By David McKenzie, CNN Updated 9:41 AM ET, Sat May 26, 2018
It is what fear sounds like.
No buzzing sales banter and gossip, no sputter of yellow and white taxis or boda boda taxi bikes. No gumbe or hip-hop music blaring from the market stalls.
Just a dreadful silence.
It was August 4, 2014, and the government of Sierra Leone had ordered more than 7 million citizens to shelter at home and pray. The Ebola epidemic was out of control, and it was time for desperate measures.
The disease would go on to claim more than 11,000 lives.
Ebola now stalks a different part of Africa.
Since early May, scientists, epidemiologists and doctors have been battling an outbreak of the virus in the Democratic Republic of Congo, the ninth the country has seen to date.
“We are preparing for the worst. The response to this epidemic is on a knife edge,” said Dr. Peter Salama, who heads the health emergency program at the World Health Organization.
But this time — and for the first time in 40 years of combating Ebola — global health experts have something akin to optimism.
Armed with an experimental vaccine and empowered by a revolution in global health security, put in place after the catastrophe of the West African epidemic, they believe that they have a real chance to snuff out Ebola’s deadly threat.
Forty years of fighting
“There are two defining epidemics of our time: the AIDS epidemic and Ebola,” said Peter Piot, director at the London School of Hygiene and Tropical Medicine.
The celebrated microbiologist has been instrumental in combating both diseases. He was founding executive director of UNAIDS and he codiscovered the Ebola virus, which emerged 40 years ago in the DRC, then Zaire, and in what is now South Sudan.
In August 1976, the headmaster of Yambuku Mission School in Équateur province arrived at the Catholic mission’s outpatient clinic, run by Belgian nuns, with chills and fever. He had just completed a two-week road trip north, toward the border of the Central African Republic, where he had purchased smoked monkey meat.
At first, he was treated for malaria and returned home. But the headmaster returned a week later with a cascade of more serious symptoms. In early September, he died of profound hemorrhaging.
More patients soon arrived, and the nuns inadvertently spread the mystery disease through dirty needles.
A broken vial of blood from one of the infected nuns eventually arrived at the Institute of Tropical Medicine Antwerp in Belgium, where Piot was working. He and his fellow scientists did not recognize the virus.
Piot was promptly dispatched to Yambuku, the youngest member of a team of scientists investigating the mysterious outbreak.
“I had never been to Africa in my life or to an outbreak, so I wasn’t really qualified, but there were no other candidates,” he said.
The symptoms he found were horrific. Patients were bleeding out from the inside.
Ebola first strikes the immune system, forming blood clots throughout the body and prompting an immune system “storm,” attacking all of the body’s vital organs and causing massive internal hemorrhaging.
In the final stages, patients bleed from their eyes.
There are multiple strains of the Ebola virus. The Zaire strain, which Piot helped identify, can kill up to 90% of those infected, based on a history of outbreaks.
Piot and his colleagues called this new form of hemorrhagic fever Ebola virus disease, after the nearby Ebola River, a tributary of the Congo River.
The team stopped the outbreak in Yambuku by tracing contacts of suspected cases and strictly isolating anyone showing symptoms, a technique used for hundreds of years. Of the 318 suspected cases, 280 died.
Piot remembers heading to London straight from the field to an emergency meeting at the school of tropical medicine he would one day lead. He says WHO and donor country officials promised immediate investment.
” ‘We will never let this happen again,’ they said. Of course, what happened? Nothing,” Piot said.
A failure to act
But it happened again — and again. And then, there was 2014.
Like that first outbreak in 1976, the West African epidemic had modest, if tragic, origins.
Seven months before Sierra Leone shut down the country, the outbreak beganwith an 18-month-old boy named Emile in neighboring Guinea.
WHO and Guinean scientists believe that Emile contracted the Ebola virus from bats near his home in the remote village of Meliandou. He died and spread the disease to his immediate family.
“Even after several months, there was a lot of talk and little action on the ground,” said Stefan Kruger, a Medecins Sans Frontieres (Doctors Without Borders) physician who was based at a treatment center in Sierra Leone. “It allowed the spread of the virus to get out of control.”
The world finally took note when American Ebola patients showed up in isolation chambers in US hospitals, flanked by doctors in “space suits.”
The prospect of a global pandemic sparked global action.
By their own admission and in scathing independent reviews of the Ebola response, WHO and foreign governments had woken up to the threat far too late.
When WHO declared the outbreak over in 2016, the final toll was devastating.
There were officially 28,616 suspected cases in the West African epidemic and 11,310 deaths, though field doctors say the death toll is probably much higher. Today, there are more than 20,000 Ebola orphans in West Africa.
Sierra Leone, Guinea and Liberia lost more than $2 billion in economic growth in 2015 alone, according to the World Bank.