Ebola virus has been found in the semen of some men who have recovered from Ebola infection, which indicates that Ebola could be transmitted through sex. Until more information is provided, the public are admonished to avoid contact with semen from male victims. If male survivors have sex (oral, vaginal, or anal sex), a condom should be used correctly and consistently every time, Ejekwu Joy writes.
The mode of presentation of Ebola disease and the potential for misdiagnosis as well as the existence of other equally devastating infections makes it imperative that standard precautions be instituted for all patients, survivors and partners, etc.
According to the WHO, a total of 18 new confirmed Ebola cases were reported in Guinea and Sierra Leone in the week compared to 33 in the previous week. This is the lowest weekly total this year.
Last month, between 30 and 37 confirmed cases were reported each week; this is the lowest number of total districts to report a confirmed case in Guinea, Liberia, and Sierra Leone since May 2014.
In Guinea, the nine reported cases were widely dispersed throughout six separate sub-prefectures. Five of the nine cases were identified post mortem. Four of the nine cases were a registered contact of a previous case, including one of the cases identified post mortem. There were 36 unsafe burials reported from seven prefectures in the week leading up to May 3. Of 374 laboratory samples tested in the week.
Recently, the World Health Organisation, WHO, issued an interim advice on the possibility of Ebola Virus being sexually transmitted.
The WHO had directed all Ebola survivors and their sexual partners to receive counseling to guard against possible transmission of the disease.
This was contained in a statement made available by WHO to newsmen in Lagos indicating that the sexual transmission of the Ebola Virus was yet to be established.
“The sexual transmission of the Ebola Virus from males to females is a strong possibility, but has not yet been proven; less probable, but theoretically possible.
“Studies have shown that Ebola virus can be isolated from semen up to 82 days after symptom onset.
A recent case investigation identified genetic material (RNA) from the virus by nucleic acid amplification tests (such as RT-PCR) 199 days after symptom onset. This is well beyond the period of virus detecting ability in the blood of survivors and long after recovery from illness,” it stated.
According to WHO, “The detection of virus genetic material many months after symptom onset is assumed to reflect the continuing, or at least very recent, presence of live and potentially transmissible Ebola virus.
“More surveillance data and research are needed on the risks of sexual transmission and particularly on the prevalence of viable and transmissible virus in semen over time,” WHO said.
WHO recommended that, in the interim, all Ebola survivors and their sexual partners should receive counseling.
It added that it was to ensure safe sexual practices until their semen has twice tested negative; and survivors should be provided with condoms.
“Ebola survivors and their sexual partners should either abstain from all types of sex or observe safe sex through correct and consistent condom use until their semen has twice tested negative.
“Having tested negative, survivors can safely resume normal sexual practices without fear of Ebola virus transmission,’’ the statement added.
WHO said that the male Ebola survivors should be offered semen testing at three months after onset of disease.
It also said that for those who tested positive, semen testing should be every month thereafter until their semen tests negative for virus twice by RT-PCR, with an interval of one week between tests. “If an Ebola survivor’s semen has not been tested, he should continue to practice safe sex for at least six months after the onset of symptoms. This interval may be adjusted as additional information becomes available on the prevalence of Ebola virus in the semen of survivors over time’’.
The statement noted that until such time when their semen has twice tested negative for Ebola, survivors should practice good hand washing with soap and water and other personal hygiene.
“This should be after any physical contact with semen, including after masturbation; used condoms should be handled and disposed safely so as to prevent contact with seminal fluids.
It however stated that Ebola virus RNA had also been detected by RT-PCR in vaginal fluid from one woman 33 days after symptom onset.
“Live virus has never been isolated from vaginal fluids.
With such limited data, it is not known for how long the virus typically persists in vaginal fluids, or whether it can be sexually transmitted from females to males,’’ WHO explained.
The world health body advocates that all survivors, their partners and families should be shown respect, dignity and compassion.
Similarly, chairman, Association of public health physicians of Nigeria, Lagos chapter, Dr Doyin Odubanjo, who spoke to Nigerian Pilot Sunday on the startling revelation, in an interview, reviewed the possibilities of Ebola being transmitted through sex.
