This post is about Ebola. If you don’t want to read about horrible things related to a horrible disease, then close out this post. Here is a pretty pic of this spot that I have recurring dreams about for no discernible reason, to shield you from the horrible things if you would rather not engage with them. the ebola stuff starts after this picture.
one of my obsessions that i love to return to is diseases. man i just love diseases! (for a nice twitter thread of all my fav disease facts from 2020, you can go here.)
i read THE HOT ZONE (1994) by Richard Preston and liked it so much that I immediately read his other book about ebola, CRISIS IN THE RED ZONE (2019). then i read a bunch of articles and papers. tbh i wanted to follow up these two ebola books with another ebola book but i thought that might be a little too weird.
EBOLA FACT 1: EBOLA IS BAD
Ebola is really bad!!!! It is like somebody decided that they should make the worst possible, most terrifying disease and ebola was the result. it attacks every single part of the body, excluding the muscles and skeletal system. when they first autopsied people with ebola, it was like the bodies had been dead for several days already; the organs were liquefied. the only way it could be worse is if it were airborne. fortunately for us, it currently only lives in fluids.
It causes people to bleed into what is called their third space. in this context, a third space is not a cafe or library.
“If you bleed into the first space, you bleed into your lungs. If you bleed into the second space, you bleed into your stomach and intestines. If you bleed into the third space, you bleed into the space between the skin and the flesh. The skin puffs up and separates from the flesh like a bag” (The Hot Zone 102).
Bleeding out of your orifices and liquefying your organs are just some of the symptoms. One of the weirder ones is ebola attacks the part of your brain that controls facial expression. ebola victims’ faces are often “mask-like.”
Also the genitals swell up. Besides vaginal and anal bleeding, testicles and labia become engorged.
EBOLA FACT 2: IT CAN EASILY MUTATE
Apparently RNA diseases like ebola are more prone to mutation. one of the fears of ebola is that it might mutate into something airborne. there was an outbreak in Reston, MD in 1989 that infected a lot of monkeys. at first, they didn’t know that it didn’t infect humans. The Reston variant of ebola is (possibly) airborne and is just a hair different than Ebola Zaire, the deadliest form of the disease.
The variant that caused the big 2014 outbreak is a mutation of Ebola Zaire, and it is one amino acid away from the original Ebola Zaire, yet more contagious because that one amino acid bonds nicely with human cholesterol.
EBOLA STORYTIME #1
During the 1989 Reston outbreak, they realized the virus was too contagious and they had to kill every monkey in the monkey facility, so they sent the army in to do it.
One of the monkeys got loose. He was a super monkey, and they could not catch him, no matter what they did. They spent days trying to catch him. He evaded every trap and every net.
A military lady was standing in a hallway when suddenly the loose monkey came charging toward her. He had been watching people stab his monkey friends with needles for days. He had a needle in his hand and he stabbed her! She passed out.
But she was OK because that virus didn’t affect humans. BUT they didn’t know that yet!
The next day, the monkey got stuck between a couple pieces of furniture and his tail was hanging out and they stabbed the tail with a massive dose of ketamine so they could kill him.
EBOLA STORYTIME #2
During the original 1976 outbreak, a doctor was going around, educating people about how to not get ebola. He told them they needed to implement “The Ancient Rule,” which is how they eradicated smallpox. The Ancient Rule is this: if somebody is sick, their whole family has to stay locked in a hut until either the survivors get better or everybody dies. Then you burn the entire hut. The Ancient Rule requires people to act inhumanely, to abandon people they care about and who need help.
So then this doctor goes to attend a woman who is dying of ebola during childbirth. The baby is still alive when it is delivered but not doing so great, so he gives it mouth-to-mouth, just following his instincts— if you see a baby struggling, you give it mouth-to-mouth. He is horrified! How embarrassing! He is going around, telling people to become machines, and then he falls into the trap of human emotion.
But he was OK because it turns out the woman had bad malaria and not ebola.
EBOLA FACT 3: EBOLA REAL BAD FOR PREGNANT LADIES
Now there are treatments and vaccines for ebola, so it is less deadly. But before that, if you were pregnant, there was a 100% chance you would die from ebola (Ebola Zaire was 80% death rate; Ebola Sudan was 60%). It kills both the baby and the mother, causing the mother to hemorrhage uncontrollably.
A mother hemorrhaging uncontrollably is incredibly dangerous for a healthcare worker. ebola slop everywhere.
EBOLA FACT 4: DON’T HAVE UNPROTECTED SEX WITH AN EBOLA SURVIVOR
Testes and eyeballs are “privileged zones” in the body, meaning that the immune response doesn’t really go there (I don’t fully understand this, scientifically).
This means the virus can exist in these areas for a long time afterward.
a lot of ebola survivors, especially children, have massive eye problems, and develop particularly awful cataracts. they discovered the ebola virus living years later in these people’s eyeballs.
they knew it lived in sperm for a while, up to 500 days, because some women had caught it from their partners.
except they were wrong. the ebola virus cannot live up to 500 days. IT CAN LIVE UP TO 5 YEARS. 5! YEARS! That’s likely how the 2014-2016 outbreak started in Guinea. FIVE YEARS.
