Late Ophthalmologic Manifestations in Survivors of the 1995 Ebola Virus Epidemic in Kikwit, Democratic Republic of the Congo

Kapay Kibadi, Kibadi Mupapa, Kivudi Kuvula, Matondo Massamba, Djuma Ndaberey, J. J. Muyembe-Tamfum, Mpia Ado Bwaka, Ann De Roo, and Robert Colebunders

Three (15%) of 20 survivors of the 1995 Ebola outbreak in the Democratic Republic of the Congo
enrolled in a follow-up study and 1 other survivor developed ocular manifestations after being
asymptomatic for 1 month. Patients complained of ocular pain, photophobia, hyperlacrimation, and
loss of visual acuity. Ocular examination revealed uveitis in all 4 patients. All patients improved
with a topical treatment of 1% atropine and steroids.

Between January and June 1995, an Ebola (EBO) epidemic occurred in the city of Kikwit and the surrounding villages in the Bandundu region of the Democratic Republic of the Congo [1]. The cumulative total of suspected cases of EBO hemor-rhagic fever (EHF) was 316, of whom 245 (77%) died. During the acute phase of EBO infection, several ocular manifestations have been observed. A conjunctival injection, a relatively early sign of EHF, was seen in ‡48% and 58% of the patients during the Kikwit [2] and Yambuku epidemics, respectively [3]. Dur-ing the EBO epidemic in Kikwit, a bilateral conjunctivitis dur-ing the acute phase of the epidemic was highly predictive for the diagnosis of an EBO infection; subconjunctival hemor-rhages have also been reported [4]. In Kikwit, certain patients with EHF complained of blurred vision or blindness during the acute phase of their illness. The etiology of these ocular manifestations remains unclear because ophthalmologic exami-nations, such as fundoscopy, were considered potentially risky procedures for health care workers (the nurse-ophthalmologist at Kikwit General Hospital died during the EBO epidemic; she may have been infected by contact with infectious blood).
During a follow-up study of surviving EBO patients, the following symptoms were noted: fever, arthralgia, myalgia, headache, fatigue, bulimia, and amenorrhea [2]. One patient developed a unilateral orchitis, 3 developed parotitis, and 4 survivors had visual problems. Herein, we describe the latter 4 patients.

ARTICLE - Optalmologic manifestations of Ebola Virus - Manifestations ophtalmogiques de Virus Ebola - J Infect Dis 1999 - Prof Dr Kibadi K et al


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