Interview with Ebola Discoverer Peter Piot 'It Is What People Call a Perfect Storm'
Almost four decades ago, Peter Piot was part of the team that discovered the Ebola virus. In a SPIEGEL interview, he describes how the disease was isolated and explains why the current outbreak is different than any that have come before.
SPIEGEL: Professor Piot, as a young scientist in Antwerp, you were part of the team that discovered the Ebola virus in 1976. How did it happen?
Piot: I still remember exactly: One day in September, a pilot from Sabena Airlines brought us a shiny blue thermos and a letter from a doctor in Kinshasa in what was then Zaire. In the thermos, he wrote, there was a blood sample from a Belgian nun who had recently fallen ill from a mysterious sickness in Yambuku, a remote village in the northern part of the country. He asked us to test the sample for yellow fever.
SPIEGEL: These days, Ebola may only be researched in high security laboratories. How did you protect yourself back then?
Piot: We had no idea how dangerous the virus we were dealing with was. And there were no high security labs in Belgium back then. We just wore our white lab coats and protective gloves. When we opened the thermos, the ice inside had largely melted and one of the vials had broken. Blood and glass shards were floating in the ice water. We fished the other, intact test tube out of the slop and began examining the blood for pathogens using the methods that were standard at the time.
SPIEGEL: But the yellow fever virus apparently had nothing to do with the nun's illness.
Piot: No. And the tests for Lassa fever and Typhoid fever were also negative. What, then, could it be? Our hopes were dependent on being able to isolate the virus from the sample. To do so, we injected it into mice and other lab animals. At first, nothing happened for several days. We thought that perhaps the pathogen had been damaged from insufficient refrigeration in the thermos. But then, one animal after the next began to die. We began to realize that the sample contained something quite deadly.
SPIEGEL: But you continued?
Piot: Other samples from the nun, who had since died, arrived from Kinshasa. When we were just about able to begin examining the virus under an electron microscope, the World Health Organization instructed us to send all of our samples to a high security lab in England. But my boss at the time wanted to bring our work to conclusion no matter what. He grabbed a vial containing virus material to examine it, but his hand was shaking and he dropped it on a colleague's foot! The vial shattered. My only thought was: "Oh shit!" We immediately disinfected everything and luckily our colleague was wearing thick leather shoes. Nothing happened to any of us.
Peter Piot, second from left, on site in Yambuku during the first Ebola outbreak in 1976.
Piot: Yes, and our first thought was: "What the hell is that?" The virus that we had spent so much time searching for was very big, very long and worm-like. It had no similarities with yellow fever. Rather, it looked like the extremely dangerous Marburg virus, which, like Ebola, causes a hemorrhagic fever. In the 1960s, the virus killed several laboratory workers in Marburg, Germany.
SPIEGEL: Were you afraid at that point?
Piot: I knew almost nothing about the Marburg virus at the time. When I tell my students about it today, they think I must come from the Stone Age. But I actually had to go the library and look it up in an atlas of virology. It was the American Centers for Disease Control which determined a short time later that it wasn't the Marburg virus, but a related, unknown virus. We had also learned in the meantime that hundreds of people had already succumbed to the virus in Yambuku and the area around it.
SPIEGEL: A few days later, you became one of the first scientists to fly to Zaire.
Piot: Yes. The nun who had passed away and her fellow sisters were all from Belgium. In Yambuku, which had been part of the colony Belgian Congo, they operated a small, mission hospital. When the Belgian government decided to send someone, I volunteered immediately. I was 27 and felt a bit like my childhood hero Tintin. And I have to admit, I was intoxicated by the chance to track down something totally new.
SPIEGEL: Was there any room for fear, or at least worry?
Piot: Of course it was clear to us that we were dealing with one of the deadliest infectious diseases the world had ever seen -- and we had no idea that it was transmitted via bodily fluids! It could also have been mosquitoes. We wore protective suits and latex gloves and I even borrowed a pair of motorcycle goggles to cover my eyes. But in the jungle heat, it was impossible to use the gasmasks that we bought in Kinshasa. Even so, the Ebola patients I treated were probably just as shocked by my appearance as they were about their intense suffering. I took blood from around 10 of these patients. I was most worried about accidentally poking myself with the needle and infecting myself that way.
