An investigation into long-term health effects in patients infected with the Ebola Sudan virus in an outbreak in Uganda in 2022 and 2023 found persistent clinical symptoms as long as 2 years out, with viral RNA detected in semen and breast milk for up to 7 months after infection. An international team published its findings in a recent issue of BMC Medicine.

Ebola Sudan virus, one of six ebolavirus species and distinct from the Zaire strain that triggered a large outbreak in West Africa and past outbreaks in the Democratic Republic of the Congo (DRC). Ebola Sudan reappeared in Uganda in September 2022 after more than a decade. It was declared over in January 2023 and resulted in 142 confirmed cases, 55 of them fatal.
Using interviews and structured clinical exams, researchers tracked the clinical symptoms of 87 lab-confirmed Ebola Sudan survivors in Uganda over a 2-year period and compared the findings with the same data from 176 age-, sex-, and village-matched controls. Also, using PCR testing, they investigated viral shedding of RNA in semen and breast milk among survivors during the follow-up.
Half had debilitating multisystem symptoms
Frequency of clinician symptoms was 57.4% higher in Ebola survivors, especially musculoskeletal, neurologic, and ophthalmologic. The risk ratio for occurrence was highest for ophthalmologic and central nervous system symptoms and lowest for the reproductive system. Notably, half of the survivors had multisystem symptoms, compared to the control group, that resulted in an inability to perform basic activities of living.
When the team looked at viral RNA persistence in body fluids, they found traces of the virus in semen for as long as 210 days and as long as 199 days in breast milk, which they said emphasizes the risk of latency and virus reactivation. Ebola is known to persist in immune-protected sites, including the testes and eyes.