The Coming Plague

by Laurie Garrett

  When Joe finally reached N’zara he sent a relayed radio signal to Karl Johnson to assure his friend in Kinshasa that he had arrived safely and could confirm there was an epidemic afoot. To accomplish such a seemingly simple task: McCormick first sent a ham radio signal to the Italian missionaries back at the Zaire border. They relayed the message to a pilot flying a missionary twin-engine plane. He ascended to sufficient altitude to be able to send an unblocked signal down the length of Zaire, where it came out of the speaker of Johnson’s single side-band radio. With such a complex system it was obvious that the message had to be short and sweet: the details would have to await Joe’s return to Bumba.

  For three weeks McCormick slept in the Land-Rover by night and interviewed epidemic victims and survivors by day. It became obvious that few people traveled between the N’zara area and Yambuku, a distance of over 400 miles.

  By the time Joe arrived the worst of the N‘zara outbreak was past, and there were no more active cases in the clinic. For several days he questioned residents of N’zara and the outlying villages, and collected blood samples. Satisfied that the epidemic was under control, his supplies dangerously low, McCormick prepared to return to Zaire. But first, with a hint of mischief, Joe wrote a note to his CDC colleague Don Francis. McCormick knew Francis was heading up an official WHO team that was trying to make its way to N’zara from Khartoum.

  Before he left, McCormick put the note in a box and left it with a town leader instructed to “give the container to the white man who will come soon from Khartoum.”

  McCormick had no idea that Francis and his team were trapped in Khartoum, hostage to terrified pilots who were refusing to fly and government bureaucrats uncertain about providing open access to the Europeans and Americans. It would be several days before the WHO team would reach the area. In the meantime, McCormick’s container, pregnant with information, waited in the hot N’zara sun.

  In American holiday terms, McCormick left Isiro on Halloween and returned to the Bumba Zone the day before Thanksgiving, having been virtually incommunicado the entire time.

  Much had happened in his absence. A full-scale epidemiological survey of all the villages surrounding the Yambuku Mission had been conducted, involving most of the International Commission members. For nearly two weeks, the team, augmented by dozens of trained local volunteers, surveyed over 550 villages, interviewed 34,000 families, and took blood samples from 442 people in the hardest-hit communities. In addition, team members gathered a sampling of local insects and animals to test for viral infection.15

  And on November 6, Zaire’s Minister of Health, Ngwété, issued an international report summarizing findings to date: 358 cases of the viral disease had occurred, 325 were fatal. That was an astonishing lethality rate of 90.7 percent.

  Ngwété said all tests in labs throughout the world proved that “this agent is a new virus.”

  “The name ‘Ebola,’ after a little river in the region where the disease first appeared, is proposed for this virus,” Ngwété concluded.16

  Somehow, having a name for the culprit had brought new energy and focus to the Yambuku investigation, and the fears of the scientists receded with repetition of the word “Ebola.” After a while, “Ebola” sounded almost routine, like “measles” or “polio.”

  That sense of relative calm evaporated when, several days later, the International Commission learned that Geoffrey Platt had contracted Ebola disease in England.

  For nearly a month Platt had toiled with caution and deliberation in his laboratory at Porton Down, trying to learn quickly as much as possible about the Sudan strain of the Ebola virus. On the morning of November 5 he was working in the Toxic Animals Wing of Porton Down, passing Ebola samples from one guinea pig to another to see if the virulence of the virus was diminished as it went through successive generations of animals. As always, he was wearing a respirator, protective lab clothes, and three layers of latex gloves.

  His hand slipped.

  The syringe containing Ebola-infected guinea pig blood jammed into the tip of his thumb, just above the nail.

  Horrified, Platt was seized by panic, and for some time—he had no idea whether it was seconds or minutes—he stared at the thumb and saw his mortality.

  “Hurry, get a grip on yourself,” he said, ripping off the three sets of gloves and squeezing hard at his punctured thumb tip.

  “Bleed, damnit! Bleed,” he muttered, but no blood appeared. He dashed out to the next chamber and shoved his hand into a disinfectant tank. For two minutes he held his digit submerged, praying against all biological probability that no virus had actually passed into his thumb; or the disinfectant was getting drawn up into the microns-wide pore created by the needle, killing the virus; or the accident hadn’t actually happened at all. He could feel his heart pounding hard against his chest, and feared the adrenaline-propelled organ was all too efficiently pumping Ebola virus throughout his body.17

  He slowly withdrew his hand from the vat, daubed it with a towel, and used a magnifying lens to search for the needle puncture site. He saw no sign of it.

  Carefully following lab exiting procedures, Platt left the Toxic Animals Wing and reported to the Laboratory Safety Office, where he was examined briefly, given a thermometer, and sent home with instructions to report any sudden rise in his temperature.

  For six days Platt paced the floors of his lab and house, losing sleep for the first time in his many years of working with lethal viruses. His wife, Eileen, did her best to shield their two preadolescent children from the growing anxiety shared by their parents.

