Dr Pierre Rollin interview and PDF transcript

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Biographical details: Originally trained as physician in France; works at CDC Viral Special Pathogens Branch for 23 years on haemorrhagic fevers including Ebola; experience in lab and outbreak response tasks. [00:01:00] Early Ebola work: starts 1989 with Ebola Reston in Virginia (lab work with non-human primates). 1995 Kikwit outbreak – clinical management of patients with Philippe Calain; MSF not yet involved in treatment. 2000 Gulu outbreak – runs lab for two months; some clinical work. Other outbreaks – ecological studies (capture rodents, bats), communication training for healthcare workers and general population. Pre-2014 context: Ebola rare disease; mostly in Central Africa (Congo, Gabon, Republic of Congo, Uganda, South Sudan). Single case Ivory Coast 1994. Previous outbreaks short-term; limited spread even to capitals like Kampala or Kinshasa. [00:04:00] 2014 outbreak onset: learns of suspected Ebola in Guinée Forestière via calls from France lab and MSF; official confirmation 21 March. Notes old 1982 paper showing Ebola antibodies in Guinea; bat reservoir distribution includes West Africa. [00:10:00] Deployment: arrives in Guinea 31 March with team of five (two epidemiologists, informatician, programmer). Objective – outbreak response and test new case/contact management software developed after 2012 Uganda/DRC outbreaks. Outbreak already in two areas: Guinée Forestière and Conakry (transmission in hospitals). Observes normal transmission patterns in Conakry; multiple reintroductions; economic impact on capital. First mission ends May 2014: belief outbreak nearly finished; similar impression among responders. Small flare in Liberia April also seemed resolved. Later realisation – cases unrecorded; likely early spread to Sierra Leone and Liberia via Kissi population across borders. Virus characteristics: same Zaire species; minor changes; taxonomy confusion caused misunderstanding. Clinical difference – severe diarrhoea resembling cholera; infectious, hard to manage; may increase transmission. Movement of people major factor; examples of corpse transport across Guinea. Second mission June–July 2014: situation worsens; more cases in Guinée Forestière; [00:35:00] resistance in villages due to burial practices and lack of broader support. Suggests need for village-level health system strengthening (drugs, wells, schools). Tail end challenges: Liberia outbreak peaked Sept 2014; fear reduced transmission. Guinea prolonged by travel and local behaviour; Forécariah ping-pong cases; elections complicate control. [00:47:00] Future prevention: need surveillance systems, labs, trained response teams, cluster detection; costly but essential for global health security. End of interview.

Dr Pierre Rollin interview and PDF transcript

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