This is January the 11th, January of course, it's February actually. I think this is 1996, this is tape number 2 and the first thing we're going to hear on this tape is the Ebola, the audio portion of the Ebola tape. These bodies are too hot to touch. The remains of a disease so virulent, so fearsome, that funeral rites are abandoned and bodies Bodies are left for crude mass burial by corpse disposal squads. Kikwit Zaire, April 1995. One outbreak in one community in one country. But could it become the next plague? We have no protection from these diseases. We cannot be isolationists in our thinking anymore.

The world is a small community of nations and when one coughs, nobody sleeps. In Zaire, they're using quarantines and a public health campaign to try to stop it. The government of Zaire took fresh steps today to stop the spread of a lethal virus. It is a terrifying killer. There is no vaccine and no cure. The survival rate here is zero. The samples taken from the victims are rushed to scientists at the Centers for Disease Control in Atlanta, Georgia. ♪♪ Within hours, their worst fears are realized. The killer is Ebola, one of the deadliest viruses on Earth. It can cause a human host to bleed to death in a matter of days.

I think the very real possibility that Ebola could come out of Africa to the West, so we've got to get to the bottom of what controls the circulation of this virus and what controls its ability to hop over into humans and what controls its possibilities for spread. Ebola is a scientific enigma. Since little is known about how it's transmitted, once an outbreak begins, no place on earth is safe. The CDC sounds the alarm, and a medical SWAT team from all over the world converges on kick-wits, ground zero of the outbreak. Ebola is a formidable enemy. These scientists are risking their lives on the front line of the battle Their mission is to stop the virus and find out where it came from They greet each other with the kick with handshake elbow to elbow to minimize contact As the scientists make their way from the airport they find themselves in a city gripped by terror.

The fear of Ebola is spreading. Thousands are trying to flee. But a military quarantine has been imposed. The international team sets up a command post. They join forces with a group of Zairean doctors who have flown in from the capital. We are very glad to meet so many courageous people from abroad. It's what inspires us and encourages us to fight this to the end. Our families were in tears when we left the capital, Kinshasa, to come here because they knew we were traveling towards death. My wife believes in reincarnation, so the first thing she said was, if you die over there, I'll kill you, which didn't, wasn't very, you know, didn't carry a lot of weight. And then she said, if you die over there, I will hunt you down through the ages and during future lives and kill you.

So I'm being very careful. The first priority is clear. Find every case and isolate it. The only way the epidemic can be stopped. An epidemiologist with the CDC, Dr. Ali Khan establishes procedures for documenting every victim. I heard about this person and I heard about this person and I only know about this person. Missing even a single one could spell disaster. I don't have any forms, but you say you know about that. Yes, yes. Well, but they're missing from here because there's no form on that.

The team fans out across the city to look for new cases. Along the way, they hope to gather information that will help them understand this mysterious virus. This is an incredible opportunity. There's not an Ebola outbreak very often, and you just have to keep remembering, do the surveillance as it contributes to disease control. So you're very tempted to go off in 20 different directions and start 20 different studies at the same time. This is not the first time that Ebola has struck Zaire. Almost 20 years before, in 1976, an outbreak erupted in a hospital in the town of Yambuku, 1,000 kilometers to the north. The disease spread rapidly, killing 9 out of 10 of its victims, leaving nearly 400 dead. An international team arrived late and had little opportunity to investigate the outbreak.

The epidemic was stopped when village elders ordered the temporary abandonment of traditional burial ceremonies, which involved touching the corpse. Instead, they quarantined villages and burned down the huts of the dead. The 1995 epidemic also began at a hospital. When we got there, the hospital was essentially deserted, a major hospital in Kikwit. There was a scattered patient here or there, many of whom had not been fed for days on time, and we walked through that hospital the first night, and it's the sort of memories that you retain for a lifetime. The local situation was so bad on the medical point of view that we, at least two of us, were involved in the cleaning of the ward. But there were still dead people in the building and the condition of work was very bad.

