All this would give him a road map of the disease at the cellular level.
He tapped commands into the server controlling the lab machines. Fortunately, the code gaining entry to this computer had been simple to guess. He had tried combinations of JURIE and ARAM and, finally, ARAMJURIE#1, and that had worked.
The lab filled with humming and faint clicking, first to his right, then to his left. Dicken stood up and checked the progress of the little plastic tubes marching in their metal tracks one by one into the prissy little mouths of the white-and-silver machines. He had to admire the way the doctors had set up the lab. It was economical, the equipment neatly arranged, with good flow-through from task to task.
Jurie and Pickman had known their business.
Still, virus hunters who fled at the first signs of a disease were not highly regarded by their peers. Very likely, Jurie and Pickman had never chased down viruses in the field. They had behaved more like lab lizards, pale from lack of tropical sun, utter cowards when confronted by their real prey.
For a moment, Dicken felt a chill. How dumb of him not to think of it earlier. Jurie and Pickman had already done the work, discovered the results; that was why they had run away. The results had been very bad.
But Dicken had found no sign of specimen kits anywhere in the lab. The equipment had barely been used, it was so new.
The chill passed, but slowly.
An hour later, he tapped the space bar on the keyboard to turn off the screen saver. A flashing green bar with “Eureka!” written across it told him he had results. The results were displayed first as thumbnails on a grid, then, at his command, as a slide show.
With grim satisfaction, Dicken saw that he had isolated a recombined variety of unencapsulated RNA virus from the blood and sputum of all the afflicted children, in titers sufficient to suggest massive infection. No other titers were so prominent.
From the beginning, seeing the buccal lesions and stomatitis, Dicken had suspected coxsackie A, known to cause most of the symptoms in the sick SHEVA children. But this strain was seldom associated with fatal illness. Coxsackie B, however, sometimes produced myocarditis, inflammatory heart disease, in infants and children. According to Dr. Kelson, myocarditis was a possible cause of death in the outbreak. Kelson had said, “There's massive tissue damage. The heart just stops.”
Coxsackie A and B typically spread by fecal contact or exchange of saliva. He did not know of any historical instances where it had spread by skin contact or in aerosols—droplets of moisture from breath or sneezing—or through residues left on surfaces, yet those kinds of transmission were necessary to explain the outbreak's rapid and pervasive expansion.
Something had changed. Coxsackie A or B, or both, had suddenly become easier to spread, and targeted to a particular population not heretofore known to be vulnerable to most common childhood viruses.
Now that he knew the type of virus, he could focus on the origin of the disease and its etiology—how it had mutated, how it spread, and where it would be expected to spread next.
Dicken typed in a request for numerical results from each set of specimens, with identification of individuals and their circumstances. The computer prepared a table, but it was complicated and unintuitive.
Dicken took out a piece of paper and began organizing the results in his own favored plot. Using a small marker, he drew three large circles on the paper. Within the first circle he swooped a C, representing the children. Inside he drew a smaller circle, labeled IC for Infected Children. Outside the first, he drew a second large circle and labeled it BT for brave teachers and staff, those who had remained.
The third circle he labeled Tr, for traitors, those who had fled.
He picked up a red felt-tip pen and began categorizing the specimen ID numbers and marking them + or – for their viral status. He then recorded them within the appropriate circles. Two of the circles rapidly filled with numbers and status marks. For now, there were no numbers in the Tr circle—he was leaving that open in case information from outside became available.
He now had points of proximity or actual contact and, presumably, opportunities for viral transmission. The pattern he saw emerging was already clear, but he refused to jump to conclusions. He did not trust either intuition or instinct. He trusted hard facts, indisputable associations, and repeated correlations.
He drew the results a second way, in columns and rows. When he had completed his chart, he drew a new table, reversing the order, and filled the boxes with the categorized numbers.
