THE COMING PLAGUE by Laurie Garrett

A review of THE COMING PLAGUE: NEWLY EMERGING DISEASES IN A WORLD OUT OF BALANCE by Laurie Garrett, published in 1994. Chapter 5: Yambuku – EBOLA

Logistical nightmares aggravated by national panic
The snowball effect began modestly enough on October 13, 1976 with Pierre Sureau’s arrival in Kinshasa, representing WHO with the task of assisting Zairian authorities in any way possible. It would be several days before transport to Yambuku could be arranged. Such delays were to become a major component of this investigation, one that was constantly plagued not only by the mysterious virus but also by logistical nightmares aggravated by national panic. All commercial flights to Bumba had ceased as a result of the regional quarantine. That left only Zairian Air Force transport to the region, but terrified pilots were rebelling against orders to enter the Bumba Zone.

“My God!” Sureau exclaimed. “That virus is fast!”
Having nursed her dear friend Sister Myriam, Sister Edmonda now lay dying in Ngaliema Hospital’s isolation ward. Sureau found her semi-delirious, severely dehydrated from days of diarrhea, feeble, anorexic, feverish, completely drained of energy; yet, surprisingly, unafraid. Sureau took a blood sample and departed. That night Sister Edmonda died. “My God!” Sureau exclaimed. “That virus is fast!”

A new patient had arrived
The following morning, October 14, Sureau returned to discover a new patient had arrived. Student nurse Mayinga N’Seka, who had attended both Sister Myriam and Sister Edmonda, was developing the first symptoms of the mysterious disease. Two days earlier, Mayinga had spent hours in a general administrative office awaiting transit papers for overseas study, where she had contact with numerous strangers and officials. She then took a taxi to Mama Yemo Hospital, where she sat in a crowded room, waiting for someone to treat her fever, headache, and muscle pains. Sureau and Ngaliema doctors quickly determined that Mayinga had the Yambuku disease, and transferred her to Ngaliema’s Pavilion 5 isolation ward. Concern and rumors started to spread through the streets of Kinshasa.

Dr. Margaretha Isaacson flew up from Johannesburg, Marburg antiserum in hand
WHO remained convinced the culprit could still be a strain of Marburg disease so Sureau and Close contacted the South African team that had treated the Australian tourists a year earlier and Dr. Margaretha Isaacson flew up from Johannesburg, Marburg antiserum in hand. The Zairian medical staff, which had been in a state of extreme agitation ever since their colleague fell ill, was thrilled to see the ‘space suits’ brought from South Africa.

Endangering the 2 million residents of the capital
They were far less enthusiastic that the entire Pavilion 5 staff be placed under quarantine to prevent the possible spread of the Yambuku virus from Ngaliema Hospital into the streets of Kinshasa, endangering the 2 million residents of the capital. For nearly a month, a half dozen staff members would be confined to Pavilion 5 and 2, forbidden to leave the confines of the area to see their families.

No further cases of Yambuku disease would develop in Kinshasa
Officials tracked down 37 people with whom Mayinga had shared meals or close contact in the days prior to her illness, placing all the unfortunate men, women and children inside Pavilion 2 for twenty-one days of quarantine. In addition, 274 people who had had recent contact with the Pavilion-bound individuals were found, blood-tested, and kept under close surveillance. Fortunately, no further cases of Yambuku disease would develop in Kinshasa. Sureau never wore a mask, and often spent long periods of time at Mayinga’s bedside, whose condition worsened the next day.

Johnson reminded the group that the virus was extraordinarily dangerous
On October 18, six weeks after the Yambuku epidemic began, the core of what would that day be dubbed the International Commission arrived with enormous crates of sophisticated equipment. Now a middle-aged veteran of dozens of CDC investigations, Johnson inspired confidence in the men around him. In coming weeks this core group would guide nearly all Yambuku-related activities, operating in several languages, crossing often difficult political and cultural boundaries. Johnson reminded the group that the virus was extraordinarily dangerous, ordered everyone to take their temperature twice a day, follow to the letter Isaacson’s recommendations for protection, and always work in teams.