Sometime- the Plague World

by Meredith Mason Brown

  “Very cute, Michael” Dan said. “Genius, maybe, if presented within moderation. Your idea fountain gushes over. But I’m not in the entertainment business, Mike; I’m just a retired lawyer. So don’t look to me to tell you what sells for funny on TV or in your line of books. Just keep on chugging. Enough of your ideas work out for you to make more than enough to pay your bills. I hereby give you permission to use the word Mori, and to say that a slippery fishy Mori is a Mori Ill. And I’ll spare you, at least for now, my thoughts on the chance of a flu epidemic breaking out in the town of Rockinam, and how unappealing it is when the person next to you in church sneezes once, sending a large wet gob of green snot into her elbow, and then sneezes a second time, sending a gob into the back of your hand.”

  “Thanks a lot for telling me such repulsive things, Dad,” Michael said. “That’s very thoughtful of you. You keep my weight down, because I can’t eat after hearing from you.” Dan’s call to Michael didn’t last much longer.

  At dinnertime with only the company of his television set, Dan poured himself and drank a scotch on the rocks, in the belief that it might be as powerful in blocking influenza disease as it was in numbing the senses. He offered some scotch to his large shaggy multibreed dog Don Carlos, who, as he always did when offered liquor, sniffed the glass and its contents, and turned his head away. In some ways the dog was more sensible and prudent than its owner. Dan then, consistent with his own practice, recorded in his leather diary the day’s events, including the flu scare at church and the Memento Mori skull. Knowing that his near-term memory was rapidly eroding as he grew older, Dan sought to keep track of developments by writing them down before they became irretrievable. After finishing the day’s diary entries, he prepared his usual sort of dinner – a hot can of soup, toast, a carrot, an apple for dessert, and a well-iced bottle of New Zealand sauvignon blanc, bought at a price comfortably within his self-imposed $12 limit.

  And the LORD said unto Moses, Rise up early in the morning, and stand before Pharaoh, and say unto him, Thus saith the LORD God of the Hebrews, Let my people go, that they may serve me.

  For I will at this time send all my plagues upon thine heart and upon thy people; that thou mayest know that there is none like me in all the earth.

  For now I will stretch out my hand that I may smite thee and thy people with pestilence; and thou shalt be cut off from the earth. (Exodus 9:13-15)

  2

  Biblical Plagues and Pestilences

  Dan woke up on Monday without a runny nose, aches, or a fever. Instead, he felt something resembling gratitude to Sunday’s flu-ridden congregants and to his own fortune-telling glimpses at the Bible, because they gave him something substantive to do. He had worked hard as a lawyer for more than four decades, but in retirement he found himself doing little more than occasional pro bono work for local charities. The flu flare-up and the biblical description of plague gave Dan a chance to learn something more about epidemics and pestilence than the bits he had accumulated as incidental learning from reading history, from news accounts of quickly spreading diseases, and from work he had done as a lawyer dealing with large pharmaceutical companies that would only attempt new vaccines for new forms of disease if the government agreed to hold the companies harmless if the disease or the vaccines turned out to be harmful.

  Dan began with the Bible. Was there some reason why, in his random opening of that book, he had encountered the text from Zechariah about the ghastly flesh-rotting plague that would strike all who waged war on Israel? Dan went on his computer to a digital copy on Google of the King James Version of the Bible, and entered the words “plague” and “pestilence.” The computer showed that the King James Version used the word “plague” 159 times and the word “pestilence” 51 times. Further exploration showed that those words were frequently used to describe fatal infections, not mild ailments like sneezes and runny noses. In Deuteronomy 28:15, for example, Dan encountered the following use of “pestilence”:

  “But it shall come to pass, if thou wilt not hearken unto the voice of the LORD thy God, to observe to do all his commandments and his statutes which I command thee this day, that all these curses shall come upon thee and overtake thee:

  21 The LORD shall make the pestilence cleave unto thee, until he shall have consumed thee from off the land, whither thou goest to possess it.

  22 The LORD shall smite thee with a consumption, and with a fever, and with an inflammation, and with an extreme burning, and with the sword, and with blasting, and with mildew; and they shall pursue thee until thou perish.”

  The Deuteronomy recitation of increasingly painful and ultimately lethal ailments sounded to Dan not to be baseless, but instead as if the biblical writers had themselves encountered plagues, or had heard in detail how fatal plagues could be – including many instances referred to in Old Testament texts written more than 2,000 years ago, well before the birth of Jesus – books such as Genesis, Exodus, Leviticus, Numbers, Deuteronomy, Kings, Chronicles, Jeremiah, Zechariah, and Ezra. Dan, who did not trust his aging memory, began writing in his notebook notes on Old Testament passages that reminded him of the kind of notes he had been obliged to write down almost sixty years earlier, when he was fifteen years old, taking a required course on the Bible at a church boarding school. In his new notes, Dan put together a tidy table of examples of plagues or pestilences, in order of their biblical appearance:

  Location of Text

  Reference to Plague or Pestilence

  Genesis 12:17

  “And the LORD plagued Pharaoh and his house with great plagues, because of Sarai, Abram’s wife.” (By having Sarai say to the Egyptians that she was Abram’s sister – not his wife – Sarai was taken into Pharaoh’s house – and, one suspects, into his bed.)

