The Hot Zone
Peter Jahrling felt that, on the whole, he was not at much risk of contracting the virus, nor was Tom. If he did contract it, he would know soon enough. His blood would test positive, or he would get a headache that wouldn’t go away. In any case, he believed very strongly that Marburg wasn’t easy to catch, and he didn’t think there was any danger to his family or to anyone else around town.
But think about Dan Dalgard cutting into monkeys. Bending over and breathing monkey when he opened their abdomens. He was bending over their intestines, inhaling fumes from a pool of Marburg blood. So then, why isn’t Dalgard dead? Well, he reasoned, nothing’s happened to Dalgard, so maybe nothing will happen to us.
Where had it come from? Was it a new strain? What was it capable of doing to humans? The discoverer of a new strain of virus gets to name it. Jahrling thought about that, too. If he and Tom were locked up in the Slammer, they would not be able to carry out any research on this virus. They were on the verge of a major discovery, and the glory of it perhaps tantalized them. To find a filovirus near Washington was the discovery of a lifetime.
For all these reasons, they decided to keep their mouths shut.
They decided to test their blood for the virus. Jahrling said to Geisbert, “We are going to get blood samples drawn from ourselves like right now.” If their blood went positive, they could immediately report to the Slammer. If their blood remained negative and they didn’t develop other symptoms, then there was little chance they could infect anyone else.
Obviously they did not want to go to the regular clinic to have an Army nurse take their blood: that would be a tip-off to the military authorities that they thought they’d been exposed. So they found a friendly civilian technician and he twisted a rubber band around their arms, and they watched while he filled some tubes with their blood. He understood what had happened, and he said he would keep his mouth shut. Jahrling then put on a space suit and carried his own blood into his Level 4 hot lab. He also took with him Geisbert’s blood and the flasks of milky stuff. It was very strange, handling your own blood while wearing a space suit. It seemed, however, quite risky to let his blood lie around where someone might be accidentally exposed to it. His blood had to be biocontained in a hot zone. If it was infected with Marburg, he didn’t want to be responsible for it killing anyone. He said to himself, Given that this was a piece of mystery meat sniffed out of a monkey carcass, I should have been a little more careful.…
Meanwhile, Tom Geisbert went off to collect some pickled monkey liver that he could photograph for viruses, hoping to prove that the Marburg-like agent lived in the monkeys. He found a plastic jug that contained sterilized pieces of liver from Monkey O53. He fished some liver out of the jug, clipped a few bits off it, and fixed the bits in plastic. This was a slow job and took many hours to finish. He left the plastic to cure overnight and went home for a couple of hours to try to get some sleep.
THE SECOND ANGEL
NOVEMBER 28, TUESDAY
Tom Geisbert lived in a small town in West Virginia, across the Potomac River from Maryland. After his separation from his wife, his two children had stayed with her for a time, and now they were staying with him, or rather, they were staying with his parents in their house down the road. Both his children were toddlers.
He got up at four o’clock in the morning, drank a cup of coffee, and skipped breakfast. He drove his Bronco in pitch darkness across the Potomac and through Antietam National Battlefield, a broad ridge of cornfields and farmland scattered with stone monuments to the dead. He passed through the front gate of Fort Detrick, parked, and went past the security desk and into his microscope area.
The dawn came gray, gusty, and warm. As light glimmered around the Institute, Tom sliced pieces of monkey liver with his diamond knife and put them into the electron microscope. A few minutes later, he took a photograph of virus particles budding directly out of cells in the liver of Monkey O53. These photographs were definite proof that the virus was multiplying in the Reston monkeys—that it was not a laboratory contamination. He also found inclusion bodies inside the monkey’s liver cells. The animal’s liver was being transformed into crystal bricks.
He carried his new photographs to Peter Jahrling’s office. Then they both went to see Colonel C. J. Peters. The colonel stared at the photographs. Okay—he was convinced, too. The agent was growing in those monkeys. Now they would have to wait for Jahrling’s test results, because that would be the final confirmation that it was indeed Marburg.
