Chief Bob Lucien sits on a high wooden chair in his unfurnished house and talks quietly of the day 10 years ago when one of the world's most virulent diseases came to his remote village.
Mayibout 2 -- its sister village is a kilometer up a track -- stretches along a wide bend of the Ivindo River and is surrounded by the vast Minkebe forest. It is a barely known region of north-east Gabon near the Cameroon border, otherwise only lived in by a few gold-panners and pygmies.
ILLUSTRATION: YU SHA
"There are 245 adults here. We hunt, but we are mainly fishermen," says Lucien. "But one day some of the eight- and nine-year-old children went into the forest with dogs. [The dogs] killed a chimp and the children brought it back. It was eaten. Then they got a terrible fever and were unable to move. Then they got diarrhea.
"We were very confused. We have malaria, sleeping sickness, yellow fever, muscular diseases here -- many, many illnesses -- but we deduced that it came from the meat. We had already noticed that many gorillas were dead in the forest.
"When we saw what was happening to the people we put them into a pirogue [canoe] and took them to the regional hospital at Makokou, two days away by river. Mostly they died."
Of the 38 people of his village who fell ill, 34 children and adults died painful, lingering deaths in the next month. High fevers were followed by intense fatigue, rashes, diarrhea, kidney and liver damage, vomiting and internal and external bleeding.
Tests were done and it was found that the victims had both Ebola and yellow fever. The government and the World Health Organization were called in, and the whole area was isolated for six weeks.
"I was very frightened. I thought I would die. I was taken to the hospital and I was there for two months," says Nesto Bematsick, one of the few survivors of the Mayibout outbreak. "The fever was terrible, but I was so ill I do not remember very much. I was ill for four and a half years afterward. Now I have recovered, but all my family died," he says.
Remarkably, the parents of several newborn children died without passing it on. Their orphans are now looked after by the village.
A few hundred miles to the south in Franceville, Eric Leroy, a young French immunologist and virologist with the Development Research Institute, arrived in Gabon in 1994 to study the immunological response to HIV at the world-renowned Centre International de Recherches Medicales, then decided to switch his research to Ebola.
Here was a dramatic illness that could be passed on by contact, that killed up to 89 percent of people who got it, yet at the time very little was known about it.
There had been, by then, only a few outbreaks: three in Sudan on the [then] Zaire border in the late 1970s; two in what is now the Democratic Republic of Congo, and one case in Gabon.
Leroy did not have long to wait before an outbreak occurred in northeast Gabon. Just over a year later, in July 1996, there was another outbreak in Boou, making three in 19 months. This time, scattered cases were diagnosed in surrounding villages and towns.
Ebola went quiet for several years in Gabon, but over the next few years the virus popped up again in Congo, Uganda, Ivory Coast and Liberia. In 2001 to 2002, it returned to northeast Gabon with more cases near Makokou. Last year, it was found just over the Congo border in Lossi, and a few weeks ago there was an outbreak that is still going on in Sudan, near where it first broke out in the 1970s. According to the WHO, there have now been a dozen epidemics.
But what links them? Why was there a 19-year gap between the first group of four epidemics and the second group of four in 1994 to 1996, and then four more years to the next set in 2001 to 2002? And, most importantly, what is the host, the creature that carries the virus without becoming infected, passing it on to primates and then humans?
Leroy, now research director for emerging diseases, directs a team of local fieldworkers. Clearly, he says, the Ebola virus passes from an unknown natural host to monkeys, chimps, gorillas and even small forest antelopes, from where it can cross to humans who eat infected animals. Deaths of primates, he says, were associated with all the Gabon outbreaks.
In the Minkouka area, people reported finding dead chimpanzees and gorillas, and in later epidemics all the primary human patients were infected while butchering dead chimpanzees. But Leroy says a direct contact between the host and humans is possible.
The disease's geographically diverse and episodic nature is also puzzling, Sometimes the virus is linked to forested areas and sometimes to the savannah. It does not pop up every year, but peaks and subsides. The epidemics usually occur at the end of the dry season and the start of the rainy season, which may also be significant.
The virus appears appears to have several geographical centers, and at least five biological and genetic subtypes, rather than one strain that mutated into different forms. It has been found in monkeys in Ivory Coast and the Philippines, where it did not spread to humans, and in an American laboratory researcher working with chimps who accidentally pricked herself with a needle.
