Data collected during the 2012 Ebola virus disease (EVD) epidemic in the
Democratic Republic of the Congo were analysed for clinical signs, symptoms
and case fatality of EVD caused by Bundibugyo virus (BDBV), establishment of
differential diagnoses, description of medical treatment and evaluation of the
quality of clinical documentation. In a quantitative observational prospective
study, global epidemiological data from 52 patients (34 patients within the
community, 18 patients treated in the Ebola Treatment Centre) were entered
anonymously into a database, subsequently matched and analysed. Relevant
findings include an over-representation of females among community EVD cases
(85.3%) and of community EVD cases in the age group of 15-54 years (82.4%).
All ETC patients had fever (55.6% of all 18 ETC patients during their hospital
stay) or self-reported fever (88.2% upon admission) at some point of time
during their illness. Major symptoms of ETC patients during hospital stay
included asthenia (82.4%), anorexia (82.4%), myalgia (70.6%), sore
throat/difficulty swallowing (70.6%), arthralgia (76.5%) and nausea (70.6%).
Gastrointestinal signs and symptoms (nausea, diarrhoea, vomiting) (76.4%) as
well as general pain (94.1%) were frequent in ETC patients. The median
duration of EVD was 18 days, while the mean incubation period was 11.3 days.
Differential diagnosis of EVD included malaria (28.3%), intestinal parasitosis
(10.9%), and infectious syndrome (10.9%). There was also an important
variation in clinical evolvement. Quality of documentation was adversely
affected by the way patient file contents were transferred from inside to
outside the high-risk zone, entailing a mean mismatch value of 27.3% between
patient file contents inside vs. outside the high-risk zone. This study adds
further description of EVD (frequently non-specific signs and symptoms, non
frequent bleeding, a long incubation period, long duration of disease) and
emphasizes the need for improving clinical monitoring and documentation in EVD
outbreak settings
