Ebola’s Ghost: Lingering Symptoms Plague Survivors

January 4th, 2016

By Gary Evans, Senior Staff Writer

U.S. healthcare workers who survived Ebola after acquiring it from patients have suffered a wide variety of symptoms and maladies, with only one survivor considered symptom free at five months after discharge, according to the Centers for Disease Control and Prevention.¹

Though it is not completely clear in all cases if post-Ebola symptoms are the result of damage inflicted during infection or reflect some lingering presence of the virus, none of the health care workers are considered an infectious threat to patients or the public and most have returned to work or other activities. However, Ebola clearly does not end at discharge, as survivors report a panoply of recurrent pains, aches, nerve tingling, hearing and vision problems, extreme fatigue, anxiety and depression.

For example, one of the U.S. nurses occupationally infected with Ebola described nightmares and fears about a future recurrence of the virus or some unintended consequences of novel treatment.²

“There are many unanswered questions about post-Ebola virus disease symptoms,” says Tim Uyeki, MD, MPH, a CDC epidemiologist who has co-authored several papers on the Ebola response. “Prospective, longitudinal research studies of Ebola virus disease survivors -- along with a comparison group of persons who did not have Ebola -- are needed to better understand the frequency, severity, duration, and pathogenesis of the complications, sequelae, and symptoms experienced by survivors.”

In one of the more shocking cases, a Scottish nurse who had been successfully treated for Ebola in January 2015 was readmitted last October for meningitis thought to be caused by surviving virus in her brain.³ She recovered again, but joins the cases of Ebola viral persistence in the eyes, semen and other so-called “immune privileged” body sites which may have evolved to mitigate collateral damage during an inflammatory immune response.

In one of the U.S. cases included in the CDC report, a physician who had completed treatment and was discharged from Emory University Hospital in Atlanta later developed vision problems and almost went blind in his left eye. He eventually recovered, but not before the affected iris actually changed color from blue to green and the virus was recovered in mutated form from the infected eye.

Overall, 11 patients with Ebola were treated in U.S. hospitals and nine survived.

References

1. Epstein L, Wong KK, Kallen AJ, et al. Centers for Disease Control and Prevention. Post-Ebola Signs and Symptoms in U.S. Survivors N Engl J Med 2015; 373:2484-2486.

2. Lupkin, S. Life After Ebola: Nurse Nina Pham Says She Has Nightmares, Aches, Hair Loss. ABC News Mar 2, 2015.

3. Paddock, C. British nurse Pauline Cafferkey defeats Ebola – again. MNT Nov. 13 2015: http://www.medicalnewstoday.com/

For more on this story see the Feb. 2016 issue of Hospital Employee Health.