Stopping Ebola: inside the CDC’s response

Most of the personnel in the CDC’s Emergency Operations Center in Atlanta is dedicated to fighting the Ebola outbreak in West Africa. Several giant screens face the room, filled with maps and charts that track the progress of the effort. BOB ANDRES / BANDRES@AJC.COM
Most of the personnel in the CDC’s Emergency Operations Center in Atlanta is dedicated to fighting the Ebola outbreak in West Africa. Several giant screens face the room, filled with maps and charts that track the progress of the effort. BOB ANDRES / BANDRES@AJC.COM

Credit: Bob Andres

Credit: Bob Andres

The Atlanta Journal-Constitution remains the premier source for Ebola-related news affecting metro Atlanta. Atlanta has emerged as a leader in the care of Ebola patients in the U.S., with four people treated at Emory University Hospital. It is also the home to the Centers for Disease Control and Prevention and Hartsfield-Jackson International Airport, one of five U.S. airports receiving travelers from the “hot zone” in West Africa. For more information see the AJC’s Ebola Web page at AJC.com/s/news/ebola/#top-news

The U.S. currently has no cases of Ebola, but in the Atlanta complex of the Centers for Disease Control, more than 400 workers continue to battle the outbreak ravaging West Africa.

Health workers train to deploy to Ebola-ravaged countries. Lab scientists strive to develop a more rapid test for the virus. Communications specialists develop educational materials calibrated to the cultures of West Africa.

Here, the headlines on Ebola – a new cluster of cases in Sierra Leone, the commencement of airport screenings in Mali – play out in very personal ways.

Denise Borntrager walks through the Emergency Operations Center, stopping occasionally to receive a hug. She’s deploying as part of the CDC’s response to the appearance of the disease in Mali, which is situated to the north of Guinea. The 53-year-old public health adviser will train workers at airports to screen departing passengers for fever or other markers of Ebola.

“I’m excited and nervous,” Borntrager says, standing outside the equipment room, where she’ll be issued a Blackberry, a laptop, a face shield and exam gloves. “I don’t speak the language, but I’ll have a translator. I really want this to be a good experience for everyone. I want to connect with the people there.”

The CDC is a major player in the world’s response to the Ebola outbreak, which has killed more than 5,000 people in West Africa, making it by far the worst outbreak in history. America’s premiere disease-fighting agency has 150 employees stationed in affected countries, and is continually rotating people in and out. The Atlanta facility remains in high gear, tasked with keeping Americans safe from Ebola by ending the outbreak in Africa.

The Atlanta Journal-Constitution was granted an exclusive tour of the CDC to view its Ebola response. The effort has pulled in workers from all corners of the agency. Borntrager usually serves as the officer-in-charge of the agency’s quarantine stations in San Diego and El Paso. This is her second tour of duty in West Africa.

As she leaves the emergency operations unit, she runs into Avi Stein, whom she hasn’t seen since they worked together in Sierra Leone. She tells him she’s off to Mali.

Stein tells her he’s headed back to Sierra Leone. There’s a warmth between them that comes from sharing life-and-death experiences, not unlike two soldiers who’ve shared combat.

They hug, and that’s a big deal.

“It’s the first time we’ve hugged,” she says.

That’s because Ebola has made West Africa a “no-hug society,” she said. It’s one of the first things you learn: as much as possible, don’t touch people.

The day of the AJC’s tour was Day 132 of the CDC’s ramped-up response to the Ebola crisis. Shelley Campbell, a biologist, has been on call 24-7 for months. She tests blood samples in the maximum containment BSL-4 lab.

Some days, she can predict her day by the morning news, such as when a new Ebola patient arrives in the United States. Other days, she creates the news, such as when she recently completed the blood tests that showed that a patient who had been treated in New York was cured, with no Ebola lingering in his blood stream.

“That was a great day,” she said.

On this day, Campbell is training two workers pulled in from the flu division to work in labs in Liberia.

There is no room for mistakes, she tells them. A false negative can return a person with Ebola to the community, putting dozens more at risk. A false positive can send a disease-free person into quarantine.

When they get to West Africa, she says, they should expect the unexpected: blood samples arriving in unsafe, makeshift packages; illegible writing on test tubes.

She says that when she dons the personal protective clothing that covers her entire body – she calls it the “spacesuit” – she never forgets the destructive power of the virus she holds in her hands.

“It always makes me pause and appreciate how dangerous it is,” said Campbell, a Covington mother of three.

When CDC workers finish their stints in West Africa, they return to the Clifton Road complex with a new perspective on their work.

Dave Daigle, who lives in Stone Mountain, recalls the widespread misinformation he saw while stationed in Lagos, Nigeria. One rumor that spread like wildfire said that salt water could cure Ebola. Later he saw a local headline that two people had died from drinking too much salt water. Such experiences motivate him now that he’s back to his regular job as an associate director of communications.

Brian Amman, an ecologist, was among those running lab tests out of a tin shack in Sierra Leone with plastic tarps for walls. It was about 95 degrees, with no fans or air conditioning, and even hotter inside his protective suit. He recalled a terrified little girl of maybe 8 or 9, the same age as his kids, coming in for an Ebola test.

“She passed away the next night,” he said. “That hammered us.”

When Amman returned to his home in Covington, the school sent his kids home until they were cleared by a doctor of any sign of Ebola.

“That was a nightmare,” he said.

Barbara Marston, who helps coordinate much of the West African response, sits among several dozen workers in the main room of the Emergency Operations Center. She faces several giant screens filled with maps and charts that detail the number of cases, their location and the concentration of infections. Essentially, the redder an area appears on the map, the worse the outbreak.

She’d like to be in West Africa, but her husband, another CDC scientist, is currently serving in Liberia.

“Somebody’s got to be home to take care of the kids,” she says.

Marston tells the group of working with an anthropologist to address a burial ritual that has turned deadly: washing the body of the deceased. Because the Ebola virus is transmitted through direct contact with the blood or body fluids of an infected person, the handling of corpses is a major source of new infections.

Many health organizations recommend cremation, but there are cultural obstacles. Some groups believe that cremation could sever the spiritual ties between the person who died and his or her ancestors.

Marston hopes the anthropologist can come up with a way to help people accept new practices. One possibility is to adapt approaches used in cases where a person dies in an accidental fire, showing family members that a body can be burned while maintaining ancestral connections.

Marston, who lives in Candler Park, speaks to her husband daily. Many days, they’re both on conference calls that review the number of cases and efforts to increase treatment capacity in Liberia.

When that phone call ends, they call back and talk about the kids.

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