In the throes of Ebola-induced delirium, a patient attempts to escape from the Ebola Treatment Unit in Hastings, Sierra Leone. A complete loss of mental facilities is common in the advanced stages of Ebola. According to medical officials at the facility, the man pictured here died hours later.

Two women stop to adjust the charcoal they carry on the road between Meliandou and Gueckadou. Melinandou, where the outbreak started, is approximately 9 miles from the border trading down of Gueckadou.

A view of Meliandou, where the virus first appeared in December 2013. Before the outbreak began, Meliandou had approximately 600 residents. One year later, between deaths and flight, only 400 remain.

Etienne Ouamouno, the father and husband of the outbreak’s first two victims, shows photographs of his wife and son, Emile. Scientists and researchers largely agree that Emile was patient zero in the West African outbreak.

Young boys play around the tree that used to house a large colony of insect bats in the village of Meliandou, Guinea. The tree, and the Angolan free tailed insect bats the once resided there became a suspect in the hunt for the reservoir host.

A large colony of fruit bats takes flight out of the trees where they live in the village of Attienkru, outside Bouake, Ivory Coast. Three species of fruit bats have historically been suspected of being the reservoir host of the Ebola virus. Bat hunting and consumption as food is common in many areas of West and Central Africa where bat populations are large.

A group of bushmeat hunters begin the process of crafting hunting attire from the bark of trees in a small village in northeastern Democratic Republic of Congo. In several historic outbreaks of Ebola virus, hunters have been the first victims.

A bushmeat hunter tries on a hunting mask, crafted from the bark of a tree, before making final adjustment in a small village in northeastern Democratic Republic of Congo.

Bushmeat hunters hunt for monkeys in the forest of northeastern Congo. Far from urban centers and the amenities that exist there, forest communities rely of bushmeat as their source of animal protein. In addition to serving as sustenance, the sale of excess bushmeat provides critical cash for health care, school fees and other expenses.

A bushment hunter carries the body of a monkey he recently shot in the forest of northeastern Democratic Republic of Congo.

Etienne Ouamouno, the father of the index victim, participates in the traditional ceremony aimed at routing out any witchcraft in the village of Meliandou, Guinea. Traditional healing is a significant aspect of culture in Guinea’s forest communities. When this picture was made, the healer (facing Etienne) had placed a chicken under the visible piece of cloth. He said that if the chicken died under the cloth, that it meant that people in the village were practicing wi

Relatives of Kanduki Ettienne, a man who passed away in village of Nendumba in northeastern DR Congo, attend his funeral. In remote areas, funerals are carried out by family members and often involve direct contact with bodies of the deceased. While Kanduki did not die of Ebola, such funeral practices contribute to the rapid spread of the virus once an outbreak has started. This area experienced an Ebola outbreak in 2012.

Members of a Red Cross burial team put on personal protective equipment before entering the home of a woman suspected of dying of Ebola in the village of Dia, Sierra Leone, near the border with Guinea. So-called “safe burials,” carried out by the International Federation of the Red Cross, are conducted in accordance with rigorous safety procedures. The dead bodies of Ebola victims are extremely infectious.

Members of a Red Cross burial team take samples from a woman suspected of dying of Ebola in the village of Dia, Sierra Leone, near the border with Guinea.

Relatives of a man suspected of dying of Ebola look on as Red Cross workers pack his body in the village of Sengema, Sierra Leone. Family and community members were encouraged not to touch the bodies of those suspected of dying from Ebola as the bodies are highly contagious. This aspect of the virus has seriously disrupted traditional funeral ceremonies.

Residents of the town of Kailahun gather along a river at dusk. At the time, Kailahun district, in eastern Sierra Leone, was the most heavily affected by the ongoing Ebola outbreak, which originated across the nearby border with Guinea.

Doctors Without Borders medical staff discuss patient status across an established safety cordon in an Ebola treatment center in Kailahun, Sierra Leone. Those in masks stand in the “high risk” zone where highly contagious Ebola victims receive treatment. They read patient information to the man in green, who transcribes it from the “white zone.” This is standard practice because nothing that has been inside the contaminated areas, including pencils

The Kabia family mourns as the body of their 1-day-old baby is removed by a member of a safe burial team outside their home in the Hill Cut neighborhood of Freetown, Sierra Leone on Wednesday, November 26, 2014. While the baby was not a confirmed Ebola case, the government of Sierra Leone mandates that all deaths in heavily Ebola-affected districts be treated as potential Ebola cases and buried in accordance with strict safety procedures. The bodies of Ebola victims are ex

People who were denied passage at a checkpoint outside of Kenema wait on the roadside. Only those in possession of a government issued permit are allowed to cross Ebola quarantine checkpoints.

A government health worker keeps tally of those who pass an Ebola quarantine checkpoint in the road leading from Freetown to Kenema, Sierra Leone. The government of Sierra Leone set up numerous checkpoints leading into and out of heavily Ebola affected areas.

A government health worker keeps tally of those who pass an Ebola quarantine checkpoint in the road leading from Freetown to Kenema, Sierra Leone. The government of Sierra Leone set up numerous checkpoints leading into and out of heavily Ebola affected areas.

An overview of the Kroo Bay neighborhood of Freetown, Sierra Leone where, in November and December, the virus spread quickly. It was densely populated areas like Kroo Bay where the virus was especially dangerous.

Family members take part in a moment of Islamic prayer during the safe removal of a deceased man in Freetown, Sierra Leone. Months into the outbreak, burial response teams modified their practice to allow for families to have a moment of prayer and reflection before the dead were removed.

