Ebola’s first appearance in the United States was not with the August arrival of Dr. Kent Brantly, a missionary who’d been infected with the virus while treating Ebola patients in West Africa.
It arrived here, in Atlanta, 38 years ago in a box.
Inside the box were glass vials, broken and coated with blood, though to a casual observer it didn’t resemble blood. The substance was thick and black after having been frozen for transport across the Atlantic. No one knew exactly why, but something in the blood was killing scores of people in villages near the Ebola River in Zaire. A similar outbreak that summer of 1976 had also killed dozens in the Sudan.
At the time, no one had clearly seen the cellular makeup of the disease. Virologists didn’t know what it was, let alone have a name for it. It was up to a trio of researchers at what is now the Centers for Disease Control and Prevention to figure out how it worked. Recently, two of those surviving researchers, Dr. Frederick Murphy and Dr. Karl Johnson, spoke at length with The Atlanta Journal-Constitution about the moment they realized that they had helped discover a new disease, one of the most lethal of its kind.
Dr. Murphy, 80, is now a pathology professor at the University of Texas Medical Branch at Galveston, where work is being done on an Ebola vaccine. Dr. Johnson, 85, is retired and lives in Oregon.
During the past nine months both men have watched history’s worst Ebola outbreak unfold. In it they’ve seen parallels to the first recorded outbreak in 1976. That’s when the then-unnamed disease was killing central African villages, health care workers and missionaries there, and crippling medical systems.
On some points of the Ebola discovery narrative Dr. Murphy and Dr. Johnson disagree, but in a collegial way. Their friendship goes back to the first epidemic. But on this they agree wholeheartedly; Ebola then and Ebola now are strikingly similar, both in their molecular makeup and in their ability to sow fear and misery.
For the doctors, the story began with the tubes of spoiled blood and the whispered words, “We’ve got something new.”
‘Absolutely unique at the time’ and ‘so strange’
The story starts 12 years before the box’s arrival. Murphy, a veterinarian fresh out college, was recruited to the CDC to start its new viral pathology unit. Three years into his term, in 1967, a hemorrhagic fever killed several researchers in Europe who were making cell cultures from Ugandan monkey kidneys to make polio vaccine. The fever was called Marburg. The CDC did research on the disease and made response preparations in case of a larger outbreak. No epidemic materialized. But the unusual shape of Marburg compelled Murphy.
“Looking at it through the electron microscope, it had these long filaments, which was absolutely unique at the time,” Murphy said. “It was so strange relative to all the other known viruses, so it sort of grabs you.”
The shape, coupled with the fever’s lethality and its then-unknown origins, kept Murphy’s team busy for a year. But with no other outbreaks and a CDC research mandate to address diseases that are active killers, “it sort of disappeared from our thinking,” Murphy said.
Until nine years later.
By then, Johnson was working at the CDC as head of the new special pathogens unit. His wife at the time, Dr. Patricia Webb, was also a researcher there.
In the summer of 1976 communication with rural central Africa was little more than ham radio service. So Johnson, Murphy and Webb were intrigued by reports coming out of the region about a virus wiping out villagers and workers in Sudan and Zaire (now the Democratic Republic of Congo). The Sudanese outbreak had a mortality rate of about 50 percent. But of particular concern was a Belgian missionary hospital in Zaire that was losing its patients, doctors, nursing nuns and priests to the disease at a far higher rate. Victims suffered through an agonizing death marked by profuse diarrhea and bleeding.
“None of the other hemorrhagic fevers we knew about had done that much damage in one spot,” Johnson said.
At the same time, British and Belgian researchers were trying to figure out what this disease was. But the CDC had one of the first, high-level biocontainment labs in the world. Calling in a favor from a British researcher in Kenya doing tests on the Sudanese strain, Johnson got him to send samples to the CDC in early October. Samples of the Zaire strain arrived at the CDC Atlanta laboratories near Emory University a couple of days after. The tubes of the Zaire strain were broken.
“Anyone else would have just taken the whole box to the autoclave and sterilized it and said, ‘Send us another box,’” Murphy said.
But Johnson’s wife, Dr. Webb, who was working with Murphy, saw an opportunity.
“Lots of elements of biocontainment is knowing what you’re doing and being very careful,” Murphy said. “She just put on a gown and gloves and mask and squeezed some fluid out of the wrapping, you know the cotton batting, and put it in cell culture.
“Within a couple of days, the cells started to look funny as if something was in them,” Murphy said.
At this point Johnson and Murphy diverge. A cell sample was put onto a slide; Johnson now says it was the Sundan sample. Murphy says it was the sample from Zaire. Yet, they agree on this: On Oct. 11, Murphy put the slide under the lens of the electron microscope.
It had the long filaments of Marburg, but something was off. Murphy snapped a series of pictures and ran to the darkroom to develop them in a chemical bath, the way film was processed at the time. They were the first known pictures of the actual Ebola virus.
“He was really sweating it when he came out,” Johnson recalled. “He was white-faced.”
‘It was maybe the most dramatic thing of my life’
Murphy and Johnson took the pictures to the head of the CDC, Dr. David Sencer, who was in a meeting with Georgia’s then-U.S. senator, Sam Nunn.
“We just barged in,” Murphy said. By then, other epidemiologists were gathering in the room after hearing that Murphy, Johnson and Webb had found something. Everyone thought it was another strain of Marburg, Murphy said. That is until Webb, who had been cross-referencing the slides with other hemorrhagic fevers, came into the room and whispered in Johnson’s ear, “‘It’s not Marburg, we’ve got something new,’” Johnson recalled.
“It was maybe the most dramatic thing of my life,” Murphy said. “Everyone just went quiet.”
Within days, Johnson was heading a research team in Zaire, where he met Dr. Peter Piot, the Belgian researcher also credited with the initial discovery of Ebola. Murphy and Webb, who is now deceased, stayed in Atlanta to continue their work on the new disease, named for the Ebola River in Zaire.
The outbreak ended after a few months. But several of the lessons learned during it came into play during this latest epidemic. The use of the separated blood or plasma, now called convalescent serum, emerged as a potential treatment. The blood of an Ebola survivor contains antibodies thought to help fight the virus. Johnson recalls it being used to help a British doctor recover during the 1976 scare. And while questions about the serum’s efficacy remain, several Ebola patients in the current outbreak have been given the serum and provided it, most notably Dr. Brantly.
There have also been drastic changes to burial practices. Burning all the belongings of an infected person, including that person’s home, was a protective measure employed back then and, in some cases, now. And health-care surveillance teams are being sent to monitor villages hit by the epidemic, a practice that continues today in Liberia, Sierra Leone and Guinea.
And yet, what eluded Murphy and Johnson then, eludes researchers now; a viable vaccine for a disease that is hard to catch, but has easily gripped the world with fear.
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