The safety protection for the workers were absent, not available for them. The outbreak was traced back to a surgical procedure performed on a young lab worker named Kim Pumu. Three nurses who had assisted at the operation soon fell ill. Taking no special precautions, fellow hospital workers attended to their needs, washing them and coming into contact with their bodily fluids. Within weeks, 36 hospital workers, doctors, nurses, and attendants had died, and most of the survivors had fled. The government asked the Irian doctors for volunteers to come here. For at least two weeks, they didn't find any. But after a while, we said that we'll go to investigate and do research. and be part of medical history in the making.

We said to ourselves, we're doctors. It's like the army. We're soldiers. We'll go and face the danger. Outside the hospital, the grieving families of the sick and dying pray for their recovery, while the medical staff takes elaborate precautions to avoid infection. Despite the sweltering heat, the safety procedures established by the international team require four layers of protective gear. A moat filled with bleach is the only barrier between the Ebola ward and the outside world. Unlike HIV, Ebola is a hearty virus that can survive outside the human body. Any contact with patients or their surroundings may prove fatal. The virus has been found in tears, blood, even on the surface of the skin. Internally it attacks the vital organs, often causing massive bleeding inside and out. There is no cure or treatment.

Death usually comes within ten days. She's in the terminal stages. There's nothing to be done. There's her husband. ♪♪ Patients in the early stages of the disease can only look on at what is likely to be their fate. This week alone, there have been 52 new deaths in Kikwit. The plague-fighting efforts of the international team have not begun to take hold. The terrifying effects of this disease were seen for the first time in Europe. During the summer of 1967 in the quiet German town of Marburg, workers at a pharmaceutical plant began dying of a mysterious ailment. The victims developed a strange rash.

Their skin tore easily. The eyeballs filled up with blood. Their faces became fixed, zombie-like. They vomited black fluid and discharged blood from every orifice. From the initial headache to death, one week. The cause was a virus, a close relative of Ebola. Lab workers became infected as a result of handling the blood and tissue of African monkeys. No one had seen anything like it. disease because all organs are involved. The liver, the brain, kidneys, all and it's a failure of every organ taken together so they suffer extremely. It must have been the same in the Middle Ages where you don't know what happens and people die and know that they can get the disease from touching.

In 1989, Ebola made its way to the U.S. Residents of this Washington, D.C. suburb had no idea that one of the world's deadliest viruses had emerged in their midst. In a primate quarantine unit in Reston, Virginia, monkeys in one of the holding rooms suddenly began to die. Secretly, a military team entered the quarantine unit and killed all 60 monkeys in the infected room. It appeared that the virus was moving through the ventilating system. In response, the military killed all 400 monkeys, ending the outbreak. This new strain of Ebola had shown the potential to spread through the air.

Had it been lethal in humans, it could have been catastrophic. Soon after the international team arrived, the epidemic in Kitwit exploded. The plague fighters worried they would not be able to stop it. I was actually very scared that this could get out of control. And there was no doubt that when you looked at the distribution of cases, it was just getting bigger and bigger and bigger every week. And that week, actually, there were 70-odd deaths in the community. I mean, you walk through the streets and people were dying. I mean, they were literally everywhere you walked, they were talking about people dying of Ebola.

We were working as hard as we could. So that week, I was extremely scared that this thing may be getting out of control. I coined the term chain of death and it was very characteristic what you would see happening in a family. There were a number of such number of such chains in the community where you would see one person become sick and then you would see their spouse or primary caregiver become sick and then four to five days later their primary caregiver would become sick and then you would just see this chain of death and you could just track it through the family until it eventually terminated. The one who died on the 20th was your mother.

And then the granddaughter died next. So it's the 21st. To break the chain of death, Ali Khan must track down all the cases and separate them from their families. This often meant interfering with the way people care for the sick and honor their dead. So how would she hear about these people being sick? Just like somebody would come in from the village? Another thing that was a factor in the outbreak is attending funerals. And we do know that during the preparation of a body, there's a lot of physical handling of the corpse. And then during the funeral itself, a large number of people may touch that body and cultural things are difficult to change obviously because they are ingrained in the way people act. But what we had to do was simply say that if somebody dies of this disease they immediately get put into a body bag, sprayed down with Lysol, popped in a coffin and buried deep.

