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  Table of Contents  
RESIDENTS PAGE
Year : 2018  |  Volume : 39  |  Issue : 1  |  Page : 65-67
 

Ebola virus: An emerging sexually transmissible infection pathogen


Department of Dermatology, Government Medical College, Baroda, Gujarat, India

Date of Web Publication21-Jun-2018

Correspondence Address:
Dr. Ashma Surani
Government Medical College Baroda, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijstd.IJSTD_21_18

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How to cite this article:
Surani A, Marfatia YS, Pal A, Shah R. Ebola virus: An emerging sexually transmissible infection pathogen. Indian J Sex Transm Dis 2018;39:65-7

How to cite this URL:
Surani A, Marfatia YS, Pal A, Shah R. Ebola virus: An emerging sexually transmissible infection pathogen. Indian J Sex Transm Dis [serial online] 2018 [cited 2018 Dec 15];39:65-7. Available from: http://www.ijstd.org/text.asp?2018/39/1/65/234867



   History of Ebola Top


The first cases of Ebola were reported simultaneously in 1976 in Yambuku, near the Ebola River in Zaire and in Nzara, Sudan.[2]


   Introduction Top


Ebola virus, a member of the family Filoviridae, is RNA virus and an emerging infectious agent that causes severe and often fatal hemorrhagic fever in humans and nonhuman primates.[2],[3]


   Natural Host Top


The natural hosts of Ebola virus are the fruit bats of Pteropodidae family. Since India comes under the home range of these bats, there is a potential risk of Indian population being affected with the virus and its disease [4] [Figure 1].
Figure 1: Fruit Bat

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   Structure Top


It looks like a piece of thread, or filament, that has been curled up a bit. Ebola is an enveloped virus, meaning that it takes part of the host cell's membrane with it when it leaves the cell.

Like all viruses, Ebola is not able to replicate on its own. It requires the help from a host cell [Figure 2].
Figure 2: Ebola Virus

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   Cells Susceptible Top


Ebola can infect a variety of cell types, including white blood cells, liver cells, and cells of the adrenal glands.[1]


   Modes of Transmission Top


Body fluids containing Ebola virus

Ebola virus is shed in a wide variety of body fluids during the acute phase of illness, including semen, saliva, breast milk, stool, and tears.

Ebola virus transmitted principally by direct physical contact with an ill person or his/her body fluids during the later stages of illness.[1]


   Sexual Transmission Top


Transmission of the Ebola virus from male to female following exposure to infected semen of survivor has been reported in one event and has been suspected in several others. The exact mode of infection (contact and sexual transmission) has yet not been elucidated. In support of the view that Ebola virus can be transmitted via semen, a single instance of heterosexual transmission of the related Marburg filovirus, from a male survivor to a female partner, was reported during an outbreak in 1967. Less probable, but theoretically possible, is female to male transmission.

Studies have shown that Ebola virus can be isolated from semen up to 82 days after symptom onset and recent virus-persistence studies identified genetic material (RNA) from the virus by nucleic acid amplification tests (such as reverse transcriptase-polymerase chain reaction [RT-PCR]) 406 days (13.5 months) after symptom onset, beyond the period of virus detectability in the blood of survivors and long after recovery from illness. Ebola virus RNA has also been detected by RT-PCR in vaginal fluid from one woman 33 days after symptom onset (Democratic Republic of Congo, 1995). Live virus has never been isolated from vaginal fluids. With such limited data, it is not known for how long virus typically persists in vaginal fluids, or whether it can be sexually transmitted from females to males.[1]

Symptoms of Ebola

The time interval from infection with Ebola to the onset of symptoms is 2–21 days, although 8–10 days is most common. Signs and symptoms include:

  • Fever, headache, joint and muscle aches, weakness
  • Diarrhea, vomiting, stomach pain, lack of appetite.


