The Hot Zone

by Richard Preston

  Fred Murphy, the other C.D.C. man, was sitting next to McCormick. He began to realize that the C.D.C. was not in a good position to argue the matter. He leaned over and whispered, “Joe! Calm your jets. Stifle it, Joe. We’re outnumbered here.”

  General Philip Russell had been sitting back, watching the argument, saying nothing. Now he stepped in. In a calm but almost deafeningly loud voice he suggested that they work out a compromise. He suggested that they split the management of the outbreak.

  A compromise seemed to be the best solution. The general and Fred Murphy quickly worked out the deal, while McCormick and Peters stared at each other with little to say. It was agreed that the C.D.C. would manage the human-health aspects of the outbreak and would direct the care of any human patients. The Army would handle the monkeys and the monkey house, which was the nest of the outbreak.

  THE MISSION

  1630 HOURS, WEDNESDAY

  Colonel C. J. Peters now felt that he had permission to get the action under way. As soon as the meeting broke up, he began to line up his ducks. The first thing he needed was a field officer who could lead a team of soldiers and civilians into the monkey house. He needed to form a military-action unit.

  He had already decided who was going to lead the mission. It was going to be Colonel Jerry Jaax, Nancy’s husband. Jerry had never worn a space suit, but he was the chief of the veterinary division at the Institute, and he understood monkeys. His people, both soldiers and civilians, were certainly going to be needed. No one else had the training to handle monkeys.

  He found Jerry in his office, staring out the window and chewing on a rubber band. C. J. said, “Jerry, I believe we have a situation down in Reston.” A situation. Code for a hot agent. “It looks like we’re going to have to go down and take those monkeys out, and we’re going to do it in Biosafety Level 4 conditions.” He asked Jerry to assemble teams of soldiers and civilian employees to be ready to move out with space suits in twenty-four hours.

  Jerry walked over to Gene Johnson’s office and told him that he’d been put in charge of the mission. The office was a mess. He wondered how Gene, as large a man as he was, could even fit himself in among the stacks of paper.

  Jerry and Gene immediately began to plan a biohazard operation. There had been a general decision to take out one room of monkeys, and see how that worked, see how things went—see if the virus was spreading. They set up their priorities.

  Priority One. Safety of the human population.

  Priority Two. Euthanasia of the animals with a minimum of suffering.

  Priority Three. Gathering of scientific samples. Purpose: to identify the strain and determine how it travels.

  Gene felt that if the team did its job properly, the human population of Washington would be safe. He put on his glasses and hunched over and fished through his papers, his beard crushed on his chest. He knew already that he was not going to go inside that building. No way in hell. He had seen monkeys die too many times, and he could not bear it anymore. In any case, his job was to gather equipment and people and move them into the building, and then to extract the people and equipment and dead animals safely.

  He had saved lists, long lists of all the gear he had brought to Kitum Cave. He pawed through his papers, swearing gently. He had literally tons of African gear. He had squirreled it away in all kinds of hiding places at the Institute, where other people couldn’t find it and rip it off.

  Gene was terribly excited, and also afraid. His nightmares about Ebola virus, the bad dreams of liquid running through pinholes into his space suit, had never really gone away. He would still wake up at night thinking, My God, there’s been an exposure. He had spent almost ten years hunting Ebola and Marburg in Africa, with little success, and suddenly one of the bastards had reared its head in Washington. His favorite saying came back to him: “Chance favors the prepared mind.” Well, the chance had come. If a piece of gear had been handy in Kitum Cave, it would be handy in the monkey house. As Gene thought about it, he realized that the building was very much like Kitum Cave. It was an enclosed air space. Dead air. Air-handling system broken, failed. Dung all over the place. Monkey urine in pools. A hot cave near Washington. And there were people who had been inside the cave who might be infected with the virus by now. How would you move your teams in and out of the hot area? You would have to set up a staging area. You would have to have a gray area—an air lock with a chemical shower of some kind. Somewhere inside that building lived a Level 4 life form, and it was growing, multiplying, cooking inside hosts. The hosts were monkeys and, perhaps, people.

