Once upon a time, well actually 1976, in the beautiful country of Zaire, now Congo, there was a river named Ebola. In a small town a couple of miles from the river a crisis emerged when people started dying fast and horribly. The nuns in the town took care of the sick people but they too became ill. What was going on? If you guessed this wrong, wow, impressive.
The river town people somehow managed to send some vials of a nun’s blood. It was travelling on a normal commercial flight, in a thermos bottle, just in the hand luggage. For the youngsters: those were the days that no airline was worrying about bringing liquids on the plane. First stop, the Institute of Tropical Medicine in Antwerp, Belgium (Zaire was a former Belgian colony).
When the Belgians took out the vials and put under their microscope they saw “a gigantic worm like structure – gigantic by viral standards (…) a very unusual shape for a virus.” The virus looked like a virus called the “Marburg virus”. This virus had been infecting laboratory people in the German city Marburg after they had worked in Uganda with ill monkeys. The Marburg virus was also known to be very deadly. After sharing this information, the World Health Organization told them to immediately send samples to a British military laboratory and to the Centers for Disease Control in Atlanta. In the end it was the CDC that proved that although it looked similar to Marburg, it was a totally new disease.
Ebola causes an outbreak every so often. The outbreaks often start from one person that gets infected by an animal. The symptoms are witnessed after a couple of days. First some that compare to how you feel the day after a night of heavy drinking and karaoke singing: sore throat, muscular pain and headaches. Then symptoms you might have expected earlier, probably at the karaoke bar, instead of days later: vomiting and diarrhea. Then the most frightening thing happens: you start bleeding from every pore, from the biggest one (yep, that one) to ones so small you didn’t even know you had them. After one or two weeks the person is dead. Well, in reality on average 50% of the persons die. But I don’t think that this percentage really comforting.
In fact: Ebola is killing its victims so quick, the outbreaks, as terrible as they are, usually outrun themselves. Simply because there are no more people left to infect.
Anybody who crosses here may die
In 1976, one of the Belgian doctors Peter Piot was send to the village to do some true epidemiology research. In his own words: “I was so excited about seeing Africa for the first time, about investigating this new virus and about stopping the epidemic.” Excitement was probably not really what the sick people were looking for, but I have to admit that from a professional perspective I understand the emotion.
Peter Piot also mentioned that when he got to the town two weeks after the outbreak there was a barrier with a sign saying: “Please stop, anybody who crosses here may die.” A true dare for even the most adventurous thrill seekers.
The medical team discovered many things, like pregnant women were injected with vitamins (that is a good thing) using just five needles to inject everyone (not a good idea…). One interesting fact they also noticed was that people were getting ill after attending funerals.
Don’t kiss dead people
Ebola is spread through contact with infected bodily fluids. And because there is a lot of this leaking bodily fluid, it is very easy for the Ebola virus to infect other people. When someone dies from Ebola, the body is still full of the virus. Any direct contact, such as washing or preparation of the deceased without protection can be a serious risk. Moreover, in a lot of African cultures it is tradition to kiss the deceased at the funeral.
The 2014 Outbreak : West Africa
In 2014 the outbreak got bigger and hit the worldwide news. It all started with a child that got infected, probably by eating bush meat, and died. The funeral took place on the border of Guinee, Sierra Leone and Liberia and people form everywhere joined. Maybe the child was kissed, maybe not, but sure thing the disease spread when the guests went back.
By the time the authorities were notified a shocking thing happened. People didn’t understand the disease. After almost 40 years of Ebola Outbreaks information about it was still lacking in villages in Guinee, Liberia and Sierra Leone. The common understanding about the disease was: if you go to the hospital, you die. The scary outfits of the medical staff probably didn’t help either. This resulted in sick and infected people hiding from the medical personnel in order not to get killed in the hospital. Thus, spreading the infection further and further.
In order to control an epidemic like this, good medical personnel just isn’t enough. You need community engagement and you need education. Preferably from local people that everybody knows and trusts.
And please, don’t kiss dead people if you don’t know how or why they died.
Picture credit: Nahid Bhadelia/CDC