Associated Press Blog: Survivors of ebola face second ‘disease’: stigma

I aim to give Ebola virus and the current West African outbreak a proper write-up in the near future, but here’s a quick link to the Associated Press blog. The blog has an interesting piece about the stigma suffered by the virus survivors in Guinea.

It is perfectly understandable that the population is terrified of the disease, and to many, contact with the survivors of the virus is deemed too much of a personal risk. One of the most interesting parts of the piece is the way that health officials are trying to fight this public perception:

The most powerful tool to combat stigma is the way health care workers treat a discharged patient, said Corinne Benazech, the representative in Guinea for Doctors Without Borders in Guinea.

“The patient never leaves alone,” she said of when Ebola survivors leave their isolation wards, and health care workers individually shake hands with the survivor.

Discharged patients receive a certificate from the minister of health that states they are no longer contagious, said Tom Fletcher, an infectious disease physician with the World Health Organization who is working in Guinea.

There is a fascinating clinical addendum to surviving ebola: the virus can linger in surviving individuals. Immunologically protected sites within the body (parts of the body where the immune system cannot fully function) appear to clear the virus more slowly. Ebola virus has been found in such regions, including the testes, the anterior chamber of the eye (the fluid behind the cornea) and potentially the mammary glands (the discussion of this paper [open access] is useful here). Whilst the virus can persist in these sites, it is eventually destroyed. Condom usage and breast milk alternatives are used to prevent spread to partners and mother to child transmission.

Importantly, from the same paper cited above:

“The absence of EBOV [Ebola virus] in the urine, low prevalence on the skin, and rapid clearance from the saliva in surviving patients provides some reassurance that the risk of secondary transmission from casual contacts, fomites, or the sharing of toilet facilities in the home after discharge from the hospital is minimal.”

Bottom line: casual contact with surviving ebola patients is not risky.

Tom Fletcher from the WHO:

“These people should be celebrated, really, as opposed to stigmatized.”

 

Cited articles:

Associated Press Blog: Survivors of ebola face second ‘disease’: stigma – Apr. 27, 2014. Diallo B. and DiLorenzo S. http://bigstory.ap.org/article/survivors-ebola-face-second-disease-stigma

Primary literature: Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites. Bausch D, et al., 2007. J Infect Dis. 196 (Supplement 2): S142-S147. doi: 10.1086/520545

 

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