On Call: A Doctor's Journey in Public Service

by Anthony Fauci

The index case in Guinea, or the original person to whom the outbreak could be traced, was thought to be a two-year-old boy who died of Ebola virus disease in December 2013 in the village of Meliandou, Guéckédou Prefecture, Guinea. The boy’s home was near a large colony of Angolan free-tailed bats. Soon after he died, his mother, sister, and grandmother became ill with Ebola and died, as did several people close to the family who had helped care for the boy or who had attended his funeral and burial rites. As quickly became clear, the sacred traditions and customs of the West African people in expressing respect and affection for their deceased loved ones were a tragic source of spread of the infection. Relatives and friends washed the bodies that were often covered with infected materials in the form of blood, feces, urine, respiratory secretions, and other bodily fluids and embraced and kissed them as a way of saying goodbye. Traditional funerals became a major source of spread of the disease. As infected people left the young boy’s funeral and went to their respective homes, the infection spread rapidly to other villages. In addition, health-care workers whose personal protective equipment was inadequate as they cared for seriously ill patients were also at high risk of becoming infected.