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Research Letter
September 2017

Cerebrospinal Fluid Examination in Survivors of Ebola Virus Disease

Author Affiliations
  • 1Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
  • 2Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Ft Detrick, Maryland
  • 3John F. Kennedy Medical Center, Monrovia, Liberia
  • 4Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
JAMA Neurol. 2017;74(9):1141-1143. doi:10.1001/jamaneurol.2017.1460

With the extent of the recent Ebola virus disease (EVD) epidemic in West Africa (including >28 000 cases and ≤17 000 survivors), many aspects of Ebola virus have become clearer, including acute manifestations, sequelae, and the possibility of relapse and persistence.1 Neurologic complications are becoming more commonly recognized in EVD during the acute phase, with long-term sequelae.24 More remarkable, however, is the potential for persistence and relapse of EVD in the central nervous system (CNS), as in the case of a nurse who developed meningoencephalitis with seizures, cranial nerve involvement, and radiculitis 9 months after EVD recovery.5 Ebola virus was recovered from the cerebrospinal fluid (CSF) at higher levels than from the blood, indicating viral replication in the CNS.5 This case reveals the need to determine the role of the CNS as a potential reservoir for Ebola virus after initial clinical recovery.

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