Carroll Lab Oxford
@carroll-lab.bsky.social
We study emerging viruses, including Ebola Virus, Nipah virus, CCHF, Mpox and SARS-CoV-2.
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This work emphasises the need to integrate virology, epidemiology, and survivor-focused policy to confront EBOV persistence. Future filovirus control will depend as much on understanding within-host dynamics as it does on zoonotic surveillance.
This work emphasises the need to integrate virology, epidemiology, and survivor-focused policy to confront EBOV persistence. Future filovirus control will depend as much on understanding within-host dynamics as it does on zoonotic surveillance.
July 21, 2025 at 9:59 AM
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This work emphasises the need to integrate virology, epidemiology, and survivor-focused policy to confront EBOV persistence. Future filovirus control will depend as much on understanding within-host dynamics as it does on zoonotic surveillance.
This work emphasises the need to integrate virology, epidemiology, and survivor-focused policy to confront EBOV persistence. Future filovirus control will depend as much on understanding within-host dynamics as it does on zoonotic surveillance.
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Citation:
Meek et al. Ebola virus persistence: implications for human-to-human transmission and new outbreaks. Explor Med. 2025. doi.org/10.37349/eme...
Citation:
Meek et al. Ebola virus persistence: implications for human-to-human transmission and new outbreaks. Explor Med. 2025. doi.org/10.37349/eme...
Ebola virus persistence: implications for human-to-human transmission and new outbreaks
Ebola virus (EBOV) infection usually leads to highly lethal EBOV disease (EVD) with associated viraemia. Viraemia is cleared in those that do survive, however, EBOV may remain hidden in the testes a
doi.org
July 21, 2025 at 9:59 AM
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Citation:
Meek et al. Ebola virus persistence: implications for human-to-human transmission and new outbreaks. Explor Med. 2025. doi.org/10.37349/eme...
Citation:
Meek et al. Ebola virus persistence: implications for human-to-human transmission and new outbreaks. Explor Med. 2025. doi.org/10.37349/eme...
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Conclusion:
EBOV persistence—particularly in the testes—poses a rare but high-impact threat to global health. Understanding, detecting, and treating this hidden reservoir is essential for future outbreak prevention and survivor care.
Conclusion:
EBOV persistence—particularly in the testes—poses a rare but high-impact threat to global health. Understanding, detecting, and treating this hidden reservoir is essential for future outbreak prevention and survivor care.
July 21, 2025 at 9:59 AM
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Conclusion:
EBOV persistence—particularly in the testes—poses a rare but high-impact threat to global health. Understanding, detecting, and treating this hidden reservoir is essential for future outbreak prevention and survivor care.
Conclusion:
EBOV persistence—particularly in the testes—poses a rare but high-impact threat to global health. Understanding, detecting, and treating this hidden reservoir is essential for future outbreak prevention and survivor care.
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Implications:
– Outbreaks can originate from humans, not just zoonoses
– Long-term viral reservoirs complicate eradication efforts
– Persistent EBOV challenges current outbreak definitions and requires rethinking public health strategy
Implications:
– Outbreaks can originate from humans, not just zoonoses
– Long-term viral reservoirs complicate eradication efforts
– Persistent EBOV challenges current outbreak definitions and requires rethinking public health strategy
July 21, 2025 at 9:59 AM
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Implications:
– Outbreaks can originate from humans, not just zoonoses
– Long-term viral reservoirs complicate eradication efforts
– Persistent EBOV challenges current outbreak definitions and requires rethinking public health strategy
Implications:
– Outbreaks can originate from humans, not just zoonoses
– Long-term viral reservoirs complicate eradication efforts
– Persistent EBOV challenges current outbreak definitions and requires rethinking public health strategy
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Key future directions:
– Develop testicular in vitro models to study EBOV persistence
– Expand semen studies using standardised protocols
– Conduct remdesivir phase 3 trials
– Investigate female and MSM transmission routes
– Monitor post-EVD sequelae linked to persistence
Key future directions:
– Develop testicular in vitro models to study EBOV persistence
– Expand semen studies using standardised protocols
– Conduct remdesivir phase 3 trials
– Investigate female and MSM transmission routes
– Monitor post-EVD sequelae linked to persistence
July 21, 2025 at 9:59 AM
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Key future directions:
– Develop testicular in vitro models to study EBOV persistence
– Expand semen studies using standardised protocols
– Conduct remdesivir phase 3 trials
– Investigate female and MSM transmission routes
– Monitor post-EVD sequelae linked to persistence
Key future directions:
– Develop testicular in vitro models to study EBOV persistence
– Expand semen studies using standardised protocols
– Conduct remdesivir phase 3 trials
– Investigate female and MSM transmission routes
– Monitor post-EVD sequelae linked to persistence
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Male-to-male sexual transmission remains unexplored in the literature, despite evidence from other viruses suggesting elevated risk via anal intercourse. The authors call for confidential, unbiased contact tracing and NHP challenge studies.