Leroy's team is investigating, via satellite photography and fieldwork, whether environmental factors are important, such as whether the climate, vegetation or anything else is changing in areas where outbreaks have occurred. But they also want to know if the people who are affected have anything in common. "Is it something in the way that they eat more of this or that food? Is there any difference in the populations?" he asks.
No one knows when Ebola first killed. Evidence has suggested the presence of the virus in Gabon since at least 1982, but Leroy is convinced that it is ancient. "I think the phenomenon is episodic, but that the passage of the virus needs particular conditions. When all the conditions are right, it breaks out. I don't believe deforestation has anything to do with it. It's present everywhere." It is possible that the virus wiped out villages many years ago without anyone recognizing it as Ebola.
Westerners fear the disease, which has inspired best-selling books and Hollywood movies. "But we should not be very afraid of it," Leroy says. "It is only transmitted by direct contact, so it is relatively easy to handle. It's not like SARS or air-transmitted diseases. Its evolution is also very rapid, so it would be difficult for someone to come out of the forest and get to France."
Vaccines are being developed but have yet to be tested on humans. Leroy calls this "a political decision." The first clinical trials are in progress at the US National Institute of Allergy and Infectious Diseases. One is a DNA vaccine containing three genes from the virus that must be given many times over several months to give protection. Two "accelerated" vaccines that do not need to be repeated have been tried successfully on monkeys and mice. However, they all face daunting regulatory hurdles and are years away from distribution.
There's also a possibility that Ebola could change its transmission route. "It's conceivable that it could one day be transmitted by something like animals' breath," Leroy says. In this nightmare scenario the disease could spread as fast as SARS.
Leroy's recent research, with others, shows clearly that the disease destroys animal populations. After last year's outbreak, chimpanzee numbers in one area near a human outbreak in Congo dropped by 89 percent and western lowland gorilla numbers halved. Other research suggests that in one area, large gorilla populations may have been almost wiped out.
"Tens of thousands of animals have already died," Leroy says, contaminated by the original host. The higher the population of animals, he says, the greater the risk that Ebola will break out. The outbreaks are linked to densities of population, but not their size.
"The recovery of the gorillas after an outbreak is very slow," Leroy says. "You need 10 to 12 years to have reproductive males and females, so to recreate a group you need three or four generations. It could take 50 to 100 years. Potentially it's very serious for gorilla populations."
But of all the unknowns, the host is the most eagerly sought. Leroy's hunch is that it is probably a bat, though others suggest a mouse. "The size of the reservoir is probably quite small, a micro-mammal," he says. He believes that it will be identified within the next three years.
Scientists at South Africa's National Institute for Communicable Diseases have injected bats with the Ebola virus and they have survived. Bats are observed in almost every outbreak, but catching the right specimens is difficult.
Birds, too, have been implicated by research done at Purdue University and the US Centers for Disease Control, where it has been shown that there are structural similarities between Ebola and some bird retroviruses. They also point to the fact that the Rift Valley acts as a divider of bird species, and that no Ebola outbreak has been observed to its east.
For the people living near the outbreaks, Ebola is a fact of life, something that can emerge at any time and almost certainly will. Gustave Mabaza, a Gabonese anthropologist working in the affected areas, spent two years visiting communities near the forests explaining why no one should touch or eat dead animals, urging hunters especially to be careful.
"In the local ikota language `Ebola' means `fist.' It's a mystery to them. Many blame themselves, saying that it is a mystic illness, related to something that they did. Others say that monkey food is good and that people who kill them [monkeys] also kill the virus.
"Yet more have approached the pygmies, who they believe can work magic and prevent them getting it. People are very afraid, but still some people continue to eat monkey meat. It's like AIDS," he says. "People know the problem, but they do not always change their habits."
On a deeper level, he says, the disease is changing the way people think. "In our whole history, we have always eaten dead animals found in the forest, Mabaza says. "Now, for the first time ever, food gathered from the forest is seen to be dangerous. That changes the whole relationship between people and the forest. It has always been part of peoples' lives: all that is good comes from the forest. Now it is not."
"What is sure is that the risk is great. We don't know the time dynamic, or the spatial dynamic, but it's out there, waiting to return."
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