Along a narrow, winding river, a team of American scientists is traveling deep into the Congo rain forest to a village that can be reached only by boat.
The scientists are from the Centers for Disease Control and Prevention, and they have embarked on this watery journey to solve a decades-old mystery about a rare and fatal disease: monkeypox.
A cousin to the deadly smallpox virus, the monkeypox virus initially infects people through contact with wild animals and can then spread from person to person. The disease produces fever and a rash that often turns into painful lesions that can feel like cigarette burns. It kills up to 1 in 10 of its victims, similar to pneumonic plague, and is particularly dangerous in children. Monkeypox is on the U.S. government list of pathogens such as anthrax and Ebola with the greatest potential to threaten human health. There is no cure.
Over the past year, reports of monkeypox have flared alarmingly across Africa, one of several animal-borne diseases that have raised anxiety around the globe. The Congolese government invited CDC researchers here to track the disease and train local scientists. Understanding the virus and how it spreads during an outbreak is key to stopping it and protecting people from the deadly disease.
In Congo Republic, many suspected monkeypox cases trace back to the village of Manfouete, a six-hour boat trip from the nearest airport. The village has 1,600 people, no electricity and no running water. The scientists are traveling upriver in a big motorized boat that looks like an open-air school bus. They must bring everything they need for their work. So a second boat — a long, wooden dugout canoe — will follow later carrying most of their supplies: boxes of traps and test tubes, a portable centrifuge, jerrycans of gasoline, a 25-kilogram sack of rice and lots of bottled water.
On the river, the scientists in their noisy boat pass men and women gracefully paddling their own wooden dugout canoes and standing with their feet far apart for balance. Some ferry entire families; others carry baskets of vegetables, smoked fish or firewood. The scientists pass huts with dried mud walls and palm-thatched roofs where brightly colored clothes are laid out to dry.
“Mbote! Mbote!” — Hello! — children shout from the riverbanks. Biologists Jeff Doty and Yoshinori Nakazawa, part of the CDC team, wave back.
The boat follows the Ubangi River to the twisting Motaba River, where the water is smooth and still and stained the color of black tea.
The last few miles are difficult to navigate. As the sun dips low in the western sky, everyone worries about arriving after dark, when chances are highest for run-ins with hippos, considered the most dangerous animals in Africa.
The sun is setting when the jungle falls away to reveal a sudden clearing framed by tall grass: Manfouete. The only structure visible from the river is the village school, where the scientists will sleep during their stay.
Working with a dozen Congolese and international experts who are part of the team, they move wooden desks and benches out of two classrooms and pitch tents to protect themselves from biting insects during the night. (They avoid a third classroom, where a two-foot-high termite mound has sprouted from the concrete floor.)
When that work is done, there is still no sign of the dugout canoe carrying the food. So the scientists go to bed hungry, listening to the rhythmic thrum and shrill noises of the jungle.