Ebola survivors face joint, eye complications

About half of Ebola survivors suffer joint pain and about a quarter have had eye complications, based on preliminary data, the World Health Organization says.

Maternal, fetal mortality has been very high among pregnant Ebola survivors

Beatrice Yordolo, who was declared a survivor of the Ebola virus on March 5, 2015, stands with family and neighbours on the outskirts of Monrovia, Liberia, in April. Researchers are starting to learn about the long-term complications among survivors. (Zoom Dosso/AFP/Getty)

About half of Ebola survivors suffer joint pain and about a quarter have had eye complications, based on preliminary data, the World Health Organization says.

The United Nations health agency held a telephone news briefing for journalists on Friday from Freetown, the capital of Sierra Leone, following a conference on Ebola survivors. 

The joint pain can be serious, said Dr. Daniel Bausch from the WHO's clinical-care team.

"This is not the sort of thing that people say 'Oh my elbow bothers me a little bit,'" Bausch said. "This can be a very  debilitating, a very serious problem that can prevent people from going back to work and from providing for their  families." 

About 25 per cent of survivors in Sierra Leone, Guinea and Liberia have shown serious eye complications with some degree of change in vision, Bausch said. Some of them have uveitis, inflammation that if left untreated can lead to blindness.

One of the challenges in treating eye complications is the lack of specialists. Sierra Leone has only two trained ophthalmologists, Bausch noted. Specialists from Emory University in the U.S., the WHO and non-governmental organizations are helping to provide eye care for Ebola survivors.

Windsor, Ont.-based Dr. Tim Jagatic of Doctors without Borders has been to West Africa three times to help control the outbreak.

The lack of doctors in Sierra Leone, Liberia and Guinea makes it difficult to treat not only patients with Ebola but those with malaria, women giving birth or people dealing with complications of other diseases, Jagatic said. 

"To give an example of how poorly staffed they are, in Bellevue Hospital in New York in Manhattan there are more doctors staffed in that hospital than in all three of those countries combined," Jagatic said.

Dr. Craig Spencer, a New York doctor infected with Ebola at a treatment centre in Guinea, was treated at Bellevue Hospital

It is difficult to compile early data on mental health consequences, such as depression and post-traumatic stress disorder, among Ebola survivors, Bausch said. 

There are no licensed drugs specifically for the Ebola virus and its complications. Several preventive vaccines and treatments are in various stages of testing.

Last week, WHO announced that an experimental Ebola vaccine designed by Canadian scientists seems to work based on the interim results of a trial in Guinea. It could be approved by regulators in weeks to months, the agency said. 

Pregnancy a challenge for doctors

Doctors said one of the challenges health-care workers are dealing with on the ground is the increasing number of survivors who are pregnant. 

To date, maternal and fetal mortality has been very high among Ebola survivors, Bausch said.

On rare occasions where a pregnant woman survives and goes into labour, the virus seems to persist in the fetus and placenta, Bausch said. The fetus and placenta seem to be "immunologically protected" sites in the body that the immune system's antibodies don't clean out. 

The eyes and testes are two other such sites.

Since the eye can be a reservoir for the virus, cataract surgery could carry infectious risks to the surgical team. Bausch said to his knowledge, cataract surgery hasn't been attempted among Ebola survivors. 

It is possible that if cataracts are removed and there is no other damage to the eye then vision will be restored. 

As of Aug. 2, WHO says nearly 27,900 cases and 11,300 deaths have been reported worldwide. There were two confirmed cases of Ebola reported in the week ending Aug. 2, one each in Guinea and Sierra Leone. It was the lowest weekly total reported since March 2014, and marks a third consecutive decline in weekly cases.

With files from CBC's Amina Zafar and Vik Adhopia


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