An Ebola outbreak in Guinea that has so far sickened at least 18 people and killed nine has stirred difficult memories of the devastating epidemic that struck the West African country between 2013 and 2016, along with neighboring Liberia and Sierra Leone, leaving more than 11,000 people dead.

But it may not just be the trauma that has persisted. The virus causing the new outbreak barely differs from the strain seen 5 to 6 years ago, genomic analyses by three independent research groups have shown, suggesting the virus lay dormant in a survivor of the epidemic all that time. “This is pretty shocking,” says virologist Angela Rasmussen of Georgetown University. “Ebolaviruses aren’t herpesviruses”—which are known to cause long-lasting infections—“and generally RNA viruses don’t just hang around not replicating at all.” //

The Guinea Center for Research and Training in Infectious Diseases (CERFIG) and the country’s National Hemorrhagic Fever Laboratory have each read viral genomes from four patients; researchers at the Pasteur Institute in Dakar, Senegal, sequenced two genomes. In three postings today on the website virological.org, the groups agree the outbreak was caused by the Makona strain of a species called Zaire ebolavirus, just like the past epidemic. A phylogenetic tree shows the new virus falls between virus samples from the 2013–16 epidemic. //

Another ongoing outbreak of Ebola in North Kivu, in the Democratic Republic of the Congo, was also started by transmission from someone infected during a previous outbreak, Delaporte notes. (The survivor had tested negative for Ebola twice after his illness in 2020.) Taken together, that suggests humans are now as likely to be the source of a new outbreak of Ebola as wildlife, he says. “This is clearly a new paradigm for how these outbreaks start.” Outbreaks sparked by survivors may even become more likely, now that increasing mobility and other factors have caused each eruption of Ebola to become bigger, resulting in more survivors, says Fabian Leendertz, a wildlife veterinarian who was involved in the sequencing.

Sometime in the early 2000s, a young Canadian filmmaker by the name of Brent Leung found himself struck by a number of facts:

The media and education establishment had instilled an obsessive fear of HIV and AIDS—not just in him—but in his entire generation.
He didn’t have a clue about the difference between HIV and AIDS or even whether there was one or, for that matter, what either is even precisely supposed to be.
Neither did virtually anyone else.
It is, of course, very unlikely that Monsieur Leung was the first to recognize this all-too-common gap between the general public’s certainty about some topic and their paucity of any actual knowledge that might warrant it.

Be that as it may, Leung’s proactive response to his befuddlement certainly was unique.

He went to the trouble of contacting all the major experts on HIV and AIDS and somehow got every single one of them to appear on camera as he asked the most basic questions about what those two acronyms represent and the relation between them.

The result of Leung’s dogged determination to get to the bottom of this disease he’d been taught to obsessively fear is about the most fascinating, can’t-stop-watching-even-if-you-want-to, 90-minutes of video that you’re likely to encounter.

That would be so even if the massive worldwide upheaval we experienced in 2020 had been nothing more than an awful bad dream.

Why do some critics fear Americans can’t safely engage in the election process amid COVID-19 when Liberia was able to do it successfully despite Ebola?

He persuaded one of the nuns who had the disease to fly with him to Kinshasa. He took blood samples before she died and sent them to Belgium, where they had an electron microscope to try to identify the culprit. Scientists there and in the United States saw this was a new virus that caused hemorrhagic fever.

They named it Ebola, after a river near the village.

The discovery, says Muyembe, was thanks to a "consortium of research."

But Google "Who discovered Ebola?" and you get a bunch of names — all of them white Western males. Dr. Jean Jacques Muyembe has been written out of history.

"Yes, but it is ..." he pauses. He takes a breath and laughs, looking for the right way to respond.

"Yes. It is not correct," he says. "It is not correct." //

When asked if he feels responsible for writing Muyembe out of history, Piot pauses.

"I think that's a fair comment," he says. "But my book was not an attempt to write the history of Ebola, but more my personal experience."

