“Those are big, fat bricks,” she said.
They were Ebola crystalloids bursting out of the lungs. The lungs were popping Ebola directly into the air. My scalp crawled and I felt suddenly like a civilian who had seen something that maybe civilians should not see.
“These lungs are very hot,” she said in a matter-of-face voice. “You see those bricks budding directly into the air spaces of the lung? When you cough, this stuff comes up your throat in your sputum. That’s why you don’t want someone who has Ebola coughing in your face.”
“My God, it knows all about lungs, doesn’t it?”
“Maybe not. It might live in an insect, and insects don’t have lungs. But you see here how Ebola has adapted to this lung. It’s budding out of the lung, right straight into the air.”
“We’re looking at a highly sophisticated organism, aren’t we?”
“You’re absolutely right. This hummer has an established life cycle. You get into “what if?” game. What if it got into human lungs? If it mutates, it could be a problem. A big problem.”
In march 1990, while the second outbreak at Reston was happening, the C.D.C. slapped a heavy set of restrictions on monkey importers, tightening the testing and quarantine procedures. The C.D.C. also temporarily revoked the license of three companies, Hazleton Research Products, the Charles River Primates Corporation, and Worldwide Primates, charging these companies with violations of quarantine rules. (Their licenses were later reinstated. The C.D.C.‘s action effectively stopped the importation of monkeys into the United States for several months. The total loss to Hazleton ran into the millions of dollars. Monkeys are worth money. Despite the C.D.C.‘s action against Hazleton, scientists at USAMRIID, and even some at the C.D.C., gave Dalgard and his company high praise for making the decision to hand over the monkey facility to the Army. “It was hard for Hazleton, but they did the right thing,” Peter Jahrling said to me, summing up the general opinion of the experts.
Hazleton had been renting the monkey house from a commercial landlord. Not surprisingly, relations between the landlord and Hazleton did not flourish happily during the Army operation and the second Ebola outbreak. The company vacated the building afterward, and to this day it stands empty.
Peter Jahrling, a whiffer of Ebola who lived to tell about it, is now the principal scientist at USAMRIID. He and Tom Geisbert, following tradition in the naming of new viruses, named the strain they had discovered Reston, after the place where it was first noticed. In conversation, they sometimes refer to it casually as Ebola Reston. One day in his office, Jahrling showed me a photograph of some Ebola-virus particles. They resembled noddles that had been cooked al dente. “Look at this honker. Look at this long sucker here,” Jahrling said, his finger tracing a loop. “It’s Reston—oh, I was about to say it’s Reston, but it isn’t—it’s Zaire. The point is, you can’t easily tell the difference between the two strains by looking. It brings you back to a philosophical question: Why is the Zaire suffer hot for humans? Why isn’t Reston hot for humans, when the strains are so close to each other? The Ebola Reston virus is almost certainly transmitted by some airborne route. Those Hazleton workers who had the virus—I’m pretty sure they got it through the air.”
“Did we dodge a bullet?”
“I don’t think we did,” Jahrling said. “The bullet hit us. We were just lucky that the bullet we took was a rubber bullet from a twenty-two rather than a dumdum bullet from a forty-five. My concern is that people are saying, “Whew, we dodged a bullet.’ And the next time they see Ebola in a microscope, they’ll say, ‘Aw, it’s just Reston,’ and they’ll take it outside a containment facility. And we’ll get whacked in the forehead when the stuff turns out not to be Reston but its big sister.”
C.J. Peters eventually left the Army to become the chief of the Special Pathogen Branch at the Centers for Disease Control. Looking back on the Reston event, he said to me one day that was pretty sure Ebola had spread through the air, “I think the pattern of spread that we saw, and the fact that it spread to new rooms, suggest that Ebola aerosols were being generated and were present in the building,” he said. “If you look at pictures of lungs from a monkey with Ebola Zaire, you see that the lungs are fogged with Ebola. Have you seen those pictures?”
“Yes, Nancy Jaax showed them to me.”
“Then you know. You can see Ebola particles clearly in the air spaces of the lung.”
“Did you ever try to see if you could put Ebola Reston into the air and spread it among monkeys that way?” I asked.
“No,” he replied firmly. “I just didn’t think that was a good idea. If anybody had found out that the Army was doing experiments to see if the Ebola virus had adapted to spreading in the respiratory tract, we would have been accused of doing offensive biological warfare—trying to create a doomsday germ. So we elected not to follow it up.”
“That means you don’t really know if Ebola spreads in the air.”
“That’s right. We don’t know. You have to wonder if Ebola virus can do that or not. If it can, that’s about the worst thing you can imagine.”
So the three sisters—Marburg, Ebola Sudan, and Ebola Zaire—have been joined by a fourth sister, Reston. A group of researchers at the Special Pathogens Branch of the C.D.C.—principally Antony Sanchez and Heinz Feldmann—have picked apart the genes of all the filoviruses. They discovered that Zaire and Reston ar so much alike that it’s hard to say how they are different. When I met Anthony Sanchez and asked him about it, he said to me, “I call them kissing cousins. But I can’t put my finger on why Reston apparently doesn’t make us sick. Personally, I wouldn’t feel comfortable handling it without a suit and maximum containment procedures.” Each virus contains seven proteins, four of which are completely unknown. Something slightly different about one of the Reston proteins is a probably the reason the virus didn’t go off in Washington like a bonfire. The Army and C.D.C have never downgraded the safety status of Reston virus. It seems classified as a Level 4 hot agent, and if you want to shake hands with it, you had better wearing a space suit. Safety experts feel that there is not enough evidence, yet, to show that the Reston strain is not an extremely dangerous virus. It may be, in fact, the most dangerous of all the filovirus sisters, because of its seeming ability to travel rather easily through the air, perhaps more easily than the others. A tiny change in its genetic code, and it might turn into a cough and take out the human race.
Why is the Reston virus so much like Ebola Zaire, when Reston supposedly comes from Asia? If the strains come from different continents, they should be quite different from each other. One possibility is that the Reston strain originated in Africa and flew to the Philippines on an airplane not long ago. In other words, Ebola has already entered the net and has been traveling lately. The experts do not doubt that a virus can hop around the world in a matters of days. Perhaps Ebola came out of Africa and landed in Asia a few years back. Perhaps—this is only a guess—Ebola traveled to Asia inside wild African animals. There have been rumors that rain forest have been importing African animals illegally, releasing them into the Philippine jungle, and hunting them. If Ebola lives in African game animals—in leopards or lions or in Cape buffalo—it might have traveled to Philippines that way. This is only a guess. Like all the other thread virus, Ebola Reston hides in a secret place. It seems quite likely, however, that the enter Reston outbreak started with a single monkey in the Philippines. One sick monkey. That monkey was the unknown index case. One monkey started the whole thing. That monkey perhaps picked up four or five particles of Ebola that came from… anyone’s guess.
PART FOUR
Kitum Cave
Highway
1993 August
Camp