Grave digging teams rest at the end of a day of burials in the King Tom cemetery in Freetown, Sierra Leone. King Tom sees the burial of an average of 40 bodies per day.

Molai Kamara, approximately 12 years old, sits alone following a discharge ceremony for Ebola survivors at the Hastings Ebola Treatment Center in Hastings, Sierra Leone on Saturday, November 29, 2014. While excitement buzzed outside as the other 55 survivors received food supplies and boarded buses to return home, Molai sat alone, still sick with other ailments and with nowhere to go. According to doctors at Hastings, Molai lost his entire family to the Ebola virus. He was

Reverend Father Paul Turay, the presiding priest at the Don Bosco Interim Care Center in Lungi, Sierra Leone spends time with orphaned children. Don Bosco runs the care center for children orphaned by the Ebola virus. At present the center looks after 43 orphans from the ages of four to 16 years of age, all of whom lost their families to Ebola. Many of the children are themselves survivors of the disease.

Dr Fabian Leendertz, a German disease researcher, inspects roosting areas of Angolan free tailed insect bats in the roof of a home in the village of Kanan Kru in Ivory Coast. Leendertz suspected that this particular species of insect bat might be the reservoir host for the Ebola virus.

Dr. Fabian Leendertz (center foreground), Kouadio Leonce (left) Krou Hermann Assemien (center in red shirt), Dede Yapo Desire (right center foreground) and Diambra Yapo Innocent (far right foreground) construct the bat-trapping apparatus in the village of Attienkru, outside Bouake, Ivory Coast on Wednesday, November 12, 2014. Dr. Leendertz is currently collecting samples from insect bats in his search for the elusive reservoir host of the Ebola virus. Scientists have been

Ari Dux, a research colleague of Dr. Fabian Leendertz, draws blood samples from the wing of an Angolan free tailed insect bat at a field site in the village of Attien Kru in the Ivory Coast.

Dr. Leendertz and his team inspect insect bat roosting areas in the roof of a home in the village of Kanan Kru, in Ivory Coast.

An Angolan free tailed insect bat pinned to a table during a necropsy in the city of Bouake in Ivory Coast. Researchers extract samples of internal organs from which they will test for Ebola virus and hopefully be able to grow live virus in highly secure laboratories. Being able to grow the virus from extracted tissue samples in the gold standard of proving a reservoir host.

Stalking a Killer: Ebola and the Hunt for its Source by Pete Muller

In 2014 the world witnesses the largest outbreak of the lethal Ebola virus. Before surfacing in Guinea, and later spreading to Liberia and Sierra Leone, the virus was largely relegated to the remote forest regions of Central Africa where sporadic outbreaks were typically short lived and claimed a relatively small number of lives. It is thought that the scope of previous outbreaks was largely contained by virtue of the extremely remote and isolated nature of the environments in which they occurred. Hunters and other people who interact regularly with the forest and wildlife that lives there were typically the first victims. While no one yet knows where exactly the virus originates, researchers know that it lurks somewhere in the forest.

In December 2013, a mysterious illness emerged in the village of Meliandou, a small community deep in the forest region of southern Guinea. It first claimed a two-year-old boy, Emile Ouamouno who died after days of suffering fever and diarrhea. Days later, his mother also fell sick and died. The cases set in motion a wave of deaths in the village leaving members of the community in a state of panic. Traditional healers were called in to assess the situation and attempt to purge the virus which many villages thought was caused by witchcraft. Meanwhile, cases emerged in the nearby town of Gueckadou, along the borders with Sierra Leone and Liberia. Soon, cases emerged in both neighboring countries and the pace of transmission increased.

With West Africa’s comparatively sophisticated road networks and thus easier movement of people, the virus moved rapidly toward population centers where infect rates exploded. By August 2014, and the death toll reached into the thousands, the World Health Organization declared the outbreak and international health emergency. International aid organizations rushed to help the affected governments, whose institutions and response capacity were exceptionally weak, to bring the outbreak under control.

Once the virus reached the densely populated capital cities of Freetown, Monrovia and Conakry, the situation spiraled out of control. Governments issued emergency orders to stop all traditional funeral practices as contact with the bodies of Ebola victims was almost certain to pass the virus. Traditional bereavement practices were severely disrupted and the social fabric of the countries was strained. Non-essential public gatherings were also prohibited. The outbreak took a heavy toll on West African economies and even those who were not affected directly by the virus were suffering severely.

As the outbreak raged in West Africa, scientific researchers redoubled their efforts to identify the mysterious source of the virus. While bats are the main suspect, their status as the host of the virus had never been empirically confirmed. Dr. Fabian Leendertz, a German disease ecologist and veterinarian, lead a team of researchers to Meliandou where they began to look for clues as to how the virus emerged. On the outskirts of the village, Leendertz noticed a large hollow tree in which a large colony of Angola free tailed insect bats recently lived. Village children often played among the trees massive roots. He came to suspect that these small insect bats, which had never before been examined, might be the reservoir host of the lethal virus. His team began to survey and test these bats in areas throughout West Africa. While his interest in the insect bats was based on reasonable suspicion, in the end, the extracted samples did not yield proof of the virus.

While infection rates in West Africa have been dramatically reduced in recent months, the reservoir host continues to lurk in the shadows. With little known about why and how the virus spills over from the animal world into people, the prospect of future outbreaks remains inevitable.

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