Ebola virus hits Zaire

From ANIMAL PEOPLE, June 1995:

KINSHASA, Zaire––An outbreak of an Ebola-type
virus generated global panic after becoming known to media in
mid-May, two months after it started. The disease is believed to
have spread to humans from green vervet monkeys, as in previ-
ous outbreaks, but where, when, and how is unknown.
As of midnight on May 15, there were 76 confirmed
cases with 64 dead, said Kinshasa University professor Jean-
Jacques Muyembe, the leading Zairean authority on the disease.
Most of the deaths came in Kikwit, a town of 500,000, about 300
miles from Kinshasa, the national capital. Three other towns
were affected, including Kenge, less than 125 miles from
Kinshasa, which has five million people but limited medical and
sanitation facilities. Kinshasa governor Bernadin Mungul Diaka,
desperately rotated troops in an attempt to thwart bribery that
undercut his attempt to impose a prophylactic quarantine.
There seemed little chance that people fleeing the out-
break would run the opposite way, as that would put them into
head-on collision with more than a million refugees from the
ongoing ethnic fighting in Rwanda and Burundi.

A form of filovirus, the Ebola disease family was iden-
tified in 1967 when surgical workers at a polio vaccine production
laboratory in Marburg, Germany, were exposed to the blood and
saliva of a batch of infected green vervet monkeys imported from
Uganda. Thirty workers fell ill; eight people died, including the
wife of a worker who was apparently infected by her husband’s
semen. The case caused the U.S. to impose a quarantine on
imported monkeys, for the first time, but that didn’t prevent an
outbreak of a similar disease in 1989, dubbed Ebola Reston, at
the Hazleton Research animal import site in Reston, Virginia. A
quick response by the Centers for Disease Control included
killing all 400 monkeys at the Reston site and revoking the import
permits of seven of the eight USDA-authorized monkey quaran-
tine sites. That strain is believed to have come with crab-eating
macacques imported from the Philippines.
In between came the Ebola Sudan epidemics of 1976
and 1979, when the disease hit parts of both Sudan and Zaire. It
took its name from a river in northern Zaire near the epicenter of
the 1976 outbreak. Nearly 500 deaths were confirmed in 1976;
the 1979 toll is unknown. “The death rate in some villages of the
Sudan topped 90%,” writes Pulitzer Prize-winning journalist
Deborah Blum in her book The Monkey Wars. “Ebola killed
patients, nurses, doctors, wiped out entire hospital staffs. By the
end, anybody left alive was fleeing. The virus destroys the
body’s blood system, ripping apart blood cells until they leak as if
punctured by a thousand tiny needles. In the end, the membranes
that contain the body’s fluid are destroyed. The body is awash in
disintegrated blood, the skin mushy and oozing,” and highly
infectious to anyone who touches it. There is no known vaccine
or cure. The incubation period is believed to range from two to
21 days.
Another outbreak may have killed 200 people in the
Nzara district of war-torn southern Sudan last year, said Father
Julio Albanesi of the Comboni Missionaires in Nairobi, Kenya.
“Nobody issued an official statement,” he said, “but the symp-
toms of the people who got sick and died were those of Ebola.
“The people there were so afraid they burned down the villages.”
Public anxiety was stoked in the developed world by
The Hot Zone, a best-selling Richard Preston novel about the
Reston outbreak; the nonfiction best-seller The Coming Plague,
by Laurie Garrett; the NBC made-for-TV movie Virus; and the
Dustin Hoffman film Outbreak, about a similar virus spreading
from Zaire.
But World Health Organization assistant director gener-
al Dr. Ralph H. Henderson on May 13 predicted the epidemic
would end quickly. “If this epidemic is like previous ones, and
the signs are that it is,” he said, “we are going to see a very rapid
drop in cases shortly. Typically the real explosion occurs in hos-
pital settings. Once you stop that, it tends to die out.” WHO
flew in 4.5 tons of gloves, gowns, and masks for hospital work-
ers, who in Zaire rarely have such luxuries. The European
Community gave $320,000 to the aid effort, while Doctors
Without Borders-Belgium sent medical expertise.
About two-thirds of the victims were health workers,
most of whom had contact with other victims before the outbreak
was identified. Three nuns from the Italy-based Little Sisters of
the Poor including Kikwit civic hospital head nurse Floralba
Rondi, 71, had died by May 12, with another nun reportedly
seriously ill and four more nuns under observation, along with
two nuns related to Rondi who attended her funeral. At the
time––April 25––Rondi was believed to have died of malaria.
Sixty members of the Little Sisters of the Poor are in
Zaire, where the order has had a medical mission since 1955.
Sister Floralba had been in Zaire three years longer than that.
A concurrent epidemic of dysentery afflicted 189 people
in the same area as the Ebola outbreak and killed 61 people by
May 13, yet caused little alarm: dysentery is familiar.
WHO confirmed on May 12 that a female researcher
from Switzerland contracted an isolated case of Ebola virus but
recovered last year. Working with monkeys in Abidjan, Ivory
Coast, she flew home to Basel upon developing a fever. An anti-
body to the virus was discovered in her blood and isolated in
February, lending hope that a vaccine can be developed.
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