Male-to-male sexual transmission remains unexplored in the literature, despite evidence from other viruses suggesting elevated risk via anal intercourse. The authors call for confidential, unbiased contact tracing and NHP challenge studies.
July 21, 2025 at 9:59 AM
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Male-to-male sexual transmission remains unexplored in the literature, despite evidence from other viruses suggesting elevated risk via anal intercourse. The authors call for confidential, unbiased contact tracing and NHP challenge studies.
Male-to-male sexual transmission remains unexplored in the literature, despite evidence from other viruses suggesting elevated risk via anal intercourse. The authors call for confidential, unbiased contact tracing and NHP challenge studies.
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Vaccination of survivors is unlikely to prevent recrudescence due to already high antibody titres. Ring vaccination of contacts remains the more promising strategy and has shown success in outbreak containment.
Vaccination of survivors is unlikely to prevent recrudescence due to already high antibody titres. Ring vaccination of contacts remains the more promising strategy and has shown success in outbreak containment.
July 21, 2025 at 9:59 AM
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Vaccination of survivors is unlikely to prevent recrudescence due to already high antibody titres. Ring vaccination of contacts remains the more promising strategy and has shown success in outbreak containment.
Vaccination of survivors is unlikely to prevent recrudescence due to already high antibody titres. Ring vaccination of contacts remains the more promising strategy and has shown success in outbreak containment.
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Remdesivir shows promise in reducing EBOV RNA in semen, but trials to date are underpowered. A phase 3 trial in future outbreaks is a critical research priority, alongside further evaluation of favipiravir at higher dosing.
Remdesivir shows promise in reducing EBOV RNA in semen, but trials to date are underpowered. A phase 3 trial in future outbreaks is a critical research priority, alongside further evaluation of favipiravir at higher dosing.
July 21, 2025 at 9:59 AM
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Remdesivir shows promise in reducing EBOV RNA in semen, but trials to date are underpowered. A phase 3 trial in future outbreaks is a critical research priority, alongside further evaluation of favipiravir at higher dosing.
Remdesivir shows promise in reducing EBOV RNA in semen, but trials to date are underpowered. A phase 3 trial in future outbreaks is a critical research priority, alongside further evaluation of favipiravir at higher dosing.
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Despite WHO guidelines, adherence to safe sex and breastfeeding advice is limited by stigma and socioeconomic factors. There is a clear need for long-term follow-up, semen testing, and community-based education to mitigate transmission risk.
Despite WHO guidelines, adherence to safe sex and breastfeeding advice is limited by stigma and socioeconomic factors. There is a clear need for long-term follow-up, semen testing, and community-based education to mitigate transmission risk.
July 21, 2025 at 9:59 AM
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Despite WHO guidelines, adherence to safe sex and breastfeeding advice is limited by stigma and socioeconomic factors. There is a clear need for long-term follow-up, semen testing, and community-based education to mitigate transmission risk.
Despite WHO guidelines, adherence to safe sex and breastfeeding advice is limited by stigma and socioeconomic factors. There is a clear need for long-term follow-up, semen testing, and community-based education to mitigate transmission risk.
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Mechanisms of persistence remain unclear. Three main theories are proposed:
– Polymerase mutations reducing viral replication
– Defective interfering genomes
– Lack of immune pressure in IPNs
Of these, polymerase mutation is supported by most evidence.