  At midnight on November 11, Platt’s temperature suddenly jumped, and he felt the chills of a fever. The following morning he reported to the Porton Down safety office. By then his fever was over 100°F, and the staff was very worried, not only on Platt’s behalf but also for everyone at the laboratory with whom he’d had contact. They immediately took a blood sample from Platt, examining a droplet under an electron microscope.

  The dreaded “???? virus” was there.

  Platt donned a respirator to protect others from his virus, and a special ambulance staffed by volunteer drivers and guided by a police escort took the English scientist to North London’s Coppetts Wood Hospital. While Platt was placed inside a new Trexler negative-pressure plastic isolator, the 160 other patients then in the hospital were hastily packed off to alternative medical facilities.

  For forty-nine days Platt languished inside his plastic environment, which was, in turn, inside an otherwise empty hospital. The large medical staff that tended to him, led by Dr. Ronald Emond, was placed under quarantine. And throughout the first week of Platt’s life-struggle, he was entirely cut off from family and friends.

  Meanwhile, Eileen and the kids were under house quarantine, forced to constantly check their own temperatures, and terrified that Geoffrey would die.

  The British government’s reaction to Platt’s illness was rapid and severe. Porton Down was immediately shut down, all its employees sent home and placed under surveillance. Several friends of the Platt family were also put under home quarantine. Over a month’s time some £200,000 was spent by the U.K. government to compensate employees for lost work time, relocate Coppetts Wood hospital patients, and monitor over 300 people for possible Ebola infection.

  Meanwhile, Platt suffered most of the symptoms seen among Ebola victims in Zaire and Sudan. His care, however, bore no resemblance to that available to the people of Yambuku.

  As Platt’s fever climbed to over 104°F, his hair fell out and he passed blood in his stools and vomitus. Dr. Emond’s team attacked the virus with every weapon available. Recently isolated human interferon—a crucial chemical of the immune system—was injected into Platt twice a day in large doses (3 million units). The ailing scientist was plac
ed on intravenous feedings, carefully selected to balance his diarrhea-disrupted electrolytes. When Candida fungal infections appeared in his throat, Platt got amphotericin B lozenges. Every fluctuation in his vital signs and blood and urine chemistry were monitored closely.

  And forty-seven hours after his fever began, Platt was infused with Sophie’s plasma, flown in from Kinshasa.

  Following the Ebola plasma treatment Platt’s condition worsened; his fever spiked again, he was extremely nauseated, his bowel was incontinent, his joints all ached, and he was very weak. Most alarming to Emond was Platt’s mental state. The bright scientist was losing his memory, couldn’t concentrate long enough to finish reading a sentence and seemed disoriented.

  Platt was indeed very confused.

  “Why am I in this plastic tent?” he wondered. “Who are these people looking at me? Where am I? Why can’t I read? Did I used to be able to read?”

  By November 20, nine days into his illness, Platt began to shed his confusion (along with dead skin and hair), and shortly before Christmas the British government was pleased to conclude that nobody else at Porton Down or in the Platt family had become infected.

  England, it seemed, was spared.

  News of Platt’s illness came to Yambuku on November 12, hitting the commission members very hard. Morale plummeted and collective fear rose. Johnson sensed that the anxiety could be impairing the team’s efforts. Certainly Max Germain, whose job was collecting wild, possibly infected animals, was on the verge of panic, and Breman had warned Karl that several team members had asked about the reliability of emergency evacuation plans for flying infected scientists to Johannesburg. Johnson tried to reassure the researchers, but he knew every movement the commission had made since the day it formed had been slowed or impaired by logistic problems.

  By November 9, Sureau, having personally searched 21 villages, identified 136 fatal Ebola cases, and mapped the complex relationships of all the dead, recovered, and well people in those villages, was ready to leave. Of all the foreigners flown into Zaire during the epidemic, Sureau had been at it the longest. He was burned out, and both he and Johnson felt the epidemic was over. Sureau began his long journey home.

  But the mystery of Ebola was far from solved.

  On November 16, McCormick cruised into Yambuku, greeting the commission members with startling news.

  “Guys,” he said, “what we have here is two totally separate outbreaks. There is no relationship between what’s going on here and what’s happening in N’zara, except they both happen to be Ebola virus.”

  Johnson looked at Joe as if he had just watched his protégé’s mind snap. Breman shook his head in disbelief. And young Piot grinned, thinking, “Jeez, this guy’s got balls!”

  McCormick explained to his disbelieving colleagues that travel between the two areas was so arduous, and the cultural gaps so great, that people simply didn’t go back and forth.

  “There’s no way the Yambuku epidemic could get to N’zara or vice versa unless some infected person traveled those roads. And I can tell you, guys, my Land-Rover was the first vehicle on those so-called roads in months … maybe years.”

