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Four studies find Ebola virus in semen of men who have recovered from the disease.

The World Health Organization (WHO) has stated in a release that human sperm can carry the Ebola virus for at least 82 days, urging men recovering from the disease to use condoms for three months after the onset of symptoms.  The WHO states that sexual transmission of Ebola virus disease (EVD) has not been documented but caution should be given when having sexual relations 3 months after testing positive for the Ebola virus.

The Ebola virus is shed in bodily fluids such as blood, vomit, faeces, saliva, urine, tears, and vaginal and seminal fluids. There is evidence that seminal fluids of convalescing men can shed the Ebola virus for at least 82 days after onset of symptoms. Although the scientific evidence is limited, it is clear that semen is a potential source of infection and could therefore cause transmission of the virus through delivery of the infectious virus on a mucosal surface.

In four studies that investigated persistence of Ebola virus in seminal fluid from convalescent patients (a total of 43 patients), three men who had recovered from Ebola virus disease were reported to shed live virus in semen 40 days, 61 days and 82 days after onset of symptoms, respectively.

In two studies, Ebola virus was isolated from semen, but subsequent infections were not identified in household contacts.

In a study performed during the Ebola outbreak in Gulu, Uganda, in 2000, the authors tested the semen of a single convalescent patient and were able to isolate Ebola virus up to 40 days after the onset of illness, the study was published in The Journal of Infectious Diseases in 2007. In a study published in the British Medical Journal in an outbreak in 1977 the researchers detected live Ebola virus in semen of one convalescent man 61 days after onset of symptoms.

A study published in the The Journal of Infectious Diseases  in 1999 also detected live Ebola virus in semen in one convalescent man 82 days after disease onset. Therefore, it is possible for Ebola virus to be present in semen for 3 months after disease onset.  Another study published in the The Journal of Infectious Diseases in the same year followed four men recovering from Ebola virus disease and their sexual partners found that no sexual partner developed symptoms.

However the WHO states that men who have recovered from Ebola virus disease should be aware that seminal fluid may be infectious for as long as three months after onset of symptoms.

Infection also occurs from direct contact through broken skin or mucous membranes with the blood, or other bodily fluids or secretions (stool, urine, saliva, semen) of infected people. Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments that have become contaminated with an Ebola patient’s infectious fluids such as soiled clothing, bed linen, or used needles.

Symptoms include but are not limited to sudden onset of fever, intense weakness, muscle pain, headache and sore throat are typical signs and symptoms. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding.  The incubation period, or the time interval from infection to onset of symptoms, is from 2 to 21 days.

The Ebola virus can only be confirmed through laboratory testing and at present has no known cure or vaccine with severely ill patients only able to receive intensive supportive care.  As the disease is spread through direct contact with the bodily fluids of an ill person, either through unsafe case management or unsafe burial practices, the WHO has put together recommendations to limit the spread of the Ebola disease which can be found here, the link also contains relevant WHO Ebola publications.

WHO also recommends that because of the potential to transmit the virus sexually during this time, male convalescent patients should maintain good personal hygiene after masturbation, and either abstain from sex (including oral sex) for three months after onset of symptoms, or use condoms if abstinence is not possible.  The WHO does not recommend isolation of male convalescent patients whose blood has been tested negative for EVD.

Source:  World Health Organisation

Ebola virus fly-though.   © 2014 Hybrid Medical Animation.
Ebola virus fly-though. © 2014 Hybrid Medical Animation.

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