Posted on 28TH AUG 2017
tagged Ebola, Worldwide

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

In this update:
[1] News
- Disability rate in survivors
- Ebola cemetery vandalism
[2] Research
- Viremia and organ damage

[1] News
- Disability rate in survivors
21 Aug 2017. Study finds high disability rate in Ebola survivors
[Ebola survivors have 7 times the disability rate of their close contacts, and the virus likely causes muscle damage.
The findings are among data from 2 new studies published in Clinical Infectious Diseases that observe survivors of Sierra Leone's Ebola outbreak to understand how often the disease causes disabilities and how it affects major organs.
Though both studies are small, they provide new insight into the lasting damage that Ebola virus disease (EVD) causes survivors.

Ebola and long-lasting disabilities (1)
In the 1st study, researchers followed 27 Ebola survivors in Sierra Leone for 1 year after diagnosis and found they were 7 times more likely than their close contacts to report a disability.
77.8 percent of the survivors reported a disability 1 year post-infection, compared with 11.1 percent of their close contacts. Disabilities included major limitations in vision, mobility, and cognition.
Disability was measured using the Washington group disability questionnaire, and the survivors were matched with 54 unaffected contacts. Mobility difficulties were the most frequent disability reported, with almost all survivors reporting musculoskeletal pain.
"This study has demonstrated that a year following acute disease, survivors of the recent EVD outbreak have higher odds of persisting disability in mobility, vision, and cognition," the authors concluded. "Mental health issues such as anxiety and depression persist in EVD survivors and must not be neglected."

Ebola virus causes muscle damage (2)
In the other study based on EVD survivors in Sierra Leone, researchers looked at the relationship between Ebola viremia and specific organ damage. They found no evidence that Ebola virus specifically damages the liver or kidney, but they did find strong evidence to suggest that the virus destroys muscles and the body's coagulation system.
This is the 1st study to compare Ebola viremia to specific biomarkers, the authors said.
To conduct the study, data on biomarkers from 49 survivors and 51 non-survivors were collected and analyzed. 10 biomarkers, including bilirubin, creatinine, and Ebola viremia were used to determine which organ systems were under attack during an Ebola infection.
While it has long been assumed that Ebola, a hemorrhagic fever, causes damage to the coagulation system, little else is known about how the virus attacks organs. Though the study provided no evidence that Ebola affected the kidneys, kidney damage is often seen in Ebola patients.
The authors said this was because Ebola viremia was strongly related to evidence of rhabdomyolysis, the rapid breakdown of muscles, which stresses the kidneys.]

[Byline: Stephanie Soucheray]

1. Jagadesh S, Sevalie S, Fatoma R, et al. Disability among Ebola survivors and their close contacts in Sierra Leone: a retrospective case-controlled cohort study. Clin Infect Dis. 2017; cix705; https://doi.org/10.1093/cid/cix705]
2. Lanini, Portella G, Vairo F, et al. Relationship between viremia and specific organ damage in Ebola patients: a cohort study. Clin Infec Dis 2017; cix704; https://doi.org/10.1093/cid/cix704 [See report below, under [2] Research. - Mod.LK]

- Ebola cemetery vandalism
23 Aug 2017. Sierra Leone: Crooks dig up Sierra Leone's 'Ebola Cemetery'. Thieves pillage the tombs of the rich and the poor, desecrating their bodies, erasing their identities.
[After a devastating mudslide hit Freetown, Sierra Leone, early last week [week of 14 Aug 2017], the nation held a painful ceremony to bury the dead. The government hired about 600 gravediggers, while a huge crowd that included President Ernest Bai Koroma and his Liberian counterpart, Ellen Johnson Sirleaf, looked on. Hundreds were interred in a new cemetery, a recent creation for people whose death arrived all of a sudden.
But few there are allowed to rest in peace. This particular graveyard in Waterloo, about 15 miles [24 km] east of the capital Freetown, is known in Sierra Leone as the "Ebola cemetery." It was used to inter 4000 victims of the 2014-15 [Ebola virus disease (EVD)] outbreak. But after the disease was contained, the cemetery was made available to the public for burial -- and hoodlums saw an opportunity.
During the [EVD] epidemic Waterloo was managed by the nongovernmental organization out of Ireland, Concern Worldwide, but since the charity handed it over to the Western Area Rural District Council, thieves have been on a rampage. They reportedly have stolen a giant tank that stores water for the cemetery's buildings, carted away zinc sheets in the toilet facility, and vandalized the pavilion that was built for visitors to sit. But that's just on the surface.

[Byline: Philip Obaji Jr]

[2] Research
20 Aug 2017: Relationship between viremia and specific organ damage in Ebola patients: a cohort study
[A study was conducted of 100 patients (49 survivors and 51 non-survivors) analyzing organ damage and viremia following EVD.
Citation. Lanini, Portella G, Vairo F, et al. Relationship between viremia and specific organ damage in Ebola patients: a cohort study. Clin Infec Dis 2017; cix704; http://tinyurl.com/yayuk2hv
Abstract. Pathogenesis of Ebola virus disease remains poorly understood. We used concomitant determination of routine laboratory biomarkers and Ebola viremia to explore the potential role of viral replication in specific organ damage.
Conclusion. This study provides evidence to support that Ebola virus may have a direct role in muscular damage and imbalance of the coagulation system. We did not found strong evidence suggestive of a direct role of Ebola virus in kidney damage. The role of the virus in liver damage remains unclear, but our evidence suggests that acute severe liver injury is not a typical feature of Ebola virus disease.]

[See source URL for full report.]

[Compiled by: Celeste Whitlow ]

Communicated by:

[Maps of the West African countries affected by the 2014 Ebola outbreak can be accessed at
Liberia http://healthmap.org/promed/p/54
Guinea http://healthmap.org/promed/p/45
Sierra Leone http://healthmap.org/promed/p/46
- Mod.LK]

See Also
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Ebola update (28): DR Congo, Uganda, research 20170607.5090956
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Ebola update (25): news, research, vaccine 20170524.5057906
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Ebola update (23): DRC, news, vaccine 20170519.5047049
Ebola update (22): WHO sit rep, news, research, vaccine 20170518.5044073
Ebola update (21): Congo DR, News, Research, Vaccine
Ebola update (20): Congo DR, news, vaccine, update 20170515.5037761
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Ebola update (17): Congo DR, vaccine, research 20170512.5031411
Ebola update (16): news, research, vaccines, funding 20170428.5000661
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Ebola update (40): Liberia, Sierra Leone, research, vaccines 20160514.4222416
Ebola update (30): Liberia re-emergence, Uganda NOT, RFI 20160404.4136987
Ebola update (20): new antiviral, prevention 20160306.4073116
Ebola update (10): Sierra Leone, vaccine, funding 20160131.3981594
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