BY LANCET GROUP.
In March, 2015, a 44-year-old female from Monrovia, Liberia, contracted Ebola virus disease and died in an Ebola treatment unit (ETU).
An extensive investigation revealed one epidemiological link to Ebola virus exposure: unprotected sexual intercourse with a male Ebola virus disease survivor.
A semen specimen collected from the Ebola virus disease survivor tested positive for Ebola virus RNA by real-time RT-PCR (rRT-PCR) 199 days after he first became ill with Ebola virus disease.
Although no infectious virus was isolated from the semen, genetic analysis of the Ebola virus collected from the semen of the Ebola virus disease survivor closely matched the Ebola virus recovered from the female patient.2
Ebola virus disease survivors were encouraged to practice abstinence or use condoms for 90 days after recovering from the disease.
However, the possibility of infectious Ebola virus persisting in the semen of survivors beyond this timeframe prompted WHO to issue new guidance.
In May, 2015, WHO released interim guidance for male Ebola virus disease survivors.
This interim guidance recommended the following:
(1) in addition to receiving condoms and sexual risk reduction counselling at ETU discharge, all male survivors should be offered semen testing for Ebola virus RNA by rRT-PCR until their semen tests negative twice for Ebola virus RNA;
(2) male survivors and their sexual partners should be provided with condoms and receive counselling to ensure safe sexual practices until their semen has twice tested negative;
(3) if a survivor’s semen has not been tested, he should practise safe sex for at least 6 months after onset of symptoms.
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