Ebola survivors suffer from severe neurological problems

July 11, 2018, University of Liverpool
Ebola
Ebola virus. Credit: NIAID

Researchers have shed new light on the psychiatric and neurological problems that Ebola survivors can suffer from, and call for more specialist support for the most severely affected patients.

A new report published in Emerging Infectious Diseases details a broad range of disorders among Ebola survivors in Sierra Leone, including stroke and debilitating migraine-type headaches. Some survivors are left unable to care for themselves.

The observational study was led by researchers at the University of Liverpool and King's Sierra Leone Partnership of King's College London, based in Connaught Hospital, Freetown and in collaboration with the Ebola Survivors Clinic at Military Hospital 34, Freetown, Sierra Leone, as part of an ongoing effort to better understand post-Ebola syndrome (PES) and improve on-going patient care following the 2014-2016 outbreak in West Africa.

To better understand the neurological and psychiatric effects of PES, adult patients with predetermined, significant symptoms such as confusion, depression and psychosis, were identified from the patient notes of over 300 Ebola survivors.

Thirty-four selected patients were invited to attend a joint neuro-psychiatric clinic in 2016 where they underwent a full neurological examination, psychiatric screening and specialist investigations including brain scan imaging.

The most frequent neurological diagnosis was migranous headache, followed by stroke, peripheral sensory neuropathy and focal peripheral nerve lesions. Most survivors had co-existent mental health needs, with the most frequent psychiatric diagnoses being major depressive disorder and generalised anxiety disorder.

Dr. Janet Scott, who lead the Post Ebola Syndrome project at University of Liverpool, said: "We knew that a disease as severe as Ebola would leave survivors with major problems—however, it took me aback to see young and previously active people who had survived but were now unable to move half their bodies, or talk, or pick up their children. These cases are on the severe end of the spectrum- but thanks to support from the Wellcome Trust, we've been able to further investigate these cases and learn more about Ebola Virus Disease in the process. Our findings support the need for larger, case-controlled studies. Post-Ebola syndrome is not going away, and those with the condition deserve better treatment."

Dr. Patrick Howlett, from King's College London, carried out this study. He said: "We found a broad set of neurological and psychiatric symptoms, from minor to extremely severe and disabling, are present in Ebola survivors well over a year after discharge from . In our selected group intermittent headaches were the most frequent neurological feature, with a variety of associated symptoms. Connaught Hospital continues to provide specialist neurological care for these patients, however there is an urgent need to support training for specialist medical professionals who can meet the needs of this survivor population."

This was a broad collaboration coordinated from the University of Liverpool. The "Survivors Clinic" was based at Military Hospital 34, in Freetown, and got specialist input in Neurology and Psychiatry was provided by a Connaught Hospital, Freetown, with support from King's Sierra Leone Partnership. We called on the particular skills of Radiology and Ophthalmology Departments at the Royal Liverpool Hospital to interpret the CT Brain Scans and retinal images. It highlights the need for a team effort in considering these complex clinical cases.

Psychiatrist Dr. Stephen Sevalie, 34 Military Hospital, added: "Psychiatric features of insomnia, depression and anxiety are common and our findings suggest that there is also a need for better understanding of the psychiatric and psychological consequences of Ebola Virus Disease. Although our Ebola Survivors Clinic includes an onsite councillor, there are many more who won't have access to the specialist care they need so we will continue to research and provide hands on support to ensure this happens."

Explore further: Improving treatments for post-Ebola syndrome sufferers

More information: Patrick J. Howlett et al, Case Series of Severe Neurologic Sequelae of Ebola Virus Disease during Epidemic, Sierra Leone, Emerging Infectious Diseases (2018). DOI: 10.3201/eid2408.171367

Related Stories

Improving treatments for post-Ebola syndrome sufferers

April 12, 2016
Researchers from the University of Liverpool and the King's Sierra Leone Partnership are to present new findings into post-Ebola syndrome at a major European conference this week.

Ebola survivors have a 'unique' retinal scar

May 15, 2017
Researchers from the University of Liverpool have conducted a study of Ebola survivors to determine if the virus has any specific effects on the back on the eye using an ultra widefield retinal camera.

Response to Ebola outbreak leads to improved mental health services in Sierra Leone

November 30, 2017
A new report highlighting how vital mental health services were developed in Sierra Leone during the response to the 2014 Ebola outbreak is published today in the WHO Bulletin.

Novel retinal lesion seen in some ebola survivors

June 15, 2017
(HealthDay)—A small percentage of Ebola virus disease (EVD) survivors have a novel retinal lesion, according to research published in the July issue of the U.S. Centers for Disease Control and Prevention's Emerging Infectious ...

80 percent of Ebola survivors suffer disabilities one year after discharge

August 21, 2017
New research, conducted by the University of Liverpool and Liverpool School of Tropical Medicine, highlights the need for long-term rehabilitation of Ebola survivors after almost 80% of those interviewed were found to have ...

Post-Ebola syndrome in Sierra Leone

February 25, 2016
Researchers from the University's Institute of Translational Medicine have conducted a study of Ebola survivors to describe the medical problems they continue to have after recovering from the acute disease. The results of ...

Recommended for you

Deadly Rift Valley fever: New insight, and hope for the future

July 19, 2018
Health control measures alone could be ineffective in the long term fight against the deadly Rift Valley fever which affects both humans and animals, a new study in the journal PNAS reports.

New guidelines to diagnose, manage rare endocrine disorders

July 19, 2018
International guidelines have been published for the first time to help doctors around the globe diagnose and manage patients with a very rare set of endocrine diseases known as pseudohypoparathyroidism and its related disorders, ...

Overuse of antibiotics not what the doctor ordered

July 19, 2018
With increased use of antibiotics worldwide linked to growing antibiotic resistance, a world-first study co-authored by a QUT researcher has highlighted the growing impact of non-prescription supply of antibiotics in community ...

Alcohol-related cirrhosis deaths skyrocket in young adults

July 18, 2018
Deaths from cirrhosis rose in all but one state between 1999-2016, with increases seen most often among young adults, a new study shows.

Hidden blood in feces may signal deadly conditions

July 17, 2018
(HealthDay)—Even if it's not visible to the naked eye, blood in the stool can be serious—a sign of a potentially fatal disease other than colon cancer, new research suggests.

Childhood abuse linked to greater risk of endometriosis, study finds

July 17, 2018
Endometriosis, a painful condition that affects one in 10 reproductive-age women in the U.S., has been linked to childhood physical and sexual abuse, according to findings published today in the journal Human Reproduction.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.