Maybe the ‘next AIDs’ comments weren’t so far off.
Although I should point out that the regular transmission shouldn’t change (droplets, non-sexual fluids inc. sweat), but it would function exactly as if it were an STD-native from a recovering/recovered carrier without quarantine.
People are surviving the disease. Doctors Without Borders, which oversees many Ebola clinics in west Africa, is sending home recovered Ebola patients with a stack of condoms, and health workers are urging them to only engage in protected sex for at least three months after recovery. The virus has been found in the semen and vaginal fluids of convalescents for weeks or even months after symptoms of Ebola have abated, setting off concern that the virus could be spread via sexual contact with otherwise healthy individuals. In men, one study found that Ebola continued to persist in semen for 90 days. U.S. health officials are echoing this caution as a small number of patients have been released from American hospitals.
…So why the “safe sex” warning when thousands of patients have survived Ebola and may have gone on to have sex, apparently without infecting their partners? Extreme caution is not an overreaction with this disease. Studies by Bausch and others have also detected live Ebola virus in sexual fluids that can successfully grow in cell culture, suggesting it could also lead to infections in other individuals. It is possible that sexually transmitted Ebola may have flown under the radar because there has been a dearth of data from outbreaks in years past. Also, although extremely unlikely, it is possible that mild Ebola—with very minor symptoms that were not recognized as such—has developed in patients’ sexual partners. Thus, the CDC warns that convalescing patients must either abstain from intercourse and oral sex for three months or use condoms for that entire time.
But what about fairly innocent stuff like kissing?
Where do you draw the line here?
With any infectious disease, when patients have a high viral load in their bodily fluids, it increases the risk they will pass disease to someone else through direct contact with those fluids. With HIV, for example, the risk of passing the disease between partners increases with higher viral load: For every 10-fold increase in viral concentration, one 2012 study suggests there is about a threefold increase in the risk of transmission per sexual act. And with HIV, condoms are a highly effective mode of blocking disease transmission because the virus is primarily spread via contact with sexual fluids or blood.
As with HIV, when Ebola progresses, a patient’s viral loads inch upward and that boosts the chance of disease transmission via contact with bodily fluids. Moreover, a certain degree of natural immunological protection for certain body parts—the central nervous system, eyes and gonads—makes it difficult for virus to exit those bodily parts, which may lead to the virus continuing to be present even after the virus was cleared from the blood, according to Bausch. And if an Ebola patient’s disease proves fatal, his viral load at death is particularly high, which boosts the risk of contracting the disease from interacting with the corpse.
Like backward funerary rituals that led to other outbreaks like Kuru?
Ebola virus manages to thrive in a variety of bodily fluids. It is found in its highest concentrations in blood, vomit and feces. But coming into direct contact with semen, vaginal fluids, saliva or even sweat could still be risky while a patient is symptomatic. (Although it’s not likely patients in the throes of illness would be engaging in sex. And live Ebola virus, according to WHO, has never been isolated in human sweat.) Just how infectious those fluids may be after recovery, however, remains a series of question marks. Studies in this area have been extremely small and continue to be largely inconclusive. Thus far, there are no recorded cases of sexual transmission of Ebola. With more than 13,500 cases currently in west Africa right now, however, public health officials do not want to take any chances.
I hate being right.