Monday, August 4, 2014

The Story of Ebola in Reston, Virginia

Ebola Reston

In October 1989 the community of Reston, Virginia went about their daily lives not realizing that a serious crisis was developing right in their back yards that would not be entirely resolved until March 1990. It was a serious calamity that could have wiped out the entire population. This dire emergency was described twenty years ago by Richard Preston in his non-fiction book, “The Hot Zone.” The “hot zone” refers to an “area that contains lethal, infectious organisms” also dubbed “hot agent,” an “extremely lethal virus, potentially airborne.” (Richard Preston, The Hot Zone, Random House, New York, 1994, p. 296)

The people in the book are real, two victims’ names have been changed, and the narrative and dialog were masterfully reconstructed from interviews and memories of those who participated in the crises.

Hazelton Research Products, a division of Corning, Inc. was importing and selling lab animals. On October 4, 1989, the monkey house called Reston Primate Quarantine Unit located not far from Leesburg Pike, received a shipment of one hundred crab-eating monkeys (a type of macaque) from the Philippines, caught on the island of Mindanao. Two of the monkeys were dead in their shipping crates. By first of November, 29 of the monkey were dead, most of them in Room F. The heating and air system had failed so it was assumed the deaths had occurred from ambient conditions.  Each night more macaques died. By November 16, a tentative diagnosis was given “simian hemorrhagic fever.”

Thomas Geisbert, an intern at the Institute discovered under his electron microscope the dreaded Ebola virus. Dr. Jahrling tested the virus cultures from the macaques against three known blood serums:

1.       Musoke (test for Marburg virus)

2.       Boniface (test for Ebola Sudan)

3.       Mayinga (test for Ebola Zaire)

The virus cultures glowed brightly against the Mayinga blood serum indicating that the monkeys in the Reston house died of Ebola Zaire strain, the deadliest of all filoviruses (Ebola).

The Institute is short for the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) located at Fort Detrick, Maryland. Its “mission is medical defense” with specialty in “drugs, vaccines, and biocontainment.”  The Institute’s Army and civilian personnel were instrumental in the containment of the Ebola Reston virus in Reston, Virginia monkey holding facility.

To contain the spread of Ebola Reston, the mutated strain of Ebola Zaire, the Army chose the bio-hazard operation of killing all the monkeys, bag them, incinerate their carcasses, and chemically clean and fumigate the building with formaldehyde gas. Their mission was to safeguard the population, euthanize the animals humanely (anesthetic, sedative, and a lethal drug), and gather samples for research from liver and spleen in order to identify the strain and how it traveled.  The entire operation was done in biohazard Level 4 suits. To a trained eye, the badly liquefied organs and tissues, the red eyes, frozen faces, and slacking muscles left no doubt that the monkeys died of Ebola. By December 7, 1989, four hundred and fifty monkeys were euthanized, some already very sick and some harboring the virus. (pp. 212-213)

Two monkey handlers got sick, one had a heart attack and another one was sent to the Fairfax Hospital with flu like symptoms and vomiting. For unknown reasons, although both had been exposed to the Ebola virus, neither had contracted Ebola.

After the three day decontamination, the building was turned back over from the Army custody to the Hazleton Research Products who bought more macaques from the Philippines from the same source in Manila. By middle January 1990, monkeys in Room C started to die with bloody noses. It was Ebola again from the Philippines, not Africa. The monkeys were destroyed and the company vacated the building.

According to Richard Preston, the disaster in that ‘building was a kind of experiment.’ “Now they would see what Ebola could do naturally in a population of monkeys living in a confined air space, in a kind of city, as it were. The Ebola Reston virus jumped quickly from room to room. … Ebola apparently drifted through the building’s air-handling ducts.” (pp. 251-252)

Strangely, an animal caretaker, “John Coleus,” who was doing a necropsy on a dead monkey, cut his thumb with a bloody scalpel, which is a major exposure to Ebola. Everyone expected him to die, but he never got sick. The virus entered his blood stream. The other two animal caretakers, however, did not cut themselves. The virus entered their bodies through “contact with lungs; everyone at USAMRIID concluded that Ebola can spread through the air.” (p. 254)

Peter Jahrling, who actually “whiffed the Ebola and lived to tell about it,” wondered, "Why is the Zaire stuff hot for humans? Why isn’t the 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.” (p. 257)

“Pictures of the lungs of a monkey infected with Ebola Zaire are fogged with Ebola. … You can see Ebola particles clearly in the air spaces of the lung,” said LTC Nancy Jaax, chief of pathology  at USAMRIID in 1989, a participant in the Reston biohazard operation.  (p. 260)

The four strains of Ebola filoviruses (string viruses) are: Marburg, Ebola Sudan, Ebola Zaire, and Ebola Reston. They are named for Ebola River, “a tributary of the Congo, or Zaire, River.” The most virulent of the viruses, the Zaire strain first appeared in September 1976 in 55 villages around the Ebola River. The kill rate is 90 percent.

