The battle against Ebola

In the movie Outbreak, researchers from the U.S. Army Medical Research Institute for Infectious Diseases and the Centers for Disease Control and Prevention have to figure out how to stop a kind of super-Ebola virus from ravaging the U.S.

In the movie Outbreak, researchers from the U.S. Army Medical Research Institute for Infectious Diseases and the Centers for Disease Control and Prevention have to figure out how to stop a kind of super-Ebola virus from ravaging the U.S.

In 1995, the same year Outbreak came out, Marta Guerra, who already had her PhD in Veterinary Medicine and was finishing her master’s degree in public health.

“I remember seeing that movie and thinking, ‘Wow, that’s what I want to do!’”

Five years later, Guerra, now with a PhD in epidemiology and a brand-new officer of the Epidemic Intelligence Service of the CDC, received orders to head out on her first international mission: to study and combat an outbreak in Uganda of Ebola virus.

She joined a team in Lacor, Uganda, working in a laboratory set up at St. Mary’s Hospital, a private hospital which had much more advanced equipment than the local government-run hospital — equipment that allowed them to diagnose people with Ebola in less than 24 hours. Accurate, fast diagnosis was important to identify Ebola patients and allow those who didn’t have the disease to be sent home, minimizing their risk of exposure. Guerra’s tasks included tracking the spread of the disease, identifying those who had been exposed and educating the public. Every day team members would go to the government-run hospital and get the list of people who were newly admitted and/or diagnosed.

“Then we would go out to the person’s home and make a list of contacts. Those contacts would have to be visited for 21 days. If there was anyone that appeared to be unhealthy or developing any kind of symptoms, then we would call in to the hospital to bring an ambulance out.” The effort involved 150 trained volunteers.

Over the course of the outbreak, 5,600 people who had been in contact with infected patients were identified and observed. Although the Ugandan government had done a “wonderful job” educating people about HIV, Guerra says, the lessons learned regarding HIV actually made it harder to deal with Ebola. Whereas people who test positive for HIV remain infected for life, people who recover from Ebola are no longer contagious and are also protected from the disease in the future.

Because of what they’d learned about HIV, people thought that anyone with antibodies to Ebola was contagious and was dangerous to have around.

“We’d find [survivors] totally by themselves, without food, because nobody wanted to share their food with them, allow them to use any dishes, anything.”

To counteract that, “I would definitely go up and touch them, or try to show them that I was not scared to be around them.

“I always ended up giving them some money so they could get food at least for a week to be able to buy some pots and pans and some things to sleep on, because some of them were not being allowed to come back to their families.”

Most people in the area would first be cared for by family members when they became ill, Guerra explains. After that, they would probably turn to traditional healers rather than trying to get to a probably distant clinic.

That led to tragedies like the death of all four sisters in one family.

Team members urged the locals to go to a clinic as soon as they felt ill. “If it was malaria, then good, you got your treatment early,” Guerra would tell them, while if it was Ebola, the patient could quickly be isolated and supportive care begun.

The researchers, who knew what precautions to take, weren’t particularly concerned about contracting the disease.

They were more worried about the risk of violence.

“We were in the territory of the Lord’s Resistance Army in northern Uganda.

“A lot of people had been displaced up there, a lot of people kidnapped and killed.”

In the end, though, Guerra’s team saw nothing of the rebels. “I think they were also very scared of the Ebola outbreak,” she says, and with good reason: it killed 225 people before being brought under control.

Despite the difficulties and dangers, Guerra calls the experience “just wonderful.”

“There are still chances to go out there and help people who are in a very disadvantaged state,” she says. “There are still chances to go out there and do investigations.”

Edward Willett is a Regina freelance writer. E-mail comments or questions to ewillett@sasktel.net. Visit Ed on the web at www.edwardwillett.com.

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