Tuesday, April 30, 2024

A00023 - Joel Breman, Doctor Who Helped Stop an Ebola Outbreak in Africa

 


Joel Breman, Who Helped Stop an Ebola Outbreak in Africa, Dies at 87

Part of a team flown in to fight the deadly virus in 1976, Dr. Breman also worked to stamp out tropical diseases like smallpox, malaria and Guinea worm.

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He was photographed looking at the camera and smiling while sitting at a table against a bright green wall. He wore a charcoal gray suit and a red necktie.
Joel G. Breman in 2020. In 1976, as an Ebola outbreak spread in Congo, he interviewed patients and witnesses, traveling from village to village and going from house to house in only “the most basic protective equipment.”Credit...ImageAV, via Breman Family

Dr. Joel Breman, a specialist in infectious diseases who was a member of the original team that helped combat the Ebola virus in 1976, died on April 6 at his home in Chevy Chase, Md. He was 87.

His death was confirmed by his son, Matthew, who said his father died of complications from kidney cancer.

“We were scared out of our wits,” Dr. Breman, recollecting his pioneer mission, told a National Institutes of Health newsletter in 2014, as a new and even deadlier Ebola outbreak raged that year.

Nearly 40 years earlier, his team of five had just landed in the interior of what is now the Democratic Republic of Congo, at a remote Roman Catholic mission hospital. They were up against a viral infection that had no name, whose origin was unknown, and that was accompanied by high fever and bleeding that led to a painful and quick death.

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Dr. Breman, dispatched by the Centers for Disease Control and Prevention, had only what he described to the N.I.H. as “the most basic protective equipment” against the disease, in contrast to the full-body spacesuit-like gear that was standard in the later outbreak. He and others on the team, laboring in intense heat and bitten by sand flies, “developed rashes and didn’t know if we would catch the virus too,” he said.

But he calmly began deploying the techniques he had honed on earlier missions to Africa, on anti-smallpox initiatives in Guinea and Burkina Faso. He interviewed patients and witnesses, traveling from village to village and going from house to house. He and his colleagues, he recalled, soon determined that the infection was “spread by close contact with infected body fluids,” and that it had been propagated at a rural hospital that was using unsterilized needles.

Over a long career, much of it spent at the Centers for Disease Control, the World Health Organization and the National Institutes for Health, Dr. Breman worked to stamp out deadly tropical diseases like smallpox, malaria and Guinea worm. But that initial Ebola outbreak, he told an interviewer in 2009, “was the scariest epidemic of my entire medical career and possibly of the last century.”

Compared with the later outbreak in West Africa, which lasted more than two years, the Congo (then Zaire) epidemic was quickly contained. There were fewer than 300 deaths, in marked contrast to the more than 11,000 from 2014 to 2016. The relative success in 1976 was partly because of Dr. Breman’s efforts to analyze, contain and isolate this frightening new virus.

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A black and white photo Dr. Berman, on the left, posing beside an African man; both are looking at the camera. Dr. Berman wears a medal pinned to the lapel of his suit jacket.
For his work in fighting an Ebola outbreak in 1976, Dr. Berman was presented with an award by Dr. Nguete Kikhela, the health minister of Zaire (now the Democratic Republic of Congo).Credit...via Breman family

“He was my mentor, and he was the leader of the team,” said Dr. Peter Piot, a former director of the London School of Hygiene and Tropical Medicine and himself a pioneering Ebola and AIDS researcher.

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“He already had great experience of outbreak investigations and fieldwork,” Dr. Piot continued. “He was a combination of walking encyclopedia and accumulated experience. He had an incredible commitment to solve problems for people, reaching out to people and listening to them.”

Dr. Breman would spend a half-hour or more simply chatting with village notables, about their families and other matters, before getting down to questions about the disease, Dr. Piot said. “He made the connection between human understanding and interaction, and data analysis. He had the human factor.”

Dr. Piot had special praise for Dr. Breman’s demeanor: “He remained calm. This was a pretty stressful time. Lots of people died. He was very patient with me.”

Dr. Breman spent two months in Congo, becoming chief of surveillance, epidemiology and control for the mission. He was then sent by the C.D.C. to help run the World Health Organization’s smallpox program in Geneva.

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By 1980, with smallpox effectively eradicated — “one of the greatest triumphs in the history of medicine,” he called it in a Story Corps interview with his son — Dr. Breman began what he called “a new career” running the disease control center’s anti-malaria program.

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He was seated at a desk in a rustic setting treating an African man while other men and boys look on. Behind them was a white stucco wall.
Dr. Breman in Ivory Coast in 1986. He spent many years in Africa trying to stamp out deadly tropical diseases like smallpox, malaria and Guinea worm, in addition to Ebola.Credit...via Breman family

At a memorial tribute on April 9, Dr. Rick Steketee, a fellow member of the American Society of Tropical Medicine and Hygiene, said that in the years that followed, and through new postings, Dr. Breman “wrote book chapters that guide the medicine and public health practice around the world and edited textbooks that influenced the practice of infectious disease control and elimination, especially in low-resource countries.” Dr. Breman was president of the society in 2020.

Joel Gordon Breman was born on Dec. 1, 1936, in Chicago to Herman Breman, a painting contractor, and Irene (Grant) Breman. When Joel was 7, the family moved to Los Angeles, where his father painted movie sets and his mother bought and sold furniture and property.

Dr. Breman attended Hamilton High School in Los Angeles. He received a B.A. in political science from the University of California, Los Angeles, in 1958 and a medical degree from the University of Southern California in 1965. He was awarded a degree from the London School of Hygiene and Tropical Medicine in 1971.

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His first assignment overseas was in Guinea, from 1967 to 1969, when the C.D.C. assigned him to run its smallpox eradication program. That mission fueled a lifelong passion for Africa, Matthew Breman said. Numerous scientific trips there followed, often as a consultant to the World Health Organization.

Dr. Breman held a number of senior positions at the National Institutes of Health, from which he retired in 2010 as a senior scientist emeritus.

In addition to his son, he is survived by his wife, Vicki; his daughter, Johanna Tzur; and six grandchildren.

“My dad loved helping others and thought it was important to help everyone,” Matthew Breman said. “I think that’s one of the reasons he went into medicine.”

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