Scientists are trying to grapple with how a Liberian woman who was cured of Ebola during the West African Ebola outbreak of 2014 – 2016 infected family members more than a year later. The revelation has caused an impediment in the works of Ebola research as scientists and global health leaders now remain uncertain on where and when such a case of persistent Ebola could occur next.

The discovery was made by a team of medical researchers who conducted a case a study in Liberia and published their report on The Lancet – a medical journal, last Monday. According to the report, a Liberian woman who had been infected of Ebola in 2014 during the outbreak but survived managed to freshly infect her family members in 2015, more than a year after she was cured. This infection came just after Liberia was declared Ebola-free and led to the death of her 15-year old son.

Health workers attending an Ebola patient

The woman originally became infected when caring for her brother who worked as a nurse’s aide during the outbreak. The brother was suffering from an unknown illness and passed it on to her sister. Both did not go for clinical testing due to the stigma and fear associated with Ebola at the time. The brother died but the woman who was pregnant at the time managed to fight off the illness. But this was not without the cost of her pregnancy as she miscarried soon after.

The woman became pregnant again and this time managed to carry the pregnancy to full term. She became ill soon after delivery and her family started caring for her. It was here when her husband and two sons developed Ebola-like symptoms, became hospitalized and tested positive for Ebola. Unfortunately, her oldest son died while her husband and younger son survived.

Persistent Ebola – Virus Hides in Unknown Locations

The scientists were surprised to realize that the woman and her nursing baby did not have the Ebola virus but had Ebola antibodies instead. According to their report, the woman had managed to suppress the virus which had, in turn, stayed dormant and hidden in a “yet to be specified” part of the body. This was the first time that a woman was seen to be a host of the Ebola virus. Previously, it was believed that only men could harbor the virus even after being cured, as the virus could stay dormant for up to two years in their semen.

A study revealed that the woman passed the Ebola anti-bodies to her suckling baby through breastfeeding which made it naturally immune to Ebola. It also pointed to her pregnancy at having caused the relapse of the virus. The relapse was because during pregnancy the immune system of a woman is suppressed to avoid inadvertent attacks on the fetus. This suppression allowed the Ebola virus in the woman to flare up, hence she became sick again. According to the report, she was not initially tested for Ebola in the health center as Liberia was now Ebola-free and was instead treated for Malaria.

Scientists now face the task of ensuring all relapses are contained and avoided altogether through adequate surveillance of both male and female survivors. Officials will also need to educate the public on how to avoid the proven sources of relapse transmissions.

In May, the World Health Organization tested and successfully used an Ebola vaccine in the Democratic Republic of Congo during an Ebola outbreak.

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