Contradictory to the widely-accepted concept that sexual transmission of Ebola virus (EBOV) is quite rare after the official end of an outbreak(1), the following preliminary case report suggests a strong possibility of human-to-human EBOV transmission through unprotected sexual contact(2) due to the long-term persistence of EBOV within immune-privileged sites characterized by testis. The semen, but not the blood, derived from the survivor continued to be positive for EBOV for much longer than the WHO-defined waiting period. It remains to be unclear, however, whether you can tell that EBOV underwent clearance from the body only because the result of quantitative RT-PCR became negative. Considering the discrepant results between EBOV-specific RT-PCR and glycoprotein/nucleoprotein-specific IgG antibodies as recognized in the blood sample on March 23, bodily fluids with the undetectable infectious EBOV can be infectious with an assembly of a nearly complete genome. Furthermore, it is plausible that stochastic genetic mutations among Ebola virus Makona variant induce the higher persistence of infective EBOV(3) or enhanced formation of infectious viral particle composed of matrix protein VP40 and nucleocapsid(4).

1.    Rogstad KE, Tunbridge A. Ebola virus as a sexually transmitted infection. Current opinion in infectious diseases 2015;28:83-5.

2.    Christie A, Davies-Wayne GJ, Cordier-Lasalle T, et al. Possible sexual transmission of Ebola virus - Liberia, 2015. MMWR Morbidity and mortality weekly report 2015;64:479-81.

3.    Calain P, Monroe MC, Nichol ST. Ebola virus defective interfering particles and persistent infection. Virology 1999;262:114-28.

4.   Noda T, Ebihara H, Muramoto Y, et al. Assembly and budding of Ebolavirus. PLoS pathogens 2006;2:e99.

Article Ebola RNA Persistence in Semen of Ebola Virus Disease Surviv...