How we discovered Ebola virus
It was October 1976 in Atlanta, and a disease that no one had ever seen
was coming into focus. Word came from an amateur radio network in Africa
that the mystery illness had killed hundreds of people in just
over a month. The chief of the viral pathology branch at the Centers
for Disease Control and Prevention was standing over an electron
microscope. Dr. Frederick Murphy, now a professor of pathology at the
University of Texas Medical Branch at Galveston, was the first to see
this unknown killer up close.
The virus would eventually be named after a river in then Zaire, now the Democratic Republic of Congo.
Dr. Murphy recalled his first encounter with Ebola, why it scared him
and what might be done to control the current outbreak in West Africa.
Here is an edited and condensed version of his conversation with The New
York Times.
What was your first thought when the Ebola virus came into focus on Oct. 13, 1976?
That day remains very vivid in my memory. It raised the hair on the
back of my neck, the first image. I was the only one left at the C.D.C.
who had worked with the Marburg virus in 1967. And the two viruses look
alike. I was pretty sure it was Marburg, which was bad enough, but by
the end of the day, we knew it was different.
Talk a little about Marburg and why that was so scary.
In 1967, Marburg virus appeared in Europe in several places that were
processing monkey kidneys to make cell culture for things like the polio
vaccine. The people started getting sick. Eventually seven people died.
That was really the first high containment work we ever did at the
C.D.C. We received the virus immediately from Germany and from Britain
and went to work on it just to get the basics, so that the C.D.C. would
be ready for whatever might happen.
It was another league of
threat. This virus was incredibly lethal in monkeys. The pathology is
dramatic. The shape of the virus is dramatic. There were so different —
Ebola and Marburg — from all the little round viruses that people would
otherwise think about. It really got our attention.
Why is shape so important?
They are actual filaments, just a flexible rod, and according to how
they lay down, the shape will look different. If you look across the
electron microscopic field, you see them in all different forms. I think
there is something in that shape that is emotional or it strikes
something fundamental in the way we think — not that all the other
viruses are alike. The variety of shapes is quite amazing. But this was
outside the frame of reference, it really just grabs you.
What did the first image of Ebola do to motivate the response to the outbreak?
To get back to Africa took more than a week of work. In the days from
the time the box arrived from being shipped from Belgium to Atlanta, it
was incredibly dramatic. The box was opened by my colleague Patricia
Webb, and all of the vials were broken. Anyone else would have brought
the box to the autoclave [for sterilization]. She put on a gown and mask
and gloves and squeezed a bit of fluid out of the cotton batting, and
put it into a cell culture with a lot of extra antibiotics to kill any
bacteria that were in there. Within two days, the cells started to look
sick. And she gave me a few drops of the cell culture, and I prepared
that for the electron microscope.
In those days, you had to be
able to grow the virus. There was no genetic identification possible. So
it had to go into cell culture and laboratory animals to identify if a
virus was even there. What Patricia Webb did was the basis for
everything else that followed.
In those days, getting another
box shipped was a big deal. Communication was very bad. There were no
cell phones. Communication between people who were in Yambuku [at the
heart of the outbreak] in Zaire was by ham radio network with amateur
ham radio operators sending the signals on through several intermediate
points to get the signal out of Africa. They were ham radio networks set
in place to help missionary hospitals. Sounds like 100 years ago,
doesn’t it?
You looked at the actual damage that the virus does. How does it affect the body?
First of all, the virus grows very quickly. There may be a weeklong
period incubation period after infection. But then the course of the
clinical infection is really dramatic. Just over a matter of days people
get so very very sick. The pathologic side is that several organs are
just destroyed by the virus, especially the liver. And the amount of
virus present in the damaged liver is overwhelming. It may be the
largest concentration of virus I’ve ever seen in one place.
Do we have any idea of how it gets there and how it proliferates?
It replicates in lymphoid tissues. It’s not just limited to the liver.
It spreads through the body through the blood and causes damage in many
places. There’s often a rash, and respiratory symptoms. There’s just so
much damage occurring so quickly that it makes sense that this virus is
so lethal.
That’s damage in humans and in some animals including monkeys and other laboratory animals, is that right?
Right. And yet, our present thinking is that the natural reservoir of
Marburg and Ebola viruses are fruit bats in which the infection is
silent.
Is there something about the virus itself that defies our scientific attempts to classify, treat and eradicate it?
For these kinds of viruses, we don’t even talk about eradication. If a
virus is living in fruit bats in Africa, there are just no ideas about
how you would even eradicate it. Prevention has to start at the place
where humans get infected. How we are going to protect people across
Africa is still a good question. We know enough about the natural
history of the virus in nature. It pops up, goes away, comes back. But
it comes back in a different place. It comes back as a different genetic
strain. There’s still a lot of mystery.
Do you think the pace
of scientific understanding increases during outbreaks like the one we
are experiencing in West Africa right now?
As has happened over
the years with Ebola outbreaks, scientists are sent to outbreak hot
spots. But the first thing that has to happen is that the scientists
have to take care of the sick people. Everybody chips in to help save
lives and make patients more comfortable and to prevent more
transmission. So the research comes way down the list. Maybe that’s why
progress has been slow.
If you were Ebola, what would you think of your prospects right now?
The way we humans have dealt with the infectious disease boils down to
only a few arrows in our quiver. We have vaccines. If the virus is
transmitted by mosquitos, we can try to control them. In the old days,
we had quarantine, which has become pretty passé. And we have few drugs.
But against the viruses there are very few.
The real question
would be, If we had a vaccine, how would we use it across Africa? Who is
going to pay for it? We’re now seeing how hard it is to eradicate
polio. We’re down to the last few places in the world where the polio
virus is still present. And we have a very good vaccine. But it’s a
complicated world out there. With polio, it’s expecting the end game,
and with other diseases, you don’t even get started. There are still
plenty of important diseases where we don’t have a vaccine. It’s not
just Ebola.
How do we beat back the current outbreak?
It’s still the standout virus. If you’re going into the laboratory to
work on the short list of the viruses that require the maximum
containment — the labs with the space suits — you’re still most focused
when you’re working with Ebola. It’s the one where you would least want
to stick yourself with a needle. It’s the first virus I think about when
I think about biocontainment in a lab.
And if you’re going to
work in the field on the reservoir animals in Africa, you have to have
all of the same kinds of biocontainment to protect yourself there.
That’s what makes everything so expensive and complicated.
The
third place where you need containment is in the hospitals and clinics
in Africa right now. You realize that many of the people who have been
infected and have died are medical care personnel. It’s a special kind
of biosafety that needs to be improved.
Do you think that level of safety is even possible in West Africa right now?
The educational side of it is huge. And it’s more than just teaching
people how to be careful. You have to provide all the equipment for
people who have been trained to protect themselves. It’s these
practical, on the ground, public health actions that limit transmission
and then stop transmission. And that all starts with educating people.
8/16/2014
How we discovered Ebola virus
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