During the 1995 outbreak of Ebola hemorrhagic fever in the Democratic Republic of
the Congo, a series of 103 cases (one-third of the total number of cases) had clinical
symptoms and signs accurately recorded by medical workers, mainly in the setting of
the urban hospital in Kikwit. Clinical diagnosis was confirmed retrospectively in
cases for which serum samples were available (n = 63, 61% of the cases). The disease
began unspecifically with fever, asthenia, diarrhea, headaches, myalgia, arthralgia,
vomiting, and abdominal pain. Early inconsistent signs and symptoms included conjunctival
injection, sore throat, and rash. Overall, bleeding signs were observed in <45% of
the cases. Typically, terminally ill patients presented with obtundation, anuria,
shock, tachypnea, and normothermia. Late manifestations, most frequently arthralgia
and ocular diseases, occurred in convalescent patients. This series is the most extensive
number of cases of Ebola hemorrhagic fever observed during an outbreak.