# Clinical Sequelae and Urogenital Viral Dynamics in Survivors of Ebola Virus Disease

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $642,920

## Abstract

PROJECT SUMMARY
The Ebola epidemic that has devastated West Africa evolved within months from a regional
humanitarian crisis to a global public health emergency. Over 27,000 infections and more than 11,000
deaths were reported by the World Health Organization (WHO) – an underestimate that already
eclipses the numbers of infections and deaths in all previous Ebola outbreaks combined by orders of
magnitude. While this epidemic has ebbed, and may even be over, the clinical complications of Ebola
virus disease (EVD) endure for the majority of the thousands of survivors. Our work and that of others
indicate that musculoskeletal, neurologic, and ocular complications can persist even two years after
recovery from acute Ebola disease. Further, there is evidence that there can be sustained shedding of
at least viral RNA in semen and vaginal fluid of survivors, which could signal presence of infectious
virus and/or serve to stimulate immune responses that may produce certain post-Ebola symptoms. The
small size of previous outbreaks and the absence of adequate infrastructure to collect, process and
analyze samples in the field have limited our understanding of the natural history of Ebola survivorship.
The primary goal of this proposal is a better understanding of the clinical sequelae of EVD. Specifically:
 In AIM I we will describe and categorize the clinical symptomatology of Ebola survivors and
 investigate host- and disease-related factors for these conditions.
  In AIM II we probe putative pathogenic mechanisms for post-Ebola conditions including sustained
 immune activation, altered gut integrity, and persistence of viral antigens in the uro-genital
compartment.
We will conduct this work in the context of close and strong working relationships with health care
leaders and Ebola survivor representatives in West Africa, and a well-developed infrastructure for
clinical research we have established in Liberia and Sierra Leone where we have recruited, enrolled,
and longitudinally followed and sampled over 400 Ebola survivors. Establishment of these cohorts
allowed our team to determine the feasibility of our approach and develop, pilot, and refine the
procedures needed to sustain high-quality data collection. This work also allows us to build and support
capacity. Staff in both nations have been trained in research methodology and are being encouraged to
develop their own proposals. We have established a validated platform for Ebola RNA detection in
blood, semen, and vaginal fluid at a national reference lab in Liberia and have trained this site in quality
control. Collectively, the proposed work will provide a much-needed characterization of the
convalescence from Ebola and its potential mechanisms, as well as better characterize the patterns of
Ebola RNA detection in genital fluids. With 25 outbreaks over the past 40 years and a notable increase
in the frequency of EVD outbreaks, the question is not if another outbreak will occur but when. This
study ...

## Key facts

- **NIH application ID:** 10134990
- **Project number:** 5R01AI123535-05
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** William Fischer
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $642,920
- **Award type:** 5
- **Project period:** 2017-03-06 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10134990

## Citation

> US National Institutes of Health, RePORTER application 10134990, Clinical Sequelae and Urogenital Viral Dynamics in Survivors of Ebola Virus Disease (5R01AI123535-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10134990. Licensed CC0.

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