Piot says at the time of that first Ebola outbreak, African scientists were simply excluded. White scientists — with a colonial mentality — parachuted in, took samples, wrote papers that were published in the West and took all of the credit.

But things are changing, he says. Muyembe, for example, is finally starting to get his due. He was recently given a patent for pioneering the first treatment for Ebola and he has received several international awards, including the Royal Society Africa Prize and, just this year, the Hideyo Noguchi Africa Prize.

"That reflects, I think, the [change in] power relations in global health and science in general," he said.

During this outbreak, Muyembe has also made a decision many thought unthinkable even a few years ago. He decided that all of the blood samples collected during this Ebola epidemic will stay in Congo. Anyone who wants to study this outbreak will have to come to his institute. //

In 1995, during another outbreak, he wondered whether antibodies developed by Ebola survivors could be siphoned from their blood and used to treat new cases. So he injected Ebola patients with the blood of survivors, taking inspiration from a practice used before sophisticated advances in vaccine-making.

"We did eight patients and seven survived," he says.

The medical establishment wrote him off. He didn't have a control group, they told him. But Muyembe knew that in this village, Ebola was killing 81% of people. Just this year, however, that science became the foundation of what is now proven to be the first effective treatment against Ebola, saving about 70% of patients.
His biggest legacy, he says, won't be that he helped to discover Ebola or a cure for it. It'll be that if another young Congolese scientist finds himself with an interesting blood sample, he'll be able to investigate it right here in Congo.

"But if this idea was accepted by scientists, we [could have] saved a lot of people, a lot of lives," he says.

About Facing Darkness

In the spring of 2014, the Ebola pandemic was sweeping across West Africa. One organization stepped up with people and resources to provide compassion and care in the Name of Jesus. But when the deadly virus infected its own medical personnel, including Dr. Kent Brantly, the epic crisis truly hit home for Samaritan’s Purse and its leader Franklin Graham. FACING DARKNESS tells an incredible true story of faith, determination, and prayer … and of how God performed a miracle!

These patients will benefit -- not threaten -- the country.

A second American infected with the potentially deadly Ebola virus arrived at Emory University Hospital on Tuesday from Africa, following the first patient last weekend. Both were greeted by a team of highly trained physicians and nurses, a specialized isolation unit, extensive media coverage, and a storm of public reaction. People responded viscerally on social media, fearing that we risked spreading Ebola to the United States.

Those fears are unfounded and reflect a lack of knowledge about Ebola and our ability to safely manage and contain it. Emory University Hospital has a unit created specifically for these types of highly infectious patients, and our staff is thoroughly trained in infection control procedures and protocols. But beyond that, the public alarm overlooks the foundational mission of the U.S. medical system. The purpose of any hospital is to care for the ill and advance knowledge about human health. At Emory, our education, research, dedication and focus on quality — essentially everything we do — is in preparation to handle these types of cases.

Further, Americans stand to benefit from what we learn by treating these patients. //

As health-care professionals, this is what we have trained for. People often ask why we would choose to care for such high-risk patients. For many of us, that is why we chose this occupation — to care for people in need. Every person involved in the treatment of these two patients volunteered for the assignment. At least two nurses canceled vacations to be a part of this team. They derive satisfaction from knowing that, after years of preparing for this type of case, they are able to help, to comfort and to do it safely. The gratitude they receive from the patients’ families drives their efforts.

Background

A record number of people survived Ebola virus infection in the 2013–16 outbreak in west Africa, and the number of survivors has increased after subsequent outbreaks. A range of post-Ebola sequelae have been reported in survivors, but little is known about subsequent mortality. We aimed to investigate subsequent mortality among people discharged from Ebola treatment units. 

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30313-5/fulltext

The two experimental treatments will continue on in more trials. //

From the trial's early data, 49% of patients given ZMapp died, as did 53% of those receiving remdesivir. By contrast, only 29% of patients treated with REGN-EB3 died, and only 34% of patients treated with mAb114 died.