Dicken cleaned up his work and tapped the plastic end of the pen on the columns, marching down, climbing back up, sweeping the marker to the right across the rows, color-coding the associations.
Any way he drew it out, the pattern was clear.
Within the special treatment center, children who had had no contact with teachers or other students for more than three days had not contracted the virus. Eight children had been in isolation cells and had been abandoned when the staff evacuated. Three had died, but all of their specimens tested negative.
Five hours ago, Middleton had phoned the lab to tell Dicken that one of the rescued children had fallen ill, and Kelson said she was likely to die. That child had almost certainly been exposed after her “rescue.”
Dicken had taken specimens from six children who had been locked in a shower room by a fleeing teacher, and not found until late yesterday. One had died from lack of special medication. None had had any contact with teachers or staff for the past forty-eight hours. Their specimens tested negative.
DeWitt and Middleton had identified fifty children whom they knew had had close contact with teachers and staff in the past sixty hours. Of these, forty had fallen ill, and twenty had died. All of their specimens tested positive. Somehow, ten had managed to avoid exposure.
He looked over the results for twenty-two teachers, staff, and security officers. All had had continuous contact with infected children for the past forty-eight hours. They were exhausted, stressed, worn down. Six of these—four nurses from the main pool and one teacher from the special treatment wing, and the counselor, Dewitt—tested positive for the virus, but in low titers compared to infected children. None showed symptoms of infection.
Neither he nor Mark Augustine tested positive.
Dicken held up his chart once more. The conclusions were compelling.
Only infected SHEVA children showed symptoms.
SHEVA children lacking recent adult contact tested negative for the virus and showed no symptoms.
Contagion did not spread from the children to adults with much efficiency, if at all; and if it was passed on, did not cause illness in adults.
Contagion probably did spread from child to child, but the chain always began with children who had had recent contact with adults.
He had not gathered specimens from every child, alive or dead, or from all the adults that had been at the school; it was possible that an asymptomatic child was the source; it was also possible that exposed adults would get ill, eventually.
But he doubted it. The children were almost certainly not the source. And adults did not get sick. The river flowed in only one direction, downstream from teachers and staff, adults, to the new children.
The computer chimed again. Dicken looked at the screen. The Ideator had identified a sequence from its standard human genomic library. He touched a box on the screen. It expanded outward, showing a gene map for an obscure and defective HERV. Coxsackie viruses—for that matter, the superfamily of Picornaviridae—had never been known to recombine with legacy retroviral genes. Yet he was looking at a protein traced to a gene from the suspect virus, and it was very similar—90 percent homologous—to a protein once coded for by an ancient human endogenous retrovirus found in two chromosomes.
The presence of the protein converted a relatively benign RNA virus into one that killed, in large numbers.
He typed in another search. The Ideator scanned the Genesys bank for a match within the
52-chromosome genome of the new children. According to the Genesys bank, that particular defective primordial HERV did not exist in any SHEVA child.
Both of its copies had been discarded during the supermitotic splitting and rearrangement of the old chromosomes.
Dicken stared at the screen for several minutes, thinking furiously. His vision blurred. He grabbed the crumpled wipe and dabbed again at his face. His left leg cramped. He pushed away from the bench and walked around the small lab room, bracing on tables, equipment.
What Augustine and the Emergency Action people feared most had happened. Ancient viruses had somehow self-corrected and contributed one or more novel genes to a common virus, producing a deadly disease. But the recombination had not taken place in SHEVA-affected children.
It had begun in adults.
Adults were creating viruses that could infect and kill the SHEVA children. Those same viruses did not harm the adults. Dicken could yet be sure, but he suspected that the viral protein took advantage of yet another protein expressed only in the children—two units not in themselves toxic, but lethal in combination.
A new role for viruses: agents of a species-level immune response. Biological warfare, one generation against another.
An old species trying desperately to kill the new? Or just an awful mistake, a slip-up with deadly consequences?
