[Book Review] Ebola: The Natural and Human History by David Quammen

At 110 pages long, this book has been one of the shortest but most educational books I have read this year. It is dark, scary, and if it was any longer it’d probably have depressed me, but it’s one important read.

Let’s dig in, shall we?

As is a lot of [infectious] diseases, Ebola is forcefully African. Its history goes as far back as 1976, deep in the forests of Congo. Almost simultaneously, another independent outbreak was recorded in South Western Sudan, now part of the republic of South Sudan. Sporadic infections have occurred and recurred in other parts of Africa in subsequent decades-in Uganda, Cote d’ivoire, Gabon and most recently in the epidemic that ravaged Guinea, Liberia, Sierra Leone and Nigeria in the years 2013 to 2016.

But in light of massive breakthroughs in medicine and research since 1976, why does the Ebola virus seem more potent than ever? That is primarily the question this book seeks to address, while making it abundantly clear that since 1976 nary anything has changed in our understanding of the virus, or our proximity to a vaccine.

Firstly, Ebola is extremely difficult to study. While widely speculated in the Scientific community to be some bat species, the reservoir animal that hosts the Ebola virus in between human outbreaks is still unknown. Science is yet to isolate a live Ebola virus from a bat [or any other animal], which is the gold standard in establishing that an organism is a reservoir for a pathogen. And this is not for a lack of trying. The problem is compounded by the fact that there are more than 1000 species of bats, accounting for about 25% of all animal species, making it a herculean endeavour for any research body.

Secondly, the Ebola virus disappears for years at a time between outbreaks, often furiously reappearing in stints at unpredictable locations.This means that its geographical distribution and physical manifestation can only really be well studied during an actual outbreak, which is difficult and risks further spreading it. As well, the fatality rates within a short time necessitates sparing use of guinea pigs, limiting the pace and scope of any scientific study.

Thirdly, there are quite a few known strains of the Ebola virus, all native to different parts of the world, majorly in Africa (Uganda, Cote d’ivoire, Sudan, DRC and Phillipines). When these strains have spread, they have had completely different outcomes and fatality rates. Presently, it is unknown whether these differences arise from the genetic makeup of the strains themselves or from physical and economic conditions of habitat locations such as diet, weather, medical access etc. It is also not very clear how Ebola [strains] affects other animals it infects (it seems to affect Chimps a lot more voraciously, but then again chimps in the wild don’t have the best medical care).

In summary, Ebola seems to consistently emerge from forested areas, and its spread is highly proliferated by poverty and traditional practises like washing the dead and reliance on traditional healers in areas with poor medical coverage. Be as it may, however, we are all sitting ducks; limited understanding of Ebola’s MO means it can re-emerge anywhere at any time in any part of the world. As of now, no one has the right answers, but at least we seem to know what the questions are.

(I’d recommend this book to everyone. It’s candidly and simply written, well sourced, and just the right length to have understand the magnitude of the problem).

Rating: 4/5 stars