Ocular Ebola Threat
Health worker’s ocular fluid tests positive for Ebola months after virus became undetectable in blood
A doctor working in West Africa was found to have the Ebola virus in the aqueous humor of his left eye 10 weeks after it was no longer detectable in his blood, and developed severe uveitis which threatened his vision – a finding which could have far-reaching implications for survivors of the recent Ebola outbreak.
Ian Crozier, an infectious disease specialist, contracted Ebola while helping to fight the epidemic in Sierra Leone in August 2014, and within a few weeks had contracted the virus and was evacuated to Emory University Hospital in Atlanta, USA. After spending some time in a critical condition he began to recover and was discharged. However, he then began to develop symptoms of ocular disease, including pain and intolerance to light, which progressed to blurred and decreasing vision. His aqueous humor tested positive for the Ebola virus using quantitative real-time PCR, despite the surface of the eye, the tear film and peripheral blood samples remaining negative for the virus.
The resulting case study (1) reports that the pathology of ocular Ebola infection is unknown, but the researchers involved theorize that the severe uveitis observed was a direct cytopathic effect of the virus. “The presence of viable Ebola virus in the eye could mean that other Ebola survivors may also be at risk for the development of uveitis,” says Steven Yeh of the Emory Eye Center. “The thousands of Ebola survivors in West Africa and healthcare workers in their home countries will need to be monitored for eye disease in the post-Ebola period.”
- JB Varkey et al., “Persistence of Ebola virus in ocular fluid during convalescence”, N Engl J Med, [Epub ahead of print] (2015). PMID: 25950269.
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