I can see her in my mind’s eye—Nurse Mayinga, the source of the virus in the United States Army’s freezers. She was a pleasant, quiet, beautiful young African woman, about twenty years old, in the prime of her life, with a future and dreams, hoping somehow that what was happening to her could not be happening. They say that her parents loved her dearly, that she was the apple of their eye. Now she is sitting in the casualty ward at Mama Yemo among the cases of malaria, among the large-bellied children in rags, and no one is paying any attention to her because all she has is a headache and red eyes. Perhaps the fact that she is crying has made her eyes red. A doctor gives her a shot for malaria and tells her that she should be in quarantine for her illness. But there is no room in the quarantine ward at Mama Yemo Hospital; so she leaves the hospital and hails another taxi. She tells the driver to take her to another hospital, to University Hospital, where perhaps the doctors can treat her. But when she arrives at University Hospital, the doctors can’t seem to find anything wrong with her, except for possibly some sign of malaria. Her headache is getting worse. She is sitting in the waiting room of this hospital, and as I try to imagine her there, I am almost certain she is crying. Finally she does the only thing left for her to do. She returns to Ngaliema Hospital and asks to be admitted as a patient. They put her in a private room, and there she falls into lethargy, and her face freezes into a mask.
News of the virus and what it did to people had been trickling out of the forest, and now a rumor that a sick nurse had wandered around Kinshasa for two days, having face-to-face contact with many people in crowded rooms and public places, caused a panic in the city. The news spread first along the mission grapevine and through government employees and among the diplomats at cocktail parties, and finally the rumors began to reach Europe. When the story reached the offices of the World Health Organization in Geneva, the place went into a full-scale alert. People who were there at the time said that you could feel fear in the hallways, and the director looked like a visibly shaken man. Nurse Mayinga seemed to be a vector for an explosive claim of lethal transmission in a crowded third-world city with a population of two million people. Officials at the WHO began to fear that Nurse Mayinga would become the vector for a world-wide plague. European governments contemplated blocking flights from Kinshasa. The fact that one infected person had wandered around the city for two days when she should have been isolated in a hospital room began to look like a species-threatening event.
President Mobutu Sese Seko, the maximum leader of Zaire, sent his army into action. He stationed soldiers around Ngaliema Hospital with orders to let no one enter or leave except doctors. Much of the medical staff was no under quarantine inside the hospital, but the soldiers made sure that the quarantine was enforced. President Mobutu also ordered army units to seal off Bumba Zone with roadblocks and to shoot anyone trying to come out. Bumba’s main link with the outside world was the Congo River. Captains of riverboats had heard about the virus by this time, and they refused to stop their boats anywhere along the length of the river in Bumba, even though people beseeched them from the banks. Then all radio contact with Bumba was lost. No one knew what was happening upriver, who was dying, what the virus was doing. Bumba had dropped off the face of the earth into the silent heart of darkness.
As the first nun at Ngaliema Hospital, Sister M.E., lay dying, her doctors had decided to give her a so-called agonal biopsy. This is a rapid sampling of tissue, done close to the moment of death instead of a full autopsy. She was a member of a religious order that prohibited autopsies, but the doctors very much wanted to know what was replicating inside her. As the terminal shock and convulsions came over her, they inserted a needle into her upper abdomen and sucked out a quantity of liver. Her liver had begun to liquefy, and the needle was large. A fair amount of the nun’s liver traveled up the needle and filled a biopsy syringe. Possibly it was during this agonal biopsy that her blood squirted on the walls. The doctors also took some samples of blood from her arm and put it in glass tubes. The nun’s blood was precious beyond measure, since it contained the unknown hot agent.
The blood was flown to a national laboratory in Belgium and to the England natural laboratory, the Microbiological Research Establishment at Porton Down, in Wiltshire. Scientists at both labs began racing to identify the agent. Meanwhile, at the Centers for Disease Control in Atlanta, Georgia—the C.D.C.—scientists were feeling left out, and were still scrambling to get their hands on a little bit of the nun’s blood, making telephone calls to Africa and Europe, pleading for the samples.