  Exodus 9-12

  To enable the Hebrews to leave Egypt, the LORD sent various escalating plagues by the LORD against Pharaoh and the Egyptians: killing all the cattle of Egypt; lethal hail and fire; locusts; and slaughter by plague of all the firstborn in Egypt, from the Pharaoh’s firstborn to the firstborn of the cattle (but passing over the Israelites).

  Exodus 32:35

  And the LORD plagued the people, because they made the calf [and worshipped the golden calf as an idol.]

  Leviticus 13 and 14

  Long list of leprosy indications, which required unclean lepers to live apart from other Israelites.

  Numbers 11:32-34

  After the Israelites who came out of Egypt complained of insufficient food, the LORD sent a wind that brought hundreds of bushels of quails to fall beside the camp of the Israelites. “While the quail flesh was yet between their teeth, ere it was chewed, the wrath of the LORD was kindled against the people, and the LORD smote the people with a very great plague”, so that the place was called Kibroth-hattaavah [that is, Graves of craving], because there they buried the people who had the craving.” [Dan added to the table a penciled note to himself: “I don’t get it. Did the fallen quails make the Israelites quail? Dear God, am I starting to sound like my wise-ass son Michael?”]

  Numbers 16:47-49

  Wrath of the LORD; “they that died in the plague were fourteen thousand and seven hundred.” [Why, Dan wondered, does the Bible contain so many multiples of seven? A quick Google look in the King James Version listed 763 uses of the word “seven.”]

  Numbers 25:1, 8-9

  When “Israel abode in Shittim, and the people began to commit whoredom with the daughters of Moab,” the Lord threatened to kill the unfaithful Israelites by plague. To stay the plague, Moses ordered the killing of Israelites who had followed Baal-peor, and who had whored after Moabite women – “And those that died in the plague were twenty and four thousand.”

  Deuteronomy 28: 58-62

  “If thou wilt not observe to do all the words of this law that are written in this book…. [t]hen the LORD will make thy p
lagues wonderful, and the plagues of thy seed, even great plagues, and of long continuance, and sore sicknesses, and of long continuance. Moreover, he will bring upon thee all the diseases of Egypt, which thou wast afraid of… Also every sickness, and every plague, which is not written in the book of this law, them will the LORD bring upon thee, until thou be destroyed. And ye shall be left few in number, whereas ye were as the stars of heaven for multitude; because you would not obey the voice of the LORD thy God.”

  1 Samuel 4-6

  After the Philistines took the ark of God from the Israelites and bring it to Ashdod [a Philistine town], the Lord’s hand was heavy on the people of Ashdod, “and he destroyed them and smote them with emerods.”

  2 Chronicles 21:14-19

  As prophesied by Elijah, because Jehoram the king of Judah had made Judah go whoring, the Lord with a great plague smote Jehoram in his bowels with an incurable disease, and after two years “his bowels fell out by reason of his sickness: so he died of sore diseases.”

  Jeremiah 21:6

  “And I will smite the inhabitants of this city, both man and beast: they shall die of a great pestilence.”

  Well before noon, Dan had finished his table of Old Testament plague references. He came away with an overwhelming and alarming sense of the recurrence of different sorts of lethal epidemics. The Bible had told him far more on this subject than the Rockinam pharmacy. Dan didn’t like what he had learned about plagues from the Bible. Nor did he like the limits on his own knowledge of plagues. It wasn’t yet nine A.M. Pacific Time. He telephoned his older son Nathaniel.

  “Am I catching you at a bad time, Nat?”

  “I’m about on the way out the door to the hospital.”

  “Can I ask you some quickies about sickness, about plagues, as described in the Old Testament?”

  “The Old Testament has a sickening effect on me from time to time, Dad. As you know, unlike you, I am not a churchgoer. Hearing about the Old Testament is not likely to make me more of a churchgoer. Probably less of one. I do have to run soon, Dad.”

  “Nat, I’ll spare you the bit in Numbers 25:1, in which ‘Israel abode in Shittim, and the people began to commit whoredom with the daughters of Moab.’ I didn’t make up those words. They’re in the King James Version, as is a statement that 24,000 unfaithful Israelites were killed by the plague. Let me try just one text that struck me as particularly impenetrable. In Numbers 11, God got mad at the Israelites who had left Egypt led by Moses, because they had been complaining about the lack of food in the wilderness. The Lord sent out a big wind that blew from the sea to the Israelites’ camp, carrying quails that fell dead by the camp in heaps at least three feet high. While the quails were between the teeth of the Israelites, the Lord in his wrath smote the people with a very great plague that killed the Israelites, who were buried at the campsite, so the Lord called the place Kibroth-hattaavah, a long name that means “Graves of craving.” What’s lethal about quails, Nat? Or were the writers of the Bible smoking something?”

