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West Africa Ebola Outbreak Highlights Need for PREDICT Program

by Jessica Burbridge

On August 8, the Ebola virus epidemic rapidly spreading through West African countries was formally declared an international public health emergency by the World Health Organization. WHO director Dr. Margaret Chan called it “the largest, most severe, most complex outbreak [of the Ebola virus] in the nearly four-decade history of the disease.”

As of August 18th, this outbreak has claimed the lives of 1,350 people and infected 2,473 since March 2014. First appearing in Guinea, the virus gradually spread over into Liberia and Sierra Leone, and is now also in Nigeria (which does not share a border with Liberia, Sierra Leone or Guinea), with fifteen confirmed cases and four deaths. Liberia and Nigeria have declared a state of emergency and the governments of each country are undertaking serious measures to limit the spread of disease, such as enforced quarantine and curfews. Several commercial airlines have stopped service in the West African countries as well.

Ebola virus disease was first described in people in 1976 in two outbreaks in Sudan and the Democratic Republic of Congo. There have been more than twenty outbreaks in human populations in Central and West Africa over the last 38 years.

Ebola outbreak in West Africa in Guinea, Liberia, Sierra Leone, and Nigeria.

Infection with Ebola virus causes fever, vomiting, diarrhea, muscle pain and bleeding, with symptoms taking anywhere between 2 to 21 days to appear. The virus is spread by direct contact with bodily fluids such as blood, sweat, urine, saliva and diarrhea. While there is no cure, it is possible to survive the Ebola virus with supportive care. Some strains of the virus have a case fatality rate of up to 90%; the current outbreak if West Africa has a case fatality rate of a little over 50%. 

Drugs to treat those infected with Ebola are in the early, experimental stages of testing and development, as are vaccines for prevention of infection. It could take months, if not years, for these experimental drugs to pass clinical trials and be officially approved for human use. That said, preliminary results are promising: Liberia’s Minister of Information, Lewis Brown, announced this week that three African doctors infected with the virus have shown “remarkable signs of improvement” with an experimental serum known as ZMapp. American aid workers Dr. Kent Brantly and Nancy Writebol, who were both infected with Ebola virus in Liberia, also received the experimental drug and made a full recovery. 

Dr. Kent Brantly, an American doctor infected with ebola in Liberia, and the first person to receive the experimental serum Zmapp.

Does Ebola Pose a Threat to the Gorillas?

Ebola virus is also lethal for great apes: conservation experts report that Ebola virus outbreaks have decimated some populations of chimpanzees and western lowland gorillas.  Ebola-Zaire, which is the strain causing the current West Africa outbreak, is suspected to have claimed the lives of over 5,000 western lowland gorillas in northern Republic of Congo’s Lossi Sanctuary between 2002 and 2004. 

Though initial spillover of the virus likely came from a reservoir host, most Lossi Sanctuary gorillas appeared to have been infected by other gorillas (Bermejo et al., 2006). This is the same manner that the virus spreads through the human population. The challenge is that, while human Ebola outbreaks are controlled in part by isolating infected people, wild great apes cannot be isolated from one another, which means an outbreak is impossible to control.

Ebola, classified within the family of filoviruses, is a zoonotic infectious disease, which means it passes between animals and people. In fact, the first reported case of a known primate-to-human transmission of Ebola was in West Africa in June 1994 when a primatologist became infected after performing a necropsy on a chimpanzee found dead in the Taï National Forest. (Formenty et al., 1999). During this 2-year epidemic, 50% of the chimpanzee population died from the Ebola virus (Le Guenno et al., 1995). Three other Ebola virus outbreaks between 1995 and 1997 in northeastern Gabon were suspected to be linked to the hunting and killing of wild chimpanzees. In the second outbreak, 18 people involved in killing and butchering a deceased chimpanzee became infected with the virus, with 4 patients dying within 48 hours of infection (Georges et al., 1999). 

According to the World Health Organization, human Ebola infection has been associated with the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the forest. Wild great apes are not the reservoir, but simply susceptible hosts, just like humans. “When an ape is infected with the virus, the incubation period is short, so the chances of a human getting the virus from great apes without coming into direct physical contact with a sick or deceased ape is extremely small” said Gorilla Doctors Co-Director Dr. Mike Cranfield.

Although Ebola vaccines are still in experimental stages, some have shown promise in protecting laboratory monkeys from Ebola infection. 

Vaccinating wild great apes should really be considered as a last resort, after all other available measures to prevent an infectious disease from impacting the population have been put in place, said Gorilla Doctors Co-Director Dr. Kirsten Gilardi. That said, if the situation is dire and the consequence of not vaccinating is certain mass mortality, then the decision to vaccinate wild great ape populations at greatest risk should be on the table.

How Are We Protecting our Gorilla Patients?