There is a branch of the C.D.C. that deals with unknown emerging viruses. It’s called the Special Pathogens Branch. In 1976, at the time of the Zaire outbreak, the branch was being run by a doctor named Karl M. Johnson, a virus hunter whose home terrain had been the rain forests of Central and South America. (He is not related to Gene Johnson, the civilian virus hunter, or to Lieutenant Colonel Tony Johnson, the pathologist.) Karl Johnson and his C.D.C. colleagues had heard almost nothing about the occurrences upriver in Zaire—all they knew was that people in Zaire were dying of a “fever” that had “generalized symptoms”—no details had come in from the bush or from the hospital where the nun had just died. Yet it sounded like a bad one. Johnson telephoned a friend of his at the English lab, in Porton Down, and reportedly said to him, “If you’ve got any little dregs to spare of that nun’s blood, we’d like to have a look at it.” The Englishman agreed to send it to him, and what he received was literally dregs.
The nun’s blood arrived at C.D.C. in glass tubes in a box lined with dry ice. The tubes had cracked and broken during shipment, and raw, rotten blood had run around inside the box. A C.D.C. virologist named Patricia Webb—who was then married to Johnson—opened the box. She found that the package was sticky with blood. The blood looked like tar. It was black and gooey, like Turkish coffee. She put on rubber gloves, but other than that, she did not take any special precautions in handling the blood. Using some cotton balls, she managed to dab up some of the black stuff, and then by squeezing the cotton between her fingertips, she collected a few droplets of it, just enough to begin testing it for viruses.
Patrica Webb put some of the black blood droplets into flasks of monkey cells, and pretty soon the cells got sick and began to die—they burst. The unknown agent could infect monkey cells and pop them.
Another C.D.C. doctor who worked on the unknown virus was Frederick A. Murphy, a virologist who had helped to identify Marburg virus. He was and is one of the world’s leading electron-microscope photographers of viruses. (His photographs of viruses have been exhibited in art museums.) Murphy wanted to take a close look at those dying cells to see if he could photograph a virus in them. On October 13—the same day Nurse Mayinga was sitting in the waiting rooms of hospitals in Kinshasa—he placed a droplet of fluid from the cells on a small screen and let it dry, and he put it in his electron microscope to see what he could see.
He couldn’t believe his eyes. The sample was jammed with virus particles. The dried fluid was shot through with something that looked like string. His breath stopped in his throat. He thought, Marburg. He believed he was looking at Marburg virus.
Murphy stood up abruptly, feeling strange. The lab where he had prepared these samples—that lab was hot. The lab was as hot as hell. He went out of the microscope room, closing the door behind him, and hurried down a hallway to the laboratory where he had worked with the material. He got a bottle of Clorox bleach and scrubbed the room from top to bottom, washing countertops and sinks, everything, with bleach. He really scoured the place. After he had finished, he found Patricia Webb and told her what he had seen in his microscope. She telephoned her husband and said to him, “Karl, you’d better come quick to the lab. Fred has looked at a specimen, and he’s got worms.”
Staring at the worms, they tried to classify the shapes. They saw snakes, pigtails, branchy, forked things that looked like the letter Y, and they noticed squiggles like a small g, and bends like the letter U, and loopy 6s. They also noticed a classic shape, which they began calling the shepherd’s crook. Other Ebola experts have taken to calling this loop the eyebolt, after a bolt of the same name that can be found in a hardware store. It could also be described as a Cheerio with a long tail.
The next day, Patrica Webb ran some tests on the virus and found that it did not react to any of the tests for Marburg or any other known virus. Therefore, it was an unknown agent, a new virus. She and her colleagues had isolated the strain and shown that it was something new. They had earned the right to name the organism. Karl Johnson named it Ebola.
Karl Johnson has since left the C.D.C., and he now spends a great deal of his time fly-fishing for trout in Montana. He does consulting work on various matters, including the design of pressurized hot zones. I learned that he could be reached at a fax number in Big Sky, Montana, so I sent him a fax. In it, I said that I was fascinated by Ebola virus. My fax was received, but there was no reply. So I waited a day and then sent him another fax. It fell away into silence. The man must have been too busy fishing to bother to answer. After I had given up hope, my fax machine suddenly emitted this reply:
