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

The disease was claiming residents of at least forty-four villages in a fifty-mile radius around Yambuku
After a three-hour flight the jet landed on Bumba’s tiny airstrip. The terrified Air Force pilots left the engines running while supplies were unloaded and left immediately. The next morning the group looked in on a handful of mystery disease patients at the Bumba hospital and met Dr. Massamba Matondo who told Sureau that the disease was claiming residents of at least forty-four villages in a fifty-mile radius around Yambuku. Sister Marcella, who had been keeping logs of the dead, presented her grim lists to Sureau. In the past month 38 of the 300 residents and employees of Yambuku had died. The visitors realized that they would have to go to every village, conducting a house-to-house investigation. No other approach would do.

Joe McCormick was needed at Ngaliema Hospital
Mayinga lost consciousness and commission members argued about contingency procedures for handling infected team members. Joe McCormick had just started unpacking his hundreds of crates of laboratory supplies for Lassa research when he received a cable from the CDC in Atlanta, instructing him to temporarily abandon the lab outside Kenema, Sierra Leone, and make his way as quickly as possible to Kinshasa, taking the portable glove-box he and Johnson had rigged up in Atlanta just weeks earlier, and other equipment that was needed at Ngaliema Hospital for testing and screening blood samples and preparing antisera against the mysterious disease.

He bluffed, bullied, and bribed his way
Just a few months earlier, having heard of McCormick’s exploits in Brazil, Johnson said to him “I’d like to send you to Sierra Leone to figure out just how widespread Lassa really is.” So in March 1976 he packed and prepared to set up a one-man Lassa research station in Sierra Leone. McCormick knew there was no easy way to get from Freetown, Sierra Leone, to Kinshasa and for three days he bluffed, bullied, and bribed his way into airplanes and through customs in Freetown, Abidjan, and, finally, Kinshasa.

The people had taken remarkably wise measures to stop the epidemic’s spread
“We must limit the numbers of us who are exposed to this virus until we determine how infectious it is,” Sureau told the group, instructing that only he and Piot should draw blood. A working pattern developed that was repeated in ten villages that day. Everywhere the group went they noticed the people had taken remarkably wise measures to stop the epidemic’s spread. Virtually all traffic on the Ebola and Zaire rivers had come to a halt, the ailing villagers and their families were kept under quarantine, bodies were buried some distance away from the houses, and there was little movement of people between communities.

As he released the tourniquet the husband let out a deep groan and died
In one village about ten miles from Yambuku, Piot and Sureau found a husband and wife lying side by side in their hut, both in the final throes of the disease. Pierre took blood from the husband while Peter prepared the wife’s arm. As he released the tourniquet and watched blood slowly fill the tube, the husband let out a deep groan and died. The wife cried out, Sureau quickly withdrew his needle, and she rolled over to embrace her dead husband. They had no idea whether their modest precautions were adequate to protect them from what they now understood first hand was a particularly horrible disease.

Mayinga died late the night of October 20, 1976
When the team members reunited at the mission after their first long and emotionally exhausting day in the villages, they compared notes and agreed that the epidemic had taken a terrible toll – in some cases claiming entire families. It would require the best their collective talents could muster to solve the mysteries of where the strange virus came from, how it was spread, and how best to prevent its resurgence. A day-old radio communication reached them from Kinshasa, via Bumba. “Mayinga died late the night of October 20.” Sureau was devastated, as were the Sisters, who felt profound gratitude for the student nurse’s courage in tending to Sisters Edmonda and Myriam. “ What we are dealing with is a virus like Marburg, but more pathogenic. A super-Marburg. The incubation time is usually eight days. How many more victims will there be in the villages? What can be done to stop this epidemic?” Sureau asked.

46 villages were affected, with over 350 deaths
Breman had been on the phone with Pat Webb at least twice a day for the three weeks prior to his arrival in Kinshasa. He knew precisely what Webb had discovered, and he carried with him microscope photos of the enemy. That night, Sureau radioed Bumba to tell Kinshasa that first surveys showed 46 villages were affected, with over 350 deaths. It broke Breman’s heart to watch the nuns ‘communicate’ with their ancient ham radio equipment, and listen through horrendous static for the voice of the monsignor in Lisala, ordering supplies and sharing information.

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