Some patients may experience:

  • Rash, red eyes, hiccups
  • Cough, sore throat, chest pain, difficulty breathing, difficulty swallowing
  • Bleeding inside and outside of the body.[1]


Laboratory diagnosis

Ebola virus infections can be diagnosed definitively in a laboratory through several types of tests, including:

  • Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
  • IgM ELISA
  • PCR
  • Virus isolation.[1]


Treatments for Ebola

At the moment, treatment for Ebola is limited to intensive supportive care and includes:

  • Balancing the patient's fluids and electrolytes
  • Maintaining their oxygen status and blood pressure
  • Treating a patient for any complicating infections.[1]


Ebola prevention

There is currently no licensed vaccine available for Ebola. Several vaccines are being tested, but at this time, none are available for clinical use.

Preventing transmission is achieved by:

  • Ensuring all health-care workers wear protective clothing and follow universal precautions
  • Implementing infection-control measures, such as complete equipment sterilization and routine use of disinfectant
  • Isolation of Ebola patients from contact with unprotected individuals.


Thorough sterilization and proper disposal of needles in hospitals are essential in preventing further infection and halting the spread of an outbreak.[1]


   The Who Recommendations for Prevention of Sexual Transmission Top


  1. All Ebola survivors and their sexual partners should receive counseling to ensure safer sexual practices and be provided with condoms when discharged from ETU. Safer sex strategies include postponing sexual debut, nonpenetrative sex, correct and consistent use of male or female condoms, and reducing the number of sexual partners
  2. Male Ebola survivors should be offered semen testing at 3 months after onset of disease, and then, for those who test positive, every month thereafter until their semen tests negative for virus twice by RT-PCR, with at least an interval of 1 week between tests
  3. Ebola survivors and their sexual partners should either:


    1. Abstain from all types of sex or
    2. Observe safer sex through correct and consistent condom use until their semen has twice tested negative. Survivors should continue to receive counseling and be provided with condoms. Having tested negative, survivors can safely resume normal sexual practices without fear of Ebola virus transmission.


  4. If an Ebola survivor's semen has not been tested, he should continue to practice safer sex for at least 12 months after the onset of symptoms; this interval may be adjusted as additional information becomes available on the prevalence of Ebola virus in the semen of survivors over time
  5. Until such time as their semen has twice tested negative for Ebola, or 12 months after symptoms onset if semen cannot be tested, survivors should practice good hand and personal hygiene by immediately and thoroughly washing with soap and water after any physical contact with semen, including after masturbation. During this period, used condoms should be handled safely, and safely disposed of, so as to prevent contact with seminal fluids
  6. Even in the absence of Ebola transmission risk, the WHO recommends the use of condoms to prevent HIV, other sexually transmitted infections, and unwanted pregnancy
  7. All survivors, their partners, and families should be shown respect, dignity, and compassion.[1]


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Centers for Disease Control and Prevention. Guidance on Personal Protective Equipment (PPE) To Be Used By Healthcare Workers during Management of Patients with Confirmed Ebola or Persons under Investigation (PUIs) for Ebola who are Clinically Unstable or Have Bleeding, Vomiting, or Diarrhea in U.S. Hospitals, Including Procedures for Donning and Doffing PPE; 2015. CDC website. Available from: http://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html. [Last accessed on 2017 Apr 14].  Back to cited text no. 1
    
2.
Kuhn JH, Becker S, Ebihara H, Geisbert TW, Johnson KM, Kawaoka Y, et al. Proposal for a revised taxonomy of the family filoviridae: Classification, names of taxa and viruses, and virus abbreviations. Arch Virol 2010;155:2083-103.  Back to cited text no. 2
[PUBMED]    
3.
Stimola A. Ebola (1st ed). New York: Rosen Pub. 2011. pp. 31, 52. ISBN 978-1435894334.  Back to cited text no. 3
    
4.
Marfatia YS. Universal precautions for a dermatosurgeon. In: Venkataram M, editor. ACSI Textbook of Cutaneous and Aesthetic Surgery. 2nd ed., Vol. 1, Ch. 7. New Delhi: Jaypee-Highlights Medical Publishers; 2017. p. 83-105.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

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   History of Ebola
   Introduction
   Natural Host
   Structure
   Cells Susceptible
    Modes of Transmi...
   Sexual Transmission
    The Who Recommen...
    References
    Article Figures

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