Characterization of long-term sequelae and immune signatures in Ebola virus disease survivors from 1976-2014 in the Democratic Republic of the Congo

Ebola virus disease (EVD) outbreaks have historically have been concentrated in Central Africa with sporadic outbreaks in the Democratic Republic of the Congo that have been increasing in frequency. In addition, Sudan virus re-emerged in Uganda following a 10 year absence. Our prior investigations in Sierra Leone have demonstrated significant mental and physical health impacts among EVD survivors 6-8 years post-recovery. However, there is little information on whether these observations are independent of geographic considerations nor whether these are conserved across Ebolavirus species. This raises important public health concerns for long-term health considerations for disease survivors. Thus, it is imperative to determine whether long-term health impacts following EVD are conserved across geographic locations and what epidemiologic or biological factors might be linked to more severe complications as well as immune durability. Here, we will address these questions with a focus on disease survivors from multiple historic EVD outbreaks within DRC. We will also examine this through questionnaires and analysis of historical samples. This investigation will address critical knowledge gaps in our understanding of this public health concern and will have important impacts for future outbreaks, including informing long-term patient care strategies.