Atypical Ebola virus disease in a rhesus macaque.

Ebola virus (EBOV), strain Makona, infected more than 30,000 people from 2013-2016 in West Africa, among them many health care workers including foreign nationals. Most of the infected foreign nationals were evacuated and treated in their respective home countries resulting in detailed reports of the acute disease following EBOV infection as well as descriptions of symptoms now known as "Post-Ebola Syndrome" which occurred months after the infection. Symptoms associated with this syndrome include uveitis and neurological manifestations. In one of our EBOV-Makona nonhuman primate studies, one animal was euthanized on day 28 after EBOV-Makona infection having completely recovered from the acute disease and cleared EBOV from the blood. During convalescence, the animal developed neurological signs and acute respiratory distress requiring euthanasia. The organ tropism had changed with high virus titers in lungs, brain, eye, and reproductive organs but no virus in liver, spleen and adrenal glands, the typical target organs for acute EBOV infection. This in part reflects sequelae described for EBOV survivors in West Africa albeit developing quicker after recovery from acute disease.