Long Ebola: The Ebola Virus can Hide for Years in the Brains of Survivors

Key Takeaways:

Ebola can persist in the brain and other organs for years, even after recovery and treatment.
Survivors may unknowingly transmit the virus, making long-term monitoring essential.
Relapse and sexual transmission are real risks, highlighting the need for safe practices and follow-up testing.

Even after surviving Ebola, some individuals may unknowingly carry the virus for years — a silent risk scientists are only beginning to understand. With fatality rates exceeding 50% in some outbreaks, Ebola remains one of the most lethal viruses known to medicine. It can hide in the brain for years despite treatment. This has been observed by US researchers in monkeys that survived their first infection.

Ebola

Ebola hiding in the brain

“We have found that about 20% of monkeys that survived a lethal dose of the Ebola virus after treatment with monoclonal antibodies still had a persistent infection – particularly in the ventricular system of the brain, where cerebrospinal fluid is produced and circulates – and even after Ebola had been removed from other organs,” said Xiankun Zen, principal investigator of the study published in Science Translational Medicine. The case of two monkeys is particularly disturbing. The animals survived the initial infection but eventually died due to a resurgence of the virus.

Ebola persisted in the brains of the monkeys that were treated with monoclonal antibodies

Long Ebola: the persistent presence of the Ebola virus in the brain caused the death of ependymocytes – a family of cells that are part of the blood-brain barrier in the choroid plexus. Severe local inflammation occurred and the virus spread to the ventricular system of the brain, causing the animals to die. The Ebola virus has also been shown to hide in humans.

In 2021, researchers analyzed the case of a man in whom the virus remained latent for five years in his testicles. The man then infected a woman in Guinea, causing an outbreak in the region. Ebola vaccines and treatments can contain outbreaks, but researchers warn that long-term monitoring of survivors is needed to prevent outbreaks. Ebola is one of the deadliest human viruses known to man, and more than half of those infected succumb to the disease.

FAQs

Can Ebola come back after recovery?
Yes. The virus can persist in the brain or testicles and reactivate months or years later.

Is Ebola sexually transmitted?
Yes. It can be passed through semen, especially in the first 12 months after recovery.

How long can Ebola stay in the body?
In rare cases, the virus has been found in immune-privileged sites for over five years.

Can survivors infect others without symptoms?
Yes. Relapses can occur silently, and survivors may unknowingly transmit the virus.

Do treatments like monoclonal antibodies remove the virus completely?
Not always. They stop the acute illness but may not clear the virus from all organs.

How can survivors reduce transmission risk?
Follow WHO guidelines: get tested regularly, practice safe sex, and report symptoms early.

Should survivors be monitored long-term?
Yes. Ongoing follow-up helps prevent future outbreaks and protects close contacts.

Final thoughts

Survivors of the Ebola virus should be monitored long-term as they could spontaneously start outbreaks by spreading the virus to those closest to them. Health authorities recommend that Ebola survivors, particularly men, follow safe sex practices and seek regular testing until bodily fluids test negative for the virus. Open communication with partners and medical professionals is essential.

References

Liu, J., Wei, M., Yang, B., Cox, R. M., Zhou, J., Kocher, J. F., Hodge, T., Swanson, K. A., Bart, S. M., Randall, R. B., Leung, A., Reed, D. S., Kang, C., & Misasi, J. (2022). Ebola virus persistence and disease recrudescence in the brains of antibody-treated nonhuman primate survivors. Science Translational Medicine, 14(659), eabi5229. https://doi.org/10.1126/scitranslmed.abi5229