When Bonnie Dighero-Kemp and Gregory Kocher work on Ebola, they use precautions. Everything is planned out, and following that plan keeps the researchers safe.
When at home, in their biosafety level four laboratory at the National Institute of Allergy and Infectious Diseases’ Integrated Research Facility on Fort Detrick, there are multiple preventative steps to keep those working with a contagious disease like Ebola safe.
But much of Dighero-Kemp’s and Kocher’s work takes them out of their lab and to areas affected by an infectious disease. They are members of a 10-person international response team.
Recently, the two were sent to the Democratic Republic of Congo where the latest outbreak of Ebola has caused more than 800 deaths between Aug. 1, 2018 and April 16, 2019, according to the World Health Organization. Dighero-Kemp and Kocher were not sent out to areas most affected by the disease due to security concerns, but while in the DRC they worked with health care workers on the ground to teach them how to use a test for the disease.
The specific test looks for Ebola antibodies, and they draw samples from various groups of people, such as those survivors or people who are actively ill, Dighero-Kemp said.
Initially, they taught staff members how to run samples from vaccinated individuals, she said. They were not necessarily testing the vaccine’s effectiveness but rather if it produced a certain response, Kocher said. They also look to test samples from health care workers, Dighero-Kemp said.
“It was a fantastic trip, and the researchers we were working with and training were extremely dedicated, extremely hardworking, eager to learn,” Dighero-Kemp said. “It was fantastic.”
The people on the ground have been working on Ebola for a while, Kocher said. Their techniques were already very good, the team just made updates and added the ability to run the test.
Dighero-Kemp and Kocher said the work was very similar to what they do with the lab, but there are different challenges when out on the field.
On Fort Detrick, everything they might need is at their fingertips, Kocher said. The equipment, security controls, the health safety person.
“Whereas when you’re in Africa, you’re a phone call away, so you’re not exactly out of contact with people, but you are a lot more on your own,” he said.
Battelle, which is the contractor that runs the Integrated Research Facility, provides a lot of pre-trip support, but once members are abroad, they know that medical help may not be easily available, Kocher said.
And because they work in a biosafety level four lab, they wear certain pressure-controlled suits when handling infectious pathogens. Out in the field they wear a different type of personal protective equipment, Dighero-Kemp said.
Getting the tests to work overseas comes down to logistical challenges, such as the lack of access to clean water, Kocher said. Dirty water can cause the test to fail.
“Because a pipette is a pipette whether you are in Liberia or the United States, but water is not always water,” he said.
Another challenge is having a power source to use some equipment or to run refrigerator or incubator in order to keep samples at specific temperatures.
The current outbreak is the second largest Ebola outbreak, Dighero-Kemp said. The first was in 2014. During that outbreak, the team went to Liberia. They continue to support National Institutes of Health clinical trials for Ebola vaccines and treatment in Liberia, Dighero-Kemp said.
Although the current outbreak is deadly, with the World Health Organization reporting 1,224 confirmed cases, 767 of which were confirmed deaths, since Aug. 1, 2018, the attention to this outbreak is less than what was seen in 2014.
“I do notice that when you talk to your family, for instance, or friends, they might not necessarily have heard about it to the level that they had for the last outbreak because the other one was so much larger,” Dighero-Kemp said.
The trip to the DRC was the start of a partnership between the Integrated Research Facility and the Institut National de Recherche Biomédicale in the DRC’s capital Kinshasa, Dighero-Kemp said.
There are future trips being planned to help the institute incorporate more lab procedures in their daily work on Ebola, she said.
And because the two are part of an international response team, they might also fly out to Liberia to help with ongoing Ebola work or another area with an infectious disease, such as Mali, Guinea or Angola, where the team also has a presence.
The team does not just fly in and perform a research task, Kocher said. Instead, they are working to help teach the local staff how to run a test or procedure so that they can continue to do it after the response team has left.
“It’s to make sure the impact we can provide is all the more lasting by having local personnel continue what we start or introduce,” he said.