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Ebola Survivors Turn Caregivers, Testing Their Immunity: Health

Tuesday, 21 Oct 2014 08:41 PM

(For more on Ebola, See EXT7)

Oct. 22 (Bloomberg) -- Amie Subah spends her days feeding Ebola patients, giving them medicine and changing children’s diapers at a treatment center in Liberia.

Her most valuable asset: As an Ebola survivor, she believes she is now immune. That means Subah doesn’t need to wear the stifling protective suits that limit doctors’ shifts to 45 minutes, and can spend hours caring for her patients protected by only a surgical robe, mask, gloves and boots,

“I’m not worried,” the 39-year-old midwife said in a telephone interview between shifts. “I know I will not contract the virus even if someone vomits on me.”

Subah is one of 11 survivors working at the Elwa 3 hospital in Monrovia with the aid group Doctors Without Borders. The physicians’ group, which has treated about a third of the 9,000 people infected in West Africa, has never seen a survivor become reinfected with the strain of virus that afflicted them, said Athena Viscusi, a social worker for the aid organization who works alongside the survivor caregivers.

“We don’t say people are immune for life because we don’t know,” Viscusi said by telephone. “But we do tell them that they will not get Ebola again during this epidemic.”

While other researchers generally agree, there is little definitive evidence on how long immunity may last. Furthermore, if the virus evolves, as it has more than 300 times over the years, a loss of immunity can’t be ruled out, said Marie-Paule Kieny, the World Health Organization’s assistant director - general for health systems and innovation.

Scientific Evidence

“To the best of my knowledge, there has not been a case of a person who has been infected who has recovered and has been infected again,” Kieny said yesterday at a briefing in Geneva. Still, she added, “there is really no scientific evidence.”

The survival rate during this outbreak is about 30 percent, according to the WHO. Immunity may stem from antibodies produced by the immune system to help people survive the disease in the first place. The antibodies are then primed to aggressively fight off any future threat from the same virus.

The WHO and others are investigating whether survivors’ blood, which would contain these antibodies, can be used to help hold off the disease in the current outbreak.

It can take a long time to fully recover from an Ebola infection, said Joseph McCormick, who was involved with first three Ebola outbreaks in Africa in 1976 and ran the U.S. Centers for Disease Control and Prevention’s high security laboratory for a decade. Most patients lose weight and feel weak as a result.

Survivor Fate

There are no known long-term consequences, though few patients have been rigorously followed because the outbreaks were in remote locations, McCormick, a professor and a regional dean at the University of Texas School of Public Health, said in a telephone interview. The fate of survivors will become more clear following this latest, biggest outbreak, he said.

There has been very little change seen in the virus in fruit bats, its normal host, which suggests those who have recovered will have broad-based immunity, he said. In addition, the different strains seem to cross react and thus should cross protect, offering greater protection, he said.

While scientists probe the immunity issue, the survivors themselves are providing valuable services on the ground.

They help care for those infected, and they carry an important message of hope. Subah says she often advises her patients that “the more you drink, the more you get strength,’” she said. “And I say, ‘make sure you eat the food,’ even if they have low appetite.”

To contact the reporters on this story: Makiko Kitamura in London at mkitamura1@bloomberg.net; Simeon Bennett in Geneva at sbennett9@bloomberg.net; Michelle Fay Cortez in Minneapolis at mcortez@bloomberg.net To contact the editors responsible for this story: Phil Serafino at pserafino@bloomberg.net; Reg Gale at rgale5@bloomberg.net Reg Gale, Andrew Pollack

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Tuesday, 21 Oct 2014 08:41 PM
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