Wednesday, December 2, 2015

Part One: In the Shadow of Mount Elgon


PART ONE

Charles Monet – Marburg Virus
The book begins by discussing a man by the name of Charles Monet who lived in western Kenya.  He was known for spending a lot of time with animals, specifically wild monkeys and birds.  He and a female friend, whose name is unknown, went on a trip to Mount Elgon on New Year Eve. The exposure they had to animals was discussed in detail.  Monet fed a wild monkey while it sat on his shoulder. They then set up their tent in an area with buffalo feces on the grass. Trees containing olives poisonous to humans also surrounded the area and monkeys feeding on the olives were living in these trees. The next morning, Monet and his friend visited Kitum Cave. There the platform in which they walked on contained elephant feces as well as bat guano (digested feces).  The cave was described as a petrified rain forest containing needle-like crystals everywhere. After the trip, Monet went back to work as usual. However, one week later he began to have a headache. As time passed, he began to show other symptoms including a backache, fever, nausea, and vomiting.  His personality began to change and his eyes turned red and droopy, his skin turned yellow and began to bruise, and he no longer seemed to understand where he was. His coworkers took him to the hospital where the doctors could not diagnose him. He was sent to another hospital via commercial airplane and his condition worsened on the flight. He began to vomit black and red vomit and eventually got a nosebleed.  Once the plane landed, he went straight to the hospital via taxi and was told to wait to be attended in the Casualty Department along with other patients. There he collapsed on the floor, lost consciousness, and yet continued to vomit and began to bleed out from his anus.

Dr. Musoke – Marburg Virus
Dr. Shem Musoke and several nurses got Monet onto a gurney and took him to the ICU. There Dr. Musoke tried to treat him while wearing no gloves. Blood ended up getting all over Dr. Musoke including in his mouth and eyes. That night Monet died and Dr. Musoke stayed by his side all night. Nine days after the blood and vomit got into Dr. Musoke’s eyes and mouth he began to get a backache and then his eyes turned red.  He got an injection for an antimalarial drug and it caused him more pain than an injection should cause. Other symptoms began to develop including jaundice, abdominal pain, and images revealed that his liver was enlarged. Dr. David Silverstein performed surgery on Dr. Musoke and ended up having trouble stopping Dr. Musoke’s bleeding. His blood was losing its ability to clot. After the surgery Dr. Silverstein sent some of Dr. Musoke’s blood samples to the CDC. Dr. Musoke was diagnosed with Marburg virus. Dr. Silverstein treated him with supportive care and Dr. Musoke was able to survive the virus.

Peter Cardinal – Marburg Virus
A 10-year-old named Peter Cardinal became sick after visiting Kitum Cave with his family. His eyes turned red and doctors though he had malaria. He was having trouble breathing and x-rays demonstrated watery mucus developing in his lungs. His skin had red spots and his fingertips turned blue. His skin then began to spontaneously bruise and his pupils dilated indicating brain death. His skin then began to fill with blood, to the point where it was almost separated from his flesh. Cardinal then died.

Ebola Sudan Victims
The first known case of Ebola Sudan was Mr. Yu. G. in southern Sudan.  No one knows how he was infected but he infected two of his workers. After Mr. Yu G.’s death his coworkers bled, went into shock, and died of massive hemorrhages.  The virus spread and ended up in a hospital in Maridi. The virus jumped from patient to patient quickly because the medical staff had been using dirty needles for injections. Eventually the remaining staff fled and the virus subsided because there were no more dirty needles being used and other people had not come in contact with the blood of the infected patients.

