The Andromeda Strain (1969), Outbreak (1995), Pandemic (2020) and several other books and movies have captured the public's fascination with and fear of deadly infectious agents. The combination of high fever with copious production of blood and a rapidly fatal infectious disease are the essential ingredients of horror science fiction. However, they came to real-life reality with the advent of the feared and formidable viral haemorrhagic fevers.

The African viral haemorrhagic fevers, the most formidable of all, with mortalities approaching 90 per cent, sowed considerable alarm and fear in South Africa when some cases were sporadically imported into Johannesburg. It was the initial imported case in 1975 that triggered the establishment of the NIV. The highly specialised maximum-security laboratory, the only one on the continent, soon became a world leader in handling and investigating these viruses. The staff of the Special Pathogens Unit (SPU) have ventured into some of the most inhospitable places on earth to help control outbreaks of the disease and have significantly advanced research into these frightening infectious agents.

THE AFRICAN HAEMORRHAGIC FEVER THREAT

The first alarm bell

The drama of the first viral haemorrhagic fever on South African soil began rather quaintly – at a dinner party in February 1975. Professor James Gear was hosting the associate director of the Rockefeller Foundation for dinner at his home. The party was about to sit down to dinner when Gear's son, Dr John Gear, a consultant physician at the Johannesburg Hospital, arrived at the house, still in hospital scrubs and greatly worried about a patient in his care. The patient was a 20-year-old Australian man who presented with a high fever, a very sore throat, vomiting blood and bleeding from needle puncture wounds. That put an end to the dinner party with Gear and his guest hurrying to the hospital to examine the patient.

The man and his female companion had hitchhiked through Zimbabwe, sleeping on occasion out in the open and coming into contact with monkeys and a civet cat. Despite intensive treatment, the young man died a few days after admission. His companion soon became gravely ill with a similar presentation but survived, as did the attending nursing sister looking after them who subsequently also became infected.