What a bloody mess

When the Ebola virus broke on April 10 this year, the scientific world went into a tizzy? It's uncontrollable, it's the big daddy of horror movies, and it's incurable. Authors look at the little killer from a safe distance

By Sumita Dasgupta, Kajal Basu
Published: Thursday 15 June 1995

What a bloody mess

Burial of one of the deadly vi (Credit: AP/PTI)The Ebola filovirus, a slender microscopic length of what resembles blood-sprinkled thread, is, in terrible truth, an insidious sociopath that spinechilling Hollywood would love to stock in its props room. No one has ever seen anything the likes of the Ebola virus before.

On April 10 this year, a Zairean worker turned into bloody mush -- after days of an infernal fever -- sloughed off the linings of his gullet and his mouth leaving the insides raw, felt his connective tissues dissolving, squirted blood from every orifice in his body, and died the most horrible death that the dismally unprepared doctors and paramedics at Kikwit had ever been witness to. The conservative death toll so far is around 150 and growing by the hour.

The Ebola Zaire is every medic's baptism by fire. According to a recent bestselling book, The Hot Zone, by journalist Richard Preston, "If influenza is a Level 1 virus, AIDS a Level 2, (Ebola is) Level 4 -- which means that there is nothing deadlier in encoded existence. International virologists, epidemologists and other disease detectives flown in from the United States, France, Switzerland, Nigeria and South Africa are moving about ponderously in "space suits" with their own internal air purifiers and not a chink in the armour. The news agencies occasionally report local paramedics doing their job without a sterilised stitch on them, but they are the brave ones who have seen their colleagues die in ignorance and uncomprehending agony. It requires a special kind of courage.

This courage is also experiential. Ebola had broken out earlier in 1976 and in 1979: at the 2nd instance, it had to be eradicated by the simple tactic of torching the small town of Nzara on the Zaire-Sudan border. No one quite knows what the carrier/vector animal is. Although the rough contours of its territory have been mapped, the residents of Central Africa, with the gigantic, uncharted rainforest glowering next to them, accept Ebola as just another of the scourges of an angry god. It's a localised way of life.

But as for the rich Northerners -- who, sociologists warn, could carry such uncontrollable, virtually invincible viruses to the rest of the world via tourists with a yen for new sites and nature's pure glory -- the Ebola is the mother of all diseases; which is why samples from the victims in Kikwit were first sent to Antwerp, Belgium, which had by then been forced to suspend work on haemorrhagic diseases by skinflint funding. Panicking medics then sent them to the Centre for Disease Control (CDC) at Atlanta, USA, which was well prepared to handle such an emergency. The moral of this boffinish buffoonery was, laments James W Leduc, expert in haemorrhagic fevers at the World Health Organization, that "it just shows the deteriorating capacity of the world to diagnose these diseases."

While this bumbling went on, a nurse and a nun who had cared selflessly for the first patient in Kikwit fell ill. The nun was evacuated to another town 70 miles to the west where she died. By then, she had already passed on the infection to 3 of her fellow nuns; 2 have since died, but not before letting the virus rampage through the filthy and mottled corridors of the Kikwit hospital and infecting the personnel. Summoned by a death rattle missive, the WHO stepped in.

It is being supported by a group from the CDC. US Air Force planes are bringing in sterilised body bags, surgical gowns, face masks with inbuilt oxygenators, latex gloves and blood plasma from warehouses in Pennsylvania -- and miles of scotch tape to secure any openings left after the suits have been worn. The European Union has also pitched in, sending regular supplies to make life little more easier for the relief workers. At last count, the "doomsday disease" -- as the Zaireans, with 2 previous Ebola outbreaks behind them -- had claimed close to 150 people. Kikwit's terrified population of 600,000 has been quarantined by a military known to be triggerhappy at the best of times, and underpaid to the point of freely accepting bribes from Kikwitians desperate enough to escape to anywhere but here. Consequently, cases have been reported in Musango and even in Kengo, a mere 200 kms from the capital Kinshasa.

