Mon, Mar 30, 2015 - Page 6 News List

Indefinite safe sex urged for Ebola survivors

LINGERING THREAT:Condoms have not been tested with Ebola, but are thought to be effective because they block transmission of much smaller viruses, experts said

NY Times News Service

The Liberian government on Saturday recommended that survivors of Ebola practice safe sex indefinitely, until more information can be collected on the length of time the virus might remain present in bodily fluids, including semen. Previously, male survivors were advised to abstain from sexual intercourse or to use condoms for three months, reflecting that the active virus had been detected for up to 82 days in semen.

Acting on new developments, all nation affected by the Ebola outbreak need to consider applying similar recommendations, said David Nabarro, the UN secretary-general’s special envoy for Ebola.

Agencies involved in the response were reviewing the issue.

“Yet again, the Ebola-affected communities are asked to deal carefully with an unknown,” Nabarro wrote in an e-mail, adding that survivors “should not be stigmatized as they take actions for the public good. They are the heroes.”

The new guidelines came one day after the death from Ebola in Liberia of Ruth Tugbah. Before her illness, the nation had gone three weeks without a new Ebola diagnosis, and hopes had risen that Liberia was nearing the end of a year-long epidemic that killed more than 4,000 people there. Tugbah’s only known risk factor was having a boyfriend who was an Ebola survivor.

Scientists detected the genetic material of Ebola from a semen sample the boyfriend provided to infectious disease investigators, officials from two Ebola response agencies said, speaking on background because they were not authorized to speak publicly.

In a potentially worrying development, officials learned that the man, whose name is not being released, was treated for Ebola in September last year.

A blood sample from his girlfriend, who tested positive for Ebola, was collected March 19. Given a maximum incubation period of 21 days for the virus, the earliest she could have been infected was Feb. 26, more than three months after the man was cured of Ebola.

Even though traces of the virus were detected in the man’s semen, that does not prove that the fluid contained active virus particles or that Tugbah was infected from it, the officials said.

To help determine that, the sample is to be sent to scientists outside Liberia who have the facilities to try to grow the virus in a culture.

Scientists in Monrovia, Liberia’s capital, were working to determine whether the virus carried by Tugbah matched the sequence of that from her boyfriend. The national laboratory gained the capacity to sequence the Ebola virus just last month with support from the US Army Medical Research Institute for Infectious Diseases.

Officials from Liberia, the US Centers for Disease Control and Prevention and the WHO scrambled on Friday to come up with the new recommendations given the developments and their sensitivity.

“For now we are encouraging survivors to have safe sex,” said Tolbert Nyenswah, Liberia’s top Ebola official. He said the nation planned to enroll survivors in a study to determine the maximum length of time the virus remains detectable.

Condoms have not been tested with Ebola, but are thought to be effective because they block transmission of much smaller viruses, bacteriophages, which are 27 nanomillimeters compared with Ebola’s 80nm, said Nathalie Jeanne Nicole Broutet, a medical officer with the WHO’s Department of Reproductive Health and Research in Geneva. “In theory, the Ebola virus would not pass [through] the condom,” she said.

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