According to him, “Transmission is nothing new, such virus as Ebola has been extracted before in the semen of men that had Ebola infection even after he has been declared Ebola free, there were still traces of the virus some weeks after. So, once it is still in the semen, it can be transmitted through sex. That is the basis; but there has not been a case actually of such transmission that has been proven; but were to establish, that, we could find the virus some weeks after because the virus was in the body fluid, when it is cleared off, it seems the last place where it is going to disappear from, is that semen, at discharge, health providers’ advice abstinence from sex or the use of condom for a period of time.
“The virus will eventually get cleared from the semen. When there is an infection in the body, it clears off almost like stage by stage from different parts of the body. People believe that the virus is not curable since it can still be traced back to the discharged person’s body; but it is curable. That is preserving the person through the complications, human body will develop immunity to the virus over a few days and weeks and that immunity is going to clears off the virus from the body of which the semen will not be the first to clear but the very last,” he said.
According to her, “People should not consider this, the infection as another HIV/ AIDS pandemic because they have different characteristics; under normal circumstances, HIV does not clear off but Ebola does and if an Ebola patient will die, they will not survive it and it kills very quickly but HIV takes a very relatively longer time.
She explained that there were counseling for survivors and partners before they are discharged except for physiological supports which they can seek and will yet be given; but they are often told to keep in touch and have numbers to reach out to health providers to know their conditions; but the survivors are counseled appropriately and discharged.
But despite all of these, the risk factors still remains contact with fluids like salivas’, sweat, blood, the body fluids generally has the risk of transmission,” Odubanjo explained.
Also speaking, the Secretary General of Medical Women Association of Nigeria, MWAN, Lagos state branch, Mrs Fumi Ige, in an interview with this paper, argued that there is no 100 percent proof that Ebola can be transmitted by sex.
“There the possibility, according to WHO, in the population that Ebola can be gotten through sex, though, it has not been 100 percent proven, as research will be carried out on body fluid of an infected person to ascertain his/her true status. But we advice at the moment for those who have been affected with the virus: to abstain from sexual intercourse for up to 90days.
“Studies are still ongoing to be sure, but there is no certainty from WHO until it’s proven; but to be on the safer side, and reduce the risk of the spread of the virus from the infected person, peradventure it turns out to be true, we advice that those who have suffered from the virus, to abstain from sex for up to 90days,” she said.
According to her, the Ebola virus has to do with semen and not about the gene; so, no vaccine yet until proven.” For the virus, it can be in the body fluid as in the semen which is not about the gene, but about the transmission like the HIV/ AIDS known as virus of the blood transmitted to another through contact. The semen is the body fluid and if the virus finds itself to the semen, through intercourse, it can be transferred from the male partner to the female.
She informed that there are no vaccines yet as far as I know, but more studies needs to be carried out on Ebola virus itself in other to characterise the virus and know what to produce against it; but this can’t really be considered as another HIV/AIDS pandemic in the making and we hope it will not get to that point because the fact that we have been able to contain the infection’s spread not only in Nigeria where we had it first, but also in west African countries, shows that it is far from HIV/ AIDS pandemic,” she explained.
Ige further disclosed that there was need to step up the ongoing enlightenment programmes as well as the need for proper hygiene in fighting the disease. She said “There has been lots of health enlightenment programmes going on to help Ebola survivors and partners. In Lagos, we are not relaxed, being fully aware of how persons travel to and fro into different parts of the world. So, the enlightenment on preventive measures is still ongoing and I want to believe that in countries like Guinea, Liberia etc where there are high incidents, enlightenment programmes are also going on.
“One risk factor revolves round hygiene that is the maintenance of good hygiene, avoiding body fluids from one person to another not only through sex. When our health habits are right, whether for Ebola or any other condition at all, the risk would be minimal, so, there is need to learn and apply proper health habits and practices starting from the home because a lot of disease conditions are actually related to hygiene primarily before other factors can be considered but if hygiene are handled, diseases minimizes,” she emphasised.

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