U.S. Team Goes to Zaire to Probe Lethal Illness : Africa: Doctors will stay ‘as long as it takes’ to find cause. Researcher links deaths to Ebola virus.

A team of federal disease detectives was dispatched to Zaire on Wednesday to investigate a deadly outbreak of what health officials strongly suspect is viral hemorrhagic fever--a devastating illness that can cause death within days by dissolving the body’s organs.

Three physicians from the Atlanta-based Centers for Disease Control and Protection, armed with a high level of protective gear--suits, gloves, respirators and goggles--will conduct a full range of field epidemiological studies and will remain in Zaire “as long as it takes” to find answers, said Bob Howard, a CDC spokesman.

The mysterious outbreak, which originated in Kikwit, a town in southwestern Zaire near the Angola border, has killed and sickened scores of people, health officials said.

There have been conflicting accounts of the caseload and death toll and confusion about whether the illnesses were caused by the same or different agents. Some accounts placed the death toll at 100 people or more.

At least 59 people have died among 189 known cases of bloody diarrhea between Jan. 1 and April 24, which may have been caused by shigellosis or typhoid fever, the World Health Organization said Wednesday.

But 33 more cases of suspected hemorrhagic fever have been reported in the same town between Feb. 6 and April 8, raising the possibility that all of the illnesses and deaths could have been caused by viral hemorrhagic fever, WHO said.

The deaths included 10 members of a medical staff, among them two Italian nuns working in a local hospital.

State television in the country reported Wednesday that authorities had effectively sealed off Kikwit, a city of about 500,000 people.

In Belgium, the international medical aid group Doctors Without Borders said a second city may also have experienced an outbreak of viral hemorrhagic fever, according to the Associated Press.

The group reported that at least 10 people in Mosango, 75 miles west of Kikwit, have been infected with what is believed to be the disease, spokeswoman Gerda Bossier said. Three of the 10 have died. The group has sent a team to Zaire to investigate.

Late Wednesday, a CDC researcher said in a television interview that the outbreak has been linked to Ebola, one of the deadliest viruses known. That conclusion came after CDC biologists tested blood and tissue samples from infected patients in Kikwit that they received earlier this week.

“We do have preliminary evidence in the laboratory that it is the Ebola virus,” said Dr. Ruth Berkelman, deputy director for infectious diseases at the CDC, on the NBC-TV news show “Nightline.”

Global health officials sought to play down any anxieties that may be raised by parallels to a recent spate of books, such as “The Hot Zone,” and films, such as “Outbreak” and “Virus,” which have dealt with the scenario of widespread public panic during a killer outbreak of a viral disease modeled after Ebola.

“We will be trying to determine who may have had contact with patients and what the route of the infection might be,” CDC spokesman Howard said. “We are always interested in controlling and preventing the spread of the disease, which is why we work so closely with the host government in these cases.”

Ebola, recognized as the cause of outbreaks in Zaire and nearby Sudan in 1976 and another in Sudan in 1979, is marked at its onset by flu-like symptoms, including malaise, fever and headache. That is followed by more severe symptoms, among them rashes, vomiting, bloody diarrhea and blood coming out of the ears and eyes. The incubation period is two to 21 days.

There is a high mortality rate associated with the illness. Death is typically caused by kidney and liver failure, as these normally solid organs begin to soften and deteriorate. There is no specific treatment or vaccine.

The virus is transmitted through blood, semen and other body secretions, and through contaminated needles and syringes. It is not spread through casual contact. In developing countries, it can be spread as a result of poor medical hygiene.

If it is carried by an animal species, it can jump to humans when, for example, an individual comes into contact with infected blood.

Although Ebola has been found in animals--specifically monkeys--the natural “reservoir” of the virus is unknown, despite extensive studies. There have been no reports of Ebola outbreaks since the previous episodes in Zaire and Sudan, although a virus similar to Ebola was detected in a shipment of monkeys imported to the United States in 1989.

The Ebola virus takes its name from the area of Zaire where it was first identified. In its previous outbreaks, 500 people were infected, with mortality rates as high as 80%, WHO said.

The CDC experts are part of an international team organized by WHO, which includes officials from the Pasteur Institute in Paris and the National Institute for Virology in Johannesburg, South Africa.

CDC experts will interview patients, care-givers and family members in an attempt to track and contain the route of infection and will take additional samples of blood and tissue for further analysis, Howard said.

Dr. Giorgio Torrigiani, director of WHO’s division of communicable diseases, said that the team was sent “at the urgent request of the government of Zaire” and “(we) will provide as much help as we can.”

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Deadly Outbreak in Zaire

Outbreaks of what is believed to be the Ebola virus have been reported in Kikwit and 75 miles in Mosango.

ABOUT EBOLA VIRUS

Background: Ebola was considered the most deadly virus before the appearance of HIV, which causes AIDS. The Ebola virus belongs to a class of organisms called filoviruses, which destroy the linings of capillaries and blood vessels, prompting fluids to drain out of the circulatory system. The virus’s course is painful, and victims typically become deranged and manic before dying of shock.

Mortality rate: It kills about 80% of those it infects.

Treatment or vaccine: None

Infection length: People who develop Ebola become ill one week after infection and usually die one week later.

How is spreads: Through body fluids and secretions, though not through casual contact. The World Health Organization considers blood contract to be the primary way it is spread. For example, most of the 274 deaths seen during a 1976 epidemic were traced to a Roman Catholic mission hospital that used the same three syringes on about 500 patients a day.

Past outbreaks: Yambuku, Zaire, in 1976, where it killed 274 people, and Nzara, Sudan, in 1976 and 1979. Caused by poor hospital hygiene.

Source: Times wire reports