Oh gods, we ask you to be with us in this hard time. This hospital has been our refuge and now the devil has taken it. Please deliver us. The Red Cross team has the most thankless job of the epidemic. Members are shunned by their neighbors and regarded as pariahs in the villages. Their visit signals only tragedy. you. I. Was I to say. If the Ebola virus were looking for somewhere to spread, it could find no better place than Kikwit. Kikwit is called a city, but it is more like a large rural village of some 400,000, with no electricity and no running water. Public health and sanitation are limited, and the illiteracy rate is almost 50%. The local diet includes insects, monkeys, and rats, all suspected carriers of the virus.

Under these conditions, the international team must somehow get the word out. Avoid contact with the sick or risk death. They organize a street-level education campaign. Banners are put up. The disease that makes your blood flow. This disease has no vaccine and no cure. You must protect yourself. It was very difficult to educate the public because there was no mass media. There was no TV, there was no radio, there was no newspapers. So everything had to depend on using alternative means to educate the community.

This fever, this disease is harsh and it's already killed many people. And I'm here to tell you that hiding patients won't help anybody. But what about the guy you buried over there? Now that it's raining, won't all this water spread the disease from the corpse through the neighborhood? Well, the Red Cross assured us that he was buried safely. He died in the outhouse and fell into the hole. It was very deep, so they buried him right there. Now, you shouldn't be scared. The Red Cross disinfected his grave and the surroundings. His remains can't come out and his germs can't get to him. Medical students are sent out into the community to identify new cases before entire neighborhoods become infected.

There's only one way to do this in Kikwit. Door to door. It looks like no one's home. They're here. They just left when they saw us coming. We're here to get some information. What's all this? I don't understand. Why are you coming to disturb people? We're students from the University of Bandungu. We're doing research.

We want to know if anyone here is sick with Ebola. This is not right. I'm innocent. I don't know anything about Ebola. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything.

I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything. I'm not going to tell you anything.

We want to know if anyone here is sick with Ebola. This is not right. I'm innocent. I don't know anything about it. I worked with the medical students here in town, and the stories that I'm hearing, it seems very natural to me, of the stigmatization, including the story of someone being killed because he was from Kikwit and was thought to have had contact. So it's natural to me that, you know, say to someone, tell us if you have Ebola, it will take you away from your family and put you in a hospital where you'll likely die and no one will want to visit you. Certainly, people don't want to tell you because of the stigma. But hospitalizing the sick is the only way to stop the disease. In the Ebola ward, Dr. Mupapa's team provides whatever human comfort they can, knowing few, if any, of their patients will survive. Each day as they leave, the medical staff is sprayed with stinging bleach, which kills the virus.

Their protective clothing is burned to ensure that it won't be reused. But they can't so easily rid themselves of the images of the ward. I'm a newlywed. We have a child. My wife was really worried about me coming here and she was pretty scared. Especially when I found out that the disease can be transmitted from a man to a woman through sperm. I write her as often as I can to tell her that everything's okay so far and that we are taking safety measures and that there's nothing to worry about. When I read his letters I feel better but even so my heart is heavy. I will only be happy the moment he returns home. I pray every morning and every night.

I'm really convinced that I'll return to Kinshasa alive. That's truly my most ardent wish. Look here. It's a picture of Daddy. Of course I'm afraid. He's touching sick and dying people every day. I'm terrified he's going to catch it. This is a disease that is merciless. I pray to God that he doesn't get sick. I'm convinced that he won't get sick. I'm sure of that now. Yet people are still getting sick and still dying, though no fewer this week than last. The epidemic rages, but a corner has been turned. As night falls, the hit movie in Kikwit is a video called Ebola. Made by a local entrepreneur, it stars the Zairean doctors who have become local heroes. Although the video is projected from a broken down VCR, there isn't an empty seat in the house.

Equally unable to escape the epidemic, even for a few hours, the medical team spends the evening swapping the latest stories. Four days before he got sick, there was a young woman admitted for surgery who was pregnant, and when they opened her up, she had a hemorrhagic ureter. Not only was he there, but she died in the OR. As the scientists gain confidence in their management of the crisis, their research mission takes on a higher priority. One of the researchers is Dr. Robert Swanepoel, a South African virologist. He is driven by the idea of finding the source of the virus. When something like this happens, you're just drawn to it. It gets to a magnet or a mosquito can.

