A New Twist to an Old Serpent? Ebola reinfection?

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[I]n my upcoming book on Ebola, I often refer to the virus as a ‘blood serpent’. This isn’t hyperbole or fear-raking on my part, it’s just an apt description of the virus’s appearance and predilection. It also reflects what I as a Christian who just happens to understand a bit of biology (even the most renowned scientists only know ‘a bit’ when it comes to God’s design) believe that our battle against disease is but one manifestation of a larger spiritual battle. Hence the ‘blood snake’, but this snake make be changing its tactics.

This new twist is reported by a physician who cared for patients in Monrovia, Liberia. In an article published at Medscape today, Dr. Paul Farmer of Boston is quoted as saying this:

Paul Farmer, MD, PhD, from Partners in Health, Boston, Massachusetts, added, “In Monrovia, a couple of children under 5 who had negative [polymerase chain reactions (PCRs) after treatment] then returned some weeks later with positive PCR.

“These are children who had a normal course of illness…and had a clinical recovery, and both of these children became ill in a day or two,” Dr Sprecher continued. “They came back and were found to be febrile and [PCR] positive again. Both children had some neurologic signs. The feeling amongst the virologists is…the virus gets into some parts of the body with immunologic protection, like the central nervous system. The immune response clears the virus from the periphery, the patient has a clinical recovery, while the viral infection progresses in the [central nervous system] and eventually returns and reemerges as a renewed positivity. At least one of the children became negative again.” [emphases added]

This idea of a dormant/reactivation cycle for Ebola is relatively unstudied. Dr. Farmer’s observation is an important one, because it is possible that Ebola infection in humans may be changing. This might actually explain a comment made by CDC Director Dr. Tom Frieden, who recently indicated that the current Ebola epidemic may prove to be ‘the next HIV’. If you’re old enough to recall the panic in the early 1980s when patients presenting with Kaposi’s Sarcoma and no underlying cause but with practically no T-cells began showing up in doctor’s offices in France, New York, and San Francisco. Initially, it was believed that the new pathogen had a preference for those living a fringe lifestyle, either drug-abusers or sexually risky (homosexuals who populated gay baths, for instance), but in France and eventually Haiti and Africa, doctors began to see patients who did not fit the early models. Once the HIV virus was isolated, the disease which had killed patients in just a few months seemed to become less aggressive. Though still life-threatening and sexually transmitted, virologists have discovered that HIV mutates, sometimes even within the same host. Some people who are HIV+ never become sick, and still others carry the virus and exhibit only mild symptoms. It’s a trickster virus. So is Ebola. If Farmer is right, then Ebola may be much more complex than we’ve thought.

Is there any research to back up Farmer’s observation. Yes. In 2008, James E. Strong, et al, published research that indicates that Ebola virus can reactivate. Their research was conducted on mice, but mice are often used to model disease processes in humans. There’s precious little other research done on this topic, but there needs to be.

For more from the quoted article, see A Turning Point for Ebola? Possible Reinfection?.