Little is known about the post-recovery persistence of Ebola virus (EBOV) and the risks of transmission from convalescent Ebola survivors during close or intimate contact. The EBOV Persistence Study is an observational cohort study including survivors at different time points of convalescence, ranging from the time of discharge from an Ebola Treatment Unit (ETU). Results and analyses will be used to update relevant counseling messages and recommendations from the Ministry of Health and Sanitation (MoHS), WHO, US-CDC and China-CDC.

The study is comprised of a pilot and a main study including specimens from adult men and women (saliva, tears, sweat, urine, semen, vaginal secretions, rectal swab, menstrual blood, breast milk (if applicable) and peripheral blood to examine immune responses). Participants are recruited from Survivor organizations, Ebola Treatment Units (ETUs), and survivor registries; special efforts are being made to recruit HIV positive survivors. Participants in the study will be followed-up at study sites in government hospitals.

Specimens (apart from peripheral blood) are tested for EBOV RNA by RT-PCR in Sierra Leone at 2-4 week intervals and some positive RT-PCR samples will be sent to US-CDC Atlanta for virus isolation. Each body fluid is collected until two negative RT-PCR results at 2 week intervals are obtained. Participants are followed until all studied body fluids are negative. Analyses of antibody response, including titers of IgM and IgG, will be repeated in parallel to the body fluid tests.

Critically important to the study, specific prevention counseling, including the provision of condoms is executed by trained counsellors. Voluntary HIV testing and counseling is offered to all participants and any HIV positive study participants are referred to national HIV services. All participants, regardless of HIV status, are referred to survivor services for post-recovery complications as needed.