Ebola virus detected in breast milk weeks after recovery

The often fatal Ebola virus (EBOV) may linger in the body longer than previously understood. A recent report has raised concerns about the possibility of post-illness transmission. New findings suggest that the virus might remain in breast milk for weeks even after clinical recovery. The findings are published in the New England Journal of Medicine.Ebola virus disease (EVD) is a rare, but severe, and often fatal illness caused by viruses that belong to the Orthoebolavirus genus of the filoviridae family. The disease affects humans and other primates. The disease, on average, has a fatality rate of 50%. The fatality rates varied 25–90% in past outbreaks.According to the WHO, the disease is transmitted to humans via wild animals (such as fruit bats, porcupines, and non-human primates). It spreads from person to person through direct contact with the blood, secretions, organs, or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.In the new report, a woman, aged 23, from the Democratic Republic of the Congo (DRC) had contracted EBOV during her pregnancy in 2019. The findings point at the possibility of post-illness transmission to infants, even as blood tests and other measures of viral load are negative.The woman received the standard monoclonal antibody therapy in Butembo, DRC. She was discharged after discharged from the treatment unit after three tests. Three consecutive negative reverse-transcriptase–polymerase-chain-reaction (RT-PCR) tests confirmed that the EBOV was no longer detectable in her blood. The woman delivered a healthy infant after 42 weeks of gestation. There was no evidence of EBOV infection in maternal blood, amniotic fluid, vaginal secretions, or the newborn.Despite the negative test result in blood and other body fluids, the doctors found viral RNA in the placenta and breast milk. The researchers asked the mother to stop breastfeeding to reduce the infant’s risk of contracting the disease. They also gave a prophylactic (preventive) monoclonal antibody to the newborn. In the follow-up test, the infant showed no signs of infection. The mother’s blood tests came back negative, but the viral RNA was still detectable in breast milk at 14 weeks after illness onset. The clinicians used the drug bromocriptine to suppress lactation and thereby protect the newborn. The researchers said that further studies are required, including viral culture tests, to better understand infection risk. The findings also suggest the potential transmission from mother to child during breastfeeding. As per the current WHO Guidelines, Ebola survivors are asked to avoid breastfeeding until viral clearance is confirmed.