations and epidemiological research in order to determine what happened and to have a strong hypothesis on it. There are a lot of facts that have given us enough information for us to react,” Gueye said
The WHO is working with the West African affected governments and a task force has been formed. “The task force will further go into epidemiology, bioinformatics and laboratory to see what we can learn from this experience and translate it into the program” said Gueye.
The risk of future outbreaks
“The fact is that we need to follow up these survivors for prolonged periods of time with frequent semen analysis for the virus. We can also provide condoms for them,” said Dr. Merawi Aragaw, Incident Manager for Ebola, Africa CDC.
“The community needs continuous education. We are trying to reach the community through health workers they can trust,” said Aragaw, adding that the Africa CDC continuously give survivors psychological support and advise partners and people in the community.
The WHO says it would improve prevention, disease diagnosis, and reaction in Ebola-affected countries.\
“It will change the way we are responding to Ebola and the way we are preventing Ebola. It is a disease that needs to be in the surveillance system and it needs a collaboration of the community, the health workers, and also it needs to be a priority for the health authorities,” Gueye said.
In humans, Ebola virus disease (EVD) is an uncommon but serious and sometimes fatal infection. Direct interaction with the blood, bodily fluids, or tissues of infected persons or animals is the most common way for the virus to transmit.
The Ebola virus in West Africa from 2014 to 2016 was the most serious to date, spreading to Liberia, Sierra Leone, and Guinea.
There were a total of 28,646 suspicious cases registered, with 11,323 deaths.