The Hot Zone

  He turned a knob, and the cellscape drifted across his field of view, and he wandered through it. He zoomed in. The scene rushed up toward him.

  His breath stopped. Wait a minute—there was something wrong with this cell. This cell was a mess. It wasn’t just dead—it had been destroyed. It was blown apart. And it was crawling with worms. The cell was wall-to-wall with worms. Some parts of the cell were so thick with virus they looked like buckets of rope. There was only one kind of virus that looked like rope. A filovirus.

  He thought, Marburg. Oh, no. This stuff looks like Marburg. He hunched over the screen. Then his stomach screwed up into a knot and turned over, and he felt an unpleasant sensation. The puke factor. He almost panicked, almost ran out of the room shouting, “Marburg! We’ve got Marburg!” He thought, Is this really happening? He sucked in his breath. He didn’t know if this thing was Marburg, but it sure as hell looked like a filovirus, a thread virus. Then an image came into his mind—an image of Peter Cardinal’s liver cells exploded and flooded with snakes. He brought the image into mental focus and compared it with what he saw on the screen. He knew exactly what the Cardinal strain looked like because he had memorized its curlicues and Cheerio shapes. What the virus did to that boy … the devastating effect on that boy’s tissues … oh, man!—oh, man!—Pete and I smelled this stuff. Pete and I have been handling this stuff, and this is a Biosafety Level 4 agent. Marburg … oh, man … A foul feeling washed over him, a sudden awareness of male reproductive glands hanging on the exterior of the body between the legs … testicles the size of pears, black and putrid, the skin peeling off them.

  He began snapping photographs with his microscope. Several negatives came out of the machine. He carried them into a darkroom and switched out the lights and began developing them. In pitch-darkness, he had time to think. He counted the days back to the date of his exposure. Let’s see, he had sniffed that flask on the Friday before he went hunting. That would have been … ten days ago. What’s the incubation period for Marburg? He didn’t know offhand. Let’s see—monkeys that inhaled Marburg virus took a long time to develop the disease, from six to eighteen days. He was on day ten.

  I am in the window to be sick. I am in prime time to be dropping over! Did I have a headache yesterday? Do I have a headache now? Do I have a fever? He placed his hand on his forehead. Feels okay. Just because I don’t get a headache on day ten doesn’t mean I won’t get a headache on day twelve. How deep did I breathe when I sniffed that flask? Did I snap the cap? That would spray stuff around. I can’t remember. Did I rub my eye with my finger afterward? I can’t remember. Did I touch my mouth with my finger? I might have, I don’t know.

  He wondered if he had made a mistake. Maybe this virus wasn’t Marburg. He was only an intern; he was just learning this stuff. Finding major Biosafety Level 4 agents on the outskirts of Washington, D.C., is not the kind of thing interns do every day. Maybe this isn’t a filovirus. How sure am I? If you go and tell your boss that you’ve found Marburg virus and you are wrong, your career goes down the tubes. If you make a bad call, then first of all you start a panic. Second, you become a laughingstock.

  He switched on the darkroom light and pulled the negatives out of the bath and held them up to the light.

  He saw virus particles shaped like snakes, in negative images. They were white cobras tangled among themselves, like the hair of Medusa. They were the face of Nature herself, the obscene goddess revealed naked. This life form thing was breathtakingly beautiful. As he stared at it, he found himself being pulled out of the human world into a world where moral boundaries blur and finally dissolve completely. He was lost in wonder and admiration, even though he knew that he was the prey. Too bad he couldn’t bring it down with a clean shot from a rifle.

  He saw something else in the pictures that left him frightened and filled with awe. The virus had altered the structure of the cell almost beyond recognition. It had transformed the cell into something that resembled a chocolate-chip cookie that was mostly chocolate chips. The “chips” were crystal-like blocks of pure virus. He knew them as “inclusion bodies.”

