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A New Understanding of Ebola Virus Disease: A Review of Post Ebola Syndrome and Viral Persistence

Dailey, Deanna Camille (2023) A New Understanding of Ebola Virus Disease: A Review of Post Ebola Syndrome and Viral Persistence. Master Essay, University of Pittsburgh.

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Ebola Virus Disease (EVD), caused by Ebola virus, is highly fatal and is mostly restricted to African countries. EVD was previously described as an acute illness, but chronic illness can result as well, making infection more of a public health concern in recent years. New developments have demonstrated that individuals can have new and/or lingering symptoms post recovery, termed post-Ebola syndrome. Another phenomenon is the persistence of Ebola virus in immune privileged sites in survivors post recovery that can lead to viral transmission and/or relapsing infection.
Four cohort studies were reviewed that looked at symptoms in survivors, with different levels of follow-up and criteria. A total of 1,833 survivors were enrolled in these studies, all survivors of the 2014-2016 outbreak. This outbreak was very difficult to control, which led to more cases of disease and more disease survivors. Symptoms reported most frequently in survivors included joint pain, headache, and fatigue. Persistence of Ebola virus post recovery has most often been detected in semen but has also been found in breast milk and ocular fluid. Viral persistence in semen has led to a minimum of 112 cases of EVD. Breast milk was linked to at least one case of EVD (from mother to child), but ocular persistence has not yet been linked to transmission.
Ebola virus is a zoonotic pathogen, making eradication an unlikely scenario. There is increased need for prevention efforts to combat the high rates of post-Ebola syndrome and instances of viral persistence in survivors, including increasing vaccination efforts of the population at risk and receipt of EVD specific treatments in infected individuals. Treatments specific for post-Ebola syndrome need to be assessed to help the growing population suffering from chronic symptoms. Despite the invaluable studies reviewed in this analysis, the pathogenesis and emergence of post-Ebola syndrome and EBOV persistence is relatively unknown and requires further study to make a meaningful impact on the 500 million individuals at risk for EVD in African countries.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Dailey, Deanna Camilledcd21@pitt.edudcd21
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairMartinson, Jeremyjmartins@pitt.edujmartinsUNSPECIFIED
Committee MemberMertz, Kristenkristen.mertz@alleghenycounty.usUNSPECIFIEDUNSPECIFIED
Date: 17 May 2023
Date Type: Completion
Defense Date: 0202
Submission Date: 6 May 2023
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 30
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Ebola Virus, Post Ebola Syndrome, Persistence of Ebola Virus, EVD
Related URLs:
Date Deposited: 17 May 2023 16:58
Last Modified: 17 May 2023 16:58


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