RETURN TO THE HOT ZONE

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The outbreak apparently began with a 36-year-old laboratory technician identified only as "Kimfumu." He arrived at a medical clinic in the small agricultural city of Kikwit, Zaire, last month for emergency surgery. But after two operations, surgeons realized they could do nothing for him; his internal organs were hemorrhaging so badly that life was quickly draining from his body. Soon after Kimfumu died, the five medical workers who treated him, including an Italian nun who assisted in the operations, began coming down with their own symptoms: headache and fever, diarrhea, massive bleeding from every body orifice and, within a few days, death.

Horrific tropical fevers are an unfortunate fact of life in Central Africa, but this was no ordinary fever. It was the fourth outbreak ever recorded of the dreaded Ebola virus, which resists all medicines and kills up to 90% of its victims. As the full measure of the danger dawned on them, alarmed government officials called for help from international public-health experts in the U.S. and Europe. They closed schools and health clinics in Kikwit, ordered people to stay off the streets, and imposed a quarantine on the city in a desperate attempt to keep the virus from spreading 250 miles west to the capital city of Kinshasa, with its 4 million people.

The effort may have been too late. When international emergency teams arrived last week at the clinic where the outbreak began, they found only 20 people left in the 350-bed facility, raising fears that patients had fled, taking the virus with them. By week's end, cases were being reported in the outlying villages of Mosango, Bonga-Yasa and Vanga. And thousands of miles away, in Bergamo, Italy, two sisters of Floralba Rondi, the nun who helped operate on Kimfumu, sat in medical quarantine. They were waiting to see if they too had been exposed when they visited Kikwit for their sister's funeral. "It's been a week of prayer," said Rosanna Rondi to an Italian newspaper.

In Kinshasa, residents fretted about their relatives and friends in Kikwit-there are no phone links and now no movement between the two cities-and feared that Ebola might breach the quarantine. Says Cornaille Mbala, a senior nurse at Kinshasa's Mama Yemo Hospital: "When this sickness hits you, you die in one week. Of course we are all afraid." And around the world, but especially in the U.S., people sensitized to Ebola's horrors by a spate of books and movies-Richard Preston's chilling best seller The Hot Zone; the TV movie Robin Cook's 'Virus'; the film Outbreak, starring Dustin Hoffman-wondered nervously whether the disease would spread out of Africa.

By week's end, there were 49 confirmed deaths from Ebola and 50 more suspected-the number was highly uncertain because Kikwit is also dealing with an outbreak of shigellosis, a form of dysentery whose symptoms can easily be confused with Ebola's. While the death toll is certain to rise, since the virus' incubation period lasts up to 21 days, infectious-disease experts doubt that the Ebola will travel much farther than it has already, even within Zaire. Says Dr. Ralph Henderson, an assistant director-general of the World Health Organization: "We are not talking about thousands or tens of thousands. This is not a plague situation."