  They were broods of virus getting ready to hatch. As the virus grows inside a cell, crystalloids, or bricks, appear at the center. Then they move outward, toward the surface of the cell. When a brick touches the inner surface of the cell wall, it breaks apart into hundreds of individual viruses. The viruses are shaped like threads. The threads push through the cell wall and grow out of the cell, like grass rising from seeded loam. As the bricks appear and move outward, they distort the cell, causing it to bulge and change shape, and finally the cell pops—it bursts and dies. The threads break away from the cell and drift into the bloodstream of the host, multiplying and taking over more cells and forming bricks and bursting the cells.

  As he looked at the bricks, he realized that what he had thought was “pepper” when he had looked at the cells in the flask ten days ago—those specks in the cells—were really inclusion bodies. That was also why the cells had looked swollen and fat. Because they were pregnant and jammed with bricks of virus. Because they were getting ready to burst.

  THE FIRST ANGEL

  NOVEMBER 27, 1000 HOURS, MONDAY

  Tom Geisbert printed the negatives on eight-by-ten glossy paper and headed for the office of his boss, Peter Jahrling. He carried his photographs down a long hallway, went downstairs and through a security door, swiping his ID card across a sensor, and entered a warren of rooms. He nodded to a soldier—there were soldiers everywhere, going about their business at USAMRIID—and went up another flight of stairs and past a conference room that displayed a map of the world on the wall. In this room, Army doctors and officials discussed outbreaks of virus. A meeting was in progress in the room. Beyond it, he came to a cluster of offices. One of them was an awe-inspiring mess, papers everywhere. It belonged to Gene Johnson, the biohazard expert who had led the expedition to Kitum Cave. Across the way was Peter Jahrling’s office. It was neatly kept and small, but it had a window. Jahrling had placed his desk under the window to get some extra light. On the walls he had hung drawings done by his children. There was a drawing by his daughter that showed a rabbit under a shining yellow sun. A shelf held an African sculpture of a human hand holding an egg on the tips of its fingers, as if the egg contained something interesting about to hatch.

  “What’s up, Tom?” Jahrling asked.

  “We have a big problem here,” Geisbert said, and he placed the photographs in a row on Jahrling’s desk. It was a gray November day, and the light from the window fell gently on the images of Medusa. “This came from the Reston monkeys,” Geisbert said. “I think it’s a filovirus, and there may be a good chance it’s Marburg.”

  Jahrling remembered sniffing the flask and said, “You’re playing a joke on me. This isn’t funny.”

  “This is no joke, Pete.”

  “Are you sure?” Jahrling asked.

  Geisbert said he felt very sure.

  Jahrling looked carefully at the photographs. Yes, he could see worms. Yes, he and Geisbert might have breathed it into their lungs. Well, they didn’t have headaches yet. He remembered remarking to the pathologist, as he cut up the little pink chunk of mystery meat in the tin foil, “Good thing this ain’t Marburg.” Yeah, right.

  “Is this stuff the right size?” Jahrling asked. He got a ruler and measured the particles.

  “It looks a little long to be Marburg,” Geisbert said. Marburg particles form loops like Cheerios. This stuff was more like spaghetti. They opened a textbook and compared Geisbert’s pictures with the textbook pictures.

  “It looks good to me,” Jahrling said. “I’m going to show it to C. J. Peters.”

  Jahrling, a civilian, had decided to notify the military chain of command. It started with Colonel Clarence James Peters, MD. He was the chief of the disease-assessment division at the Institute, the doctor who dealt with the dangerous unknowns. (“The interesting stuff,” as he called it.) C. J. Peters had built up this divisio
n almost singlehandedly, and he ran it singlehandedly. He was a strange sort of military man, easygoing and casually brilliant. He had wire-rimmed glasses, a round, ruddy, pleasant face with a mustache, a light Texas drawl. He was not a large man, but he liked to eat, and he believed himself to be overweight. He spoke fluent Spanish, which he had learned during his years in the jungles of Central and South America, hunting for hot agents. He was required by Army regulations to show up for work at eight o’clock in the morning, but he usually drifted in around ten o’clock, and then worked until all hours of the night. He disliked wearing a uniform. Usually he wore faded blue jeans with a flaming Hawaiian shirt, along with sandals and dweebish white socks, looking like he had just spent the night in a Mexican hotel. His excuse for his lack of uniform was that he suffered from athlete’s foot, an incurable tropical strain that he’d picked up in Central America and could never quite get rid of, and so he had to wear socks with sandals in order to keep air circulating around his toes—and the jeans and the flaming shirt were part of the package.

