Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: Clinical observations in 103 patients

During the 1995 outbreak of Ebola hemorrhagic fever in the Democratic Repub lic of the Congo, a series of 103 cases (one-third of the total number of c ases) had clinical symptoms and signs accurately recorded by medical worker s, mainly in the setting of the urban hospital in Kikwit. Clinical diagnosi s was confirmed retrospectively in cases for which serum samples were avail able (n = 63, 61% of the cases). The disease began unspecifically with feve r, asthenia, diarrhea, headaches, myalgia, arthralgia, vomiting, and abdomi nal pain. Early inconsistent signs and symptoms included conjunctival injec tion, sore throat, and rash. Overall, bleeding signs were observed in <45% of the cases. Typically, terminally ill patients presented with obtundation , anuria, shock, tachypnea, and normothermia. Late manifestations, most fre quently arthralgia and ocular diseases, occurred in convalescent patients. This series is the most extensive number of cases of Ebola hemorrhagic feve r observed during an outbreak.