Outbreak (13 page)

"I thought you told me that Dr. Richter had been to Africa," said Ralph. "It seems to me that is the crucial fact. After all, Africa is where this virus is endemic."

"True," said Marissa. "But the time frame is all wrong. His incubation period would have been six weeks, when all the other cases averaged only two to five days. Then consider the problem of relating the two outbreaks. Dr. Zabriski hadn't been to Africa, but the only point of connection was that the two doctors attended the same medical conference in San Diego. And again, that was six weeks before Dr. Zabriski got sick. It's crazy." Marissa waved her hand as if she were giving up.

"At least be happy you controlled the outbreaks as well as you did. I understand that it was worse when this virus appeared in Africa."

"That's true," agreed Marissa. "In the Zaire outbreak in 1976, whose index case may have been an American college student, there were three hundred eighteen cases and two hundred eighty deaths."

"There you go," said Ralph, feeling that the statistics should cheer Marissa. He folded his napkin and put it on the table. "How about stopping at my house for an after-dinner drink?"

Marissa looked at Ralph, amazed at how comfortable she'd become with him. The surprising thing was that the relationship had developed on the telephone. "An after-dinner drink sounds fine," she said with a smile.

On the way out of the restaurant, Marissa took Ralph's arm. When they got to his car, he opened the door for her. She thought that she could get used to such treatment.

Ralph was proud of his car. It was obvious in the loving way he touched the instruments and the steering wheel. The car was a new 300 SDL Mercedes. Marissa appreciated its luxuriousness as she settled back in the leather seat, but cars had never meant much to her. She also couldn't understand why people bought diesels since they had an uncomfortable rattle when they started and idled. "They are economical," said Ralph. Marissa looked around at the appointments. She marveled that someone could delude himself that an expensive Mercedes was economical.

They didn't speak for a while, and Marissa wondered if going to Ralph's house at that time of night was a good idea. But she trusted Ralph and was willing to let their relationship develop a little further. She turned to look at him in the half-light. He had a strong profile, with a prominent nose like her father's.

After they had settled on the couch in the parlor, with brandy snifters in hand, Marissa mentioned something she had been afraid to point out to Dubchek in his current patronizing mood. "There is one thing about the two index cases that I find curious. Both men were mugged just a few days before they got sick." Marissa waited for a response.

"Very suspicious," said Ralph with a wink. "Are you suggesting that there is an 'Ebola Mary' who robs people and spreads the disease?"

Marissa laughed. "I know it sounds stupid. That's why I haven't said anything to anyone else."

"But you have to think of everything," added Ralph. "The old medical-school training that taught you to ask everything, including what the maternal great-grandfather did for a living in the old country."

Deliberately, Marissa switched the conversation to Ralph's work and his house, his two favorite subjects. As the time passed, she noted

that he did not make any moves toward her. She wondered if it were something about herself, like the fact that she'd been exposed to Ebola. Then, to make matters worse, he invited her to spend the night in the guest room.

Marissa was insulted. Perhaps just as insulted as if he'd tried to drag her dress over her head the moment they walked in the front door. She told him thank you, but she did not want to spend the night in his guest room; she wanted to spend the night in her own house with her dog. The last part was meant to be an affront, but it sailed over Ralph's head. He just kept on talking about redecorating plans he had for the first floor of the house, now that he'd lived there long enough to know what he wanted.

In truth, Marissa did not know what she would have done if Ralph had made any physical advances. He was a good friend, but she still didn't find him romantically attractive. In that respect, she thought Dubchek's looks distinctly more exciting.

Thinking of Cyrill reminded her of something. "How do you and Dr. Dubchek know each other?"

"I met him when he addressed the ophthalmology residents at the University Hospital," said Ralph. "Some of the rare viruses like Ebola and even the AIDS virus have been localized in tears and the aqueous humor. Some of them even cause anterior uveitis."

"Oh," said Marissa, nodding as if she understood. Actually she had no idea what anterior uveitis was, but she decided it was as good a point as any to ask Ralph to drive her home.