As a zoonotic disease, Ebola is directly linked to conservation: conducting thorough wildlife disease surveillance and minimizing human/wildlife conflict will be paramount in preventing a future outbreak.

The current outbreak underscores the critical importance of wildlife disease research, such as the work being done through the USAID-funded Emerging Pandemic Threats PREDICT project. Since 2009, Gorilla Doctors has been in charge of implementing the PREDICT project in Uganda and Rwanda, and our PREDICT veterinarians have worked in places where people and wildlife come into close contact to conduct surveillance of wildlife (such as primates, bats, and rodents) for viruses that may pose an emerging pandemic threat. Both PREDICT teams carefully monitor information on outbreaks of highly infectious diseases such as Ebola virus and Yellow Fever in human populations as well. Our PREDICT teams have traveled to outbreak sites to collect samples from domestic and wild animals in order to determine if the outbreak is related to contact that people may have had with wild animal populations.

In Africa, while the wildlife reservoir for Ebola virus is unknown, several species of fruit bat, particularly Hypsignathus monstrosus, Epomops franqueti and Myonycteris torquata, are considered possible natural hosts for Ebola, because molecular testing has detected Ebola virus positive animals, even though they do not exhibit signs of infection.

Gorilla Doctors PREDICT veterinarians collect samples from a fruit bat near Bwindi Impenetrable National Park, Uganda. 

“If Ebola was reported in Rwanda, Uganda, or DRC, Gorillas Doctors would recommend shutting down tourism to prevent exposure of the gorillas to the deadly virus from people,” said Gorilla Doctors Co-Director Dr. Mike Cranfield. “The gorilla population would continue to be monitored for signs of illness and with appropriate permission from the governments, we would obtain the vaccines safely used in captive chimpanzees and have them shipped to the region. If there was a suspicious case of mortality we would collect samples to confirm Ebola and then ask permission from the host governments to vaccinate the population.”

A high percentage of mountain gorillas are habituated to human presence, making it theoretically possible to vaccinate the majority of the population via remote darting systems. In fact, in 1990 at the request of the Rwandan government, Gorilla Doctors vaccinated dozens of mountain gorillas with a human measles vaccine when measles was strongly suspected to be causing a lethal outbreak in the gorilla population. 

“The present vaccine trials of the Ebola vaccine, which uses only portions of the virus and thus can’t cause the disease, has shown very promising results in monkeys and great apes” said Dr. Cranfield. “...although the studies have used small numbers of animals and long term effects have not been studied.”

Preventative Measures Implemented in Rwanda & Uganda

A 2000 outbreak of the virus in northern Uganda infected 425 people and claimed the lives of 224. The government quickly implemented a travel ban to and from northern Uganda, isolating the outbreak and successfully stopping the spread of the virus. Dr. Benard Ssebide, Gorilla Doctors Research Project Coordinator for PREDICT Uganda, sees the current spread of Ebola in West Africa as particularly problematic because “the local people do not understand what Ebola is and what causes it. They believe it is a curse from God -- that it afflicts those not living in Godly ways. They chase away doctors or health officials from their villages. When they get sick, they hide.”

In contrast, according to Dr. Benard, “…people are quick to report themselves to a hospital or local clinic when they become ill in Uganda. They will promptly be isolated and given supportive care, drastically reducing the chances for the infection to spread.”

Intensive screening has been implemented in both Uganda and Rwanda’s airports, and already several individuals with fever and other symptoms who have landed in Kigali or Kampala have been quarantined, though none have tested positive for the virus.

Gorilla Doctors Head Rwanda Veterinarian, Dr. Jean Felix Kinani, recently participated in a meeting organized by the Ministry of Health to discuss plans to protect the country from an Ebola outbreak. Educational posters and 35,000 flyers have since been distributed to hospitals, health centers and doctor’s offices throughout the country. Isolation facilities have been set up at various points throughout Rwanda and personal protection equipment has been distributed to hospitals and health clinics while hundreds of health care workers are receiving “refresher training” on the treatment of the Ebola virus.

As the West African countries continue to fight the spread of Ebola, governments around the world are preparing to protect their countries from potential infection. Gorilla Doctors will continue to work closely with the Rwandan, Ugandan, and Congolese health ministries to protect both the local human population and the critically endangered eastern gorillas from this deadly virus.

For more about the Gorilla Doctors PREDICT work, click here

To listen to Dr. Kirsten Gilardi's recent interview on "Ebola and Zoonotic Disease Surveillance" on KDRT, click here.


