Back in the mid-1980s, I and my family had lived in Uganda for a while, in the very year president Milton Obote was overthrown by a military regime.
Caught in the intermittent crossfire between the militia and the government forces, we could easily have been hit by whizzing bullets.
We were lucky. We were able to make it out of Kampala, the capital, safely, before it fell to the rebels. We’d escaped trouble by a whisker.
But after having read Richard Preston’s “The Hot Zone, I began to wonder that dangerous as the coup d’état had been, it was a pathogen that could have been far deadlier, one that lurked in our vicinity, without our knowledge.
Published in 1994, the book traces the roots of Ebola and other closely related viruses, and tracks their evolution during the period between 1967 and 1993.
Viruses of a myriad kind have been around for as long as Earth has been, but this particular clan hadn’t appeared in the human realm until roughly about 30 years ago. Or, it could well be that they had, but their appearance hadn’t received any attention up until then.
The trail begins in 1980, with a Frenchman, an employee of a sugar plant at the foothills of an extinct volcano called Mount Elgon, which straddles Kenya and Uganda. He came down with what, at the time, was a mundane symptom—a mere headache—soon after he got back from a camping trip to the mountain.
Within days, he melted in a massive pool of blood, leaving behind a puzzle for the scientific community to solve. What did him in?
It turned out that he’d been infected with a “hot agent” (U.S. military slang for a very, very, lethal virus): Marburg, named after the old German town, where it’d been detected more than a decade earlier. It’s a convention that viruses are named after the place in which they’re first discovered.
Its home, however, is held to be the dense tropical rain forests of East Africa.
It erupted in the laboratories of Behring Works, a pharmaceutical company in the business of producing vaccines from green monkeys, which they imported regularly from Uganda. It was 1967. The primates were being shipped from a station in Entebbe, where the inspection procedures were woefully lax.
The monkey trader was buying wild monkeys from villagers on the Ssese Islands, a wooded archipelago in the northwestern corner of Lake Victoria. He’d ship those that appeared healthy. Those that showed signs of illness were separated from the pack, and were set free in a location not far from where they were being procured. And if he fell short on supply, he’d pick out a few from the sick lot, and send them to Europe.
The path of Ebola has been unpredictable, invisible, sporadic, full of unexpected turns, and lulls. The disease has caught people off-guard, and destroyed them gruesomely.
In July, 1976, a storekeeper in a cotton factory in Nzara, a town in south Sudan, came down with a strange hemorrhagic fever that triggered a long chain of infection.
Two months later, an even more pernicious strain showed up in the tiny village of Yambuku, in northern Congo (earlier known as Zaire), some 60 miles from the Ebola River. It surfaced in a rudimentary clinic, run by Belgium nuns.
A teacher from a school—also run by the mission—went to get some pills there after he felt unwell upon returning from a road trip. He got a shot of medication. Soon, he broke with the virus. It jumped from person to person, sweeping through the entire hospital, sparing almost no one. At the same time, 55 settlements in the neighborhood were also struck.
Both were incidents of Ebola.
A chief reason for the uncontrolled spread of the contagion in its early days was the rampant use of unsterilized needles. Unhygienic medical practices were what, ironically, fanned the flames of past outbreaks.
At the beginning of each day, Preston writes, the staff at Yambuku dispensary would lay out five hypodermic syringes on a table, and they’d use them to give injections to crowds of patients all day long, mixing the blood of one with that of another. Now and then, they’d rinse the needles in a pan of warm water.
Ebola has been capricious, appearing without warning and abruptly slinking away, for reasons that aren’t fully clear.
Preston strikes the perfect balance in tone and content. The narrative reads like a Michael Crichton thriller, fast-paced and riveting.
Kitum Cave is Mount Elgon’s equivalent of the Times Square subway station. It is an underground traffic zone, a biological mixing point, where different species of animals and insects cross one another’s paths in an enclosed air space. A nice place for a virus to jump species.
Only, it makes your skin crawl because it’s not “The Andromeda Strain.” It’s reality. It makes you think twice about brushing your hand against a crushed insect or touching a rock.
His trenchant descriptions of the cold progression of the disease makes its horror come alive in all its grotesqueness. He reconstructs a scene on board a Fokker Friendship flight from Kisumu to Nairobi in which he describes the critical condition of a patient, who can’t stop throwing up into a barf bag.
The airsickness bag fills up to the brim with a substance known as the vomito negro or the black vomit. Which isn’t really black, but is a “speckled liquid of two colors—black and red—a stew of tarry granules, mixed with fresh arterial blood. It is hemorrhage, and it smells like a slaughterhouse.
He pauses to interpose snatches of lucid, jargon-free molecular biology and epidemiology, complete with photographs of the organism.
While most virus particles are ball shaped, resembling “peppercorns,” Ebola belongs to a family of “filoviruses”—comprised of Marburg, Ebola Sudan, and Ebola Zaire—that look like threads. Of the three, the third is the most destructive.
An Ebola virion is a skinny tube, made of seven braided proteins, arranged in an elongated structure. Within that is a strand of RNA, the molecule that contains its genetic code or genome, and tells it how to replicate.
Viruses are the smallest of parasites that can’t live autonomously. Outside the host cell, they are more “dead” than “alive.” But a curious aspect of their life is that unlike living cells, which once stop working, can’t be revived, they can. They can switch back on the instant they come into contact with a living system, and begin to multiply. What does truly kill them, though, is sunlight and moisture.
Preston devotes roughly half the book to an event that the media did not reference in the wake of a handful of cases in American healthcare workers, returning from the Ebola-stricken West Africa.
Back in the winter of 1989, an affluent Washington, D.C. suburb was on the brink of a massive outbreak. A company called Hazelton Research Products, a supplier of animals for research, had received a shipment of monkeys from the Philippines. It was using a one-story building in an office park in Reston as a monkey house.
Soon after arrival, a few creatures fell severely ill, and dropped dead in their cages. But by then, whatever had afflicted them had taken root in the entire establishment. More and more animals died with an alarming speed.
The in-house veterinarian, unable to fathom the plague, consulted the United States Army Medical Research Institute of Infectious Diseases (or U.S.A.M.R.I.I.D.), located next door, on Fort Detrick, Maryland.
The army researchers ran a battery of tests and concluded that it was the dreaded Ebola. What was even more deeply disturbing was that this strain could travel through the air.
In very tight secrecy, the military put together a biohazard SWAT team and men and women in helmeted suits moved in on the epicenter. Over a course of three days, in a silent operation that ran from dawn to dusk, over 500 monkeys were euthanized, and the facility, fumigated.
Fortunately, this variant had no effect on humans.
Preston’s reasoning behind the emergence of such killer agents, capable of decimating the humankind sound. It’s a response of Earth’s ecosystem, he believes, to what it perceives as an “infection by the human parasite.” It’s a righteous reaction against the relentless encroachment of colonies of concrete and citizens, which threaten it with extinction.
In the most recent spate of attack, in which Ebola has been burning savagely through the populations of Liberia, Guinea, and Sierra Leone, at this writing, it has taken the lives of more than 7,500.