Over the next few days, Marissa adapted to a more normal life, although every time the phone rang, she half expected to be called out for another Ebola disaster. Remembering her resolve, she did pack a suitcase and kept it open in her closet, ready for her to toss in her cosmetics case. She could be out of her house in a matter of minutes, if the need arose.

At work, things were looking up. Tad helped her perfect her viral laboratory skills and worked with her to write up a research proposal on Ebola. Unable to come up with a working hypothesis for a possible reservoir for Ebola, Marissa concentrated instead on the issue of transmission. From the enormous amount of data that she'd amassed in L.A. and St. Louis, she had constructed elaborate case maps to show the spread of the illness from one person to another. At the same time, she'd compiled detailed profiles on the people who had been primary contacts but who had not come down with the disease. As Dr. Layne had suggested, close personal contact was needed,

presumably viral contact with a mucous membrane, though, unlike AIDS, sexual transmission had only been a factor between Dr. Richter and the medical secretary and Dr. Zabriski and his wife. Given the fact that hemorrhagic fever could spread between strangers who shared a towel, or by the most casual close touch, Ebola made the AIDS scare seem like a tempest in a teapot.

What Marissa wanted to do was to validate her hypothesis by using guinea pigs. Of course such work required the use of the maximum containment lab, and she still had not obtained permission.

"Amazing!" exclaimed Tad, one afternoon when Marissa demonstrated a technique she'd devised to salvage bacteria-contaminated viral cultures. "I can't imagine Dubchek turning down your proposal now."

"I can," answered Marissa. She debated telling Tad about what had happened in the L.A. hotel, but once again she decided not to do so. It wouldn't accomplish anything and might cause problems in Tad's relationship with Cyrill.

She followed her friend into his office. As they relaxed over coffee, Marissa said, "Tad, you told me when we went into the maximum containment lab that there were all sorts of viruses stored in there, including Ebola."

"We have samples from every outbreak. There are even samples frozen and stored from your two outbreaks."

Marissa wasn't at all sure how she felt about people referring to the recent epidemics as "hers." But she kept that thought to herself, saying instead, "Is there any place else that the Ebola virus is stored, other than here at the CDC?"

Tad thought for a moment. "I'm not sure. Do you mean here in the

U.S.?"

Marissa nodded.

"The army probably has some in Ft. Detrick at the Center for Biological Warfare. The fellow that runs the place used to be here at the CDC and he had an interest in viral hemorrhagic fevers."

"Does the army have a maximum containment lab?"

Tad whistled. "Man, they've got everything."

"And you say the man in charge at Ft. Detrick has an interest in viral hemorrhagic fever?"

"He was one of the people along with Dubchek who had been sent out to cover the initial Ebola outbreak in Zaire."

Marissa sipped her coffee, thinking that was an interesting coincidence. She was also beginning to get a germ of an idea, one so unpleasant that she knew she could not consider it a reasonable hypothesis.

"One moment, ma'am," said the uniformed sentry with a heavy Southern accent.

Marissa was stopped at the main gate to Ft. Detrick. Despite several days of trying to argue herself out of the suspicion that the army might have somehow been responsible for Ebola being loosened on an unsuspecting public, she had finally decided to use her day off to investigate for herself. Those two muggings continued to nag at her.

It had only been an hour-and-a-half flight to Maryland and a short drive in a rent-a-car. Marissa had pleaded her field experience with Ebola as an excuse to talk to anyone else familiar with the rare virus, and Colonel Woolbert had responded to her request with enthusiasm.

The sentry returned to Marissa's car. "You are expected at building number eighteen." He handed her a pass that she had to wear on the lapel of her blazer, then startled her with a crisp salute. Ahead of her, the black-and-white gate tipped up, and she drove onto the base.

Building #18 was a windowless concrete structure with a flat roof. A middle-aged man in civilian clothes waved as Marissa got out of her car. It was Colonel Kenneth Woolbert.

To Marissa, he looked more like a university professor than an army officer. He was friendly, even humorous, and was unabashedly pleased about Marissa's visit. He told her right off that she was the prettiest and the smallest EIS officer he'd ever met. Marissa took the good with the bad.