The fatality rate of the current outbreak is estimated to be around 70%.

Moreover, when researchers looked at how patients fared when they sought treatment early in the disease progression, the drugs looked even better. Only 6% of those treated early with REGN-EB3 died, and 11% of those treated early with mAb114 succumbed to the disease. Mortality rates for early treatments with ZMapp and remdesivir were 24% and 33%, respectively.

Moving forward, researchers will only carry on with REGN-EB3 and mAb114 in further trials.

How a private airline in Cartersville, Georgia, became the government’s go-to evacuation system for Ebola, and, eventually, everything else.

Phoenix Air itself had been around since the early 1970s, when Dent Thompson’s brother Mark had started it as a skydiving school after returning from piloting helicopters in Vietnam. Over the intervening decades, the airline had evolved from its original charter into the business of doing “difficult things.” These were, as Dent says, aviation tasks so complex, paperwork-intensive, and/or unenviable that, once you’d established yourself as the only airline willing to do them, you could have all the contracts you wanted.

a report from the Center for Global Development by Jeremy Konyndyk: Struggling with Scale: Ebola’s Lessons for the Next Pandemic. Click or tap through to download the full report. The summary:

The next global pandemic is a matter of when, not if. Preparing for this inevitability requires that policy­makers understand not just the science of limiting dis­ease transmission or engineering a drug, but also the practical challenges of expanding a response strategy to a regional or global level. Achieving success at such scales is largely an issue of operational, strategic, and policy choices—areas of pandemic preparedness that remain underexplored.

The response to the 2014–2015 Ebola outbreak in West Africa illuminates these challenges and highlights steps toward better preparedness. Ebola was a known disease whose basic transmission pathways and con­trol strategies were understood. Yet traditional Ebola control strategies were premised on small, non-urban outbreaks, and they rapidly proved inadequate as the disease reached urban environments, forcing policy­makers to develop new strategies and operational plat­forms for containing the outbreak, which generated unique policy challenges and political pressures. Lack­ing a blueprint for controlling Ebola at scale, response leaders scrambled to catch up as the disease began threatening the wider West African region.

This report explores the lessons of the Ebola outbreak through the lens of the US and UN policymakers who were forced to construct an unprecedented response in real time. It tells the story of their choices around four major policy challenges:

A 42-day-old baby was discharged from the Katwa CTE on Saturday, May 11, 2019. Daniella was admitted to the CTE with her mother on April 11, 2019 when she was only 12 days old. Her mother, who arrived in a state of advanced coma, died at CTE the next day. Daniella was collected on April 12 and was positive. After 30 days of treatment with mAb 114, Daniella was cured. She survived thanks to the work of the health staff and the nannies who took turns at her bedside 24 hours a day but also because she was taken care of as soon as she became ill. Nannies are men and women cured of Ebola, and therefore immune to the virus, who care for sick children and babies during their hospitalization.//

[Since departure of MSF from conflict zone and transfer to DRC MOH]:

• Increased number of health providers in CTEs. The new managers continued to work with MSF-trained caregivers, but they also recruited more care providers to ensure better individual follow-up for each patient. Moreover, from now on, the whole of the medical staff is Congolese and has been recruited locally. //

• Without taking into account those who died less than 48 hours after admission to the CTE, the case-fatality rate for confirmed patients fell from 43.4% to 31.1% in the Butembo CTE and from 43.2% to 33.8%. % at Katwa CTE.

Ebola virus infection was more widespread in this spillover population than previously recognised (21 vs 11 cases). We show the first serological evidence of survivors in this population (eight anti-Ebola virus IgG seropositive) and report a case fatality lower than previously reported (55·6% vs 100% in adults). These data show the high community coverage achievable by using a non-invasive test and, by accurately documenting the beginnings of the west African Ebola virus outbreak, reveal important insight into transmission dynamics and risk factors that underpin Ebola virus spillover events.