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| In this photo taken Sunday, Aug. 9, 2015, laboratory technician Mohamed SK Sesay, who contracted and survived Ebola but saw many of his colleagues die and now has joint and muscle pains and loss of sight, holds the child of one of his work colleagues who died of the disease, in Kenema, Sierra Leone. Lingering health problems afflicting many of the roughly 13,000 Ebola survivors have galvanized global and local health officials seeking to determine how widespread the ailments are, and how to remedy them, with the World Health Organization calling it an emergency within an emergency. |
DAKAR, Senegal
(AP) -- Lingering health problems afflicting many of the roughly
13,000 Ebola survivors have galvanized global and local health officials
to find out how widespread the ailments are, and how to remedy them.
The
World Health Organization calls it an emergency within an emergency.
Many of the survivors have vision and hearing issues. Some others
experience physical and emotional pains, fatigue and other problems. The
medical community is negotiating uncharted waters as it tries to
measure the scale of this problem that comes on the tail end of the
biggest Ebola outbreak in history.
"If we can
find out this kind of information, hopefully we can help other Ebola
survivors in the future," Dr. Zan Yeong, an eye specialist involved in a
study of health problems in survivors in Liberia, told The Associated
Press.
About 7,500 people will enroll - 1,500
Ebola survivors and 6,000 of their close contacts - and will be
monitored over a five-year period in the study launched by Partnership
for Research on Ebola Vaccines in Liberia, or PREVAIL.
Only
about 40 percent of those infected have survived Ebola, according to
WHO estimates. But while the survivors beat the odds, preliminary
research shows that many are still suffering. Around half those who
received post-recovery check-ups have joint pain, said Dr. Daniel
Bausch, an Ebola expert and consultant for WHO.
"We
don't have the capacity yet - we wish we did - to follow every
survivor," he said. Consequently, the percentage of survivors who have
complications isn't known, he said.
He
described the joint pain as "very debilitating and a very serious
problem that can prevent people from going back to work and providing
for their family."
Some degree of changes in
vision has been reported by roughly 25 percent of the survivors who have
been seen by medics, he said, including severe inflammation of the eye
that if untreated can result in blindness, he said. The Ebola virus has
been found, in at least a few cases, to linger in the eyes, though
experts say it is not transmitted through tears.
Morris
Kallon, 34, a health worker who survived Ebola in a village in
Liberia's Grand Cape Mount County, said he had fevers, headaches, lower
abdominal pain and red eyes after he returned home.
"I
have been experiencing whole lot of problems within my body system," he
said. "I still feel pains in my back. It is very difficult for me to
swing my arms. ... My vision is always blurred, like dew on my face."
Lab
technician Mohamed SK Sesay was working at a hospital in Kenema, a town
in eastern Sierra Leone, testing blood samples for Ebola when he fell
sick with the virus. About eight members of his team got infected and he
was among the few survivors, WHO said.
After
he recovered, he was discharged from an Ebola treatment unit in
September. He was still weak, and says he was shunned by his community.
Then his health deteriorated.
"Sleepless
nights. Joint pain. Muscle pain," he said. "I started experiencing loss
of weight. ... Loss of sight was the worst one that set me off. I used
to cry. I couldn't see my computer."
He was attended to by one of Sierra Leone's few eye doctors and his health improved overall, but he still has bad days.
"My
biggest challenge is now my health," he said. He loses vision from time
to time. Sometimes if people call out to him on the street he can't
hear them.
Eye problems were noted in some
survivors of Ebola outbreaks in Congo in 1995, in Uganda's Gulu district
in 2000 and in Uganda's Bundibugyo district in 2007. But with such
small numbers, past outbreaks haven't provided sufficient opportunities
for extensive study, Bausch said.
Now, with
thousands of survivors, doctors want to learn why people are
experiencing these ailments, how they affect the body, what percentage
of survivors has issues and how to treat them.
Experts
also want to learn whether the physical problems are directly caused by
the virus, whether they existed before, are side-effects or perhaps
autoimmune reactions, Bausch said.
"It's too early ... to know what the direct effect or link is to Ebola, if at all," Bausch said.
In
early August, WHO gathered experts in Sierra Leone who concluded that
more needs to be done to provide better care plans for survivors, and
more research and specialist help is needed.
Post-recovery
problems haven't been confined to West African survivors, whose health
might not have been strong to begin with considering the poor state of
health care in Liberia, Sierra Leone and Guinea - the three impoverished
countries most affected by Ebola - even before the epidemic.
Dr.
Ian Crozier, an American who became infected while working in Sierra
Leone for WHO, developed an inflammation and high pressure in one eye
months after being released from treatment. His iris temporarily changed
color from blue to green; doctors found his eye contained the Ebola
virus. He is still recovering, but his vision has improved, according to
Emory University Hospital which has been treating him.
Nancy
Writebol, who last year became the second American infected with Ebola,
said she suffers joint pain, mostly in her knees. She said she had
problems with her vision, but they seem to have gone away.
She
assists a weekly survivor clinic in Liberia at ELWA hospital run by
Serving In Mission, a North Carolina-based Christian organization. She
noted that Liberia's health-care system is broken and many survivors
lack running water and electricity in their homes, making their recovery
more arduous than that of survivors in the West.
"There
are a lot that are having troubles with vision," she said. "One of the
greatest complaints that we see is joint pain. And you can tell just by
the way people are moving that they are suffering."
Dr.
Rick Sacra, an American Ebola survivor who helps at the ELWA Liberia
hospital every few months, said when he was in Liberia in June and July,
he saw a mixture of depression and post-traumatic stress disorder in
the 15 to 40 people that came to survivor clinic appointments each week.
Physically the main complaints involve the eyes, joints and nerve
problems, he said. Less common symptoms are rashes, headaches, abdominal
discomfort and cough.
"I know there's likely a
large number of survivors who are fine, but then you have smaller
subsets who have one or more of these complications," he said.
Sacra also suffered eye problems that were treated with steroids. He told AP he has fully recovered.
The
epidemic, which has claimed nearly 11,300 lives, has significantly
slowed, with only three confirmed cases emerging in the last weekly
reporting period, according to WHO figures. But experts and survivors
say the struggle to deal with the residual damage is just starting.
Dr.
Anders Nordstrom, the WHO representative for Sierra Leone, said: "It is
increasingly clear that emerging from an ETU (Ebola treatment unit) is
just the beginning."
