INSERM/Reacting, the French Ebola Task Force, and Institut de Recherche pour le Développement.

Ninety-eight semen specimens were obtained for Ebola virus (EBOV) RNA screening from 68 men in Guinea during the convalescent phase of EBOV infection. Ten samples from 8 men were positive for EBOV up to 9 months after onset of the disease, with decreasing trends in the proportion of positive samples and the level of viral RNA. Safe sex practices should be observed after discharge from treatment centers.

Background With the increasing frequency and impact of Ebola virus disease (EVD) outbreaks illustrated by recent epidemics, good knowledge on extent of viral persistance or RNA detection in body fluids from survivors is urgently needed. Methods Ebola viral RNA shedding was studied with molecular assays in semen (n=1,368), urine (n=1,875), cervico-vaginal fluid (n=549), saliva (n=900), breast milk (n=168) and feces (n=558) from EVD survivors in Guinea (POSTEBOGUI cohort, n=802) at a regular base until 40 months after inclusion. Results 27/277 (9.8%) male survivors tested positive for Ebola RNA in at least one semen sample. The probability of remaining positive for Ebola RNA in semen was estimated at 93.02% and 60.12% after three and six months. Viral RNA in semen was more frequent in patients with eye pain (p=0.036), joint pain (p=0.047), and higher antibody levels to Ebola virus antigens (NP (p=0.001), GP (p=0.05) and VP40 (p=0.05)). Ebola RNA was only rarely detected in other body fluids from EVD survivors : saliva (1/454) urine (2/593), breast milk (2/168), cervico-vaginal secretions (0/273), feces (0/330). RNA was detected in breast milk one month after delivery but 500 days after discharge of Ebola treatment unit (ETU) in a women who became pregnant seven months after discharge from the ETU. Conclusions The frequency and potential long term presence of viral RNA in semen confirm that systematic prevention measures in male survivors are required. Our observation in breast milk suggest that our knowledge on viral reservoir in immune priveledged sites and its impact are still incomplete.

This study modeled the presence of Ebola virus RNA in the semen of male Ebola survivors participating in the Postebogui study in Guinea. The median time of reverse-transcription polymerase chain reaction negativity was 46.4 days after symptom onset (95% confidence interval, 11-82.6). The results emphasize the importance of the World Health Organization recommendations for survivors' management.

Background The 2014/15 Ebola outbreak in West Africa resulted in 11,000 deaths and massive strain on local health systems, and the ongoing outbreak in Democratic Republic of Congo has afflicted more than 3000 people. Accurate, rapid Ebola diagnostics suitable for field deployment would enable prompt identification and effective response to future outbreaks, yet remain largely unavailable. The purpose of this study was to assess the accuracy of three novel rapid diagnostic tests (RDTs): an Ebola, an Ebola-Malaria, and a Fever Panel test that includes Ebola, all from a single manufacturer. Methods We evaluated the three RDTs in 109 Ebola-positive and 96 Ebola-negative stored serum samples collected during the outbreak in Guinea in 2014/15, and tested by real-time polymerase chain reaction (RT-PCR). Sensitivity, specificity, and overall percent agreement were calculated for each RDT using RT-PCR as a reference standard, stratified by Ct value ranges. Results All tests performed with high accuracy on samples with low Ct value (high viral load). The Fever Panel test performed with the highest accuracy, with a sensitivity of 89.9% and specificity of 90.6%. The Ebola and Ebola-Malaria tests performed comparably to each other: sensitivity was 77.1 and 78% respectively, and specificity was 91.7% for the Ebola test and 95.8% for the Ebola-Malaria test. Conclusions This study evaluated the accuracy of three novel rapid diagnostic tests for Ebola. The tests may have significant public health relevance, particularly the Fever Panel test, which detects seven pathogens including Ebola. Given limitations to the study resulting from uncertain sample quality, further evaluation is warranted. All tests performed with highest accuracy on samples with low Ct value (high viral load), and the data presented here suggests that these RDTs may be useful for point-of-care diagnosis of cases in the context of an outbreak. Restrictions to their use in non-severe Ebola cases or for longitudinal monitoring, when viral loads are lower, may be appropriate. Highlighting the challenge in developing and evaluating Ebola RDTs, there were concerns regarding sample integrity and reference testing, and there is a need for additional research to validate these assays.