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Ebola: Then And Now

TESS VIGELAND, HOST:

For all the miracles of modern medicine, the basic response to Ebola outbreaks has not changed much since the disease first appeared in 1976. Back then, Dr. Joel Breman was living in Michigan, working as a state epidemiologist. He had just returned from several years in Africa working on smallpox eradication. Ebola broke out that summer, and the Centers for Disease Control and Prevention asked him to go back and investigate the new virus.

JOEL BREMAN: No one was sure what it was when they first called me.

VIGELAND: The only thing Breman was told was that it was spreading quickly, and it killed anyone who was exposed to it. Breman joined an international team of doctors and researchers working to control an outbreak of this mysteriously lethal virus. That's when he met Dr. Karl Johnson.

KARL JOHNSON: It was so brand-new, and that nobody knew - there hadn't been one word written. There hadn't been a name given to this virus. All it was was killing people.

VIGELAND: When Johnson and Breman landed in Kinshasa, the capital city of what is now the Democratic Republic of Congo, an infected patient - a Catholic nun - and her nurse had both died from Ebola.

BREMAN: As we arrived in Kinshasa, absolute panic...

VIGELAND: They needed to find out how the virus spread and fast.

JOHNSON: I mean, we all knew that this could turn into a world pandemic of the kind that had never been seen.

VIGELAND: They heard about 120-bed hospital that had recently shut down. Most of the hospital staff there had died of Ebola. The question was how? Johnson says, they found out that the hospital had been administering injections to patients - nearly 200 day - and the needles they were using were contaminated.

JOHNSON: All they did was boil, once a day at the end of the day, the four or five syringes used for those 200 injections.

VIGELAND: That's when they knew it was spread through unsterilized needles and through close contact with infected patients. Breman, with his experience in smallpox eradication, knew the solution was a matter of isolating patients. The last smallpox outbreak had only been a few years prior, so it was still fresh in people's minds. Some medical workers were already starting to copy that same method to deal with Ebola.

BREMAN: They knew about it, and they also were isolating patients themselves before we got there.

VIGELAND: Breman says, that, plus the quarantine of hundreds of thousands of people in infected zones, helped stop the spread. About three months later, the outbreak of this new and mysterious disease in central Africa was over. Of the 318 cases, 280 people died. The lessons from that outbreak still inform the response today.

BREMAN: The isolation, quarantine, the incubation periods - that is built on information that we found in 1976.

VIGELAND: As for Johnson, he says, he sometimes wishes he could go back with the knowledge he has now.

JOHNSON: And I have occasionally woken up at three o'clock in the morning and wished that I were 30 years younger. (Laughter). Transcript provided by NPR, Copyright NPR.