The building felt like a bunker. Entry was obtained through a series of sliding steel doors activated by remote control. Small TV cameras were mounted above each door. The laboratory itself, however, appeared like any other modern hospital facility, complete with the omnipresent coffeepot over the Bunsen burner. The only difference was the lack of windows.

After a quick tour, during which the presence of a maximum containment lab was not mentioned, Colonel Woolbert took Marissa to their snack shop, which was nothing more than a series of vending machines. He got her a donut and Pepsi, and they sat down at a small table.

Without any prompting, Colonel Woolbert explained that he'd started at the CDC as an EIS officer in the late fifties and had become increasingly interested in microbiology and ultimately virology. In

the seventies, he'd gone back to school, at government expense, to get a Ph.D.

"It's been a hell of a lot better than looking at sore throats and clogged ears," said the Colonel.

"Don't tell me you were in pediatrics!" exclaimed Marissa. They laughed when they realized they had both trained at Boston's Children's Hospital. Colonel Woolbert went on to explain how he'd ended up at Ft. Detrick. He told Marissa that there had been a history of movement between Detrick and the CDC and that the army had come to him with an offer he couldn't refuse. He said that the lab and the equipment were superb, and best of all, he didn't have to grovel for funds.

"Doesn't the ultimate goal bother you?" asked Marissa. "No," said Colonel Woolbert. "You have to understand that three-quarters of the work here involves defending the U.S. against biological attack, so most of my efforts are directed at neutralizing viruses like Ebola."

Marissa nodded. She'd not thought of that.

"Besides," continued Colonel Woolbert, "I'm given complete latitude. I can work on whatever I want to."

"And what is that just now?" asked Marissa innocently. There was a pause. The colonel's light-blue eyes twinkled.

"I suppose I'm not violating the confidentiality of the military by telling you, since I've been publishing a string of articles on my results. For the last three years my interest has been influenza virus."

"Not Ebola?" asked Marissa.

Colonel Woolbert shook his head. "No, my last research on Ebola was years ago."

"Is anyone here at the center working on Ebola?" asked Marissa. Colonel Woolbert hesitated. Then he said, "I guess I can tell you, since there was a Pentagon policy paper published on it in Strategic Studies last year. The answer is no. No one is working on Ebola, including the Soviets, mainly because there is no vaccine or treatment for it. Once started, it was generally felt that Ebola Hemorrhagic Fever would spread like wildfire to both friendly and hostile forces."

"But it hasn't," said Marissa.

"I know," said Colonel Woolbert with a sigh. "I've read with great interest about the last two outbreaks. Someday we'll have to review our assessment of the organism."

"Please, not on my account," said Marissa. The last thing she wanted to do was encourage the army to work with Ebola. At the same time she was relieved to learn that the army was not fooling around with the virus just then.

"I understand you were part of the international team that was sent to Yambuku in 1976," she said.

"Which makes me appreciate what you're doing. I can tell you, when I was in Africa I was scared shitless."

Marissa grinned. She liked and trusted the man. "You are the first person to admit being afraid," she said. "I've been struggling with my fear from the first day I was sent to L.A."

"And for good reason," said Colonel Woolbert. "Ebola's a strange bug. Even though it seems it can be inactivated quite easily, it is extraordinarily infective, meaning that only a couple of organisms have to make entry to produce the disease. That's in marked contrast to something like AIDS, where billions of the virus have to be introduced, and even then there is only a low statistical chance that the individual will be infected."

"What about the reservoir?" asked Marissa. "I know the official position is that no reservoir was discovered in Africa. But did you have an opinion?"

"I think it is an animal disease," said Colonel Woolbert. "I think it will eventually be isolated to some equatorial African monkey and is therefore a zoonosis, or a disease of vertebrate animals that occasionally gets transmitted to man."

"So you agree with the current CDC official position about these recent U.S. outbreaks?" asked Marissa.

"Of course," said Colonel Woolbert. "What other position is there?"