The Atlanta Journal-Constitution
Sunday, January 11, 2009
The local doctor in the remote Ugandan district had just died from Ebola. The death toll mounted as a newly discovered strain of the gruesome disease spread through the Bundibugyo region. Authorities erected isolation tents for incoming patients. Fear was rampant.
Dr. Eileen Farnon, an epidemiologist in the Centers for Disease Control and Prevention’s Special Pathogens Branch, was relatively new to the team dispatched to this “hot zone” in December 2007. But she knew the drill required to enter the hospital’s Ebola ward: Put on the bunny suit, rubber boots, thick apron, mask and goggles. This was her third visit in a year to Africa to investigate outbreaks of Ebola or its deadly viral cousin, Marburg hemorrhagic fever.
“Health care workers were afraid they were exposed; everyone was on high alert,” said Farnon, recently recalling the tents packed with patients lying on mattresses on the ground next to vomit buckets. Her job was to extract blood for testing and information for tracking.
Once again, Farnon’s unit is keeping track of another Ebola outbreak, reported recently in the Democratic Republic of Congo. It’s the same place she was in September and October of 2007, when the virus sickened 264 people and killed 187, a 71 percent mortality rate. This time, the virus seems to be contained, so she doesn’t think her team will return —- unless things deteriorate.
It’s been trial by immersion for the 36-year-old Atlanta resident, who alternately refers to her current position as “my first real job” and “my dream job.”
For most, jetting off to the Earth’s far corners to face deadly diseases and encounter sick and terrified locals would be a nightmare. But Farnon and others in her unit live for this.
“Each outbreak is clearly a tragic event, but it’s an opportunity for us to learn how these diseases work,” she said.
“We had a good year,” joked her boss, Pierre Rollin, a veteran of many outbreaks who was scheduled this weekend to travel to the Philippines, where Ebola was recently found in pigs. “That has never been seen before.”
It was Rollin and his comrades who helped Farnon decide on her career path in 1996. He was on the CDC “hot zone” team investigating an Ebola outbreak a year earlier that killed more than 250 people in Zaire (now the Democratic Republic of Congo). She was a lab tech with a sense of adventure and an inner detective when she saw Rollin on an episode of the TV documentary “Nova.”
“I said, ‘You know, that’s kind of what I’d like to do,’ ” she recalled. Soon, she was in medical school.
Ebola has been a mystery since it surfaced in 1976. Simultaneous outbreaks in Sudan and Zaire killed more than 400 people. Its origin is unclear, as is how it is transmitted. (Bats are now a focus.) It seems to appear out of nowhere and then disappear. There is no known effective treatment or vaccine.
The random and utterly destructive nature of the virus —- blood often flows from orifices, including the eyes, and an outbreak can kill up to 90 percent of its victims —- turns a region suffering an Ebola outbreak into a very scary place.
Add to the mix outsiders in protective garb and things can get weird.
Dave Daigle, a CDC spokesman who has traveled to outbreaks, said soldiers in gear arrived in one village and quickly and efficiently got rid of bodies —- further terrifying the population.
Farnon said visiting health care workers have learned to go slow with residents and, when possible, approach them wearing normal garb. It can be difficult to gain trust from suspicious, frightened people.
“It’s important to explain what you are doing, why you are there,” she said. Farnon’s upbringing —- her father was a teacher, her mother a doctor —- made her a natural at explaining issues in an engaging and thorough way.
Her job is to link and gather information from clinicians, lab people and the local population and then communicate the results back to the residents. The teams gather information to try to determine the origin of the virus and its path. That way it can be contained and, ultimately, researchers can learn something about the hard-to-crack disease. Talking to victims, their families and local officials is key. When did they first show symptoms? What were they doing before that? Who have they encountered?
Farnon must draw lines of personal contact and determine whether people in those lines have the virus. In doing so, she gets to know residents and their families and friends. “You have a window into people’s lives you’d never see,” she said. “You get to know families very well and in the end, it’s hard to leave them.”
Talking the infected into going to the hospital is vital.
“The fear is, they hear people go to the hospital to die,” she said. “You tell them they can get supportive care but they also put their family at risk by not going.”
Farnon is laid-back, but pride runs through the unit, which is said to be a bit of a hot-shot bunch.
She admits enjoying the adrenaline, the chase, the problem solving and the exotic cultures.
“It’s a unique field. It’s high-profile. There’s a certain amount of risk,” she said. “There is a bit of the cowboy mentality. It’s kind of like the military, a lot of team building.”
“It’s fascinating on one hand and, obviously, important for people’s health. There are so many unanswered questions.”
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