Mechanisms of persistence remain unclear. Three main theories are proposed:
– Polymerase mutations reducing viral replication
– Defective interfering genomes
– Lack of immune pressure in IPNs
Of these, polymerase mutation is supported by most evidence.
July 21, 2025 at 9:59 AM
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Mechanisms of persistence remain unclear. Three main theories are proposed:
– Polymerase mutations reducing viral replication
– Defective interfering genomes
– Lack of immune pressure in IPNs
Of these, polymerase mutation is supported by most evidence.
Mechanisms of persistence remain unclear. Three main theories are proposed:
– Polymerase mutations reducing viral replication
– Defective interfering genomes
– Lack of immune pressure in IPNs
Of these, polymerase mutation is supported by most evidence.
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Recrudescence (reactivation of virus in IPNs) has caused severe disease, especially meningoencephalitis and uveitis, in multiple survivors. These events are rare but clinically severe and capable of igniting new transmission chains.
Recrudescence (reactivation of virus in IPNs) has caused severe disease, especially meningoencephalitis and uveitis, in multiple survivors. These events are rare but clinically severe and capable of igniting new transmission chains.
July 21, 2025 at 9:59 AM
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Recrudescence (reactivation of virus in IPNs) has caused severe disease, especially meningoencephalitis and uveitis, in multiple survivors. These events are rare but clinically severe and capable of igniting new transmission chains.
Recrudescence (reactivation of virus in IPNs) has caused severe disease, especially meningoencephalitis and uveitis, in multiple survivors. These events are rare but clinically severe and capable of igniting new transmission chains.
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Sexual transmission from persistent virus has previously started outbreaks, including a 2021 outbreak traced to a male survivor infected 5 years prior. Genomic data confirmed the virus was not from a new zoonotic spillover but from the 2013–2016 lineage.
Sexual transmission from persistent virus has previously started outbreaks, including a 2021 outbreak traced to a male survivor infected 5 years prior. Genomic data confirmed the virus was not from a new zoonotic spillover but from the 2013–2016 lineage.
July 21, 2025 at 9:59 AM
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Sexual transmission from persistent virus has previously started outbreaks, including a 2021 outbreak traced to a male survivor infected 5 years prior. Genomic data confirmed the virus was not from a new zoonotic spillover but from the 2013–2016 lineage.
Sexual transmission from persistent virus has previously started outbreaks, including a 2021 outbreak traced to a male survivor infected 5 years prior. Genomic data confirmed the virus was not from a new zoonotic spillover but from the 2013–2016 lineage.
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Persistence is best characterised in semen. Longitudinal cohort studies show EBOV RNA can be detected for up to 988 days. Meta-analysis estimates ~7 of 5,000 male survivors may still be shedding at 5 years post-infection (95% CI: 0–43).
Persistence is best characterised in semen. Longitudinal cohort studies show EBOV RNA can be detected for up to 988 days. Meta-analysis estimates ~7 of 5,000 male survivors may still be shedding at 5 years post-infection (95% CI: 0–43).
July 21, 2025 at 9:59 AM
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Persistence is best characterised in semen. Longitudinal cohort studies show EBOV RNA can be detected for up to 988 days. Meta-analysis estimates ~7 of 5,000 male survivors may still be shedding at 5 years post-infection (95% CI: 0–43).
Persistence is best characterised in semen. Longitudinal cohort studies show EBOV RNA can be detected for up to 988 days. Meta-analysis estimates ~7 of 5,000 male survivors may still be shedding at 5 years post-infection (95% CI: 0–43).
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The 2013–2016 West Africa EBOV epidemic revealed a critical paradigm shift: EBOV can persist in immune privileged niches (IPNs) such as the testes, brain, and eyes for months to years after recovery, with potential for delayed transmission.
The 2013–2016 West Africa EBOV epidemic revealed a critical paradigm shift: EBOV can persist in immune privileged niches (IPNs) such as the testes, brain, and eyes for months to years after recovery, with potential for delayed transmission.
July 21, 2025 at 9:59 AM
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The 2013–2016 West Africa EBOV epidemic revealed a critical paradigm shift: EBOV can persist in immune privileged niches (IPNs) such as the testes, brain, and eyes for months to years after recovery, with potential for delayed transmission.