Marburg

Charles Monet, after traveling to Kitum Cave on Mount Elgon (located between Uganda and Kenya), came down on January 8, 1980 with the Marburg virus and died in a Nairobi hospital on January 15, attended by Dr. Shem Musoke (the Marburg virus test is named after him).  Dr. Musoke came down with the Marburg virus nine days later. Dr. Musoke survived with no memory of his ordeal. He became a leading physician at the Nairobi Hospital with Dr. David Silverstein who saved his life and the lives of many others when he persuaded the Kenyan officials to shut down the Nairobi Hospital in order to prevent further infections. Vials of Musoke’s infected blood were sent to labs around the world. “The Marburg in his blood had come from Charles Monet’s black vomit and perhaps originally from Kitum Cave.  (pp. 32-33)

In 1987, a Danish boy called “Peter Cardinal” went by car on a summer trip with his family who wanted to show him “the beauty and sweetness of Kenya.” He got sick, turned black-and-blue with little red spots, red eyes, unable to breathe, and died of Marburg in spite of treatment at Nairobi Hospital by Dr. David Silverstein, the same doctor who saved Dr. Musoke’s life. “Peter Cardinal” had visited the same cave Charles Monet did, Kitum Cave on Mount Elgon. (pp. 90-96)

Marburg virus kills 25 percent of patients. Marburg is an African organism but was named after the German town Marburg because the virus erupted there first in 1967 in Behring Works, a producer of vaccines from kidney cells of African green monkeys imported from Uganda. The first reported victim was Klaus F. who fed the monkeys and washed their cages. He became ill on August 8, 1967 and died two weeks later. (p. 26)

Prior to the Klaus F. casualty, in the period of 1962-1965, there were unconfirmed reports of people and monkeys dying with symptoms of bleeding and a “peculiar skin rash” on the slopes of Mount Elgon in Eastern Uganda.

Red eyes, fever, uncontrolled vomiting of black blood, sloughing off intestinal tissues, fulminating liver failure, brain damage, veins bursting, and liquefaction of tissues are some of the horrendous symptoms of Ebola.

Richard Preston said that Marburg has an effect on humans as if they were exposed to radiation – connective tissues, intestines, skin are affected, hair dies at the root, radiation-like burns cause skin to peel off hands, faces, feet, and genitals, blown up or semi-rotten testicles. (p. 27)

Ebola virus is composed of seven different proteins, four of which are completely unknown, their structure and function are a mystery. Ebola is a distant relative of measles, mumps, and rabies, the parainfluenza virus, and the syncytial virus. Ebola attacks the immune system in a similar manner of HIV. (p. 46)

Ebola Zaire

The Mayinga strain of the Ebola Zaire came from a nurse working at a hospital in Zaire who cared for a Roman Catholic nun who died of Ebola. The young woman’s name was Mayinga N. The nun infected Mayinga when she bled all over her.  The twenty year old died of Ebola on October 19, 1976. (p. 54)

“No one caught the virus from nurse Mayinga, even though she had been in close contact with at least thirty-seven people and shared a bottle of soda pop with someone, and not even that person became ill.” (p. 89)

How infectious is Ebola Zaire? “Five or ten Ebola-virus particles suspended in a droplet of blood could easily slip through a pinhole in a surgical glove, and that might be enough to start an explosive infection.” (p. 63)

Ebola Zaire kills much of the host while it is still alive. It turns the inside of the body into “digested slime of virus particles,” “the collagen in the body turns to mush, and the underlayers of the skin die and liquefy.” The mouth bleeds, heart bleeds into itself, brain swells with dead blood cells and strokes, eyes fill up with blood, other orifices ooze blood, liver swells, turns yellow, liquefies, and cracks. Epileptic convulsions appear in the final stages. (pp. 72-75)

Karl Johnson, one of the discoverers of the Ebola Virus, said to the author, “A virus can be useful to a species by thinning it out.” (p. 83)

Ebola Zaire, twice as lethal as Ebola Sudan, was first mentioned in September 1976 in a region of northern Zaire called Bumba Zone in the vicinity of the Ebola River, but nobody knows who the first victim was.

A school teacher received an injection from the Yambuku Hospital with one of the five hypodermic syringes that were used to give shots to hundreds of people in the outpatient and maternity clinics. This teacher came down with Ebola Zaire a few days later. Nobody knows who the person was who received the shot right before the school teacher. Ebola erupted in 55 villages around the hospital, first in those who received shots and then in family members, particularly women who prepare the dead for burial. (p. 71)

Ebola Sudan

The first identified case, that later became Ebola Sudan and “nearly devastated the human population of southern Sudan,” was Mr. Yu. G., a storekeeper in a cotton factory in the town of Nzara. No one knows where he got the infection, the bats roosting in the ceiling of the room above his desk, trapped in cotton fibers, from rats, etc.  Two other men who worked with him died as well of Ebola. One individual known as P.G. passed Ebola to his alleged mistresses in town.

The hospital personnel of the Maridi hospital in Sudan exacerbated the infection by giving injections to many patients with the same dirty and infected needles.

The Ebola Sudan was twice as lethal as the Marburg strain with a 50 percent fatality. Richard Preston compared it to the death rate from the black plague. A few hundred people were killed in central Sudan and then the virus died out. (pp. 68-69)

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