Free No Time to Lose: A Life in Pursuit of Deadly Viruses by Peter Piot

a little like in those jokes where a Belgian, an American, a Frenchman, and a Zairean might all walk into a bar.
    FOR THE NEXT two days we toured villages every morning, taking blood where we could, jotting down every potentially telling detail and piece of data we could muster. We saw patients with blood crusting around their mouths or oozing from their swollen gums. They bled from their ears and nose and from their rectum and vagina; they were intensely lethargic, drained of force.
    In every village we organized a meeting with the chief and elders. After the ritual passing of a plastic cup of roughly distilled arak —banana alcohol, which Pierre had the courage (or perhaps the common sense) to refuse—we asked them to describe their experience of the new illness, the number of cases and deaths, the dates, whether they had knowledge of any people currently sick. We questioned every villager we came across about day-to-day practices—unusual contact with animals, new areas of forest cleared, food and drink, travel, contact with traders.
    We heard of entire families who had been wiped out by the swift-moving virus. In one case, a woman in Yambuku had died days after giving birth, swiftly followed by her newborn. Her thirteen-year-old daughter, who had traveled to Yambuku to take charge of the child, fell ill once she returned to her home village and died days later; followed by her uncle’s wife, who had cared for her; then her uncle; and then another female relative who had come to care for him. This extremely virulent interhuman transmission was frightening.
    We were all familiar with our terms of mission: we were here just for three or four days, to act as scouts in preparation for the arrival of a larger team that would try to set up systems to control the epidemic and break ground for further research. Our job was to document what was going on, sketch out some basic epidemiology, take samples from acutely sick patients, and, if possible, find recovering convalescents who might provide plasma to help cure future sufferers.
    And we were doing that job—harvesting samples, collecting data, and cataloging the basic logistical equipment that the larger team would need to bring. But we knew that from a human point of view this simply wasn’t enough. We needed to stop the virus from infecting and killing people.
    The mystery fever’s epidemic curve was starting to take shape. The classical epidemiological curve is pretty simple; it plots the number of new cases of an infection against time. In the simplest type of outbreak the number of people infected rises gradually, then picks up pace, reaching a peak at the midpoint of the graph. Once the virus has exhausted its stock of easy victims (the weak or easily accessible), the rate of new infections begins to wane until the epidemic fades to a whisper.
    All of us were aware of the many exceptions to this in real life—the unexpected outliers, the blips and lags, the complications of propagated epidemics with secondary and tertiary infections. But night by night, as we jotted down data and sketched out a picture from our interviews and notes, it appeared that although people were still dying (and dying horribly), the peak number of new infections around the Yambuku mission might be, at least provisionally, behind us.
    This was a huge relief. But another conclusion also began to take shape, and it was a great deal more uncomfortable to deal with. Two elements linked almost every victim of the mystery epidemic. One factor was funerals: many of the dead had been present at the funeral of a sick person or had close contact with someone who had. The other factor was presence at the Yambuku Mission Hospital. Just about every early victim of the virus had attended the outpatient clinic a few days before falling ill.
    We developed near-certitude about the mode of transmission one evening, when Joel and I were drawing curves showing the number of cases by location, age, and gender.