Ebola virus is still an inscrutable bug in more ways than one, and Ebola virus disease is still a mystifying affliction as well as a ghastly, incurable one—with or without DIC, with or without melting organs and bloody tears. “I mean, it’s awful,” Johnson stressed. “It really, really is.” He had seen it almost before anyone else, under especially mystifying conditions—in Zaire, 1976, before the virus even had a name. But the thing hasn’t changed, he said. “And frankly, everybody in the world is much too afraid of it, including the medical fraternity worldwide, to really want to try and study it.” To study its effect on a living, struggling human body, he meant. To do that, you would need the right combination of hospital facilities, BSL-4 facilities, dedicated and expert professionals, and circumstances. You couldn’t do it during the next outbreak at a mission clinic in an African village. You would need to bring Ebola virus into captivity—into a research situation, under highly controlled scrutiny—and not just in the form of frozen samples. You would need to study a raging infection inside somebody’s body.
That isn’t easy to arrange. He added: “We haven’t had an Ebola patient yet in the US.” But for everything that happens, there is a first time.
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England had its first case of Ebola virus disease in 1976. Russia had its first case (that we know of) in 1996. Unlike the Swiss woman who did the chimp necropsy in Côte d’Ivoire, these two unfortunate people didn’t pick up their infections during African fieldwork and come home prostrate in an ambulance jet. Their exposure derived from laboratory accidents. Each of them suffered a small, fateful, self-inflicted injury while doing research.
The English accident occurred at Britain’s Microbiological Research Establishment, a discreetly expert institution within a high-security government compound known as Porton Down, not far from Stonehenge in the rolling green countryside southwest of London. Think of Los Alamos, but tucked into the boonies of pastoral England instead of the mountains of New Mexico, and with bacteria and viruses in place of uranium and plutonium as the strategic materials of interest. In its early years, beginning in 1916, Porton Down was an experiment station for the development of chemical weapons such as mustard gas; during World War II, its scientists worked also on biological weapons derived from anthrax and botulin bacteria. But eventually, at Porton Down as at USAMRIID, with changing political circumstances and government scruples, the emphasis shifted to defense—that is, research on countermeasures against biological and chemical weapons. That work involved high-containment facilities and techniques for studying dangerous new viruses, and therefore qualified Porton Down to offer assistance in 1976, when WHO assembled a field team to investigate a mysterious disease outbreak in southwestern Sudan. Deep-frozen blood samples from desperately ill Sudanese patients arrived for analysis—at about the same time, during that fretful autumn, as blood samples from Yambuku went to the CDC. The field people were asking the laboratory people to help answer a question: What is this thing? It hadn’t yet been given a name.
One of the lab people at Porton Down was Geoffrey S. Platt. On November 5, 1976, in the course of an experiment, Platt filled a syringe with homogenized liver from a guinea pig that had been infected with the Sudanese virus. Presumably he intended to inject that fluid into another test animal. Something went amiss, and instead he jabbed himself in the thumb.
Platt didn’t know exactly what pathogen he had just exposed himself to, but he knew it wasn’t good. The fatality rate from this unidentified virus, as he must have been aware, was upwards of 50 percent. Immediately he peeled off his medical glove, plunged his thumb into a hypochlorite solution (bleach, which kills virus) and tried to squeeze out a drop or two of blood. None came. He couldn’t even see a puncture. That was a good sign if it meant there was no puncture, a bad sign if it meant a little hole sealed tight. The tininess of Platt’s wound, in light of subsequent events, testifies that even a minuscule dose of an ebolavirus is enough to cause infection, at least if that dose gets directly into a person’s bloodstream. Not every pathogen is so potent. Some require a more sizable foothold. Ebolaviruses have force but not reach. You can’t catch one by breathing shared air, but if a smidgen of the virus gets through a break in your skin (and there are always