A longitudinal study of Ebola sequelae in Liberia

PREVAIL III Study Group

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND Multiple health problems have been reported in survivors of Ebola virus disease (EVD). Attribution of these problems to the disease without a control group for analysis is difficult. METHODS We enrolled a cohort of EVD survivors and their close contacts and prospectively collected data on symptoms, physical examination findings, and laboratory results. A subset of participants underwent ophthalmologic examinations. Persistence of Ebola virus (EBOV) RNA in semen samples from survivors was determined. RESULTS A total of 966 EBOV antibody-positive survivors and 2350 antibody-negative close contacts (controls) were enrolled, and 90% of these participants were followed for 12 months. At enrollment (median time to baseline visit, 358 days after symptom onset), six symptoms were reported significantly more often among survivors than among controls: urinary frequency (14.7% vs. 3.4%), headache (47.6% vs. 35.6%), fatigue (18.4% vs. 6.3%), muscle pain (23.1% vs. 10.1%), memory loss (29.2% vs. 4.8%), and joint pain (47.5% vs. 17.5%). On examination, more survivors than controls had abnormal abdominal, chest, neurologic, and musculoskeletal findings and uveitis. Other than uveitis (prevalence at enrollment, 26.4% vs. 12.1%; at year 1, 33.3% vs. 15.4%), the prevalence of these conditions declined during followup in both groups. The incidence of most symptoms, neurologic findings, and uveitis was greater among survivors than among controls. EBOV RNA was detected in semen samples from 30% of the survivors tested, with a maximum time from illness to detection of 40 months. CONCLUSIONS A relatively high burden of symptoms was seen in all participants, but certain symptoms and examination findings were more common among survivors. With the exception of uveitis, these conditions declined in prevalence during follow-up in both groups. Viral RNA in semen persisted for a maximum of 40 months.

Original languageEnglish (US)
Pages (from-to)924-934
Number of pages11
JournalNew England Journal of Medicine
Volume380
Issue number10
DOIs
StatePublished - Mar 7 2019

Fingerprint

Liberia
Longitudinal Studies
Survivors
Uveitis
Ebolavirus
Ebola Hemorrhagic Fever
Semen
Neurologic Manifestations
RNA
Antibodies
Myalgia
Memory Disorders
Viral RNA
Arthralgia
Physical Examination
Fatigue
Headache
Thorax

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

Cite this

A longitudinal study of Ebola sequelae in Liberia. / PREVAIL III Study Group.

In: New England Journal of Medicine, Vol. 380, No. 10, 07.03.2019, p. 924-934.

Research output: Contribution to journalArticle

PREVAIL III Study Group. / A longitudinal study of Ebola sequelae in Liberia. In: New England Journal of Medicine. 2019 ; Vol. 380, No. 10. pp. 924-934.
@article{4edfb10c16ca4345827da6aaa539786b,
title = "A longitudinal study of Ebola sequelae in Liberia",
abstract = "BACKGROUND Multiple health problems have been reported in survivors of Ebola virus disease (EVD). Attribution of these problems to the disease without a control group for analysis is difficult. METHODS We enrolled a cohort of EVD survivors and their close contacts and prospectively collected data on symptoms, physical examination findings, and laboratory results. A subset of participants underwent ophthalmologic examinations. Persistence of Ebola virus (EBOV) RNA in semen samples from survivors was determined. RESULTS A total of 966 EBOV antibody-positive survivors and 2350 antibody-negative close contacts (controls) were enrolled, and 90{\%} of these participants were followed for 12 months. At enrollment (median time to baseline visit, 358 days after symptom onset), six symptoms were reported significantly more often among survivors than among controls: urinary frequency (14.7{\%} vs. 3.4{\%}), headache (47.6{\%} vs. 35.6{\%}), fatigue (18.4{\%} vs. 6.3{\%}), muscle pain (23.1{\%} vs. 10.1{\%}), memory loss (29.2{\%} vs. 4.8{\%}), and joint pain (47.5{\%} vs. 17.5{\%}). On examination, more survivors than controls had abnormal abdominal, chest, neurologic, and musculoskeletal findings and uveitis. Other than uveitis (prevalence at enrollment, 26.4{\%} vs. 12.1{\%}; at year 1, 33.3{\%} vs. 15.4{\%}), the prevalence of these conditions declined during followup in both groups. The incidence of most symptoms, neurologic findings, and uveitis was greater among survivors than among controls. EBOV RNA was detected in semen samples from 30{\%} of the survivors tested, with a maximum time from illness to detection of 40 months. CONCLUSIONS A relatively high burden of symptoms was seen in all participants, but certain symptoms and examination findings were more common among survivors. With the exception of uveitis, these conditions declined in prevalence during follow-up in both groups. Viral RNA in semen persisted for a maximum of 40 months.",
author = "{PREVAIL III Study Group} and Sneller, {Michael C.} and Cavan Reilly and Moses Badio and Bishop, {Rachel J.} and Reilly, {Cavan S} and Moses, {Soka J.} and Johnson, {Kumblytee L.} and Dehkontee Gayedyu-Dennis and Hensley, {Lisa E.} and Higgs, {Elizabeth S.} and Avindra Nath and Kaylie Tuznik and Justin Varughese and Jensen, {Kenneth S.} and Bonnie Dighero-Kemp and Neaton, {James D.} and {Clifford Lane}, H. and Jim Neaton",
year = "2019",
month = "3",
day = "7",
doi = "10.1056/NEJMoa1805435",
language = "English (US)",
volume = "380",
pages = "924--934",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "10",

}

TY - JOUR

T1 - A longitudinal study of Ebola sequelae in Liberia

AU - PREVAIL III Study Group

AU - Sneller, Michael C.