EBOLA STORYTIME #3
This story is actually about the Marburg virus, another related virus that is horrible but slightly less deadly. There is a cave in Kenya, right near the Uganda border, called Kitum Cave. it is very beautiful. it contains a petrified forest and lots of crystals. All sorts of animals use it as a highway and a salt lick (it’s full of salt), and paths have been carved by elephant tusks. fruit bats exist in colonies toward the outside of the cave, while insectivore bats exist toward the inside. there is a sign outside that says it is a “must visit” site.
so you might go to kitum cave and marvel in the beauty. but you might also go to kitum cave and catch the marburg virus, which happened to two people in two separate occasions during the ‘80s, a French man and a Danish boy. they both died.
EBOLA FACT 5: DON’T EAT BATS
Don’t eat bats.
EBOLA FACT 6: CUTTING A VIRUS
Cutting a virus is really hard because viruses are so tiny. in order to do this, you need a knife that is made out of a diamond. this diamond knife is the sharpest thing in the world. except it can be ruined by a touch of your fingertip, by the oils in your skin.
once you slice the virus, you need to place the specimen in water to view it. the best tool for doing this is a human eyelash attached with a piece of tape to a popsicle stick. there was one particular lab worker who had the best eyelashes: not too thick and not too thin, nice and long, with a tapered point.
it all sounds like a fairytale.
EBOLA PICTURES
here are my 2 favorite ebola photos, both from the original (known) outbreak in 1976.
i have been looking at this photo a whole lot because it frightens me so much. i like to look at it before i fall asleep at night. (Why???? i have no idea.) it seems like the most cursed photo of all time. she looks so scared.
I also love this one, of one of the nurse-nuns looking at the graves of the ebola victims.
EBOLA FACT 7: CURES COME FROM TOBACCO
one of the (possible— they haven’t collected enough data on it to know for sure) cures for ebola is called ZMapp, which is a combination of 3 different scientist teams’ efforts in developing antibodies. One of the teams, Mapp Pharmaceuticals, put Ebola genes into a tobacco plant. so insane! then they turned the tobacco plant into a pulp and got its antibodies. The two founders of Mapp Pharmaceuticals were living in Del Mar at the time, which is where I am right now as I write this.
EBOLA FACT 8: PEOPLE DON’T TRUST THE GOVERNMENT
One reason the 2014 Ebola outbreak was so bad is because the locals didn’t think it was real, and believed it was just a conspiracy to control them. History doesn’t repeat itself but it rhymes.
According to Preston, the outbreak was not stopped by science but by people changing their habits, by doing things like reverse quarantining, practicing The Ancient Rule, and making their own PPE out of trash bags and pantyhose.
EBOLA PICTURES #2
Ebola is pretty. A lot of people who study it find it to be terrifyingly beautiful. Marburg, Restin, and Ebola are all part of the filovirus family. Most viruses are balls, like covid. Filoviruses are strands like spaghetti. Ebola in particular is known for its hook-and-eye shape.
EBOLA HEROES
This part of the book made me so sad, and all I was thinking while I read it was “Oh God, ebola is horrible, oh God, this is so horrible.”
A lot of CRISIS IN THE RED ZONE is set in Sierra Leone, at a hospital in Kenema, which had a Lassa ward. Doctor Humarr Khan was the main doctor there, and he was an expert in Lassa fever; Lassa is a disease with symptoms similar to ebola.
He was an excellent doctor. He authored papers and lectured and collaborated with the leading doctors and scientists on infectious diseases. He could have been a doctor anywhere, but he preferred to stay in Sierra Leone serving his people, even though he was paid just about nothing.
There was a nurse in this ward named Auntie Mbalu Fonnie. She was an excellent nurse and was extremely dedicated.
Even though this hospital was one of the only ones equipped for a disease like ebola, and even though it was staffed by this especially well-qualified doctor and especially well-qualified nurse, it was quickly overwhelmed. They ran out of PPE and bleach. The wards were overcrowded and many nurses stopped going to work. Dr. Khan and the people at his hospital pled for more resources, but they were ignored. Nobody cared about this tiny hospital in Sierra Leone.
Auntie caught ebola while trying to save another nurse, who was pregnant, by giving her a treatment that worked well for Lassa: an abortion followed by a D&C. This was exceptionally dangerous but Auntie was desperate. She really wanted to save her friend. Her friend died. Both Dr. Khan and Auntie caught Ebola while trying to care for their people. So did several other equally dedicated and qualified nurses— these people who could not bring themselves to stop working, despite their trauma, exhaustion, and the level of danger. Because of this, they died.
Dr. Khan’s case was particularly heartbreaking because he could have been given ZMapp, which was in the same healthcare facility where he ended up. He was not given the treatment for a few reasons. One, it was a Doctors Without Borders site, and these doctors are big on the idea that everyone should be treated the same. The other patients were not offered ZMapp, so Dr. Khan could not have it. This makes no sense, because Dr. Khan could have saved many more people— but one thing I liked about Preston’s book was he pointed out that these doctors were uniquely traumatized and exhausted, so maybe they weren’t thinking very clearly.
The other reason was nobody knew if the treatment would be effective and safe. They thought that if Dr. Khan died, there would be unrest because people would say the white Americans were experimenting on Africans. They were already attacking the Doctors Without Borders.
I’m still mad they didn’t give him the ZMapp, though.
This is Humarr Khan:
This is Auntie:
This is the article they wrote, alongside a bunch of other people, which was published posthumously.
lol finally the deep dive into your ebola obsession we’ve been waiting for. found this terrifyingly fascinating though.
Wow!!!! The monkey!! Privileged zones! The mask! V v. Interesting. Terrifying.