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People in in protective suits prepare for a demonstration of their work at the SITTU (Severe Infections Temporary Treatment Unit) in Monrovia, Liberia in April 2015. Kay Nietfeld/DPA/PA Images

Fears raised after Ebola reemerges in woman one year after all-clear

Her husband and sons may have been infected with the virus as a result.

THE EBOLA VIRUS may have reemerged in a woman a year after she survived contracting the deadly virus.

The woman’s husband and two of their sons may have been infected with the virus as a result.

Researchers looking into the last-known cluster of infections from a source within Liberia, occurring in November 2015, said the case highlights the need for continued surveillance.

In a research paper published in The Lancet Infectious Diseases journal, they said transmissions from latent Ebola virus infections are rare, but that their findings highlight the importance of close surveillance once countries are declared Ebola-free.

The virus can persist in certain parts of the body after recovery from acute infection, and Ebola virus RNA has previously been detected in semen, breast milk and cerebrospinal fluid (which is found in the brain and spinal cord) of survivors.

Previously there have only been two cases of the virus reemerging, and this new cluster is the first indication of transmission from a persistently infected female survivor of Ebola virus disease.

“Despite no current active Ebola virus transmission chains in west Africa, Ebola virus persistence could pose a continued risk for resurgence of cases and may have the potential for a large-scale outbreak, if not detected rapidly and controlled,” lead author Emily Kainne Dokubo of the US Centers for Disease Control and Prevention said.

Further studies are needed to better understand viral persistence and transmission, and to reduce stigma against survivors.

“Additionally, countries and global health partners should continue to focus on strengthening health systems to prevent, rapidly detect, and respond to Ebola virus infections in the region,” she stated.

11,000 deaths

In 2014 and 2015, the Ebola virus disease outbreak in west Africa resulted in more than 28,000 cases and 11,000 deaths across Liberia, Guinea and Sierra Leone.

The first case in Liberia was reported in March 2014, and infection then spread rapidly across the country, killing more than 4,800 people. In May 2015, Liberia was declared free of human-to-human Ebola virus transmission.

In June 2015, a month after Liberia had been declared Ebola-free, a flare-up of a cluster of cases highlighted the potential for retransmission, but the rapid and robust response was effective in limiting additional infections, and the country was again declared free of Ebola virus transmission in September 2015.

As part of the new cluster report, the authors conducted an investigation of a family of six (mother, father and four sons aged two months, five years, eight years and 15 years), and analysed the genetics of the Ebola virus detected among some of the individuals.

Health services first identified the family when the 15-year-old son showed symptoms of the Ebola and tested positive in Monrovia, Liberia, on 19 November 2015. Once the Ebola virus infection was confirmed, he was moved into a treatment unit but died on 23 November.

At this point, both the father and the eight-year-old brother also tested positive for Ebola virus RNA, and experienced some symptoms (tiredness, headache and fever) but both recovered.

Pregnancy 

The mother tested negative for Ebola virus RNA. However, she had positive Ebola virus antibodies indicating prior infection, and an investigation suggested she survived an acute Ebola virus infection in July 2014.

The researchers believe that the mother’s infection may have re-emerged after her pregnancy, making the infection flare-up in October 2015, then transmitting the virus to her family.

Genetic analysis suggests that the virus carried by the father, the 15-year-old son and the eight-year-old son were similar, and that it was a continuation of the 2014 west African Ebola virus outbreak, when the mother suffered an acute infection after having cared for her brother who died from the disease.

The two-month-old son also had a low level of antibodies to the virus, which is likely to be caused by the transfer of maternal antibodies through breast milk.

By assessing the family’s history, the researchers ruled out travel to areas with active Ebola virus transmission, association with people who had travelled from these areas, and contact with animals that could transmit the Ebola virus as the possible source of infection.

Exactly how the virus was passed from family member to family member remains unclear, but the authors suggest it could be close physical contact or contact with bodily fluids.

The authors note some limitations to their study, including that the genetic analysis of the father’s virus in November 2015 was incomplete.

In addition, there were no available samples from the mother and the mother’s brother in 2014. During this time Ebola treatment units had limited capacity to fully investigate and diagnose cases.

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    Mute Finbarr Barry
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    Mar 5th 2019, 1:23 PM

    A methodone clinic has opened opposite a primary school in Waterford City and a new homeless service is opening next to a special needs primary and secondary school also in Waterford City…

    No word from Tusla on this though

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    Mute Bryan Yelahw
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    Mar 5th 2019, 1:44 PM

    @Finbarr Barry: What has it got to do with Tusla? Bizarre comment.

