Thursday, October 27, 2016

A forty-year walk with Ebola – it hasn’t been a 'walk in the park'

By Esther Nakkazi

40 Years ago, around September, the first Ebola blood samples were carried by a Congolese woman in her handbag from Zaire to Belgium on Sabena airlines. Yes, you read that correctly.

Currently, with an Ebola outbreak anywhere, travelers not even remotely near the source have to fill in forms, temperatures have to be taken, suspects quizzed and isolated or even denied access to places. It is the drill.

The fascinating 40-year history of Ebola since the first outbreak in Yambuku, a small village in the DRC, was told at the 8th international symposium on filoviruses in Antwerp, Belgium.

Nothing is the same anymore. Zaire is now the Democratic Republic of Congo, Sabena airlines - then the national carrier for Belgium - closed in 2001, its succeeded by Brussels Airlines.

As you know, this last Ebola outbreak was vastly different from all the ones before. Ebola has become a household name now, 40 years after Yambuku.

Forty years ago, though, Ebola was unknown.

In 1976, in Yambuku, a small village in Mongala Province in northern DR Congo, a young doctor Jean-Jacques Muyembe was ordered by the minister of health to make investigations about a disease that had killed some people.

Muyembe arrived with a medical assistant. The health workers suspected typhoid or yellow fever. Muyembe examined some sick people and collected blood samples without gloves. His hands and fingers were stained with blood but he just washed it off with water and soap. In addition, he collected liver samples from 3 nurses who had died.

When a nurse who he knew was vaccinated from typhoid and yellow fever said she had a fever the alarm bells started to ring. The trio (Muyembe, the medical assistant, and nurse) flew to Kisansha to further investigate the samples.

The disease was nothing they knew. Sadly, the nurse and medical assistant died in the next few days but Muyembe was saved - not by the ‘moon suit’ but by washing his hands with water and soap.

A Congolese woman who was traveling to Belgium on Sabena airlines was asked to drop the samples off at the Institute of Tropical Medicine (ITM) in Antwerp, where Muyembe’s friend was working.

The Ebola samples arrived in Belgium in September 1976. Dr. Guido van der Groen picked them up on his bicycle. They were packed in used containers. He took them for proper storage at ITM.

Here the team tried to identify the virus and found that it was close to the Marburg virus isolated from monkeys in Uganda by the Germans, but clearly, it was not the same. Muyembe was informed about it and warned that it concerned a very dangerous new virus. They then tried to give the new virus a name.

At first, they opted for Yambuku where the index case was discovered but they soon realized that if you use the name of a town it will cause too much stigma. Then they looked for any landmark near Yambuku and found the Ebola river which is why Ebola is now named after a river near Yambuku.

The Ebola forty-year journey has seen 25 outbreaks by now, 30,900 cumulative cases and 12,800 deaths. A new book ‘on the trail of Ebola’ by Dr. Guido van der Groen details this history.

Frontline health workers have been most affected by Ebola over the years, but right now it is a serious public health threat. Many ongoing efforts in terms of policy, diagnostics, and research are being discussed at this symposium.

Clearly, the Ebola journey hasn’t been a ‘walk in the park’.


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