Ebola Zaire Victims
The Ebola Zaire strain was twice as lethal as Ebola Sudan. It appeared in a district by the name of Bumba Zone in northern Zaire. The first human case remains unknown however the disease surfaced in a clinic run by nuns called the Yambuku Mission Hospital. A schoolteacher had taken a trip to northern Zaire where he and his friends bought antelope and monkey meat. Upon returning from the trip his wife cooked it and they ate it. He began to feel sick and got an injection at the clinic. The nuns used the same five syringes on hundreds of patients all day and did not clean the regularly. It is unknown whether the man got infected during the trip, from the meat, or from the injection with the dirty needle. The virus erupted simultaneously in 55 villages surrounding the clinic. Many nuns were infected and died. Sister M. E. was infected and taken to Ngaliema Hospital in Kinshasa, Zaire where she died. Sister E. R. accompanied her and ended up getting infected and dying as well. Nurse Mayinga N. was infected with the virus. She was in denial and travel around town for 2 days. Eventually she returned to the hospital and died. Nobody that she came in contacted with during her days in town was infected.

Marburg Virus
Marburg virus is a ring shaped filovirus. A filovirus is a virus that is shaped like a thread. Marburg virus affects the central nervous system as well as the brain. Signs and symptoms include headaches, red eyes, backaches, fever, nausea, vomiting, depersonalization, and spontaneous bruising. Other symptoms include jaundice, abdominal pain, and the blood looses its ability to clot. Before dying the victim can undergo different types of spacing. First space is when you bleed out into your lungs. Second space is when you bleed into your stomach and intestines. Third space is when you bleed into the space between the skin and the flesh and they eventually become separated.

Ebola Sudan
It is twice as lethal as the Marburg virus. Ebola Sudan causes bleeding and shock. Signs and symptoms include mental derangement, psychosis, and depersonalization. Massive hemorrhages from all openings of the body occur and then the victim dies. The mortality rate for Ebola Sudan is 50%.

Ebola Zaire
Ebola Zaire is almost twice as lethal as Ebola Sudan. This strain attacks every organ and tissue in the body except skeletal muscle and bone. Clots appear in the bloodstream and block blood supply to different parts of the body. The skin develops petechiae (red spots that signify hemorrhages under the skin). The connective tissue in the body is liquefied and the skin develops a maculopapular rash. This rash consists of tiny white blister mixed with red spots. Rips appear in the skin from which blood comes out of and the skin begins to bruise. Every opening in the body begins to bleed and the surface of the tongue sloughs off. The heart muscle softens and bleeds into itself, the brain becomes clogged with dead blood cells, and the eyeballs are filled with blood which and leads to blindness. Even though the body is filed with blood clots, the bleeding that occurs outside of the body cannot clot. He liver, kidneys, and intestines are also destroyed and the spleen turns into one big blood clot. Ebola patients have epileptic convulsions during the final stage and after dying their bodies begin to dissolve.

Gerald and Nancy Jaax
Majors Gerald and Nancy Jaax where then introduced to the story. They are a married couple and are both veterinarians that work for the US Army. Major Nancy Jaax began to work with Ebola in the biosafety level four labs. She entered the lab without realizing that there was a hole in the glove of her space suit.  Blood from the monkey she was working on got into the glove but upon further inspection it turned out that the blood did not get passed the first layer of gloves she was wearing under the space suit. She later finds out that the two healthy monkeys in the lab somehow got infected with Ebola. She realized Ebola is airborne.

Part One Reaction

As I was reading this part I found myself forgetting that the victims where not aware of the disease or their exposure to it. Because of my previous knowledge about viruses I was able to recognize the actions that lead to their infections. For instance, when Monet was in the cave the detailed description of the animal feces everywhere and then the sharp crystals were a clear indication that he would begin showing symptoms of the virus soon after the trip. I was in utter shock when the doctors sent him to another hospital via commercial airplane and then again when Dr. Musoke was attending to him with no gloves on. The book became suspenseful when Nancy Jaax was working with Ebola in the lab. I too felt fear for her as she was removing the layers of gloves to see of the money blood had gotten to the cut on her hand and then relief when it was revealed that it had not. After it was known that Peter Cardinal had visited Kitum Cave I too felt Eugene Johnson’s excitement for the expedition to the cave. It was disappointing that when there they could not find the source of the virus and even more disappointing that they had to euthanize the monkeys even though they were not infected.





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