Survivors

In the wake of the 2014 West Africa and 2018 Democratic Republic of the Congo outbreaks, the two largest outbreaks of Ebola disease to date, there are now more Ebola disease survivors than ever before. This large number of survivors provides a chance to better understand how ebolaviruses affect people who have recovered, and to advise survivors on how to take care of themselves and their communities.

Recovery from Ebola

Recovery from Ebola disease depends on good supportive care and the patient’s immune response. Investigational treatments are also increasing overall survival.

Those who do recover develop antibodies that can last 10 years, possibly longer. Survivors are thought to have some protective immunity to the species of ebolavirus that sickened them. It is not known if people who recover are immune for life or if they can later become infected with a different species of ebolavirus. Some survivors may have long-term complications, such as joint and vision problems.

Health Concerns for Survivors of Ebola

In most cases, people who have completely recovered from Ebola disease do not become reinfected. However, many survivors suffer from health issues after recovery from Ebola.

The most commonly reported complications are:

• Tiredness
• Headaches
• Muscle and joint pain
• Eye and vision problems (blurry vision, pain, redness, and light sensitivity)
• Weight gain
• Stomach pain or loss of appetite

Other health problems can include memory loss, neck swelling, dry mouth, tightness of the chest, hair loss, hearing problems (ringing in the ears and hearing loss), pain or tingling in the hands and feet, inflammation of the pericardium (tissue around the heart), inflammation of one or both testicles, changes in menstruation, impotence, decreased or lost interest in sex, difficulty falling or remaining asleep, depression, anxiety, and post-traumatic stress disorder (PTSD).^[1]–[9]

The timing of onset, severity, and duration of complications among Ebola disease survivors are variable.

Persistence of Ebolaviruses

Ebolaviruses can remain in areas of the body that are immunologically privileged sites after acute infection. These are sites where viruses and pathogens, like ebolaviruses, are shielded from the survivor’s immune system, even after being cleared elsewhere in the body. These areas include the testes, interior of the eyes, placenta, and central nervous system, particularly the cerebrospinal fluid. Whether the virus is present in these body parts and for how long varies by survivor.

Scientists continue to study the long-term effects of ebolavirus infection, including viral persistence, to better understand how to provide treatment and care to Ebola disease survivors.