The 2013–2016 West Africa EBOV epidemic revealed a critical paradigm shift: EBOV can persist in immune privileged niches (IPNs) such as the testes, brain, and eyes for months to years after recovery, with potential for delayed transmission.
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Citation:
Nguyen et al. SARS-CoV-2 infection enhancement by amphotericin B: implications for disease management. J Virol (2025). doi.org/10.1128/jvi....
Citation:
Nguyen et al. SARS-CoV-2 infection enhancement by amphotericin B: implications for disease management. J Virol (2025). doi.org/10.1128/jvi....
SARS-CoV-2 infection enhancement by amphotericin B: implications for disease management | Journal of Virology
AmB and nystatin are common treatments for fungal infections but were predicted to
strongly interact with SARS-CoV-2 proteins, indicating their potential modulation
or inhibition against the virus. Ho...
doi.org
June 24, 2025 at 2:19 PM
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Citation:
Nguyen et al. SARS-CoV-2 infection enhancement by amphotericin B: implications for disease management. J Virol (2025). doi.org/10.1128/jvi....
Citation:
Nguyen et al. SARS-CoV-2 infection enhancement by amphotericin B: implications for disease management. J Virol (2025). doi.org/10.1128/jvi....
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More broadly, this work underscores the importance of validating in silico drug repurposing predictions with rigorous mechanistic and functional assays. Computational hits may have unanticipated off-target effects in the context of viral co-infections.
More broadly, this work underscores the importance of validating in silico drug repurposing predictions with rigorous mechanistic and functional assays. Computational hits may have unanticipated off-target effects in the context of viral co-infections.
June 24, 2025 at 2:19 PM
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More broadly, this work underscores the importance of validating in silico drug repurposing predictions with rigorous mechanistic and functional assays. Computational hits may have unanticipated off-target effects in the context of viral co-infections.
More broadly, this work underscores the importance of validating in silico drug repurposing predictions with rigorous mechanistic and functional assays. Computational hits may have unanticipated off-target effects in the context of viral co-infections.
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Key conclusions:
- AmB and nystatin enhance SARS-CoV-2 entry and replication in vitro
- Enhancement is mediated by interference with IFITM3 antiviral function
- Caution is warranted when using AmB in patients with active COVID-19
- Alternative antifungals should be considered
Key conclusions:
- AmB and nystatin enhance SARS-CoV-2 entry and replication in vitro
- Enhancement is mediated by interference with IFITM3 antiviral function
- Caution is warranted when using AmB in patients with active COVID-19
- Alternative antifungals should be considered
June 24, 2025 at 2:19 PM
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Key conclusions:
- AmB and nystatin enhance SARS-CoV-2 entry and replication in vitro
- Enhancement is mediated by interference with IFITM3 antiviral function
- Caution is warranted when using AmB in patients with active COVID-19
- Alternative antifungals should be considered
Key conclusions:
- AmB and nystatin enhance SARS-CoV-2 entry and replication in vitro
- Enhancement is mediated by interference with IFITM3 antiviral function
- Caution is warranted when using AmB in patients with active COVID-19
- Alternative antifungals should be considered
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Clinical implications: AmB is commonly used to treat COVID-associated mucormycosis. This study suggests it may inadvertently worsen SARS-CoV-2 infection in the lungs, particularly with Omicron and other variants relying more on endocytosis.
Clinical implications: AmB is commonly used to treat COVID-associated mucormycosis. This study suggests it may inadvertently worsen SARS-CoV-2 infection in the lungs, particularly with Omicron and other variants relying more on endocytosis.
June 24, 2025 at 2:19 PM
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Clinical implications: AmB is commonly used to treat COVID-associated mucormycosis. This study suggests it may inadvertently worsen SARS-CoV-2 infection in the lungs, particularly with Omicron and other variants relying more on endocytosis.
Clinical implications: AmB is commonly used to treat COVID-associated mucormycosis. This study suggests it may inadvertently worsen SARS-CoV-2 infection in the lungs, particularly with Omicron and other variants relying more on endocytosis.