You're not going to find out where the thing came from, and we really don't know. But most scientists believe that Ebola's natural home is the rainforest. So this outbreak provides a critical opportunity to search for it in its natural setting. With rare diseases like Ebola, diseases that have not been properly studied, every epidemic has to be seen in two ways. It's an emergency to control the epidemic and save human lives, but at the same time it's a responsibility to collect research data that will inform you about future epidemics.

Between outbreaks, Ebola lives within one of the many thousands of insect or animal species that inhabit the rainforest. But scientists have never succeeded in identifying which one. It's really a medical curiosity in these places I mean where does it hold up and how does it pop up here again in Zaire after 20 years. That's what keeps a lot of us motivated and interested in this virus. I'm not sure what makes a good virologist. I've heard the Americans have sort of described the type of person I am as an old-fashioned swamps thumping epidemiologist, did you like? Bats have been found in the vicinity of previous outbreaks, but no one has ever found a bat with a trace of Ebola virus in its blood. This time, Robert Swanepoel hopes to make a breakthrough.

Only when the natural host is identified will it be possible to predict where the virus might strike next. In each new blood sample is the possibility of an answer. But what happens when the virus makes its move from its animal host to a human being? What is its lethal strategy? Blood samples at different stages of the disease are collected by Dr. Pierre Roland. We know nothing on Ebola because during the 76 outbreak only a few blood samples were taken. So our hope in this outbreak is to get enough samples from patients at different periods of the disease. An outbreak every 20 years is not like working with a serial killer that has the same pattern all the time.

The priority is to try to stop the outbreak first and then collect as much specimen that you can so you can learn something. Working in conditions far below standard laboratory safety levels, Roland risks his life handling samples which contain enough Ebola to kill thousands. Kikwit is still under siege. The Zairians have been fighting this epidemic for ten weeks now. More than 200 people have died. The burials go on, but fewer than before. The number of new cases continues to drop. Every victim has been traced.

The chain of transmission well documented. The end is in sight. Back at the command center, the epidemiologists analyze the accumulating data. Their efforts pay off with a dramatic breakthrough. They identified patient zero, the individual they believe contracted the disease. Not from another human being, but from a creature in the rain forest. All the cases have been charted on a timeline, tracing a path of destruction back to this very first known victim. He died four months before the first case appeared at the hospital. His name was Gaspar Minga. Gaspar Minga was a charcoal worker living in Kikwit. He was survived by his brother Pierre and his father in a song. They treasured a picture of Gaspar's funeral, which is now the extraordinary portrait of the start of an outbreak.

Judo, Gaspar's son, is now dead. Michael, Gaspar's nephew, dead. Deceased. Deceased. I don't know the origins of this disease. Only God knows. I'm not a scientist. I'm a person. I too hope to learn its origin. Somewhere in this vast forest lives an organism which harbors the Ebola virus. Now the international team can narrow down their search to the area surrounding Gaspar Minga's home and work. What we have probably is a disease that occurs in nature and very accidentally transfers to a human being. Now what we've done is to try and follow the so-called index case, the first person who was infected and who essentially was the beginning of this terrible epidemic.

They trace Minka's steps back to his last working place. This is a charcoal pit. It takes three months to do the entire process at one charcoal site for which the man earns 15,000 zaire, which is about three dollars. Three months hard work. The gentleman who was the index case here had nearly completed this pit. Rather, sadly, he left over here his hoe in the tree and little bundle of cloth. And of course nobody will touch that now. Searching the area around Minga's charcoal pit, Paul Ryder and his colleague Russ Coleman use a goat as bait, hoping to determine whether an insect might be Ebola's carrier. This disease is a great enigma. It has appeared only a few times in history. In every case the tremendous contagious nature of the disease has captured people's imagination. When this whole expedition began the safety issues were discussed at great length.

There's certain behaviors that can put us at risk. We're out here now and you know we're collecting insects and it's a remote possibility. We're trying to avoid any bites or anything. We wear insect repellent. We've got our clothes treated with permethrin to keep them off. So we're trying to minimize any of that risk. This is a challenge of a kind that is very hard to describe. Of course there's human tragedy involved and we would like to think that the work that we do will help alleviate that kind of tragedy in the future. It's natural history in its most vibrant form. We are looking at all the creatures of the forest and trying to understand how they interact in this one particular way.