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    Mute Darren Bates
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    Mar 5th 2019, 1:45 PM

    @Finbarr Barry: what would Tusla have to do with any of that? Just pure NIMBYism by you

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    Mute Finbarr Barry
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    Mar 5th 2019, 4:59 PM

    @Bryan Yelahw: when the drug adicts come onto school grounds and do number twos In Front of kids then it is Tuslas problem

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    Mute Finbarr Barry
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    Mar 5th 2019, 5:00 PM

    @Darren Bates: definitely not… Especially next to a special needs school where vulnerable kids attend

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    Mute K
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    Mar 5th 2019, 5:33 PM

    @Finbarr Barry: it’s actually not. Contact the management of the centre or the Gardaí.

    5
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    Mute Mark Lamb
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    Mar 5th 2019, 2:21 PM

    Tusla Rotten to the Core of Hell shame on ye for what ye did to Maurice McCabe and his Wife Lorraine McCabe and their innocent Children putting False Child Rape in the Tusla Data Files make you think how many more innocent families have being Destroyed By Tusla Social Workers & the Gardai /Irish Police why most people in Ireland did not hear of this is most of this Evil Acts go on in family Law Courts in Secret Camera any one who has dealt with Tusla Social Workers need to get their data information Now you maybe the next Maurice McCabe … O Ya how are the staff who cover up the Grace Case getting on in Tusla ???

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    Mute Martin Brennan
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    Mar 5th 2019, 2:55 PM

    Ask those like Garda McCabe who about Re integrity and competency of Tusla – Most of whom demand lecturer hall parenting and zero experience

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    Mute Rebecca Ní Smurchú
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    Mar 5th 2019, 2:03 PM

    Well done to the children and young people involved in this. A great initiative!

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    Mute Michael Lynch
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    Mar 5th 2019, 3:17 PM

    Why don’t Tusla staff do this in person if child welfare is such a concern for them? Maybe none of them could handle the responsibility. Oh wait, 4 year degree course makes them experts when they’re barely out of childhood themselves.

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    Mute K
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    Mar 5th 2019, 5:01 PM

    @Michael Lynch:

    Hi Michael.
    I think the idea of this is to try and provide some materials children can use themselves in their own time to rationalise TUSLA intervention, which ranges from child protection, fostering, family support and psychology to name a few.

    There is one TCD degree in Ireland that you can do that’s 4 years and open to under 23 year olds. Most BSW courses you need to be 23 to start and go on for 4 years. Hence a general graduate age of at least 27/28. Most SWs have Masters which means at least 5 years in University with placements and significant social care or voluntary experience or come as mature students.

    Very few, if any SWs get into the job for money or respect. They do it to try and make a difference. Blame the system, not the frontline worker.

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    Mute Caroline Reid
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    Mar 5th 2019, 5:08 PM

    @Michael Lynch: staff often try to do this but sadly the young person quite often doesn’t want to listen. They are understandably hurt and angry. This allows them to look up the information when they are ready and at their own pace.

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    Mute Seán C
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    Mar 5th 2019, 1:19 PM

    Copy and paste job.

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    Mute Shakka1244
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    Mar 5th 2019, 12:49 PM

    ° ARE in?

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    Mute Karen Wellington
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    Mar 5th 2019, 1:08 PM

    @Shakka1244: Tulsa is one single organisation. Tulsa is in their lives.

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    Mute sean o'dhubhghaill
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    Mar 5th 2019, 2:36 PM

    @Karen Wellington: TUSLA! Tulsa is a place 24 hours away.

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    Mute Karen Wellington
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    Mar 5th 2019, 3:57 PM

    @sean o’dhubhghaill: what can I say; Oklahoma just doesn’t get enough press but I‘m here to change all that

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    Mute Niamh Foley
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    Mar 5th 2019, 8:55 PM

    A welcome introduction for children but shouldn’t this have been made available to children when Tulsa took over from the hse?? 2014 I believe this happened. Thousands of children left confused over the years I’m sure. Will we ever be proactive instead of reactive??

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    Mute John Scott1281
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    Mar 5th 2019, 1:33 PM

    Aimed mainly at 4 to 8yr olds , sure they’re only little geniuses. ” The wheels on the bus go round and round ” designed by Barney.

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    Mute GRANjzT
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    Mar 5th 2019, 1:52 PM

    @John Scott1281: That is a 2 year old. A 4 to 8 year old would put you to shame, believe me.

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