Marburg strikes primarily in Central Africa (though it’s named for a German village where there was one outbreak, which is so sadly typical). In Central Africa, the most common funeral ritual is to wash the corpse and kiss it goodbye. The motivating belief is that the lack of a proper funeral will anger the spirit of the deceased and cause that spirit to seek vengeance. In the process of that ritual bathing, the five million Marburg viruses per drop of blood find their next victims. One has to appreciate the irony: the deceased exacts viral vengeance because his relatives do what they are supposed to do to avoid vengeance.
When Professor Huke said the virus was “beautiful” or “beautifully adapted” or whatever the phrase, he was right. Remember, we do not even agree on whether viruses are living things or not. We do know that they exist primarily to replicate themselves; the better a virus is at replicating itself, the better its chances of surviving for another hundred million years or so. Natural selection helps organisms that help themselves. When I was later thrust abruptly into the media spotlight, my first mistake was speaking like a microbiology professor. When I described Capellaviridae as “elegant”—I was at least politic enough not to call it “beautiful”—I meant only that it was well adapted from an evolutionary standpoint. My comment was meant to underscore the scientific challenge that we faced in breaking the chain of transmission. Obviously, with the risk of a pandemic hanging over the nation, I can understand how my comment was interpreted differently. I did not mean to be callous or indifferent. I have since apologized formally, but I will repeat the essence of that statement here: I was speaking as a scientist. I was speaking about a shockingly devilish and dangerous pathogen in the same way that a detective might describe a wily serial killer. I did not “admire” this raging virus, as Home Depot Media stupidly suggested. We had our work cut out for us—that was all. I assume, given my role in stopping the epidemic and saving untold lives, I can be forgiven my poor word choice.
7.
PROFESSOR HUKE FASCINATED ME. FIVE MINUTES INTO THE lecture, and I was already convinced that I should take the course, whether Sloan was in it or not. “Should you be worried about Marburg?” Huke asked the class. Most of the students nodded yes, but no one raised a hand to answer. “You’re nodding ‘yes,’” he said, making eye contact with a guy wearing a DARTMOUTH FOOTBALL cap in the second row. “Why?”
“Because I don’t want to bleed out of every orifice,” the guy in the football cap answered. There were titters from the class, as we each imagined bleeding to death out of our ears, nose, mouth, eyes, and asshole. Even Huke conceded with a little grin that the answer was clever, if not particularly deep.
“Fair enough. Do you think that’s likely to happen?” Huke asked.
“Not if I stay out of Central Africa,” Football Cap Guy said.
“What if it spreads? There are flights from Liberia to Brussels three times a week,” Huke prodded. He let this prospect sink in, before turning in my direction. He made eye contact and took a half step forward. “Are you worried?” he asked. I was four or five rows back, usually far enough to be safe from this kind of thing. He just looked at me, not rudely, but it was clear he was going to wait for an answer. Some of the students in the rows in front of me turned and looked back.
“Well, I wasn’t worried when I got out of bed this morning,” I said. “Now I am, I guess.” The class laughed again. Huke got the answer he was looking for.
“You can stop worrying. For all the horror of this virus, we’re talking about a couple of hundred cases a year. Even in the places where it’s endemic, the infection rate is extremely low,” Huke explained. There was a brief clicking of keyboards as students made a note of this fact, which felt like it could turn up on the midterm.
“What if it were used as a biological weapon?” a girl asked at the end of my row. Huke wheeled excitedly in her direction.
“We’ve been close! The Soviets had that capacity during the Cold War. They never used biological weapons, thankfully, but they had them. So, yes, you’re correct. If the goal were to inflict mass casualties on a population in a particularly horrific way, Marburg would be a good mechanism—as would a lot of the other organisms that we’re going to talk about in this class. So does that worry you?” The question was directed back at the girl in my row. She was a soccer player, tall and tan and fit, probably in KKG or one of the other popular sororities.
“Sure,” she answered earnestly.
“Well, you can relax, at least about Marburg,” Huke assured her. “Transmission requires direct contact with a victim’s bodily fluids. We can contain that. The outbreaks are horrible, but then they fade away as we sequester the victims. But smallpox, now, that’s a nasty little virus, far worse than Marburg because it spreads more easily.” There were clicking keyboards around the room. This stuff would definitely be on the midterm. I was typing along with the rest… “an airborne virus that can be inhaled, like the flu”… “the more serious form of smallpox, Variola major, kills thirty or forty percent of those who become infected”… “black pustules on the skin.”
Huke paused; the clicking keyboards continued for a few seconds as we caught up. Then he delivered his carefully scripted finale, the virus equivalent of that last burst of fireworks on the Fourth of July: “In the twentieth century, smallpox killed at least three hundred million people—more than the world wars, the Soviet purges, the Great Leap Forward, and just about every other man-made catastrophe combined.” He paused again. The typing stopped and most of us looked up. Then, when he had our full attention, he continued, “I was born in 1967. That year smallpox killed two million people around the world.”
“Holy shit,” someone exclaimed up front.
“Yes,” Huke answered. “That’s about right. You know what’s even crazier? Edward Jenner had invented the smallpox vaccine a hundred and fifty years earlier!” There was lots of clicking as Huke walked us through the mechanics of immunization… “infecting an individual with cowpox, a milder relative of the smallpox virus, causes the body to produce antibodies”… “wealthy countries developed mass immunization programs…”
“What happened on October twenty-sixth, 1977?” Huke asked with a dramatic flourish. I had no idea. I looked around the room; apparently no one else did, either. After the suspense mounted sufficiently, he told us: “The World Health Organization diagnosed the very last naturally occurring case of smallpox in Somalia. The very last case! After that, the WHO certified the global eradication of smallpox—the first and only time that we have completely triumphed over a major contagious disease.” Huke must have given this lecture twenty-five or thirty times in his career. Still, he was not faking the excitement. He thought this stuff was so remarkably cool that we had no choice but to share his enthusiasm. A disease that could kill two million people in a single year, wiped out by human ingenuity.
Huke walked us through the details, which felt more like an adventure story than biology. The developed countries had already eradicated the virus through immunization. That left the disease lurking in some of the poorest, most war-ravaged places on the planet. The goal was to identify outbreaks in those places and then contain them. Teams of public health experts were dispatched with radios to these forlorn outposts so they could call in any outbreaks. At the first sign of smallpox, the vaccine was rushed to the scene and anyone who had come into contact with the victim was immunized. “In some cases, guards were posted at the doors of infected households so no person could spread the disease,” Huke explained, relishing the detail. “The strategy was called surveillance and containment. And on October twenty-sixth, 1977, the very last case of smallpox on the planet was identified and isolated. That is how and why you live in a world free of that horrible disease.”