He secured the samples, backed up the computer files, made a set of printouts, locked up the lab, and brutally shoved the outer door of the research building. It slammed open, and he walked out into the glare of the afternoon sun.
50
PENNSYLVANIA
Mitch had put on one of George Mackenzie's white terry robes to check on Stella. He now lay on the bed beside Kaye, the robe ridiculously short over his long legs. His breathing was even. She could feel his hand, large and wide, with long, thick fingers, resting on her arm.
Kaye rolled over and put her head on his chest, where the robe had pulled open. “Have I been acting a little crazy?” she asked.
Mitch shook his head. “Defensive.”
“Do you remember before we were together? You were doing archaeology. I was working away madly, and confused.”
“I wasn't doing much archaeology,” Mitch said. “I've been out of action for longer than I've known you. My own damned fault.”
“I loved your rough hands. All the calluses. What would we be without Stella?”
Mitch's eyes narrowed. Wrong question.
“Right,” Kaye said. She lay back on the pillow. “I insisted. We don't have any other life now.”
“I helped,” Mitch said.
“I've neglected you. In so many ways.”
Mitch shrugged.
“What do you want for Stella?” Kaye asked.
“A reasonably normal life.”
“What will that be? She isn't like us, not really.”
“She's more like us than she's different.”
Kaye wiped her eyes with the back of her hands. She could still feel the caller, and when she touched it with her thoughts, waves of comfort surged through her and her eyes flowed over. She could not understand this feeling of glorious ease in the midst of their fear.
Mitch touched her cheek. His finger gently dabbed the wet corner of one eye.
“What's it like to have a stroke?” she asked. “Or a seizure?”
“You're the doctor,” Mitch said, taken aback.
“Sam had a stroke,” Kaye said. Sam was Mitch's father.
“He went down like a tree,” Mitch said.
“He was paralyzed and he died in a couple of hours.”
“It was fast. What are you getting at?”
“Do people have seizures that make them feel good? They wouldn't go to the doctor for that, would they?”
“I've never heard of such a thing,” Mitch said.
“But it wouldn't be reported, would it, unless they happened to catch it . . . on an MRI or CAT scan or something. The brain is so mysterious.”
“What brings this on?” Mitch asked. “We make love and you talk about having good strokes.” He tried to smile. “It's called having an orgasm, little lady.”
Kaye lifted her head and rolled over to face him, refusing to be amused. “Have you ever felt something or someone touch your thoughts? Approving of everything about you, filling you with understanding?”
“No-o-oo,” Mitch said. He did not like this conversation at all. There was a glow about Kaye's face that reminded him of when she was pregnant, a soft and intimate light in her eyes.
“Is it rare? What do people do, who do they talk to, when it happens that way?”
“What way?”
Kaye sat up and put her hands on his shoulders, staring at him imploringly, helpless. “Is that what makes people religious?”
The look on Mitch's face was so serious, she had to smile. “Maybe I'm becoming a priestess. A shaman.”
“Generally,” Mitch began, putting on a professorial tone, “shamans are a little crazy. The tribe feeds them and puts them to work. Shamans are more entertaining than reading entrails or tossing knucklebones.”
Kaye clenched her jaw. “I'm trying to understand something.”
“Out on the dock, did you feel like you were having a stroke?” Mitch asked, unable to keep the concern from his voice.
“I don't know.” She smiled as if at a pleasant memory. “It's still with me.”
“You're pregnant again, morning sickness?”
“No, damn it,” Kaye said, poking his arm. “You're not listening.”
“I'm not hearing anything I can understand. Tell me, straight . . . did it feel like an episode, a breakdown? We've been under a lot of stress.” He stood up by the side of the bed, leaving the short robe behind. Kaye watched him, his forearms and chest and the tops of his shoulders covered with coarse hair, and her gaze dropped to his genitals hanging at postcoital parade rest, waving with the nervous swing of his arms.