Jahrling wanted to nail down this Marburg as fast as he could. He spent most of the day in a space suit, working in his hot lab, putting together his tests. In the middle of the day, he decided that he had to call Dan Dalgard. He couldn’t wait any longer, even without test results. He wanted to warn Dalgard of the danger, yet he wanted to deliver the warning carefully, so as not to cause a panic. “You definitely have SHF in the monkey house,” he said. “We have definitely confirmed that. However, there is also the possibility of a second agent in at least some of the animals.”
“What agent? Can you tell me what agent?” Dalgard asked.
“I don’t want to identify the agent right now,” Jahrling said, “because I don’t want to start a panic. But there are serious potential public health hazards associated with it, if, in fact, we are dealing with this particular agent.”
Somehow, the way Jahrling used the words panic and particular made Dalgard think of Marburg virus. Everyone who handled monkeys knew about Marburg. It was a virus that could easily make people panic.
“Is it Marburg or some similar agent?” Dalgard asked.
“Yes, something like that,” Jahrling said. “We’ll have confirmation later in the day. I’m working on the tests now. I feel it’s unlikely the results will be positive for this second agent. But you should take precautions not to do any necropsies on any animals until we’ve completed the tests. Look, I don’t want to set off too many whistles and bells, but I don’t want you and your employees walking into that room unnecessarily.”
“How soon can you get back to me with a definite yes or no about this second agent? We need to know as soon as possible.”
“I’ll call you back today. I promise,” Jahrling said.
Dalgard hung up the phone highly disturbed, but he maintained his usual calm manner. So there was a second agent in the building, and it sounded as if it was Marburg. The people who had died in Germany, he knew, had been handling raw, bloody monkey meat. The meat was full of virus, and they got it on their hands, or they rubbed it on their eyelids. He and other people at the company had been cutting into sick monkeys since October—and yet no one had become sick. Everyone had worn rubber gloves. He wasn’t afraid for himself—he felt fine—but he began to worry about the others. He thought, Even if the virus is Marburg, the situation is still no different from before. We’re still stuck in a pot. The question is how to get ourselves out of this pot. He called Bill Volt and ordered him not to cut into any more monkeys. Then he sat in his office, getting more and more annoyed as the day darkened and Peter Jahrling did not call him back. He wondered if any of the men had cut themselves with a scalpel while performing a dissection of a diseased monkey. Chances were they wouldn’t file an accident report. He knew for sure that he had not cut himself. But he had performed a mass sacrifice of approximately fifty animals. He had been in contact with the blood and secretions of fifty animals. That had been on the sixteenth of November. Eleven days ago. He should be showing some symptoms by now. Bloody nose, fever, something like that. Or maybe he just hadn’t broken with virus yet.
At five-thirty, he called Jahrling’s office and got a soldier on the phone, who answered by saying, “How can I help you, sir or ma’am?… I’m sorry, sir, Dr. Jahrling is not in his office.… No sir, I don’t know where he is, sir.… No, he has not left work. May I take a message, sir?” Dalgard left a message for Jahrling to call him at home. He was feeling steadily more annoyed.
1500 HOURS
While Dalga
rd fretted, Jahrling was in his space suit. He worked steadily all afternoon in his own lab, hot zone AA-4, at the center of the building, where he fiddled with the flasks of virus culture from the monkey house. It was a slow, irritating job. His tests involved making the samples glow under ultraviolet light. If he could make the samples glow, then he knew he had the virus.
In order to do this, he needed to use blood serum from human victims. The blood serum would react to viruses. He went to the freezers, and got out vials of frozen blood serum from three people. Two of the people had died; one had survived. They were:
1. Musoke. A test for Marburg. Serum from the blood of Dr. Shem Musoke, a survivor. (Presumably reactive against the Kitum Cave strain, which had started with Charles Monet and jumped into Dr. Musoke’s eyes in the black vomit.)
2. Boniface. A test for Ebola Sudan. From a man named Boniface who died in Sudan.
3. Mayinga. A test for Ebola Zaire. Nurse Mayinga’s blood serum.
The test was delicate, and took hours to complete. It was not made easier by the fact that he was shuffling around in his space suit the whole time. First he put droplets of cells from the monkey culture onto glass slides, and let them dry, and treated them with chemicals. Then he put drops of the blood serum on the slides. The blood would glow in the presence of the target virus.
