Biosecurity: Inside the hot zone

In the late '60s, the Surgeon General of the United States said that we were closing in on the worldwide eradication of infectious diseases.

'There were no known treatments': Dr. Jerry P. Jaax told stories of the ­frightening Ebola outbreak in Reston, Va., that spread from a research facility of 500 monkeys and inspired a best-selling book and film.

Since, then, says Dr. Jerry P. Jaax, the world has faced "HIV, SARS, AIDS, tuberculosis (TB), drug-resistant TB, exotic pests, Nipah virus, hantavirus, West Nile virus, drug-resistant pathogens, Ebola, bovine spongiform encephalopathy (BSE), Lyme disease, and that doesn't even take into account what somebody might do on purpose. When it comes to emerging infectious disease and bioterrorism, we have a lot of work to do," he adds.

Jaax should know. In fact, he and his wife Nancy Jaax confronted an Ebola virus outbreak in Reston, Va. Their work inspired a best-selling book titled "The Hot Zone," which ultimately inspired the film "Outbreak."

According to Jerry Jaax, the Reston outbreak remains "an important turning point in the recognition of infectious disease in public health."

Then employed with the U.S. Army Veterinary Corps, Jaax recalls that interest in infectious disease in public health in 1989 was clearly focused on risks to our armed forces. "No one had even considered what might happen if something went wrong in the United States. Most people were worried about humans, but plants and animals are a huge component of the threat spectrum."

In this case, the Ebola virus swept through a research facility with some 500 monkeys. At the time, says Nancy Jaax, they were treating it as biosafety level 3 (BSL3) emergency, which means it poses a significant health threat but there are countermeasures. When diagnostic testing kept pointing to Ebola, the threat spectrum was raised to biosafety level 4 (BSL4). In other words, there were no known treatments. More testing revealed that they were in the middle of an outbreak with an entirely new strain of Ebola virus.

"You can't imagine," Nancy Jaax says. "You think you are at the top of the rollercoaster, and all of a sudden you are at the bottom. We were treating it like a BSL3 agent. You were trying to remember who had it, who looked at it. We went into a kind of diagnostic brain lock. You know that this virus is supposed to be in Africa. It certainly was not supposed to have come from a group of monkeys from the Philippines, flown to Amersterdam, and flown to New York. By the way, two of the animals that were sick were taken home at night by an animal caretaker. We were very frightened," Nancy Jaax says.

And the detective work that goes along with combating an outbreak is just one component to the response. There's containment issues and safety for laboratory workers, especially in handling animals potentially infected with a new virus without a known treatment.

And what happens when a monkey escapes?

Jerry Jaax had first-hand experience.

In fact, he offered a comparison between Hollywood and reality.

"At 9 a.m., the Hollywood army discovered there was a virus killing hundreds of people in California. The guy gets on television telling everyone they were looking for a monkey. This lady saw this little drawing up in her daughter's room. She said, 'I think that looks like the monkey.' She called and told them: 'I think my daughter has seen the monkey.' The (response team) piled in a helicopter. They get to the house and throw some apples off the back deck. Out of a redwood forest comes this monkey. They shoot the monkey with a tranquilizer gun, jump into the helicopter and fly back to the town where all the people are dying. They take this little monkey, the size of a Scottie, into the laboratory and get a couple of tanker trucks of antibody to save the world," Jerry Jaax says.

The reality is: a monkey did get loose and he and three colleagues chased it all day. They finally sedated the escaped animal by trapping it behind some cages. "And I can tell you that if you inject enough ketamine in the tip of a tail, it will anesthetize a monkey."

And while Jerry Jaax says he can make light of the incident now, it was quite serious.

During this outbreak, they identified 42 people who had been near the virus. Luckily, no one seroconverted. And while Ebola remains a serious problem in Great Ape populations in Africa, it's only today that scientists are publishing promising data on a new vacccine.

The threat to public health has never been more urgent, Jerry Jaax says. "Things like global travel, overpopulation, urbanization, and climate change are speeding up the zoonotic and enzootic diseases. We are in the midst of a resurgence of old diseases and new diseases on a global scale. When it comes to emerging infectious disease and bioterrorism, we have a lot of work to do," Jerry Jaax adds.