A

TLANTA — A new exhibit here memorializing the response to the West African Ebola outbreak features hundreds of artifacts and photographs taken at the peak of the crisis. Among them, a special deck of playing cards grabs the eye.

These cards would make for a gruesome game of poker.

The ace provides a brief explanation of Ebola. Two through five identify early symptoms like fever, headache, and muscle pain. Six is a later symptom — vomiting.

The decision by public health responders to communicate about Ebola in this way was both ingenious and a stark reminder of the challenges they faced as they tried to warn people in West Africa about Ebola and to get them to recognize and act on a disease threat many had never seen before.

Ebola Cards
A deck of cards used for public health education. Helen Branswell/STAT

The deck is part of a new and poignant special exhibit at the Centers for Disease Control and Prevention, in the agency’s David J. Sencer CDC Museum. Sencer, who died in 2011, happens to have been the CDC’s director in 1976, when the first known outbreak of Ebola occurred in Yambuku, Zaire — now the Democratic Republic of Congo.

The West African outbreak — which began in December 2013 and took more than two years to extinguish — was horrific and unprecedented in scope. There were more than 28,600 cases — nearly a dozen times as many as were recorded in all previous Ebola outbreaks combined. More than 11,300 people died.

The carnage — stretching over three countries and racing through crowded city slums — demanded an international response of a militaristic scale.

Newsletters

Sign up for our Daily Recap newsletter

Please enter a valid email address.

Hundreds of CDC staffers were deployed to the affected countries as well as to neighboring nations struggling to prevent the outbreak’s flames from engulfing them as well. It was by far the largest international emergency response effort in the CDC’s history.

But even as the outbreak raged through Guinea, Sierra Leone, and Liberia, the agency was considering how it could capture what was transpiring and make sure these events were not lost to history.

“We knew right from the start that we were in historic times and that an exhibit was in order,” said Louise Shaw, the curator of the new special exhibit. “We started thinking about it almost immediately.”

The densely packed exhibit contains more than 300 artifacts.

Ebola exhibit - racks
Wooden racks used to dry sterilized boots, aprons, and gloves worn by health care workers treating those with Ebola in Liberia in 2015. Rein Skullerud/World Food Programme
Ebola exhibit
A teacher in Guinea uses a non-contact thermometer to check students for fever before they enter the classroom on Jan. 19, 2015, the day school reopened during the Ebola epidemic. Martine Perret/UNMEER

There’s a wooden stand with rubber boots and thick gloves sprouting from its arms — a makeshift apparatus used by doctors and nurses to thoroughly clean and dry their protective gear between wearings.

There’s a photo of a handwritten ledger of patients admitted to a hospital in Kenema, in Sierra Leone. Shaw explained that one responder would photograph the ledger because modern electronic record-keeping wasn’t an option in remote areas.

Much of the exhibit underlines the challenging conditions faced by those trying to contain the epidemic. A bright blue hotline phone — set up in a community — provides instructions to call 117 if a case of Ebola was suspected. A sign reminds children to tune into the radio for lessons; schools were closed in affected areas to lessen the risk of disease transmission.

A section of the exhibit also recounts the heroic and harrowing work done by safe burial teams. The body of a person who has died from Ebola oozes with viruses; traditional funeral practices often ended up infecting grieving family members who prepare bodies for burial. Ebola’s psychic scars have been slow to heal in West Africa and many of the safe burial workers have been subjected to ostracization and stigma.

Interspersed throughout the exhibit are videos in which CDC staff recount their experiences in recorded interviews. Scores of photographs depict the rudimentary conditions under which they worked. In one, a sheet of paper sign identifies a small tent — not tall enough to stand in — in a field as the CDC office in an outpost in Liberia.

“We tried to capture what was going on, the intensity,” Shaw explained.

Ebola exhibit
A family member of Emile Ouamouno, 2, the first known victim of the Ebola epidemic in West Africa, holds a photograph of a newborn Emile with his mother and father. Suzanne Beukes/UNICEF

Indu Ahluwalia, an epidemiologist who spent five weeks in Sierra Leone at the time of the outbreak, struggled to compose herself as she wandered through the exhibit.

Her voice cracking and her eyes welling with tears, she recalled trying to trace a chain of people who had been in contact with some Ebola patients.

“I did an investigation where 35 people died,” Ahluwalia explained. “We followed it down to third-generation [cases]. And pretty much everybody in that chain died. That was really hard.”

At the time she was sent to West Africa — over Christmas and New Year’s 2014 — Ahluwalia worked in maternal and child health. She now works on smoking and health.

That she was sent to an Ebola outbreak speaks volumes about the scope of the response and how it taxed the CDC. Traditionally specialists responding to Ebola outbreaks are drawn from the ranks of highly trained scientists experienced in work on “special pathogens” — the most dangerous viral threats. But the CDC had so many people in the field during the West Africa outbreak that it relied on personnel from across the agency.

Ebola exhibit
An educational mural in Monrovia, Liberia, that shows symptoms and prevention of Ebola. Aphaluck Bhatiasevi/WHO

Before the Ebola outbreak, the 2010 earthquake in Haiti had prompted the CDC’s largest response ever to an international health crisis, with 50 staffers at a time in the field. At the height of its Ebola response, on any given day, roughly 200 CDC employees were in West Africa. There were nearly 2,500 CDC deployments to the three countries during the outbreak.

Of course, armies of other responders from multiple countries and organizations such as Doctors without Borders battled to extinguish the West African epidemic. Shaw acknowledged the exhibit here is CDC-centric, but there are references throughout to the roles played by others.

“That’s very important because there were so many partners and players involved,” she said.

The CDC museum, located in the CDC Visitors Center, is open to the public weekdays from 9 a.m. to 5 p.m. and until 7 p.m. on Thursdays. The exhibit will run until May 25, 2018.

“Typically we don’t keep [temporary] exhibits up this long,” said Shaw. “But this one was such a monumental effort and it’s so totally reflective of CDC’s work we decided to keep it up.”

An earlier version of this story incorrectly stated that before the Ebola crisis, the 2000 earthquake in Haiti had prompted the CDC’s largest response ever to an international health crisis. The earthquake to prompt that response was in 2010.

Leave a Comment

Please enter your name.
Please enter a comment.

Sign up for our Morning Rounds newsletter

Your daily dose of news in health and medicine.