Post-Ebola Syndrome, Sierra Leone

Abstract

Thousands of persons have survived Ebola virus disease. Almost all survivors describe symptoms that persist or develop after hospital discharge. A cross-sectional survey of the symptoms of all survivors from the Ebola treatment unit (ETU) at 34th Regimental Military Hospital, Freetown, Sierra Leone (MH34), was conducted after discharge at their initial follow-up appointment within 3 weeks after their second negative PCR result. From its opening on December 1, 2014, through March 31, 2015, the MH34 ETU treated 84 persons (8-70 years of age) with PCR-confirmed Ebola virus disease, of whom 44 survived. Survivors reported musculoskeletal pain (70%), headache (48%), and ocular problems (14%). Those who reported headache had had lower admission cycle threshold Ebola PCR than did those who did not (p<0.03). This complete survivor cohort from 1 ETU enables analysis of the proportion of symptoms of post-Ebola syndrome. The Ebola epidemic is waning, but the effects of the disease will remain.

Keywords: Ebola virus; Post-Ebola syndrome; Sierra Leone; sequelae; viruses.

Figure 1

Age distribution of patients at Ebola survivors clinic at the 34th Regimental Military Hospital, Wilberforce Barracks, Freetown, Sierra Leone. Cycle threshold levels at hospital admission by age are shown in Table 1.

Figure 2

Comparison of the most common post-Ebola syndrome symptoms with admission C_t results, 34th Regimental Military Hospital, Wilberforce Barracks, Freetown, Sierra Leone. A) Headache, B) musculoskeletal pain, C) ocular problems. Specific C_t levels are shown in Table 2. *Indicates significant difference (p<0.03). C_t, cycle threshold.

Figure 3

Scale Venn diagram illustrating the overlap between the 3 main symptom groups among persons with post-Ebola syndrome seen at the Ebola survivors clinic at the 34th Regimental Military Hospital, Wilberforce Barracks, Freetown, Sierra Leone. Seven patients did not have any of the 3 main symptom groups.