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Ebola RNA Persistence in Semen of Ebola Virus Disease Survivors - Preliminary Report

OPEN The New England journal of medicine | 16 Oct 2015

GF Deen, B Knust, N Broutet, FR Sesay, P Formenty, C Ross, AE Thorson, TA Massaquoi, JE Marrinan, E Ervin, A Jambai, SL McDonald, K Bernstein, AH Wurie, MS Dumbuya, N Abad, B Idriss, T Wi, SD Bennett, T Davies, FK Ebrahim, E Meites, D Naidoo, S Smith, A Banerjee, BR Erickson, A Brault, KN Durski, J Winter, T Sealy, ST Nichol, M Lamunu, U Ströher, O Morgan and F Sahr
Background Ebola virus has been detected in the semen of men after their recovery from Ebola virus disease (EVD), but little information is available about its prevalence or the duration of its persistence. We report the initial findings of a pilot study involving survivors of EVD in Sierra Leone. Methods We enrolled a convenience sample of 100 male survivors of EVD in Sierra Leone, at different times after their recovery from EVD, and recorded self-reported information about sociodemographic characteristics, the EVD episode, and health status. Semen specimens obtained at baseline were tested by means of a quantitative reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay with the use of the target-gene sequences of NP and VP40. Results A total of 93 participants provided an initial semen specimen for analysis, of whom 46 (49%) had positive results on quantitative RT-PCR. Ebola virus RNA was detected in the semen of all 9 men who had a specimen obtained 2 to 3 months after the onset of EVD, in the semen of 26 of 40 (65%) who had a specimen obtained 4 to 6 months after onset, and in the semen of 11 of 43 (26%) who had a specimen obtained 7 to 9 months after onset; the results for 1 participant who had a specimen obtained at 10 months were indeterminate. The median cycle-threshold values (for which higher values indicate lower RNA levels) were 32.0 with the NP gene target and 31.1 with the VP40 gene target for specimens obtained at 2 to 3 months, 34.5 and 32.3, respectively, for specimens obtained at 4 to 6 months, and 37.0 and 35.6, respectively, for specimens obtained at 7 to 9 months. Conclusions These data showed the persistence of Ebola virus RNA in semen and declining persistence with increasing months since the onset of EVD. We do not yet have data on the extent to which positivity on RT-PCR is associated with virus infectivity. Although cases of suspected sexual transmission of Ebola have been reported, they are rare; hence the risk of sexual transmission of the Ebola virus is being investigated. (Funded by the World Health Organization and others.).
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Biological warfare, Ebola, Sierra Leone, DNA, Microbiology, RNA, Genome, Viral hemorrhagic fever
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