Originally published 1 January 2002
As if AIDS-afflicted Africa didn’t have enough to contend with, the deadly Ebola virus keeps raising its ugly head, most recently in the West African nation of Gabon.
The virus is transmitted through contact with bodily fluids — blood, mucus, and saliva. Early flulike symptoms are followed by severe internal bleeding, vomiting, and diarrhea. Mortality is high. There is no cure for the disease, but patients treated early for dehydration can survive.
The Ebola virus was first identified in the Sudan in 1976. Since that time, more than 800 people, including medical workers, have died of the disease.
That Ebola has not become a continental or even global scourge is due to the heroic efforts of medical men and women from the World Health Organization, the Centers for Disease Control in Atlanta, the Institut Pasteur in Paris, the London Institute of Hygiene and Tropical Medicine, and nongovernmental organization such as Médecins Sans Frontières, Médecins du Monde, and the International Red Cross and Red Crescent.
A team of workers dispatched by the WHO was quick on the ground in Gabon when the recent outbreak surfaced.
Anyone who is inspired by stories of remarkable courage should read Laurie Garrett’s The Coming Plague: Newly Emerging Diseases in a World Out of Balance. She tells of the doctors and scientists who hurry to the scenes of potential epidemics to identify pathogens and direct efforts to contain them.
The book is now seven years old, but it remains the best introduction to the war against disease — and true heroism never goes out of date.
Read about Dr. Joe McCormick, for example, formerly of the CDC, who stayed on the job in N’zara, Sudan, trying to identify and stifle a viral outbreak even though he thought he had been infected by a deadly virus with an incubation time of five to seven days. “I just didn’t see the point of going to some hospital and getting everybody in a stew, sitting and waiting to get sick, and thinking all the while about the work I should have been doing in N’zara,” he told Garrett.
McCormick’s story could be multiplied a thousandfold. The doctors, nurses, and scientists who fight on the front lines of disease control know that microbes respect no political boundaries, and that, in an age of mass air travel, a pathogen can jump from the Sudan to Boston in a matter of hours.
In the aftermath of September 11, we are on heightened alert for the biological agents that human terrorists might spread, but microbes are quite capable of spreading terror all by themselves. There are 6 billion humans on the planet, and our proliferating biomass is an increasingly attractive breeding ground for fast-evolving microbes.
More than ever before, the planet’s entire human population is potentially available to fast-moving pathogens, and our vaunted technological prowess is nothing if we ignore poverty, ignorance, or disease anywhere. An outbreak of Ebola in Gabon has the potential to explode in our faces, even with our affluence and apparent safety.
As medicine Nobel laureate Joshua Lederberg has said: “We are in an eternal competition. We have beaten out virtually every other species to the point where we may now talk about protecting our former predators. But we’re not alone at the top of the food chain.” He is talking, of course, about invisible pathogens. The damage we can do to each other is small compared to what microbes might inflict if they outwit our ever-vigilant doctors and scientists.
Fourteenth-century visitations of the Black Death killed one-third of Europe’s population. The Great Flu Epidemic of 1918 killed 40 million people worldwide; more American soldiers died of flu than in World War I combat. Tens of millions of people are currently infected by HIV. “Nature is not benign,” Lederberg said.
Unfortunately, disease fighters must contend not only with microbes but also with apathetic or antagonistic governments, rapacious warlords and warring tribes, religious taboos, limited resources, entrenched bureaucracies, and the indifference of those of us in the developed world who care more about our own fat pocketbooks than the general well-being of humankind.
Meanwhile, Ebola, HIV, and a host of other pathogens are busy mutating, swapping genes, and evolving strategies to fatten their own metaphorical pocketbooks. In the crowded and mobile state of the present world, we are more vulnerable than ever.
Firefighters and police reaped well-deserved praise for their heroism on September 11. Our soldiers, too, have garnered admiration for their courage in the field. But the equally heroic efforts of the doctors, nurses, and scientists who work year in and year out in the squalid villages, crowded refugee camps, and teeming cities of the developing world to stem disease are seldom recognized.
Without them, we would be facing a far more serious danger than merely human predators.
