Abstract
Presentation Description :
The most recent Ebola virus disease (EVD) outbreak in West Africa is the largest outbreak in history with over 28,000 persons infected and over 11,000 deaths. The case fatality rate ranges between 57-60% in the three highest transmission countries - Sierra Leone, Liberia, and Guinea. The magnitude of the outbreak has led to the largest EVD survivor cohort in history, many of whom are at risk for the post Ebola syndrome, a constellation of disease findings including arthritis/arthralgias, fatigue, psychosocial stress, and uveitis. Prior reports of uveitis in EVD survivors are limited although a spectrum of uveitis (anterior and posterior uveitis) has been reported in limited case series. One recent EVD survivor developed severe, sight-threatening panuveitis and required intensive medical treatment to avert severe vision impairment and blindness. During his care, the patient was found to harbor live, replicating Ebola virus in his aqueous humor in a high concentration, which likely contributed to the disease pathogenesis. Our patient's findings had ramifications from individual, public and global health perspectives. Recent World Health Organization estimates have described ocular symptoms in up to 40-50% of EVD survivors and uveitis is estimated to occur in approximately 20-25% of EVD survivors although the precise incidence and prevalence remain unknown. The approach to evaluation and treatment of EVD survivors in a resource-limited, post EVD outbreak setting, clinical manifestations, and ongoing work by the World Health Organization, Ministry of Health and Sanitation of countries in West Africa, and partnering organizations will be discussed and a comprehensive update on EVD-associated uveitis will be provided.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.