grandmother also died. An ape (chimp or gorilla?) reportedly bit a domestic goat, infecting it; the goat was slaughtered in due course, skinned by a thirteen-year-old boy, and then the boy’s family began falling ill. No, a dead monkey was eaten. No, bats were eaten. Mostly these tales couldn’t be substantiated, but their currency and their general themes reflected a widespread, intuitive comprehension of zoonoses: Relations between humans and other animals, wild or domestic, must somehow lie at the root of the disease troubles. In early December, and then again in January 2008, came reports of suspicious animal deaths (monkeys and pigs) in outlying regions of the country. One of those reports also involved dogs that died after being bitten by the sickened monkeys. Was it an epidemic of rabies? Was it Ebola? The Ministry of Health sent people to collect specimens and investigate.
“Then there was a new epidemic—of fear,” said Dr. Sam Okware, Commissioner of Health Services, when I visited him in Kampala a month later. Among Dr. Okware’s other duties, he served as chairman of the national Ebola virus task force. “That was the most difficult to contain,” he said. “There was a new epidemic—of panic.”
These are remote places, he explained. Villages, settlements, small towns surrounded by forest. The people feed themselves mostly on wildlife. During the Bundibugyo outbreak, residents of that area were shunned. Their economy froze. Outsiders wouldn’t accept their money, scared that it carried infection. Population drained from the major town. The bank closed. When patients recovered (if they were lucky enough to recover) and went home from the hospital, “again they were shunned. Their houses were burned.” Dr. Okware was a thin, middle-aged man with a trim mustache and long, gesticulant hands that moved through the air as he spoke of Uganda’s traumatic year. The Bundibugyo outbreak, he said, was “insidious” more than dramatic, smoldering ambiguously while health officials struggled to comprehend it. There were still five questions pending, he said, and he began to list them: (1) Why were only half of the members of each household affected? (2) Why were so few hospital workers affected, compared to other Ebola outbreaks? (3) Why did the disease strike so spottily within the Bundibugyo district, hitting some villages but not others? (4) Was the infection transmitted by sexual contact? After those four he paused, momentarily unable to recall his fifth pending question.
“The reservoir?” I suggested. Yes, that’s it, he said: What’s the reservoir?
Bundibugyo virus in Uganda, 2007, completes the outline sketch of ebolavirus classification and distribution as presently known. Four different ebolaviruses are scattered variously across Central Africa and have emerged from their reservoir hosts to cause human disease (as well as gorilla and chimpanzee deaths) in six different countries: South Sudan, Gabon, Uganda, Côte d’Ivoire, the Republic of the Congo, and the Democratic Republic of the Congo. A fifth ebolavirus seems to be endemic to the Philippines, and to have traveled from there several times to the United States in infected macaques. But how did it get to the Philippines, if the ancestral origin of ebolaviruses is equatorial Africa? Could it have arrived there in one soaring leap, leaving no traces in between? From southwestern Sudan to Manila is almost seven thousand miles as the bat flies. But no bat can fly that far without roosting. Are ebolaviruses more broadly distributed than we suspect? Should scientists start looking for them in India, Thailand, and Vietnam? Or did Reston virus get to the Philippines the same way Taï Forest virus got to Switzerland and Johannesburg—by airplane?
If you contemplate all this from the perspective of biogeography (the study of which creatures live where on planet Earth) and phylogeny (the study of evolving lineages), one thing becomes evident: The current scientific understanding of ebolaviruses constitutes pinpricks of light against a dark background.
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People in the villages where Ebola struck—the survivors, the bereaved, the scared but lucky ones not directly affected—had their own ways of understanding this phenomenon, and one way was in terms of malevolent spirits. In a single word, which loosely encompasses the variety of beliefs and practices seen among different ethnic and language groups and is often used to explain rapid death of adults: sorcery.
The village of Mékouka, on the upper Ivindo River in northeastern Gabon, offers an instance. Mékouka was one of the gold camps in which the outbreak of 1994 got its start. Three years later, a medical anthropologist named Barry Hewlett, an American, visited there to learn from the villagers themselves how they