In the darkened doorway of an abandoned building, the medical team finds an empty coffin, waiting like carrion. One by one, neighbors explain, the family that lived there died. First the daughter, 18, went to the Kikwit 2 maternity hospital in late March for a caesarean section. When she got home her incision began to bleed. Then her organs began to melt. The red-black sludge wiggled out of her eyes, her nose, her mouth. Soon her parents got sick. Her father, some villagers believe, died of horror: he told his wife that if she died, he would die too on the next Friday. And he did, followed by another daughter, then two sons, and a nurse who had helped tend them.
Two houses away, a new widow sits and watches the visitors making their way through town. Her husband, she quietly admits, also helped take care of the sick family. Then he died. She buried his body, but the mattress where he lay sick is still in the house. Dr. David Heyman of the World Health Organization listens to her story, and his heart sinks. He knows as much about the lethal Ebola virus as anyone alive; he was part of the team that investigated the first recorded outbreak, also in Zaire, two decades ago. Now he is leading the international brigade that has come to the city of Kikwit to battle the new emergency. "The virus is still loose, and it's spreading," he says. "If the mattress is warm and damp, and people go in and sleep on it, we're going to be in trouble." The villagers are terrified, and resigned. "It's useless for us to do anything," says a neighbor, Mbangu Fioti. "What can we do against this disease?"
For a while last week it looked as though the outbreak might soon be brought under control. The plague police-medical teams dispatched by who in Geneva, the Centers for Disease Control and Prevention (cdc) in Atlanta and other public health groups-had set up an effective isolation ward at the main hospital in Kikwit, where the first case had been identified. Belgium's Doctors Without Borders (Medecins Sans Frontieres, or MSF) rushed in loads of gloves, gowns, masks and other essential equipment to restore hygiene to filthy clinics. But when the strike forces, aided by local medical students, fanned out through the countryside around Kikwit, trying to follow the path of the fever, it became clear that the danger was far from past.
The teams' job was to figure out who might have been infected already and to warn people at risk. At first doctors thought the victims could all be traced back to a 36-year-old lab technician named Kimfumu, who died at Kikwit's main hospital last month. But once they discovered the case of the woman infected even earlier at the Kikwit 2 maternity hospital, they realized the crisis was worse than they had imagined. "It's a huge epidemic," Heyman says of the previously unrecorded cases, "and it's got nothing to do with the main hospital." By week's end who doctors had counted 97 Ebola deaths, and the toll seemed certain to rise much higher. The only good news was that the disease had not yet spread-as far as anyone could tell-to the 4 million people of Kinshasa, 250 miles to the west.