This is the second of two parts. You can read Part 1 here.
THE next step of the International Commission investigating the 1977 outbreak of haemorrhagic fever in Yambuku, Zaire (now the Democratic Republic of Congo or DRC), was to pay antibody-positive people in the town to donate blood plasma for use in treating new patients. Though the blood was screened and found free of malaria or hepatitis-B infections, ‘virtually all had circulating filarial larvae, principally Loa Loa’, a parasitic worm. These filarial larvae are microscopic parasitic nematodes (roundworms) spread by deer fly. Infections were endemic in the region. Marburg and Ebola virus are also classified as ‘filovirus’ which means thread virus. Ebola virus was identified using electron microscopes as thread-like particles in the livers of victims. The Commission report questions the specificity of the Ebola antibody test, as the blood of four San Blas Indians in Panama, where there has never been an epidemic of Ebola, also tested positive for Ebola antibodies. Was a relationship between nematodes and either the sickness or the antibodies ever explored, or did it simply not fit the vaccine and viral pathogens paradigms?
The other 1976 outbreaks of an Ebola ‘variant’ occurred 500 miles away in Sudan between June and November. The first people to get sick worked in a cotton factory in the town of Nzara. The factory had resident rats and bats which investigators blamed as the animal source, without evidence. Factory workers were treated at an onsite clinic for minor medical issues and many, like the Yambuku mission teacher, were given injections of chloroquine to treat malaria. Once again the largest outbreak was associated with a hospital, in a nearby town called Maridi. Initial suspicions were that the illness was due to yellow fever, although smallpox and typhoid fever were also candidates.
At a 1977 symposium convened to review the outbreaks, one South African scientist observed, ‘In my limited experience the histology [study of tissue] of yellow fever, Marburg, Ebola, is so similar that a specific diagnosis is impossible on one specimen.’
Suspecting typhoid fever, the Sudanese themselves began a mass vaccination campaign. Another symposium attendee who was a member of the Yambuku investigation team questioned whether this vaccination campaign, during which 13,914 doses were given, played a role.
‘The hospital material for such a large number of vaccinations was certainly insufficient while the sterilisation procedures were the same as in Yambuku. Could not therefore injections have played an equally important role in the Sudan as in Yambuku?’ asked Dr Van Nieuwenhove. He pointed out that the death rate for hospitalised patients was 25 per cent in August but rose to 70 per cent in October following the vaccination campaign.
Dr Babiker of Sudan’s National Public Health Laboratory in Khartoum didn’t think there was a new disease at all, saying, ‘I think this historical information is probably meaningless because the noes [sic] are that the outbreak is probably not a new disease. But I think if [it] would not have spread to Maridi and Yambuku hospitals, no one would have remembered it. There has never been any outbreak like these before, because amplifying forces have not been there: a needle, an amazing remarkable social structure or a newly established teaching hospital where these kind of outbreaks can happen. You need this sort of secondary amplifiers to get a recognisable outbreak.’
How prophetic Dr Babiker was. Prior to 1995 Marburg and Ebola were identified infrequently, in sparse numbers and linked to laboratories and hospitals. That began to change in the mid-1990s when fears over bioterrorism were deliberately stoked in the US. Ebola took hold in the popular imagination as a horror disease after biological defence researchers who had worked at the US military’s Fort Detrick laboratory were interviewed for a 1992 New Yorker article. A book, The Hot Zone, described as a ‘non-fiction thriller’, and the movie version Outbreak followed.
In 1995 an outbreak of yellow fever in Gabon prompted a vaccination campaign. It was reclassified as Ebola after retrospective testing by the CDC found Ebola antibodies, the specificity of which had been found in 1977 to be questionable, in addition to yellow fever antibodies. Ebola and yellow fever share the same symptoms and are indistinguishable without laboratory antigen or PCR testing. Identifying a specific virus is necessary only for the purpose of developing vaccines. Yellow fever vaccines can themselves cause haemorrhagic fevers and the virus can be transmitted via the blood of the recently vaccinated. It is notable that the three cases identified as Marburg in the 1970s and 1980s which were not associated with laboratories occurred in travellers visiting Africa who would have been vaccinated as it was a WHO requirement for entry. High doses of beta-lactam antibiotics which are widely available over the counter in Africa can also cause bleeding disorders.
In practice the EID (emerging infectious diseases) narrative around disease hotspots is a pretext to introduce more surveillance laboratories to identify pathogens in poor countries, many of which like DRC are rich in rare and valuable natural resources such as gold or rare earth minerals needed for the ‘green economy’.
US military preparedness and biodefence preparedness are the principal drivers. Since the 2014 Ebola PHEIC in West Africa, the US military has been industriously building disease surveillance laboratory networks in the Middle East and West Africa. When Brigadier General Deydre Teyhen, from the Walter Reed Army Medical Research Institute of Infectious Disease, spoke at the Biodefense Commission’s Manhattan Project forum in July 2019, she explained that as per President Trump’s 2018 Biodefense Strategy (written by Dr Robert Kadlec), the US military operates a global research network to detect infectious disease and that half the authorised vaccines in use in the US were discovered, designed or developed at Walter Reed by US military researchers. ‘We often say our mission is ‘Soldier Health, World Health’ but in a lot of these countries that World Health, when you fight infectious disease, can lead to World peace,’ said Teyhen, referring to a report from two Biodefense Commissioners which justifies US biodefense programs by claiming that infectious disease outbreaks in developing countries could cause instability and armed conflict and need to be viewed as a threat to US national security.
To paraphrase Major General Smedley Butler, the decorated US Marine who exposed the bankers’ coup to install a fascist dictatorship in America in 1933, the ‘War on Microbes’ is a racket. Seek and ye shall find – and pharma riches will follow, could be its motto. If it’s not, it should be because there’s no doubt that the 21st century business model for the biodefence industry depends on steadily churning out new vaccines for every manner of new viruses, or variants of old viruses however questionable the need or the science is.