Abstract Details

Title Cerebrospinal Fluid Findings in Ebola Survivors with Neurological Sequelae

Topic Infectious Disease

Presentation(s) (-)

Poster/Presentation
Number 003

Objective

Background Neurological findings are a common feature of acute infection with Ebola virus disease (EVD) and have been reported in survivors. Reports of recurrent meningoencephalitis in an EVD survivor months after recovery from EVD emphasize the need of monitoring for neurological complications.

Design/Methods EVD survivors enrolled in the Prevail III EVD natural history study underwent neurological examination. Participants with neurological symptoms both during EVD (coma/delirium/meningitis) and during recovery (headache/memory loss), and abnormal neurological exams were identified as potential candidates (n= 22). These participants were informed about the procedure; those who decided to proceed were screened for eligibility for LP (n=18). Participants were 18-60 years, Ebola antibody positive, had no new neurologic findings at time of LP, HIV antibody negative, had no recent seizure/head trauma/NSAID, no papilledema and PT, aPTT, and platelet results within normal limits prior to LP. For patients who met these criteria and signed informed consent (n=14), LPs were performed in the standard fashion, with operators in full personal protective equipment (PPE). 15-20 cc of CSF was collected per LP. The fluid was evaluated for Ebola viral RNA by two different Reverse Transcriptase–Polymerase Chain Reaction (RT-PCR) assays at the Liberian Institute for Biomedical Research (LIBR) lab. CSF cell count, glucose, and protein were measured.

Results 8 participants underwent LP, with 7 successful LPs. The median time from Ebola Treatment Unit discharge was 407 days. CSF from all 7 patients was negative for Ebola by PCR. All 7 samples had normal cell count, glucose, and protein.

Conclusions In this study, seven EVD survivors with neurologic sequelae underwent LP. No evidence of Ebola persistence or overt inflammation was detected in CSF. This study is the first systematic evaluation of CSF in Ebola survivors.

Authors/Disclosures
Bridgette J. Billioux, MD PRESENTER	Dr. Billioux has nothing to disclose.
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Avindra Nath, MD, MBBS, FAAN (National Institutes of Health)	The institution of Dr. Nath has received research support from National Institutes of Health. The institution of Dr. Nath has received research support from Target ALS. Dr. Nath has received intellectual property interests from a discovery or technology relating to health care.

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