Latest Ebola Report Out


By Ayodele Deen Cole

A new report published in Emerging Infectious Disease (EID) has details of broad range of disorders among Ebola survivors in Sierra Leone, including stroke and debilitating migraine-type headaches and that some are left unable to care for themselves.

The said report was recently launched to help the new government know some of the challenges facing Ebola survivors in the country with the observational study led by researchers at the University of Liverpool and Sierra Leone Partnership of King’s College London, based in Connaught Hospital, Freetown and in collaboration with the Ebola Survivors Clinic at the 34 Military Hospital, Freetown, 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. It is broad collaboration coordinated from the University of Liverpool. The Survivors’ Clinic received specialist input in Neurology and Psychiatry, provided by Connaught Hospital with support from King’s Sierra Leone Partnership.

The report also highlights the need for a team effort in considering these complex clinical cases. According to Dr. Janet Scott, who led the Post Ebola Syndrome project at University of Liverpool, the exercise was carried out 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. She also said that a disease as severe as Ebola would leave survivors with major problem. She said she was taken aback when she beheld 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 Welcome Trust for its support. We have been able to further investigate these cases and learn more about Ebola Virus Disease in the process,” she said, adding, “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 hospital. In our selected group intermittent headaches were the most frequent neurological feature, with a variety of associated symptoms.” Connaught Hospital, he said, continues to provide specialist neurological care for these patients but however stated that there is an urgent need to support training for specialist medical professionals who can meet the needs of this survivor population. Psychiatrist Dr. Stephen Sevalie at the 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.”