  Furthermore, he argued, there were no Ebola cases in the villages between N’zara and the Bumba Zone, and the Sudanese epidemic seemed less severe; more people appeared to survive Ebola in N’zara. McCormick’s theories were dismissed out of hand by most commission members, and official WHO accounts of the 1976 outbreaks implied there was some as yet undiscovered link between the two epidemics.18

  Joe stubbornly insisted, however, that despite what seemed coincidence on an unnaturally profound scale, the two epidemics were entirely separate events. He would not abandon that belief with the passage of time, and years later would provide irrefutable proof that Nature had, indeed, rolled an incredibly bizarre set of snake eyes.19

  VII

  While McCormick wrote up his Sudanese findings for the commission, epidemiology investigations continued in the Yambuku area. Piot was left alone full-time in Yambuku, while other commission members combed neighboring areas. A few days after Joe’s return, Piot got a radio message from Johnson, telling him a Zairian Air Force helicopter would arrive shortly to bring him back to Bumba for a meeting with “U.S. Embassy officials.” Piot protested: why should he, a Belgian, fly back to brief a group of Americans?

  “Look, Peter, they want to see firsthand what’s going on. Don’t argue with me. Just get your butt on that copter,” Johnson said.

  Piot got off the radio grumbling about the “sick tourism” of the U.S. Embassy and CIA interests, but reluctantly prepared to meet the Zairian helicopter.

  As he paced about the mission, the skies suddenly darkened and he could tell a storm was coming. Out of the blackened sky came the Puma helicopter. Without shutting off its engines, the pilot opened his cockpit window and called out to Piot. When Piot asked the pilot about the safety of flying such a large cumbersome helicopter in a storm, he smelled the familiar scent of Zairian beer on the pilot’s answering breath.

  “Pas de problème,” the pilot insisted.

  Piot asked a few more questions, studied the pilots, and concluded the two of them were drunk.

  “The hell with it,” Piot said. “I’m not going to that meeting.” As he waved off the pilots, a Yambuku villager ran up crying, “Doctor, please! I’ve never been in the air before. If you are not going, may I take your place?”

  Piot shrugged, helped the young man into the helicopter, and waved the aircraft on its way.

  Two days later a somber Johnson radioed Piot with bad news, telling him that the drunken pilots had crashed the helicopter. Everybody on board died, and a hunter found the wreckage in the jungle southwest of Yambuku.

  Piot listened in disbelief as Johnson went on to explain that the Zairian Air Force was holding Piot personally responsible for the deaths.

  “They’re saying you sabotaged the helicopter because you’re some kind of Belgian colonialist,” Johnson continued. “And they’re insisting you have to go out there, get those bodies and perform autopsies. There’s no ifs, ands, or buts on this one, Peter. You have to do it. The entire research effort could be shut down in an instant if the Zairian military tells Mobutu we’re a bunch of CIA agents or something.”

  Shaken and angry, Piot jumped in his Land-Rover and drove as fast as roads would allow to Bumba. There, he was assigned a detail of prisoners from the local jail, who worked all night under Piot’s direction, making three coffins. The next morning Piot and the prisoners were flown by bitterly angry Zairian Air Force pilots to a plantation on the edge of the jungle area in which the hunter had spotted the wreckage. With the prisoners in a line behind him hauling the coffins and supplies, Piot cut a path through the rain forest. Whatever image the sight of Piot, the coffins, and the prisoners conjured for local villagers, it was obviously one of great interest. As the grim group cut its way deeper into the jungle, it was joined by clusters of the curious. Eventually, over a hundred people trailed the coffin bearers.

  The wind first told them when they had reached their destination, for it carried the stench of three human bodies that had literally cooked for four sweltering days in the equatorial jungle. Piot, standing a foot taller than most of his companions, peered ahead, trying to catch a glimpse of the helicopter. The jungle canopy was so dense that little sunlight penetrated it. Still unable to see the copter, Piot paused and pulled a respirator out of his knapsack.

  At the ghastly sight of the wreckage, all the prisoners screamed in horror and ran away. When he turned to look straight at the wreckage, Piot had to struggle hard to hold back a wave of nausea. The bodies had bloated in the humid heat, their eyes bulged, insects crawled over their taut skin, and the stench was over
powering. Fighting back his disgust, Piot forced himself to walk up to the first body, formaldehyde sprayer in hand, to ready it for the coffin.

  It was the young villager. Piot swayed, feeling suddenly dizzy. “This should have been me,” he thought. “I should have been in that seat, instead of this poor fellow.”

  He looked at the villagers, at the bodies, and called out, “The shoes! The shoes! Whoever helps me gets their shoes!”

  A cluster of boys ran forward, helped Piot stuff the bodies into their tight coffins, removed the shoes, and then carried the horrendous burdens—unlidded to compensate for the swelling—out of the jungle.

  When they reached the plantation Piot found the military pilots busily pursuing the business of alcohol consumption. They had refused to assist in the removal of the bodies, and looked on Piot with undisguised contempt.

  “Here are your colleagues,” Piot said, pointing at the gruesome coffins.

  The pilots gulped down more beer and arak, ordered Piot to put the bodies in the aircraft, and made it clear that they were in no mood to argue with a white man from Belgium. For half an hour Piot sat white-knuckled, barely able to breathe, clutching the armrests of his helicopter seat as the belligerent, inebriated pilots maneuvered their copter and its macabre cargo to Bumba. When they landed, Piot was beside himself with rage and fear; he called the bluff of Bumba military officers, refused to perform the autopsies they had demanded, and declared, “You have your bodies, I’ve done my part, the hell with you!”