Wednesday, November 19, 2014

Indian Ebola survivor- Quarantined.


    Seldom have I got the chance to talk about any topic again and again in this blog that has only attracted more readers. Oh yes, You got it right. Once again, talking about Ebola 2014. When the outbreak began, it wasn't predicted by any that this would be such a mega outbreak. As of on November 11, 2014 a total of 14,383 Ebola cases have been reported as of November 11 from three West African countries (Source). The media attention that has been received is simply great. And when a country announces they have a fresh case, its the fastest news in circulation.

    The most important news, Democratic Republic of Congo has been declared officially as "outbreak free", after not registering any new case since October 4. There are no new cases for 42 days which is the officially accepted time to declare as outbreak free. Of course the after effects are still being dealt with. And the second most, India quarantines a Ebola survivor. I have purposefully mentioned as a "survivor" and not as the first case in India. There seems to be a lot of panic in the media reports and the story has been blended in press as of to indicate India has its case. Hmmm. Let me try and tease that situation out.

    The suspect is a 26-year-old survivor, successfully treated for Ebola in Liberia and released from a health facility back in late September. He had no symptoms. He was cleared to fly after he had tested negative by standard blood tests (In fact he tested 3 times as negative). However, his semen tested positive. This discussion seems to be over to me after listening to multiple episodes of TWiV podcasts in recent shows, were this has been discussed in immense details. The basic point boils down to the fact that Ebola seems to be surviving in patients semen (Culture positive) even after they have recovered from illness for about 2- 3 months, possibly more. To the best of knowledge, there are no documented case of sexually transmitted case of Ebola. I have though seen arguments over the internet, that it could be possible and there is a documented evidence of similar scenario in a related virus- "Marburg virus". Best advice at this point is no sex after Ebola recovery for at least 90 days. There is a definitive lack of research on the possibilities of Ebola latency in body fluids.

      I totally agree with the move of health officials quarantine for the "just in case" scenario.  However, It should be considered that he has been treated, survived and cleared by blood tests. This indicates that he is no more diseased. However, to call it the first case is unwarranted. In fact technically speaking, he is not even a case. The outbreak currently seems to be currently in a decline phase and the outbreak should be officially over worldwide, hopefully in a few months.
Bausch DG, Towner JS, Dowell SF, Kaducu F, Lukwiya M, Sanchez A, Nichol ST, Ksiazek TG, & Rollin PE (2007). Assessment of the risk of Ebola virus transmission from bodily fluids and fomites. The Journal of infectious diseases, 196 Suppl 2 PMID: 17940942

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