Echo-Bravo Spells – Ebola

An unfortunate outbreak of Ebola, a type of hemorrhagic fever, is now attacking medical personnel as fast as it is decimating civilians in Guinea, west Africa.

This dire event plays out in a region already ravaged by economic woe.

How dire?

Over a decade ago, our team of medical and engineering staff were quarantined in a town in northern Angola after a student died from hemorrhagic fever. This episode is recounted in a chapter in my book titled Water After War – Seasons in Angola.

The event began when one of our staff invited medical personnel to the town where we lived so they could be trained as vaccinators.

 

“Using UN vehicles that traveled in the region, Ana Maria sent out letters to health officials throughout Uige province. She requested that they each send one delegate to attend a vaccination course she would hold in Maquela. All fourteen invited health delegates appeared days before the course began. One walked two hundred kilometers in four days. Several others had walked more than one hundred kilometers each.

“One of these students grew ill in Maquela. His headache and fever gave way to vomiting blood and he entered Maquela’s hospital unconscious. There was blood in his urine. He bled from his nose. In the poorly lit and primitive conditions of Maquela’s hospital, where reed mats were used as beds rather than mattresses, Dr. Karen and nurses from Médecins Sans Frontières (MSF) filled this patient with intravenous solutions, then provided him with a blood transfusion.”

Before the widespread use of cell phones, we used a radio in our vehicle to communicate the symptoms to our headquarters in the city of Luanda, Angola’s capital. Staff then transmitted this information to the Center for Disease Control (CDC) in the US. Our French friends sent the same information to the renowned Pasteur Institute in France.

“On a dirt road in rural Maquela, four of us sat inside the vehicle with our ears tilted toward the crackling, high frequency static. Dr. Karen spoke to a nurse from our organization with years of emergency room hospital experience. Karen requested that we switch to speak on a lesser used radio frequency, and afterwards spoke again.

“What did you say?” asked the nurse, named Paula. “I didn’t copy. Something bola?”

“That’s Echo Bravo,” Karen said, prompting her with phonetic cues. “Echo Bravo Oscar Lima Alpha.” Paula traced the letters for E-B-O-L-A on a writing pad before her voice turned stern.

“Give me the details.”

And so the waiting began.

“The virus we dreaded was discovered in 1976 in the area of the Ebola River in northern Zaire. There had been few major outbreaks since then, although we knew that one occurred in Zaire earlier that year. Alarmed, we read what we could about the sickness from the sparse medical texts in Maquela (we had no access to the internet then). First, we knew there was a two to twenty-one day incubation period before an infected person grew ill. This was followed by symptoms that included headache, fatigue, muscle pain, and fever. These worsened to a condition of vomiting, diarrhea, and massive bleeding from all body orifices. There was no effective treatment or preventive vaccine for the sickness. Ninety percent of those who contracted Ebola died.”

We were instructed not to leave the dilapidated town where we worked, and United Nations supply planes halted their visits. We were cautioned not to leave our base.

“When we informed MSF of a possible outbreak of Ebola, they cordoned this patient off with a rope. They also posted a special guard before the hospital entryway who wore rubber boots and a white face mask. They next dismissed all non-emergency patients. Six local nurses, alerted by the word Ebola, fled into the hills.”

After the student died, our French friends passed on news from the Pasteur Institute.

 

“The antibodies had been for hemorrhagic fever in general, but not specifically for Ebola. Because there were several types of such fever, the results did not necessarily indicate a highly lethal strain. Once again, our sense of alert diminished. Ebola was no longer a concern.

“That evening Dr. Karen and I sat on our front porch. I asked her about the four other types of hemorrhagic fever.

“How many are found in this part of Africa?”

“All,” she replied.

We never encountered another case of hemorrhagic fever. But the memory of how the symptons were described, how the nurses fled, how the town was locked down, and cohorts and colleagues maintained physical distance from one another, still provides a grim reminder of the importance that nations maintain the capability to diagnose, track, and contain viral outbreaks.

Sympathies to all of those impacted by this nasty outbreak in West Africa.