In one of the world’s most wretched corners, even the rescuers were at risk: three Zairean Red Cross volunteers died and a fourth fell ill simply because they had handled bodies. By the weekend 97 people in all had perished from massive hemorrhaging, including four Italian nuns, and an additional 31 were confirmed carriers. Experts say a “fourth wave” of deaths is inevitable, as those who were exposed as long as three weeks ago fall ill. But after that the outbreak could taper off. Reports that two victims had been found 300 miles away in the capital, Kinshasa, proved baseless. So did fears in London that two travelers from Zaire were carrying the disease. “There are no reports of the disease outside of a limited radius of little villages surrounding Kikwit,” says a World Health Organization spokesman. Top international epidemiologists privately told NEWS-WEEK that they were predicting the outbreak would ultimately claim about 300 victims-slightly fewer than died in Ebola outbreaks in Zaire and neighboring Sudan in 1976.
The disease detectives who began arriving in the stricken city of 300,000 two weeks ago have traced the outbreak to a man known only as Kimbambu, who died at a local hospital on March 27. Kimbambu infected a 36-year-old lab technician, who spread the virus to the staff of Kikwit General Hospital before he died in mid-April. Scores of patients have fled the 600-bed hospital in nearby Mosango; some employees now refuse to go to work. “Everyone was afraid,” says Gabriel Muhungu, an English teacher in Kikwit. “We didn’t know where it was coming from.”
Relief workers are finding that it’s a hard sell to persuade those who may have been infected to return to hospitals. The fears are well placed; even at the best-equipped regional hospital, stocks remain pathetically short, and in most cases the disease is fatal no matter what help is provided. Last week the Atlanta-based federal centers for Disease Control and Prevention, the Belgian branch of the relief group Medecins Sans Frontieres and other organizations rushed consignments of protective equipment to Kikwit General, where two more Italian nuns lay dying. It was scarcely reassuring to those who might seek medical attention that nearly half the victims so far have been medical workers.
But terror enforces its own quarantine. In Kikwit, ostracism is the fate of anyone who looks ill or shows the symptoms that signal Ebola’s acute, contagious phase-bleeding from the eyes, ears and skin.Some suspected carriers have been pelted with rocks. A neighborhood called Nzinda, where 15 of the victims lived, is particularly tense. These days no one will come near the mud-daub hut at 80 Avenue Kwenge, where a man dumped red-eyed outside the doorway, his gaze fixed in a bleary stare. It was a security guard at Kikwit General, Bavon Mikweni, who brought the Ebola virus home to the one-room hovel where he lived with four others. On April 22 he died in agony; his wife, a sister-in-law and a son soon followed. “Our neighbors are afraid to approach us because they think we may be infected,” says a daughter, Arlette, who now is being cared for by an uncle.“We don’t have anybody to support us.”
Short course: Officials of the World Health Organization worked to quell fears that the Ebola virus could spread from Kikwit to the rest of Zaire-and the rest of the world. “We are satisfied with the response,” says WHO spokesman Philippe Street. On Saturday, authorities reopened the main highway to the capital. Ebola’s viciously short course is self-limiting. “Before carriers can give it to other people they will die,” predicts one expert. “You get it and you die. . . It cannot become a mass epidemic because it will burn itself out.”
Will the fight go any better the next time? Virologists are still baffled about why the rare disease reappeared after lying dormant for nearly 20 years. Where the virus hides in nature is a mystery. But if there is another outbreak, it might not go undetected for so long. At first, medical workers in Kikwit thought they were treating cases of “red diarrhea”-a serious but usually nonlethal gastrointestinal ailment. It was only when lab tests belatedly confirmed the Ebola virus that Zairean officials sounded the international alarm. If the virus strikes again, “we will be able to carry out more rapid diagnosis and impose faster preventive measures,” said Jean-Jacques Muyembe, a Zairean specialist who helped fight the country’s first Ebola epidemic. That can scarcely comfort those who have seen the disease up close, but so far it’s the best the medical profession has to offer.