  C. J. Peters could swim through a bureaucracy like a shark. He inspired great loyalty in his staff, and he made enemies easily and deliberately, when it suited him or the needs of his staff. He drove a red Toyota that had seen better days. On his travels in rain forests and tropical savannas, he ate with pleasure whatever the locals were eating. He had consumed frogs, snakes, zebra meat, jellyfish, lizards, and toads cooked whole in their skin, but he thought he had never eaten salamanders, at least none that he had been able to identify in a soup. He had eaten boiled monkey thigh, and he had drunk banana beer fermented with human saliva. In central Africa, while leading an expedition in search of Ebola virus, he had found himself in termite country during swarming season, and he had waited by termite nests and collected the termites as they swarmed out and had eaten them raw. He thought they had a nice sort of nutty taste. He liked termites so much that he refrigerated them with his blood samples, to keep the termites fresh all day so that he could snack on them like peanuts with his evening gin as the sun went down over the African plains. He was fond of suffocated guinea pig baked in its own blood and viscera. The guinea pig is split open like a book, offering treasures, and he enjoyed picking out and eating the guinea pig’s lungs, adrenal glands, and brain. And then, inevitably, he would pay a price. “I always get sick, but it’s worth it,” he once said to me. He was a great believer in maps, and his offices always contained many maps hung on the walls, showing locations of outbreaks of virus.

  Jahrling put Geisbert’s photographs in a folder. He didn’t want anyone to see them. He found Peters at a meeting in the conference room that held the map of the world. Jahrling tapped him on the shoulder. “I don’t know what you are doing right now, C. J., but I’ve got something more important.”

  “What is it?”

  Jahrling held the folder closed. “It’s a little sensitive. I really don’t want to flash it here.”

  “What’s so sensitive?”

  Jahrling opened the folder slightly, just enough to give C. J. a glimpse of spaghetti, and snapped it shut.

  The colonel’s face took on a look of surprise. He stood up, and without a word to the others, without even excusing himself, he walked out of the room with Jahrling. They went back to Jahrling’s office and closed the door behind them. Geisbert was there, waiting for them.

  Jahrling spread the photographs on his desk. “Take a look at these, C. J.”

  The colonel flipped through the photographs. “What’s this from, anyway?” he asked.

  “It’s from those monkeys in Reston. It doesn’t look good to me. Tom thinks it’s Marburg.”

  “We’ve been fooled before,” C. J. said. “A lot of things look like worms.” He stared at the photographs. The worms were unmistakable—and there were the crystalloids—the bricks. It looked real. It felt real. He experienced what he would later describe as “a major pucker factor” setting in. (This is a military slang term that refers to a certain tightening sensation in the nether regions of the body, in response to fear.) He thought, This is going to be an awful problem for that town in Virginia and those people there. “The first question,” he went on, “is what are the chances of laboratory contamination?” The stuff could be the Army’s own Cardinal strain—it might have somehow leaked out of a freezer and gotten into those flasks. But that seemed impossible. And the more they pondered it, the more impossible it seemed. The Cardinal strain was kept in a different area of the building, behind several walls of biocontainment, a long distance from the monkey flasks. There were multiple safeguards to prevent the accidental release of a virus like Marburg Cardinal. That just wasn’t possible. It could not be a contamination. But it might be something other than a virus. It might be a false alarm.