AU - Reilly, Cavan

AU - Badio, Moses

AU - Bishop, Rachel J.

AU - Reilly, Cavan S

AU - Moses, Soka J.

AU - Johnson, Kumblytee L.

AU - Gayedyu-Dennis, Dehkontee

AU - Hensley, Lisa E.

AU - Higgs, Elizabeth S.

AU - Nath, Avindra

AU - Tuznik, Kaylie

AU - Varughese, Justin

AU - Jensen, Kenneth S.

AU - Dighero-Kemp, Bonnie

AU - Neaton, James D.

AU - Clifford Lane, H.

AU - Neaton, Jim

PY - 2019/3/7

Y1 - 2019/3/7

N2 - BACKGROUND Multiple health problems have been reported in survivors of Ebola virus disease (EVD). Attribution of these problems to the disease without a control group for analysis is difficult. METHODS We enrolled a cohort of EVD survivors and their close contacts and prospectively collected data on symptoms, physical examination findings, and laboratory results. A subset of participants underwent ophthalmologic examinations. Persistence of Ebola virus (EBOV) RNA in semen samples from survivors was determined. RESULTS A total of 966 EBOV antibody-positive survivors and 2350 antibody-negative close contacts (controls) were enrolled, and 90% of these participants were followed for 12 months. At enrollment (median time to baseline visit, 358 days after symptom onset), six symptoms were reported significantly more often among survivors than among controls: urinary frequency (14.7% vs. 3.4%), headache (47.6% vs. 35.6%), fatigue (18.4% vs. 6.3%), muscle pain (23.1% vs. 10.1%), memory loss (29.2% vs. 4.8%), and joint pain (47.5% vs. 17.5%). On examination, more survivors than controls had abnormal abdominal, chest, neurologic, and musculoskeletal findings and uveitis. Other than uveitis (prevalence at enrollment, 26.4% vs. 12.1%; at year 1, 33.3% vs. 15.4%), the prevalence of these conditions declined during followup in both groups. The incidence of most symptoms, neurologic findings, and uveitis was greater among survivors than among controls. EBOV RNA was detected in semen samples from 30% of the survivors tested, with a maximum time from illness to detection of 40 months. CONCLUSIONS A relatively high burden of symptoms was seen in all participants, but certain symptoms and examination findings were more common among survivors. With the exception of uveitis, these conditions declined in prevalence during follow-up in both groups. Viral RNA in semen persisted for a maximum of 40 months.

AB - BACKGROUND Multiple health problems have been reported in survivors of Ebola virus disease (EVD). Attribution of these problems to the disease without a control group for analysis is difficult. METHODS We enrolled a cohort of EVD survivors and their close contacts and prospectively collected data on symptoms, physical examination findings, and laboratory results. A subset of participants underwent ophthalmologic examinations. Persistence of Ebola virus (EBOV) RNA in semen samples from survivors was determined. RESULTS A total of 966 EBOV antibody-positive survivors and 2350 antibody-negative close contacts (controls) were enrolled, and 90% of these participants were followed for 12 months. At enrollment (median time to baseline visit, 358 days after symptom onset), six symptoms were reported significantly more often among survivors than among controls: urinary frequency (14.7% vs. 3.4%), headache (47.6% vs. 35.6%), fatigue (18.4% vs. 6.3%), muscle pain (23.1% vs. 10.1%), memory loss (29.2% vs. 4.8%), and joint pain (47.5% vs. 17.5%). On examination, more survivors than controls had abnormal abdominal, chest, neurologic, and musculoskeletal findings and uveitis. Other than uveitis (prevalence at enrollment, 26.4% vs. 12.1%; at year 1, 33.3% vs. 15.4%), the prevalence of these conditions declined during followup in both groups. The incidence of most symptoms, neurologic findings, and uveitis was greater among survivors than among controls. EBOV RNA was detected in semen samples from 30% of the survivors tested, with a maximum time from illness to detection of 40 months. CONCLUSIONS A relatively high burden of symptoms was seen in all participants, but certain symptoms and examination findings were more common among survivors. With the exception of uveitis, these conditions declined in prevalence during follow-up in both groups. Viral RNA in semen persisted for a maximum of 40 months.

UR - http://www.scopus.com/inward/record.url?scp=85062697714&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062697714&partnerID=8YFLogxK

U2 - 10.1056/NEJMoa1805435

DO - 10.1056/NEJMoa1805435

M3 - Article

VL - 380

SP - 924

EP - 934

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 10

ER -