  “Sounds to me that those Bible writers wrote about a kind of plague that the Israelites had actually seen. You’ve stumbled onto something that may be major, Dad. I used to be pretty good at plague stuff. You may remember that I spent some time, right after medical school, working at the CDC – the Centers for Disease Control and Prevention in Atlanta – looking through microscopes at microbes for one kind of viral outbreak or another, while I was wrapped in sweaty space suits so the nasty virus that was in the microbes couldn’t get at me. You heard of avian flu? Avian just means relating to birds. You may think of Avis as a kind of car rental agency, but avis in Latin means bird. Birds can get ailments that can spread quickly from bird to bird, killing millions of birds. For us humans, the scary part comes if and when the virus mutates in such a way that it can spread from birds to people, and can sicken or even kill the people. In the past century or so there have been quite a few avian flu epidemics among birds, and several bouts of highly pathogenic avian influenza that have infected humans, mostly after direct close contact with dead or sick birds. I think you’ve found something in the Bible that I won’t disagree with – and in Numbers 11 you may have found the oldest case of avian flu ever recorded, although the biblical writers didn’t seem expressly to connect the quails’ death with the deaths of the food-craving Israelites. The good news is that I haven’t heard of an avian flu that is in America right at this moment, nor of an avian flu that that is in some other country these days, and that jumps from birds to people. CDC and the World Health Organization (WHO?, you may ask – and WHO it will be) try to keep track of locations and types of avian flu. So does NIAID, the National Institute of Allergy Institutes of Allergy and Infectious Diseases, which is part of the National Institutes of Health. Organizations like these stockpile vaccines that may block bird-to-human or human-to-human spreading of avian flus. So far as I know, none of these organizations in this flu season has warned about that kind of spreading, though there had been some NIAID-assisted research a year or two ago that talked about H5N1 avian influenza combining with a human seasonal flu strain in a way that caused an avian flu that caused severe disease. I haven’t heard much about that one lately, apart from some news of H7N9 bird flu in Hong Kong, which sounded a bit similar to the severe acute respiratory syndrome (a disease abbreviated as SARS) that killed a few hundred people in Hong Kong in 2003. And so far as I know, Dad, you’re not raising poultry or other birds around your house.”

  “You got that right, Nat. I don’t have even a hen or a parrot at my place. My only live-in friend, since your mother died, is Don Carlos, the shaggy dog. I have been in China, a vast country that has had outbursts of avian flu – but many decades have gone by since I was last over there.”

  “Good. Do you know what zoonoses are?”

  “Zoo noses? Like the sniffer snouts of camels or aardvarks in a zoo?”

  “Nice try, Dad. Zoo is short for zoon, meaning animal, in Greek. Nosos is Greek for disease. Zoonoses are diseases of animals that can migrate to humans (or vice versa). Animals that can carry diseases to people include apes, bats, birds, cattle, dogs (maybe even your beloved Don Carlos might become a carrier), pigs, lice, rats, ticks, and raccoons – in other words, not just birds. And many diseases can be borne by these other living things – not just flu, but also Ebola virus, anthrax, hanta virus, Marburg fever, yellow fever, and Black Death. I can’t come close to remembering the whole list off the top of my head, given the many years since I was at CDC. Viruses keeps changing into new forms that can be spread in different ways, and that circumvent existing immunity defenses. MERS, for example – which stands for Middle East Respiratory Syndrome – is a disease that wasn’t laboratory confirmed until the fall of 2012. The MERS disease started in places like Saudi Arabia, but it has spread from the Middle East into Europe, and more recently in South Korea. MERS has been primarily borne by one-hump camels, but it sometimes spreads from person to person. As its name suggests, MERS harms mostly through respiratory infections. It has been killing close to half of the people it has infected. And there’s a mosquito-borne virus called chikungunya – the very name sounds dangerous, as if a coward might shoot you – Michael would probably carry on about “chicken gun ya.” That virus started in Africa, is in the Caribbean now, and seems likely to spread to Central and South America – and conceivably to the U.S. The point is there always seems to be something, some kind of nasty virus, but with a wide range of different spreaders of different diseases, and different human immune defenses, partly depending on the age of the person. A couple of years back, CDC reported that an H3N2 flu strain had caused a lot of trouble that year, especially for those 65 or older. The vaccine was only 9% effective in that age group, but about 56% effective for kids and adults.”

  “Do I count as adult?”

  “To the CDC, you’re beyond adulthood for this purpose, Dad. You’re 74 – although I’m sure y
ou’re still hot stuff. Well, I’ve got to run, or I’ll be way late at the hospital, and some patient will suffer and die of cancer, and it will be because your question about the Bible slowed me down. That big book makes me nervous. I’ve told you I’m not big on religion. But it’s good for you and me to brush up on plagues, because sooner or later they’re bound to happen. You should read up on them in the history books and the science books. Read about the plague that slaughtered the Athenians in the Peloponnesian War, and about the Black Death in the 1300s, and about the different kinds of flu outbreaks. There’s lots of lingo and buzzwords, but you’ll also get the dynamics of plagues, including how the viruses mutate to be able to survive and grow – and how exposure to the viruses sometimes kills, and sometimes helps us to survive by building up our immunities. I don’t know why you began studying up on the plague world – that whole world is a plague of plagues, all too often.”