  “People around here see something long and stringy, and they think they’ve got a filovirus,” C. J. Peters said. “I’m skeptical. A lot of things look like Marburg.”

  “I agree,” Jahrling replied. “It could be nothing. It could be just another Loch Ness monster.”

  “What are you doing to confirm it?” the colonel asked him.

  Jahrling explained that he was planning to test the cells with human blood samples that would make them glow if they were infected with Marburg.

  “Okay, you’re testing for Marburg,” C. J. said. “Are you going to include a test for Ebola?”

  “Sure. I already thought of that.”

  “When will your tests be done? Because if those monkeys have Marburg, we have to figure out what to do.”

  Dan Dalgard, for example, was a prime candidate for coming down with Marburg, because he had dissected that monkey.

  “I’ll have a definite yes or no on Marburg by tomorrow,” Jahrling said.

  C. J. Peters turned to Tom Geisbert and said that he wanted more proof—he wanted pictures of the agent actually growing in monkey liver from a monkey that had died in the monkey house. That would prove that it lived in the monkeys.

  C. J. could see that a military and political crisis was brewing. If the public found out what Marburg does, there could be panic. He stood up with a photograph of snakes in his hand and said, “If we are going to announce that Marburg has broken out near Washington, we had better be damned sure we are right.” Then he dropped the photograph on Jahrling’s desk and returned to his meeting under the map of the world.

  • • •

  After C. J. Peters left Jahrling’s office, a delicate conversation occurred between Peter Jahrling and Tom Geisbert. They shut the door and talked quietly about the whiffing incident. It was something they had better get straight between them. Neither of them had mentioned to Colonel C. J. Peters that they had whiffed that flask.

  They counted the days back to their exposure. Ten days had passed since they had uncapped the flask and breathed what could be eau de Marburg. Tomorrow would be day eleven. The clock was ticking. They were in the incubation period. What were they going to do? What about their families?

  They wondered what Colonel Peters would do if he found out what they had done. He might order them into the Slammer—the Level 4 biocontainment hospital. They could end up in the Slammer behind air locks and double steel doors, tended by nurses and doctors wearing space suits. A month in the Slammer while the doctors hovered over you in space suits drawing samples of your blood, just waiting for you to crash.

  The doors of the Slammer are kept locked, the air is kept under negative pressure, and your telephone calls are monitored—because people have emotional breakdowns in the Slammer and try to escape. They start flaking out by the second week. They become clinically depressed. Noncommunicative. They stare at the walls, speechless, passive, won’t even watch television. Some of them become agitated and fearful. Some of them need to have a continual drip of Valium in the arm to keep them from pounding on the walls, smashing the viewing windows, tearing up the medical equipment. They sit on death row in solitary confinement, waiting for the spiking fevers, horrible pain in the internal organs, b
rain strokes, and finally the endgame, with its sudden, surprising, uncontrollable gushes of blood. Most of them claim loudly that they have not been exposed to anything. They deny that anything could go wrong with them, and ordinarily nothing does go wrong with them, physically, in the Slammer, and they come out healthy. Their minds are another story. In the Slammer, they become paranoid, convinced that the Army bureaucracy has forgotten about them, has left them to rot. When they come out, they are disoriented. They emerge through the air-lock door, pale, shaken, tentative, trembling, angry with the Army, angry with themselves. The nurses, trying to cheer them up, give them a cake studded with the number of candles equal to the number of days they’ve been living in the Slammer. They blink in confusion and terror at a mass of flaming candles on their Slammer cake, perhaps more candles than they’ve ever seen on one of their own birthday cakes. One guy was locked in the Slammer for forty-two days. Forty-two candles on his Slammer cake.

  Many people who have been isolated in the Slammer choose to cut down on their work in Level 4, begin to find all kinds of excuses for why they really can’t put on a space suit today or tomorrow or the day after that. Many of the people who have been in the Slammer end up quitting their jobs and leaving the Institute altogether.