Romeo Doe, a 29-year-old tailor who survived Ebola in Liberia, is struggling to cope with the impact of a disease that killed seven members of his family and now threatens his livelihood. Since he was released from an Ebola centre in the capital Monrovia in November, pressure is rising in his eyes and affecting his vision - a complaint some doctors say is common among survivors of the West African outbreak.
There are a growing number of survivors of the disease in the region, between 5,000 and 10,000 according to the United Nations, and some complain of side effects months after their recovery - a condition some doctors are calling "post-Ebola Syndrome" (PES). "Since I was discharged I have felt this pain in my eyes," said Doe. "They, as you can see, are red; they are hurting me. I want the government to help me get back on my feet."
Ebola, which has killed almost 9,000 people across Guinea, Liberia and Sierra Leone, initially causes fever and vomiting, then attacks the immune system and vital organs, often causing internal and external bleeding. About 60 percent of Ebola patients have died in the current outbreak, typically from shock or organ failure.
Some of those who have survived the disease report a mixture of symptoms after their recovery, including vision problems, joint pain, hair and memory loss and anxiety attacks. Margaret Nanyonga, a doctor who treated Ebola patients in the town of Kenema in Sierra Leone, said she had seen survivors go blind. Overall about half of those she saw recover reported declining health, she said.
Doctors say it is not yet clear how long the symptoms last. There is also no scientific literature or medical consensus on any new syndrome among West African survivors or how many people might be affected. Dan Kelly, founder of the non-profit organisation Wellbody Alliance and a doctor specialising in infectious diseases, says the situation can be complicated by poor medical records making it hard to separate any new symptoms from pre-existing conditions. Ebola, like many severe infections, may also weaken survivors and make other illnesses more likely.
Kelly said some Ebola after-effects appear linked to the infection itself, with some patients developing symptoms similar to so-called autoimmune disorders - where the immune system is overstimulated and begins to attack the body's own tissues. Other patients develop symptoms similar to uveitis, he said, an eye inflammation causing blindness. "With post-Ebola syndrome there is an autoimmune response: it's revved up, and we don't really know why," he told Reuters by telephone from Sierra Leone where he is helping with the Ebola response.