SPIEGEL: But you apparently managed to avoid becoming infected.
Piot: Well, at some point I did actually develop a high fever, a headache and diarrhea ...
SPIEGEL: ... similar to Ebola symptoms?
Piot: Exactly. I immediately thought: "Damn, this is it!" But then I tried to keep my cool. I knew the symptoms I had could be from something completely different and harmless. And it really would have been stupid to spend two weeks in the horrible isolation tent that had been set up for us scientists for the worst case. So I just stayed alone in my room and waited. Of course I didn't get a wink of sleep, but luckily I began feeling better by the next day. It was just a gastrointestinal infection. Actually, that is the best thing that can happen in your life: You look death in the eye, but survive. It changed my whole approach, my whole outlook on life at the time.
SPIEGEL: You were also the one who gave the virus its name. Why Ebola?
Piot: On that day, our team sat together late into the night -- we had also had a couple of drinks -- discussing the question. We definitely didn't want to name the new pathogen "Yambuku virus" because that would have stigmatized the place forever. There was a map hanging on the wall and our American team leader suggested looking for the nearest river and giving the virus its name. It was the Ebola River. So by around three or four in the morning, we had found a name. But the map was small and inexact. We only learned later that the nearest river was actually a different one. But Ebola is a nice name, isn't it?
SPIEGEL: In the end, you discovered that the Belgian nuns had unwittingly spread the virus. How did that happen?
Piot: In their hospital, they regularly gave pregnant women vitamin injections using unsterilized needles. By doing so, they infected many young women in Yambuku with the Ebola virus. We told the nuns about the terrible mistake they had made, but looking back I would say that we were much too careful in our choice of words. Clinics that failed to observe this and other rules of hygiene functioned as catalysts in all additional Ebola outbreaks. They drastically sped up the spread of the virus or made the spread possible in the first place. Even in the current Ebola outbreak in West Africa, hospitals unfortunately played this ignominious role in the beginning.
SPIEGEL: After Yambuku, you spent the next 30 years of your professional life devoted to combating AIDS. But now, Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?
Piot: No, not at all. On the contrary, I always thought that Ebola, in comparison to AIDS or malaria -- didn't present much of a problem because the outbreaks were always brief and local. Around June it became clear to me that there was something fundamentally different about this outbreak. At about the same time, the aid organization Doctors Without Borders sounded the alarm. We Flemish tend to be rather unemotional, but it was at that point that I began to get really worried.
SPIEGEL: Why did WHO react so late?
Piot: On the one hand, it was because their African regional office isn't staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for hemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard. But since August, WHO has regained a leadership role.
SPIEGEL: There is actually a well-established procedure for curtailing Ebola outbreaks: isolating those infected and closely monitoring those who had contact with them. How could a catastrophe such as the one we are now seeing even happen?
Piot: I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic, there were many factors that were disadvantageous from the very beginning. Some of the countries involved were just emerging from terrible civil wars, many of their doctors had fled and their healthcare systems had collapsed. In all of Liberia, for example, there were only 51 doctors in 2010, and many of them have since died of Ebola.
SPIEGEL: The fact that the outbreak began in the densely populated border region between Guinea, Sierra Leone and Liberia ...
Piot: also contributed to the catastrophe. Because the people there are extremely mobile, it was much more difficult than usual to track down those who had had contact with the infected people. Because the dead in this region are traditionally buried in the towns and villages they were born in, there were highly contagious Ebola corpses traveling back and forth across the borders in pick-ups and taxis. The result was that the epidemic kept flaring up in different places.
- Part 1: 'It Is What People Call a Perfect Storm'
- Part 2: 'An Outbreak in Europe Would Quickly Be Brought Under Control'