Dr. Eddy Intervenes to Free Ensnared Bageni Group Baby

Kagera, who is estimated to be 1.5 years old, is a male infant born to mother Rubaka during the M23 rebel occupation of the Mikeno Sector in 2012. He is one of only two infants in Bageni group in Virunga National Park. With M23 occupying the gorilla sector during the time of his birth, Gorilla Doctors was not able to safely conduct routine health monitoring of the habituated mountain gorillas, so the first time Kagera was observed by one our veterinarians was on February 11, 2013. Since then, he has been in good health and growing larger and stronger by the day.

The two infants in Bageni group in Virunga National Park.

Last weekend, Chief Park Warden of the Mikeno Sector Innocent Mburanumwe contacted Gorilla Doctors after Kagera was seen with a snare wrapped around his right leg. The remnants of the snare were trailing the baby as he moved around and Kagera was reportedly limping. To make matters worse, his mother was observed leaving him behind to travel on his own as the group moved in the rain (instead of carrying him on her back as is typical with a young infant).  

Drs. Eddy and Martin immediately made the journey from Goma to Rumangabo, prepared to intervene and remove the snare on Sunday, August 16. Here is Dr. Eddy’s report:

“Early Sunday morning, Dr. Martin and I joined a team of ICCN rangers and trekked from the Gatovu patrol post up to Bageni group, loaded down with intervention equipment and supplies. An advance team of trackers had moved in ahead to locate the group and found them in the Hagarara area. They radioed to us, providing details of the group’s exact location and we quickly made our way through the dense forest.

When we arrived to the group, dominant silverback Bageni was resting with two females and both infants. Kagera was resting on his mother, Rubaka, and the nylon rope snare was wrapped loosely around his right ankle.

Silverback Bageni resting with adult female Rubaka and her infant Kagera.

We observed three wounds on the sole of his foot and his leg was slightly swollen. When the group began moving, the infant followed his mother, dragging his leg and crying out, likely because the wounds on his foot were causing him pain and he didn’t want to be left behind. We made the decision to anesthetize both the infant and his mother to ensure the intervention could be completed safely for both the infant and the field team.

At 11:07am, mother Rubaka was anesthetized with a combination of Ketamine and Dexmedetomidine, while Kagera was darted with Ketamine alone for sedation. When the baby was darted, he screamed, alerting silverback Bageni who quickly moved in to stand guard over the mother and infant. 

About 10 minutes passed and both animals were fully sedated when silverback Bageni allowed us to approach. We removed the rope snare, cleaned the wounds with Betadine, administered antibiotics and anti-inflammatory/pain medications and conducted physical exams of both animals. We also collected blood, fecal and urine samples, as well as oral and nasal swabs for future research and testing. 

Dr. Eddy removes the rope snare from the infant's ankle.

The infant's foot had small superficial wounds, likely from other group members trying to remove the snare.

Drs. Eddy and Martin work quickly to remove the snare, complete a physical exam and collect samples.

Once the intervention was complete, the mother woke first and moved off into the forest after the group. We carried Kagera, who was still groggy from the anesthesia, to the group so that he would not be left behind and another subadult female stepped in to care for the baby in place of his mother. After 40 minutes, Rubaka reappeared and retrieved Kagera, carrying him away into the dense vegetation.

Trackers will continue to closely monitor the situation to make sure that Kagera's wounds don't become infected and his behavior, feeding and energy level remains normal. Drs. Eddy or Martin will revisit the group in the coming days to assess the infant's condition.


This is the eighth gorilla that Gorilla Doctors has freed from a poacher's snare this year. Help us ensure that every ensnared gorilla will receive treatment through an emergency medical intervention by making a secure online donation today:


Dr. Julius Studies Bat Genetics at The Field Museum of Natural History, Chicago

Dr. Julius Nziza, Gorilla Doctors Research Project Coordinator for PREDICT Rwanda, is wrapping up an interesting six-week stint in Chicago where he's studied the genetics of bat species in Rwanda and curating techniques at The Field Museum of Natural History. Dr. Julius is working with Dr. Bruce Patterson, the MacArthur Curator of Mammals, Dr. Bill Stanley, the Head of Mammals Collections and Anna E. Goldman, Chief Mammals Preparator and Collections Assistant at The Field Museum of Natural History.

Dr. Julius with Dr. Maria Perez (Argentina -Museo Paleontologico Egidio Feruglio Museum), Michael Bartonjo (National Museum of Kenya) and Dr. Bruce Patterson (The Field Museum of Natural History).

Dr. Julius working on samples in The Field Museum of Natural History.

Dr. Julius working in The Field Museum of Natural History.

Since 2009, Dr. Julius has led our PREDICT research in Rwanda, humanely collecting samples from bats, rodents, primates and other wildlife living in areas of intense human-wildlife activity to look for emerging pandemic threats and infectious diseases. 

