1976 OUTBREAK IN ROUGHLY THE SAME REMOTE AREA IN THE CONGO AS OUTBREAK NOW
The first ever outbreak of Ebola in the world, in Congo in 1976 was caused by injections administered in a remote mission hospital, according to a report on the outbreak written by an international commission.
The report “Ebola haemorrhagic fever in Zaire, 1976” was written in 1978 and appeared in the Bulletin of the World Health Organization.
Congo was called Zaire until 1997.
The report states that the first person to get sick with Ebola did so five days after receiving an injection against malaria at Yambuku Mission Hospital, and almost all the following Ebola cases had received injections at the hospital or had had close contact with another case.
Wikipedia also references the report but the link to it on WHO’s website appears to be broken.
The current outbreak in Bas Uele is relatively close to Yambuku.
Medecins sans Frontieres is active in the Congo.
The index case in this outbreak had onset of symptoms on 1 September 1976, five days after receiving an injection of chloroquine for presumptive malaria at the outpatient clinic at Yambuku Mission Hospital (YMH). He had a clinical remission of his malaria symptoms.
Within one week several other persons who had received injections at YMH also suffered from Ebola haemorrhagic fever, and almost all subsequent cases had either received injections at the hospital or had had close contact with another case.
Most of these occurred during the first four weeks of the epidemic, after which time the hospital was closed, 11 of the 17 staff members having died of the disease. All ages and both sexes were affected, but women 15-29 years of age had the highest incidence of disease, a phenomenon strongly related to attendance at prenatal and outpatient clinics at the hospital where they received injections. The overall secondary attack rate was about 5%, although it ranged to 20% among close relatives such as spouses, parent or child, and brother or sister.
Active surveillance disclosed that cases occurred in 55 of some 550 villages which were examined house-by-house. The disease was hitherto unknown to the people of the affected region.
Both the incubation period, and the duration of the clinical disease averaged about one week. After 3-4 days of non-specific symptoms and signs, patients typically experienced progressively severe sore throat, developed a maculopapular rash, had intractable abdominal pain, and began to bleed from multiple sites, principally the gastrointestinal tract. Although laboratory determinations were limited and not conclusive, it was concluded that pathogenesis of the disease included non-icteric hepatitis and possibly acute pancreatitis as well as disseminated intravascular coagulation.
This syndrome was caused by a virus morphologically similar to Marburg virus, but immunologically distinct. It was named Ebola virus. The agent was isolated from the blood of 8 of 10 suspected cases using Vero cell cultures. Titrations of serial specimens obtained from one patient disclosed persistent viraemia of 106.5-104.5 infectious units from the third day of illness until death on the eighth day. Ebola virus particles were found in formalin-