She laughed.
This stopped Mitch cold. He stood like a statue, staring down on her. He had not heard Kaye laugh like that, at him, at the ridiculousness of life, in well over a year, maybe two; he couldn't remember the last time.
“You sound happy,” he said.
“I'm not happy,” Kaye insisted indignantly. “Life's a bowl of shit, but our daughter . . .” Her face crumpled. Through her fingers, she sobbed, “She's going to live, Mitch. That's a blessing, isn't it? Is that what I'm feeling—thankfulness, relief?”
“Thankful to what?” Mitch said. “The god who gives little children nasty diseases?”
Kaye spread out her arms, gesturing with her fingers at the bedroom, the lace coverlet, wood-paneled walls, pressed flowers under glass in ornate gold frames, the decorative water pitcher on the little white wicker table by the nightstand. Mitch watched her puffy eyes and red face with real concern. “We are luckier than others,” she said. “We are so lucky our daughter is alive.”
“God didn't do that,” Mitch said, his voice turning sour. “We did that. God would have killed her. God is killing thousands like Stella right now.”
“Then what am I feeling?” Kaye asked. She held out her hands and Mitch gripped them. A blackbird sang. Mitch's eyes went to the window.
“You're bouncing back,” he said, his anger smoothing. “We can't feel like shit all the time or we'd just give up and die.” He pulled her up on her knees on the bed, and expertly hugged her until her back popped.
“Ow,” she said.
“That did not hurt,” Mitch said. “You feel better now.”
“I do,” Kaye affirmed, arms around his neck.
Stella pushed through the door. “I've got this thing on my wrist,” she said, tugging at the medical tape. “My skin hurts.” She stared at them, naked, together. There was no use keeping secrets from her; she could smell everything in the room. Stella had seemed to instinctively understand the whys and wherefores of sex even as a toddler. Nevertheless, Mitch released Kaye, swung his body away, and reached
for the robe.
Kaye pulled the coverlet into a wrap and went to her daughter. Stella leaned into her arms and Kaye and Mitch carried her back to her bed.
51
OHIO
“Our last link to the outside world,” Augustine said, holding up a satellite phone. “Secret Service, bless them. But I had to think of it. They're hiding out in their cars, and they did not volunteer.” He climbed the flight of steps to Trask's office. Dried vomit—not his own—ran in streaks down his leg.
Dicken sidled up the steps behind Augustine. “The school has a secure server. I have Jurie's password for the lab computers, but not the password to go outside the school.”
“I know. What are we looking at, anyway?”
“Coxsackie, a new strain,” Dicken said. “The children have hand, foot, and mouth disease.”
Augustine pushed the door to the office open. “Like the cattle?”
Dicken shook his head. “You're tired. Listen to me. Not foot and mouth, it's HFMD. Hand, foot, and mouth. Common childhood viral infection.”
“Recombined?” Augustine sat behind the desk and propped the phone on the desk. He punched a number, got a rasping and wheedling noise, then swore and punched another.
“Yes,” Dicken said.
“With old endogenous viruses?”
“Yes.”
“Shit. How is that possible?”
“It's a mechanism I haven't seen before.”
“Then why bother to call?” Augustine stopped in mid-dial, disgusted. His fingernails were black with dirt and secretions. “It's all over.”
“No, it isn't. The recombined genes can't possibly be from the children,” Dicken said. “They don't have them. They were excised and discarded when their chromosomes reformed during supermitosis.”
Augustine raised his chin. “We helped the virus recombine?”
Dicken nodded. “It may have traveled in us and mutated silently for years. Now it's making its move—against the children.”
“Proof?”
“Proof enough,” Dicken said. “Most of what we need, anyway. We can send in my results. The CDC just needs to do their own analysis, compare my findings with their own. I'm sure they'll match. Then, we tell Ohio to back off and get Emergency Action to calm down. This is not a killer plague—not for us.”