Dr. Julius, along with PREDICT Field Veterinarian Dr. Olivier Nsengimana, has collected thousands of blood, saliva, and fecal samples from bats living in and around Rwanda's Volcanoes National Park, Akagera National Park and Nyungwe National Park over the last five years. Bats are known carriers of many viruses including Ebola, Marburg, rabies, MERS, and SARS and as the current Ebola pandemic in West Africa rages on, we are reminded of the dire importance of wildlife disease research such as the USAID funded PREDICT program. (Stay tuned for our upcoming article on Ebola and how it could pose a threat to our gorilla patients.) 

Dr. Julius traveled from Rwanda to Chicago with 70 bat carcasses and 160 muscle tissue samples, courtesy of the Rwanda Development Board Tourism and Conservation Department, who owns the samples.

The genetic research and curating work Dr. Julius is completing in Chicago is “very important. We have been collecting samples from bats without knowing the exact species we are dealing with” said Dr. Julius. “It’s important to be able to associate the pathogen with the exact species of bat as we build this international database of infectious disease.”

Dr. Julius observes a bat outside of Volcanoes National Park, Rwanda.

A bat captured for sample collection for PREDICT research.

This is the third time Dr. Julius has visited the United States. In 2009, he attended an 8-week ENVIROVET Summer Course on aquatic and terrestrial ecosystem health through the University of Illinois and the White Oak Conservation Center in Florida. He returned to the US to complete a Safe Capture Course, focusing on safe capture techniques of primates and also attended the annual AAZV conference in 2011.

“The work I am doing in Chicago is intriguing and important, but I’ve also enjoyed seeing the city and visiting the John Shedd Aquarium, the Navy Pier, Hyde Park and lots of museums” said Dr. Julius. “ It’s a beautiful city with lots of interesting history… I’m particularly fascinated with how the city layout was designed and it’s true what they say, it is a ‘windy city’!”

Dr. Julius will return to Rwanda on August 25th when he will begin wrapping up phase 1 of the PREDICT project for Rwanda and continue completing his Master of Science degree in International Infectious Disease Management from Uganda’s Makerere University.

For more about the Gorilla Doctors PREDICT project in Rwanda and Uganda, click here


Zirikana Falls Victim to Poacher's Snare for the Second Time, Docs Suspect Big Brother Ntakibazo Freed Him

Trackers from the Rwanda Development Board contacted Gorilla Doctors on August 5 to report that Zirikana, a 7-year-old male mountain gorilla in Umubano group had become caught in a wire snare. This was the second time this poor guy had been caught in a snare (Gorilla Doctors freed Zirikana from a snare in January 2011 when he was just 3-years-old.) Click here to read about the intervention. 

Zirikana, a 7-year-old male mountain gorilla in Umubano group.

Drs. Jean Felix assembled the intervention team and they trekked up the mountain first thing in the morning to remove the snare and administer treatment. Gorilla Doctors director Dr. Mike Cranfield, Drs. Jean Felix, Noel and Elisabeth Nyirakaragire (RDB Veterinary Warden) comprised the intervention team and were joined by Gorilla Doctors interns Jean Claude Tumushime and Gaspard Nzayisenga, RDB trackers and porters to haul the intervention kits. The team trekked up the Bisoke volcano early morning on August 6 and reached the group where they were ranging at 2,919 meters altitude. 

"When we arrived in the group, Zirikana was climbing trees and his limb was free of the snare; he was behaving normally and feeding with the group" said Dr. Jean Felix. "We observed the group for 30 minutes while older brother Ntakibazo groomed Zirikana carefully. Zirikana could have removed the snare himself, but with Ntakibazo's close attention to his little brother, we suspect he may have been responsible for removing the wire. No injury was noticed where the snare was but there was a circumferential line around the wrist and some hair was missing. The entire group was moving together and behaving normally."   

Older brother Ntakibazo grooms Zirikana.


Silverback Rano, Leader of Titus Group, Dies Suddenly, Gorilla Docs Investigate

In a shocking and sad turn of events, 21-year-old silverback mountain gorilla Umushikirano (Rano), leader of Titus group in Volcanoes National Park, was found dead Monday morning when Fossey Fund trackers arrived to the group. There were no visible signs of injury or illness and his body was carried down the mountain and transported to the Gorilla Doctors headquarters in Musanze, where a necropsy was conducted by Drs. Jean Felix and Noel to try to determine the cause of this young silverback’s sudden death. Through the necropsy, Gorilla Doctors determined that Rano suffered a perforation of the small intestine and acute peritonitis, though we cannot be sure of the cause of the perforation. Dr. Jean Felix and team found copious amounts of tapeworms in Rano's intestinal tract, but we will not know for sure whether this contributed to his death until histopathology is complete. Histopathology will be conducted by our Veterinary Pathologist based at UC Davis, Dr. Linda Lowenstine, which will provide further insight into the cause of death.

Silverback Rano, former leader of Titus group in Volcanoes National Park, Rwanda.