Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients

Between 6 and 22 June 1995, 8 patients in Kikwit, Democratic Republic of th e Congo, who met the case definition used in Kikwit for Ebola (EBO) hemorrh agic fever, were transfused with blood donated by 5 convalescent patients. The donated blood contained IgG EBO antibodies but no EBO antigen. EBO anti gens were detected in all the transfusion recipients just before transfusio n. The 8 transfused patients had clinical symptoms similar to those of othe r EBO patients seen during the epidemic. All were seriously ill with severe asthenia, 4 presented with hemorrhagic manifestations, and 2 became comato se as their disease progressed. Only 1 transfused patient (12.5%) died; thi s number is significantly lower than the overall case fatality rate (80%) f or the EBO epidemic in Kikwit and than the rates for other EBO epidemics. T he reason for this low fatality rate remains to be explained. The transfuse d patients did receive better care than those in the initial phase of the e pidemic. Plans should be made to prepare for a more thorough evaluation of passive immune therapy during a new EBO outbreak.