Other teams set out to trap rodents and small mammals in the hope that one of their captured specimens will prove to be Ebola's natural host. Breakfast. They turn their field camp into a laboratory as they prepare to measure and dissect their samples. Two five eight. Villagers look on with amusement as the team cautiously handles animals local people eat for lunch. Many people have looked at specimens in prior outbreaks and no one has found anything yet. So I suppose from that point of view it means that our chances of success are slim, but on the other hand, if no one ever looks, no one's ever going to find it. There's a dead body in that house. I asked you yesterday if anyone was sick. You said no. Back in town, a crowd gathers. The medical students have found a new victim. To them, If they aren't bleeding, they're not sick.

Now we find a dead body. The education campaign has turned out to be a double-edged sword. No longer mourned in traditional ceremonies, some victims are abandoned by their families, who fear any contact may prove fatal. The medical students must make sure that no one touches the body, which is teeming with Ebola. Close the door. Tie it shut.

Aware of the risks, but not equipped to handle them, they are forced to improvise. Wait, wait. Don't take them off like that, no. I know. Put them over there in the hole. No, I should burn them. You take them and throw them over there. Yes, I know it's dangerous. Throw it in the hole. It's deep enough. It's dangerous for the kids.

No, no, no. It's deep enough. Can't we burn them? Their function now understood, the Red Cross teams are greeted with relief. chillingly efficient disposal. Although Ebola is a ruthless killer, it is not totally without mercy. The medical team now finds that one in five patients are still alive. They survived Ebola. These convalescents no longer show symptoms of the illness, but they are still confined to the hospital because the virus remains in their blood and can be transmitted through bodily fluids.

No one knows how these patients develop this strong immune response, the antibodies that save them. Since there is no cure for the virus, I know that God must have cured me. God cured me. Suddenly, a frightening new case arises. Yesterday we admitted a new case, one of our nurses. She's here in the emergency ward now, and the clinical diagnosis is Ebola. To see a nurse with whom you've worked every day sick with this disease is terrible and I really don't want to see her die. Nicole Organa worked alongside the doctors, always in full protective gear. Somehow she became infected. The doctors suddenly feel vulnerable.

The Zairean physicians devise a plan, one that is experimental. They know that the blood of survivors has antibodies against the virus. They reason that if they transfuse Nicole with that blood, perhaps those antibodies will save her. They take Nicole's blood to type it. Before deciding whether to proceed with their plan, they must find a convalescent with the same blood type. A few last cases show up in the isolation ward. The battle for Nicole's life may be critical for them. As they go about their rounds, the Zairean doctors know that with each passing hour, Nicole's chances for survival decline. Even as they help other patients, the doctors become increasingly convinced that they must execute their plan to save Nicole and perhaps these final few patients as well.

The foreign members of the team are against the treatment. There's basic risk in giving an individual blood products from someone else. There's a lot of infectious risk. There's HIV is very prevalent. There's hepatitis B, hepatitis C. Certainly in that setting one of the greatest concerns would be if the person that you're treating doesn't have Ebola, if they have malaria or typhoid or something else and the person that you're getting the transfusion from still has Ebola virus circulating in their blood and is infectious, but that would be the worst thing you could do, is to give someone who didn't have Ebola, Ebola.

The Zaireans test Nicole's blood and find a convalescent with matching type. Now they must make a decision. Knowing that the foreign doctors are opposed, they meet privately. What if we transfuse convalescent plasma to someone who doesn't have Ebola? What if our diagnosis is wrong? It's clearly a clinical case. It's obvious she has Ebola. We shouldn't doubt our diagnosis. We've seen so many cases now. We should at least wait until tomorrow. In the meantime, let's present and defend our position in front of the scientific community.

What do you think? In America, they don't believe in transfusing patients with convalescent blood. Never mind, we should answer to ourselves. I think we have to try this experiment. Maybe not on every one of these last few cases, but at least on our nurse. Personally, I think we could have transfused her this morning. The diagnosis is clearly Ebola, so I don't see why we should wait another 24 hours. Okay, I think we all agree that we do the transfusion. And that we should do it as soon as possible. Their decision made, the doctors approach a convalescent patient whose blood type matches Nicole's.