Now it was time to look. This had to be done in total darkness, because the glow would be faint. He shuffled over to a storage closet, and went inside it, and closed the door behind him. A microscope sat on a table in the closet, and there was a chair, and from the wall hung an air hose. He plugged the hose into his space suit and put the slides into the microscope. Then he turned out the lights. He felt around in the darkness for the chair, and sat down. This was not a fun place to be if you happened to have a touch of claustrophobia—sitting in a pitch-black Level 4 closet while wearing a space suit. Peter Jahrling had made his peace with suffocation and darkness a long time ago. He waited for a minute to give his eyes time to adapt to the dark, and the little sparkles of light in his eyes as they adjusted to the darkness eventually faded away, while cool, dry air roared around his face and whiffled the hair on his forehead. Then he looked through the binocular eyepieces of the microscope. He wore his eyeglasses inside his space suit, and that made it particularly difficult to see. He pressed the faceplate against his nose and squinted. He moved his face from side to side. His nose left a greasy streak inside his faceplate. He twisted his helmet until it was turned nearly sideways. Finally he saw through the eyepieces.
Two circles drifted into his sight, and he focused his eyes, bringing the circles together. He was looking down into vast terrain. He saw cells dimly outlined in a faint glow. It was like flying over a country at night, over thinly populated lands. It was normal to see a faint glow. He was looking for a bright glow. He was looking for a city. He scanned the slides with his eyes, back and forth, back and forth, moving across the microscopic world, looking for a telltale greenish glow.
The Musoke did not glow.
The Boniface glowed weakly.
To his horror, the Mayinga glowed brightly.
He jerked his head back. Aw, no! He adjusted his helmet and looked again. The Mayinga blood serum was still glowing. The dead woman’s blood was reacting to the virus in the monkey house. He got an ugly feeling in the pit of his stomach. Those monkeys didn’t have Marburg. They had Ebola. Those animals were dying of Ebola Zaire. His stomach lurched and turned over, and he sat frozen in the dark closet, with only the sound of his air and the thud of his heart.
CHAIN OF COMMAND
1600 HOURS, TUESDAY
This can’t be Ebola Zaire, Peter Jahrling thought. Somebody must have switched the samples by accident. He looked again. Yeah, the Mayinga blood serum was definitely glowing. It meant he and Tom could be infected with Ebola Zaire, which kills nine out of ten victims. He decided that he had made a mistake in his experiment. He must have accidentally switched around his samples or gotten something mixed up.
He decided to do the test again. He turned on the lights in the closet and shuffled out into his lab, this time keeping careful track of his vials, bottles, and slides to make sure that nothing got mixed up. Then he carried the new samples back into the closet and turned out the lights and looked again into his microscope.
Once again, the Mayinga blood glowed.
So maybe it really was Ebola Zaire or something closely related to it—the dead woman’s blood “knew” this virus, and reacted to it. Good thing this ain’t Marburg—well, guess what, it ain’t Marburg. This is the honker from Zaire, or maybe its twin sister. Ebola had never been seen outside Africa. What was it doing near Washington? How in the hell had it gotten here? What would it do? He thought, I’m onto something really hot.
He was wearing his space suit, but he didn’t want to take the time to decon out through the air lock. There was an emergency telephone on the wall in his lab. He disconnected his air hose to extinguish the roar of air so that he could hear through the receiver, and he punched Colonel C. J. Peter’s phone number.
“C. J.!” he shouted through his helmet. “IT’S PETE JAHRLING. IT’S REAL, AND IT’S EBOLA.”
“Naw!” C. J. replied.
“YEAH.”
“Ebola? It’s gotta be a contamination,” C. J. said.
“NO, IT ISN’T A CONTAMINATION.”
“Could you have gotten your samples mixed up?”
