Abstract
BackgroundIn the wake of the West African Ebola virus disease (EVD) outbreak of 2014–2016, thousands of EVD survivors began to manifest a constellation of systemic and ophthalmic sequelae. Besides systemic arthralgias, myalgias, and abdominal pain, patients were developing uveitis, a spectrum of inflammatory eye disease leading to eye pain, redness, and vision loss. To investigate this emerging eye disease, resources and equipment were needed to promptly evaluate this sight-threatening condition, particularly given our identification of Ebola virus in the ocular fluid of an EVD survivor during disease convalescence.Methodology/Principal findingsA collaborative effort involving ophthalmologists, infectious disease specialists, eye care nurses, and physician leadership at Eternal Love Winning Africa (ELWA) Hospital in Liberia led to the development of a unique screening eye clinic for EVD survivors to screen, treat, and refer patients for more definitive care. Medications, resources, and equipment were procured from a variety of sources including discount websites, donations, purchasing with humanitarian discounts, and limited retail to develop a screening eye clinic and rapidly perform detailed ophthalmologic exams. Findings were documented in 96 EVD survivors to inform public health officials and eye care providers of the emerging disease process. Personal protective equipment was tailored to the environment and implications of EBOV persistence within intraocular fluid.Conclusions/SignificanceA screening eye clinic was feasible and effective for the rapid screening, care, and referral of EVD survivors with uveitis and retinal disease. Patients were screened promptly for an initial assessment of the disease process, which has informed other efforts within West Africa related to immediate patient care needs and our collective understanding of EVD sequelae. Further attention is needed to understand the pathogensis and treatment of ophthalmic sequelae given recent EVD outbreaks in West Africa and ongoing outbreak within Democratic Republic of Congo.
Highlights
The West African Ebola virus disease (EVD) outbreak from 2014–2016 was of historic magnitude with over 28,600 cases and 11,300 deaths predominantly within the highest transmission countries of Liberia, Sierra Leone and Guinea.[1]
As reports of eye disease emerged via communications with providers in West Africa, in addition to the repatriation of health care workers (HCWs) from West Africa to the United States following Ebola virus (EBOV) infection[4,5], the clinical imperative for rapid screening evaluation of EVD survivors and assessment of the prevalence of eye disease, clinical spectrum, and treatment algorithms became increasingly evident
Eternal Love Winning Africa Hospital is a health facility founded by Serving in Mission (SIM) in 1965 located in Paynesville City, Monrovia, Liberia
Summary
The West African Ebola virus disease (EVD) outbreak from 2014–2016 was of historic magnitude with over 28,600 cases and 11,300 deaths predominantly within the highest transmission countries of Liberia, Sierra Leone and Guinea.[1]. In the wake of the West African Ebola virus disease (EVD) outbreak of 2014–2016, thousands of EVD survivors began to manifest a constellation of systemic and ophthalmic sequelae. Myalgias, and abdominal pain, patients were developing uveitis, a spectrum of inflammatory eye disease leading to eye pain, redness, and vision loss. To investigate this emerging eye disease, resources and equipment were needed to promptly evaluate this sight-threatening condition, given our identification of Ebola virus in the ocular fluid of an EVD survivor during disease convalescence
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