This is nightmarish news. While Ebola is -- in rather misleading Hippocratical assuaging -- hard to catch (only through mucus or blood contact), even a single stretch of the virus (just a few microns long) is enough to infect a body by exploding into hyperproduction.

From individual hyperproduction to assemblyline human infection is a short hop, particularly if helped along by carnal contact. On the one hand, the Ebola River -- where the virus was first "discovered" in 1976 -- debouches into the Zaire (Congo) River, which is teeming with animal life, any of which could be the Ebola virus carrier/vector. Further, medics say, it could be helped along by the sex workers lining the Kinshasa Highway, also known, for obvious reasons, as the "AIDS Highway". The frightening fact is that both the river and the highway meet at Kinshasa.

And Kinshasa is a busy, busy city, impossible to monitor to the last person. Scientists say that if Ebola breaks in Kinshasa, god help the world. Can the virus slip out of the boundaries of Zaire and spread into the rest of the planet? The only way to react to this question is through optimism and the hope that the medics will come up with "something". Humans are not welcoming hosts to the virus; a patient dies within 2 to 21 days of being infected and that virus dies with him. The autodestruct ensures that the infection doesn't spread.

Unfortunately, there are factors that over rule the human anatomy: Zaire's Mobutu Sese Seko government's humanitarian and governance record is so tatty that most of the country's 42 million Zaireans would love to see him fall to the virus. In fact, health experts are convinced that pervasive malnutrition and poverty has made the people particularly defenceless against diseases such as Ebola. In the face of the emergency, however, the scenario has changed. The ragtag government machinery is working at a feverish pitch to enforce preventive measures. Government troops have set up roadblocks in and around Kikwit, but their palms are in a constant state of grease. Schools and health clinics have been closed down, flights cancelled and agricultural work in this farming province has ground to a halt. The capital, Kinshasa is also being guarded by soldiers, as the desperate Zairians and other foreign nationals try to force their way in.

But the security blanket provided by the government is allegedly punctured by numerous loopholes. The governor of Kinshasa, Bernadin Mungul Diaka, has himself admitted to the press that "soldiers have been taking bribes to let people into the capital." Besides, the urban hospitals in a poverty-ridden country like Zaire can hardly provide the airtight sanitation shield required to check the menace. New syringes are in short supply and reusable syringes and hypodermic needles are undoubtedly a major contributors to the current outbreak. In Kikwit, medics have either fled or stayed behind in a state of such exhaustion that the virus could get to them easily. As for cleaning up the blood that squirts like a garden hose through the wards?: well, there aren't enough medics.

But these are only problems at the surface, which perhaps can be overcome with more intense and sincere human efforts. The real malady is far more deeprooted. The Ebola outbreak has yet again driven home the chilling message that has been giving scientists and doctors across the world sleepless nights for some time now. Our planet has been assaulted by new viruses with terrifying regularity in recent decades. Most are still obscure menaces affecting a handful of human beings in remote African nations. But as they are viral, they are untreatable. And HIV has proved that if given leeway, a viral scourge can descend upon the human race like a gigantic tidal wave. Ebola is what is called the "sleeper": one chink and it is in. It does the genocide and then, without warning, goes into hiding -- no one knows where. It hides between human outbreaks.

Scientists have in previous outbreaks attempted to extract Ebola from just every living organism -- insects, bats and even plants that could have been harbouring the virus before it jumped the "species barrier" into humans. So far, they have met with little success. But one fact has been more or less clearly established: that Ebola lurks in the virgin rainforests of Zaire. The problem is that by hacking down the pristine tropical forests and trespassing into hitherto untouched territories, human beings have unleashed this deadly scourge upon themselves. In other words, thoughtless environmental destruction is the driving force behind the emergence of the Ebola.

The Ebola may yet be contained, but will the modern world learn a lesson from this disaster? "It's a classic warning. We've had a booming shot across our bows just now, and you could feel the wind whistle as it went by," says Richard Preston. Or else the terrifying viral wave will continue unabated...

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