“YEAH, I KNOW—MY FIRST THOUGHT WAS THAT SOMEBODY HAD SWITCHED THE SAMPLES. BUT THEY WEREN’T SWITCHED, C. J.—BECAUSE I DID THE TEST TWICE.”
“Twice?”
“EBOLA ZAIRE BOTH TIMES. I’VE GOT THE RESULTS RIGHT HERE. I CAN PASS THEM TO YOU. TAKE A LOOK FOR YOURSELF.”
“I’m coming down there,” C. J. said. He hung up the phone and hurried downstairs to Jahrling’s hot lab.
Jahrling, meanwhile, picked up a sheet of waterproof paper on which he had written down the results of his tests. He slid the paper into a tank full of EnviroChem. The tank went through the wall to a Level 0 corridor outside the hot zone. The tank worked on the same principle as a sliding cash drawer in a teller’s window. You could pass an object from the hot zone through the tank into the normal world. The object would be disinfected on its way through the tank.
C. J. stood at a thick glass window on the other side, looking in at Jahrling. They waited for several minutes while the chemicals penetrated the paper and sterilized it. Then C. J. opened the tank from his side and removed the paper, dripping with chemicals, and held it in his hands. He motioned to Jahrling through the window: Go back to the phone.
Jahrling shuffled back to the emergency telephone and waited for it to ring. It rang, and there was C. J.’s voice on the line: “Get out of there, and let’s go see the commander!”
It was time to move this thing up the chain of command.
Jahrling deconned out through the air lock, got dressed in his street clothes, and hurried to C. J. Peters’s office, and they both went to the office of the commander of USAMRIID, a colonel named David Huxsoll. They brushed past his secretary—told her it was an emergency—and sat down at a conference table in his office.
“Guess what?” C. J. said. “It looks like we’ve found a filovirus in a bunch of monkeys outside Washington. We’ve recovered what we think is Ebola.”
Colonel David Huxsoll was an expert in biohazards, and this was the sort of situation he thought the Institute was prepared to handle. Within minutes, he had telephoned Major General Philip K. Russell, MD, who was the commander of the United States Army Medical Research and Development Command, which has authority over USAMRIID, and had set up a meeting in Russell’s office in another building at Fort Detrick.
Colonels Huxsoll and Peters spent a few moments talking about who else should be brought in. They hit upon Lieutenant Colonel Nancy Jaax, the Institute’s chief of pathology. She could identify the signs of Ebola in a monkey. Huxsoll picked up his phone. “Nancy, it’s Dave Huxsoll. Can you get over to Phil
Russell’s office right now? It’s damned important.”
It was a dark November evening, and the base was beginning to quiet down for the night. At the moment of sundown that day, there was no sun visible, only a dying of the light behind clouds that flowed off Catoctin Mountain. Jaax met Jahrling and the two colonels on their way across the parade ground beside the Institute. A detail of marching soldiers stopped before the flagpole. The group of people from the Institute also stopped. From a loudspeaker came a roar of a cannon and then the bugle music of “Retreat,” cracklish and cheap-sounding in the air, and the soldiers lowered the flag while the officers came to attention and saluted.
C. J. Peters felt both embarrassed and oddly moved by the ceremony. “Retreat” ended, and the soldiers folded up the flag, and the Institute people continued on their way.
General Russell’s office occupied a corner of a low-slung Second World War barracks that had been recently plastered with stucco in a hopeless effort to make it look new. It had a view of the legs of Fort Detrick’s water tower. Consequently, the general never opened his curtains. The visitors sat on a couch and chairs, and the general settled behind his desk. He was a medical doctor who had hunted viruses in Southeast Asia. He was in his late fifties, a tall man with hair thinning on top and gray at the temples, lined cheeks, a long jaw, pale blue eyes that gave him a look of intensity, and a booming, deep voice.
C. J. Peters handed the general a folder containing the photographs of the life form that inhabited the monkey house.
General Russell stared. “Holy shit,” he said. He drew a breath. “Man. That’s a filovirus. Who the hell took this picture?” He flipped to the next one.
“These were done by my microscopist, Tom Geisbert,” Jahrling said. “It could be Ebola. The tests are showing positive for Ebola Zaire.”