Update, August 30, 2014

A Tragic Toll: Several Authors of an Ebola Study Died From… Ebola

By
Betsy McKay

A new study reveals in a personal and tragic way the horrific toll the Ebola outbreak is taking, including on health workers.

Six authors of the paper – which was published online in Science and analyzed sequenced Ebola strains – died before it went to press. Five of the deaths were attributed to Ebola and one to a stroke that a colleague believes was due at least in part to stress from the physical and emotional toll the epidemic took. They include three nurses, two laboratory technicians and a physician.

“These are all people we worked with on Lassa fever together for seven years,” says geneticist Pardis Sabeti, who is the lead author on the paper and an associate professor at Harvard University’s Center for Systems Biology. She is also a senior associate member of the Broad Institute of Harvard and MIT, which has been collaborating with scientists in Sierra Leone on genetic variations in the Lassa fever virus. Like Ebola, this is a viral hemorrhagic fever.

Mbalu Fonnie, Alice Kovoma and Alex Moigboi – all of whom were nurses – contracted Ebola while caring for a fellow nurse, who was pregnant and infected with the virus. Mohamed Fullah worked as a technician in a Lassa fever lab and is believed to have caught Ebola from a family member. Sidiki Saffa, another technician in the same lab, died of a stroke, which Sabeti attributes to “the sheer stress he was under.”

The authors also included Sheik Humarr Khan, a top doctor in Sierra Leone who was helping lead his country’s response to the Ebola outbreak and whose death drew global attention and debate over whether he should have been given access to ZMapp. This is the experimental drug given to a small number of patients, including two American missionaries and three Liberian healthcare workers. Khan and others were supposed to visit Boston this summer to collaborate on a new program, Sabeti tells us.

The study itself shed some new light on the early days of the largest Ebola outbreak in history, and the virus causing it. The researchers analyzed 99 Ebola virus genomes collected from 78 patients who had Ebola in the first three weeks of the outbreak in Sierra Leone. Analyzing genetic changes, they concluded that the virus was likely brought to West Africa from Middle Africa within the last decade.

The outbreak began with an encounter by a single person with a source, or reservoir, of the virus, the researchers say. The virus then spread rapidly from one person to another, with family members and health care workers infecting themselves unintentionally, unaware of the cause of illness.

The researchers explain that the virus crossed from Guinea into Sierra Leone in May with the burial of a traditional healer who had been infected while treating Ebola patients in Guinea. The burial set off a chain of transmission in Sierra Leone, as 13 women who had attended the funeral contracted the disease. The researchers also found the virus mutated significantly and said more study is needed to figure out the impact of those changes, and that could affect the accuracy of diagnostic tests.

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On New Front Line, Some Ukrainians Lose Faith in Europe

By
James MarsonFighters Facing Russia-Backed Rebels Hope for Western Military Aid.

Residents assist Ukrainian troops in organizing defenses outside Mariupol on Friday.
Agence-France Presse/Getty Images

MARIUPOL, Ukraine—For several weeks last winter, bus driver Ivan Borys ferried people from his hometown in western Ukraine to and from the demonstrations in Kiev in favor of closer ties with the European Union.

Now, the 51-year-old holds a rifle in this southern port city, the newest front line of Ukraine’s confrontation with Russia—and wonders where Europe is now.

“They promised to help, but how are they helping?” Mr. Borys said, standing next to a truck that volunteers had armored with metal plates.

He said that Europe’s promotion of peace talks and a political solution—rather than throwing its weight behind Ukraine with weapons and other military assistance—has simply encouraged Russian aggression. “Do they want war?” he asked.

Many Ukrainians welcomed U.S. and EU support during the protests against a corrupt, pro-Russia government, when many Western politicians joined them on the main protest square in Kiev. But the West has tread cautiously since then in dealing with the aftermath, which has seen Russia invade and annex Crimea and support a rebellion in the country’s east.

In Mariupol, with Russian tanks a few dozen miles away, frequent European statements noting concern and calling for de-escalation bring snickers.

“What needs to happen for Europe to wake up?” said Dmitry Durnyev, a newspaper editor. “Should we blow up the gas pipeline?” he added, referring to the pipelines that deliver much of Europe’s natural-gas supply from Russia via Ukraine.

Many of the tens of thousands from across the country who risked life and limb on Kiev’s central square during violent protests in the winter to support Ukraine’s westward path now feel betrayed.

“This is a war between Russia and Ukraine, between democracy and dictatorship,” said a volunteer fighter near the front line.

Western sanctions against Russia—starting with travel bans and asset freezes on officials and companies, and widening in July to some economic sectors—have done little to deter Russian President Vladimir Putin from backing the separatists in the five-month conflict in Ukraine’s east.

As Kiev forces put the rebels on the defensive in recent weeks, Mr. Putin, who sees Ukraine as part of its sphere of influence, stepped up his support, providing men, heavy weapons and even regular army units, according to Western and Ukrainian officials. Russia denies this.

After the opening of a new front this past week by troops and tanks that the North Atlantic Treaty Organization says came over the border near Mariupol, U.S. and European officials said they would consider stepping up their sanctions again.

Ukrainian President Petro Poroshenko is flying to Brussels on Saturday to appeal to a summit of European leaders for stronger sanctions and, probably, military aid.

Western leaders also have given financial aid, but have said from the start that they won’t fight here. That hasn’t stopped some Ukrainians from dreaming of deliveries of large stocks of modern weapons and seriously crippling sanctions against Russia.

Many point to a 1994 memorandum where Ukraine received security assurances from the U.S., the U.K. and Russia in return for giving up its nuclear weapons. Also driving anger are France’s continued plans to sell two warships to Russia worth more than $1.5 billion.

To be sure, Ukraine’s government has also stumbled in its attempts to hold off Russia-backed forces. The men on the front lines in Mariupol are armed with little more than rifles and grenades.

Cars stuffed with belongings have been heading west out of town, away from the expected clashes. On Friday evening, downtown streets and cafes in this city of 500,000 were all but deserted.

Some of those who are left are doing what they can to aid the city’s defense. Volunteers from a group called New Mariupol drive from checkpoint to checkpoint bringing food and other supplies to soldiers.

In a downtown office Friday, six women sat unraveling burlap sacks and tying the fibers to nets to create camouflage for sniper positions. They have also helped equip a local hospital to treat those wounded in battle. Dozens of men have registered in a new volunteer battalion to defend the city.

The preparations, while full of enthusiasm, appear small-scale in contrast with what officials and fighters here say is a large Russian force of tanks, artillery and troops.

Maria Podybailo, a teacher in sunglasses and cargo pants who coordinates the volunteers, said she felt she had to do something.

“If I sat at home I’d go mad,” she said. “So I am doing this so I don’t go mad and help as well.”

A group of around 30 men and women grabbed shovels Friday to dig trenches around the roadblock on the road east out of the city toward the Russian border.

“It hurts,” said Oleg Zalishchuk, a 46-year-old window-fitter. “But people understand there will be no help.”

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