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Previous preprints suggesting AmB as antiviral were based on late timepoint measurements or did not distinguish entry from replication. This study systematically addresses timing, dose, and mechanism.
Previous preprints suggesting AmB as antiviral were based on late timepoint measurements or did not distinguish entry from replication. This study systematically addresses timing, dose, and mechanism.
June 24, 2025 at 2:19 PM
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Previous preprints suggesting AmB as antiviral were based on late timepoint measurements or did not distinguish entry from replication. This study systematically addresses timing, dose, and mechanism.
Previous preprints suggesting AmB as antiviral were based on late timepoint measurements or did not distinguish entry from replication. This study systematically addresses timing, dose, and mechanism.
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AmB concentrations that enhanced SARS-CoV-2 infection in vitro (0.78–3.12 µM) are within the range found in pulmonary tissue during standard liposomal AmB treatment. This raises concerns for its use during active SARS-CoV-2 infection.
AmB concentrations that enhanced SARS-CoV-2 infection in vitro (0.78–3.12 µM) are within the range found in pulmonary tissue during standard liposomal AmB treatment. This raises concerns for its use during active SARS-CoV-2 infection.
June 24, 2025 at 2:19 PM
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AmB concentrations that enhanced SARS-CoV-2 infection in vitro (0.78–3.12 µM) are within the range found in pulmonary tissue during standard liposomal AmB treatment. This raises concerns for its use during active SARS-CoV-2 infection.
AmB concentrations that enhanced SARS-CoV-2 infection in vitro (0.78–3.12 µM) are within the range found in pulmonary tissue during standard liposomal AmB treatment. This raises concerns for its use during active SARS-CoV-2 infection.
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In Huh7 cells, AmB and IFITM3 knockdown produced redundant effects, indicating AmB bypasses or suppresses IFITM3 antiviral activity. In Calu-3 cells (which use TMPRSS2-dependent entry), the effect was more modest.
In Huh7 cells, AmB and IFITM3 knockdown produced redundant effects, indicating AmB bypasses or suppresses IFITM3 antiviral activity. In Calu-3 cells (which use TMPRSS2-dependent entry), the effect was more modest.
June 24, 2025 at 2:19 PM
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In Huh7 cells, AmB and IFITM3 knockdown produced redundant effects, indicating AmB bypasses or suppresses IFITM3 antiviral activity. In Calu-3 cells (which use TMPRSS2-dependent entry), the effect was more modest.
In Huh7 cells, AmB and IFITM3 knockdown produced redundant effects, indicating AmB bypasses or suppresses IFITM3 antiviral activity. In Calu-3 cells (which use TMPRSS2-dependent entry), the effect was more modest.
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Importantly, AmB appears to counteract IFITM3-mediated antiviral restriction, particularly in cell types like Vero E6 and Huh7 that rely on endocytosis for viral entry. This mirrors previous findings with influenza A virus.
Importantly, AmB appears to counteract IFITM3-mediated antiviral restriction, particularly in cell types like Vero E6 and Huh7 that rely on endocytosis for viral entry. This mirrors previous findings with influenza A virus.
June 24, 2025 at 2:19 PM
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Importantly, AmB appears to counteract IFITM3-mediated antiviral restriction, particularly in cell types like Vero E6 and Huh7 that rely on endocytosis for viral entry. This mirrors previous findings with influenza A virus.
Importantly, AmB appears to counteract IFITM3-mediated antiviral restriction, particularly in cell types like Vero E6 and Huh7 that rely on endocytosis for viral entry. This mirrors previous findings with influenza A virus.
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RNA-seq analysis showed no significant change in host gene expression, suggesting AmB acts at the biophysical level by altering membrane properties to facilitate viral entry.
RNA-seq analysis showed no significant change in host gene expression, suggesting AmB acts at the biophysical level by altering membrane properties to facilitate viral entry.
June 24, 2025 at 2:19 PM
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RNA-seq analysis showed no significant change in host gene expression, suggesting AmB acts at the biophysical level by altering membrane properties to facilitate viral entry.
RNA-seq analysis showed no significant change in host gene expression, suggesting AmB acts at the biophysical level by altering membrane properties to facilitate viral entry.