The drill is becoming increasingly familiar to infectious-disease experts. With each outbreak they learn more about Ebola–some veteran health workers have fought it a half-dozen times. But once again the source of a potentially cataclysmic eruption is eluding them. The Gulu epidemic has already infected at least 139 people and claimed 51 lives. Health officials are watching about 200 others who are thought to have encountered carriers. (Ebola is spread through direct contact with the bodily fluids of an infected person.)
This outbreak brings a disturbing new twist. Scientists are now fairly certain the most recent outbreaks originated somewhere in the rain forests of Central and West Africa. The last major eruption, in 1995, exploded in the town of Kikwit in what was then Zaire, infecting more than 300 people and killing 245 of them. But Gulu is nowhere near Central Africa’s rain-forest belt. And this is the first time the disease has struck in Uganda, leading scientists to ponder the frightening possibility that the virus has somehow adapted itself to new conditions and migrated during the past five years of dormancy.
It’s more likely that an unsuspecting carrier brought the infection from outside the area recently. Some experts speculate the disease was imported by a Ugandan soldier returning from the Democratic Republic of the Congo (the former Zaire). Ugandan forces there have been fighting alongside Congolese rebels to overthrow President Laurent Kabila.
Whatever the virus’s source, it is wreaking havoc. In the isolation ward of Lacor Hospital in Gulu two beds sit next to the open window. On one lies a corpse, wrapped in a black plastic sack. On the other, a dying woman under a light blue sheet heaves her last breaths. “If we get patients into the hospital soon after the first symptoms appear then we have a chance to save them by making sure they are continually rehydrated,” said Dr. Mathew Lokwiya, an administrator at Lacor. Officials expect the death toll to continue to rise this week, but believe they can contain the epidemic. In contrast to previous outbreaks where the mortality rate rose as high as 90 percent, in Gulu it is closer to 40 percent–in large part because officials mobilized rapidly and provided early treatment. Some experts also believe the outbreak may be caused by a less potent strain of the virus originating in Sudan. “We are learning more about this virus every time it presents itself,” said Dr. Guenael Rodier, director of the WHO’s communicable-diseases department.
Right now scientists are working furiously to break the chain of transmission. Schools in Gulu have been closed, traditional funeral rites banned. Ugandan officials are quarantining three regions and are threatening to use force to prevent circulation. They are requiring anyone dealing with the sick to wear full protective gear, and teams of Red Cross workers have fanned out into neighboring towns and villages actively looking for cases.
It is because Ebola strikes so infrequently that scientists are struggling to understand it. Since it was first identified in the Democratic Republic of the Congo in 1976, outbreaks occurred as long as 10 to 15 years apart. WHO officials say once they have contained the epidemic, they will begin the work they really came to do. By analyzing the chain of events that brought death to Gulu, they hope to find Ebola’s elusive hiding place and discover how the virus lies dormant for years–before it re-emerges to claim its next set of victims.
