Wellness

Sex And Masturbation Could Put Ebola Recovery In Jeopardy

Traces of the virus can be found in semen six months later.
A woman waits for a consultation at the Star of the Sun Health Centre in the Monrovia township of West Point on April 29, 2016.
A woman waits for a consultation at the Star of the Sun Health Centre in the Monrovia township of West Point on April 29, 2016.

By Tom Miles

GENEVA (Reuters) - Isolated flare-ups of Ebola may point to a higher risk of transmission via the semen of male survivors than previously thought, undermining hopes of ending West Africa’s deadly outbreak by the end of the year.

The World Health Organization’s advice is that all male survivors should be tested three months after the onset of symptoms and then monthly until they know they have no risk of passing on the virus through their semen, Bruce Aylward, head of the WHO’s Ebola response, told a news conference.

But a forthcoming study in the New England Journal of Medicine, based on around 200 survivors, found that around half still had traces of the virus in their semen after six months, a clinician familiar with the study told Reuters.

“The old advice of three months is no longer good,” the clinician said. “The number of people with persistent virus in their semen is much greater than expected.”

The clinician, who was not authorized to speak about the study, added that the risk might not only be from sex but also from masturbation.

“It’s not the sex that is dangerous, it’s the semen that is dangerous,” said Aylward, who mentioned the study during a news conference but did not give details. “How people actually get exposed, in soiled linens or whatever, is not clear.”

Transmission through semen may explain why a few cases continue to occur even though the outbreak has been almost completely eradicated by an intense international effort, recently bolstered by the deployment of a trial vaccine in Guinea and Sierra Leone.

“This virus and this outbreak in particular has a nasty sting in the tail,” Aylward said. “It’s not finished, by a long shot.”

The latest flare-up, in a village on the northern border of Sierra Leone, followed the death of a 67-year-old woman late last month, 50 days after the previous confirmed case in the region. Transmission chains are considered to have been broken after 42 days with no new infections.

However, Aylward said that sexual transmission was “obviously not a huge risk, because if it were we would have seen a lot more in the areas that were hardest hit at the beginning of this outbreak.”

(Reporting by Tom Miles; Editing by Robin Pomeroy)

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1
Ebola is highly infectious and even being in the same room as someone with the disease can put you at risk
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Not as far as we know. Ebola isn't contagious until symptoms begin, and it spreads through direct contact with the bodily fluids of patients. It is not, from what we know of the science so far, an airborne virus. So contact with the patient's sweat, blood, vomit, feces or semen could cause infection, and the body remains infectious after death. Much of the spread in west Africa has been attributed to the initial distrust of medical staff, leaving many to be treated at home by loved ones, poorly equipped medics catching the disease from patients, and the traditional burial rites involving manually washing of the dead body. From what we know already, you can't catch it from the air, you can't catch it from food, you can't catch it from water.
2
Cancelling all flights from west Africa would stop the spread of Ebola
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This actually has pretty serious implications. British Airways suspended its four-times-weekly flights to Liberia and Sierra Leone until the end of March, the only direct flight to the region from the UK. In practice, anyone can just change planes somewhere else and get to Britain from Europe, north Africa, or the Middle East. And aid agencies say that flight cancellations are hampering efforts to get the disease under control, they rely on commercial flights to get to the infected regions. Liberia's information minister, Lewis Brown, told the Telegraph this week that BA was putting more people in danger. "We need as many airlines coming in to this region as possible, because the cost of bringing in supplies and aid workers is becoming prohibitive," he told the Telegraph. "There just aren't enough seats on the planes. I can understand BA's initial reaction back in August, but they must remember this is a global fight now, not just a west African one, and we can't just be shut out." Christopher Stokes, director of MSF in Brussels, agreed: “Airlines have shut down many flights and the unintended consequence has been to slow and hamper the relief effort, paradoxically increasing the risk of this epidemic spreading across countries in west Africa first, then potentially elsewhere. We have to stop Ebola at source and this means we have to be able to go there.”
3
Temperature screening at airports is an effective way to stop those who have the disease from travelling
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The screening process is pretty porous, especially when individuals want to subvert it. Wake up on the morning of your flight, feel a bit hot, and you definitely don't want to be sent to an isolation booth for days and have to miss your flight. Take an ibuprofen and you can lower your temperature enough to get past the scanners. And if you suspect you have Ebola, you might be desperate to leave, seeing how much better the treatment success has been in western nations. And experts have warned that you cannot expect people to be honest about who they have had contact with. Thomas Eric Duncan, the Ebola victim who died in Texas, told officials he had not been in contact with anyone with the disease, but had in fact visited someone in the late stages of the virus, though he said he believed it was malaria. The extra screening that the US implemented since his death probably wouldn't have singled out Duncan when he arrived from hard-hit Liberia last month, because he had no symptoms while travelling.
4
Border staff should stop people coming in to the country who are at risk
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They're not doctors, and it's a monumental task to train 23,500 people who work for the UK Border Agency how to correctly diagnose a complex disease, and spot it in the millions of people who come through British transport hubs. Public Health England has provided UK Border Force with advice on the assessment of an unwell patient on entry to UK, but they can't be expected to check everyone.
5
Screening at British airports should be implemented to stop unwell people coming in from affected areas
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As mentioned before, the UK, especially London, is a major transport hub. Unlike the US, most of those coming from west Africa will have crossed through Europe, so infected people could be coming from practically anywhere, not just flights directly from those countries. This would require the UK to screen every returning traveller, as people could return to the UK from an affected country through any port of entry. This would be huge numbers of low risk people, at vast, vast expense.