  2000 HOURS, WEDNESDAY

  Dan Dalgard left USAMRIID and drove back to his office on Leesburg Pike, arriving there around eight o’clock. The office was deserted; everyone had gone home. He straightened up his desk, shut down his computer, and removed a floppy disk that contained his daily diary, his “Chronology of Events.” He put the disk into his brief case. He said good night to a security guard at the front desk and drove home. On the road, he realized that he had forgotten to call his wife to tell her that he would be late. He stopped at a Giant Food supermarket and bought her a bunch of cut flowers, carnations and mums. When he arrived home, he reheated his dinner in the microwave and joined his wife in the family room, where he ate sitting in a recliner chair. He was exhausted. He put another log into the wood stove and sat down at his personal computer, which was located next to his clock-repair bench. He inserted the floppy disk and began typing. He was bringing his diary up to date.

  So much had happened during the day that he had difficulty keeping it all straight in his mind. In the morning, he had learned that the monkey caretaker named Jarvis Purdy was in the hospital, reportedly with a heart attack. Jarvis was resting comfortably, and there had been no reports that his condition was getting worse. Should I have notified the hospital that Jarvis might be infected with Ebola? If he does have Ebola, and it spreads within the hospital, am I liable? Jesus! I’d better get someone to go over to the hospital first thing tomorrow and tell Jarvis what’s going on. If he hears it on the news first, he’s liable to have another heart attack!

  He had gotten all the other monkey caretakers fitted with respirators, and he had briefed them on what was known about the transmission of Ebola and Marburg to humans, and he had suspended all daily operations in the building other than feedings once a day, observation, and cleaning of the animal rooms. He had briefed the staff in the laboratory on Leesburg Pike—which had been handling monkey blood and tissue samples—about the need to handle these specimens as if they were infected with the AIDS virus.

  I must remember to inform labs that have received animal shipments from us to notify the C.D.C. if any unusual animal deaths occur. What about the exposure to those people who had been working on the air-handling system? What about the laundry service? Wasn’t there a telephone repairman in recently? Perhaps last week—I can’t remember just when that was. Holy Christ! Have I missed anything?

  While he was updating the day’s events on the computer, the telephone rang. It was Nancy Jaax on the line. She sounded tired. She told him that she had just finished the necropsies of the seven animals. She told him that her findings were consistent with either SHF or Ebola. She said it could be either one or both. Her results were ambiguous.

  RECONNAISSANCE

  NOVEMBER 30, THURSDAY

  By the time Dan Dalgard woke up the next morning—it was now Thursday, exactly a week after Thanksgiving Day—he had made up his mind to invite the Army in to clean up one room, Room H, where the outbreak now seemed to be centered. He telephoned C. J. Peters and gave the Army permission to enter the monkey house. The news that they had the green light for a biohazard operation spread instantly through USAMRIID.

  Colonel Jerry Jaax called a meeting of all the commissioned officers on his staff, along with two sergeants. They were Major Nathaniel (“Nate”) Powell, Captain Mark Haines, Captain Steven Denny, Sergeant Curtis Klages, and Sergeant Thomas Amen, and he invited a ci
vilian animal caretaker named Merhl Gibson to attend. These people were the core of his team. He put it casually to them: “Do you want to go to Reston?” Some of them had not heard of Reston. He explained what was going on, saying, “There are some monkeys that need to be euthanized. We’d like for you to play. Do you want in? Do you want to go?” They all said they wanted to play. He also figured that Nancy was going to play. That meant that he and Nancy would be inside the building at the same time. The children would be on their own tomorrow.

  They were going to make an insertion into the monkey house, go into one room, kill the monkeys in that room, and take samples of tissue back to the Institute for analysis. They were going to do the job in space suits, under conditions of Level 4 biocontainment. The team would move out at 0500 hours tomorrow morning. They had less than twenty-four hours to get ready. Gene Johnson was gathering his biohazard equipment right now.

  Gene drove down to Virginia and arrived at the monkey house in midmorning for a reconnaissance, to get a sense of the layout of the building and to figure out where to put the air lock and gray zone, and how to insert the team into the building. He went with Sergeant Klages, who was wearing fatigues. As they turned into the parking lot, they saw a television van parked in front of the monkey house, the newscaster and his crew drinking coffee and waiting for something to happen. It made Gene nervous. The news media had begun to circle around the story early on, but they couldn’t seem to get a handle on it, and USAMRIID was trying to keep it that way.

  Gene and the sergeant parked under a sweet-gum tree by the low brick building and went in through the front door. As they opened the door, the smell of monkey almost knocked them over. Whoa, Sergeant Klages thought, Whoa—we shouldn’t even be in here without a space suit. The building stank of monkey. Something ugly was happening here. The whole god-damned place could be hot; every surface could be hot. The monkey workers had stopped cleaning the cages, because they did not want to go into the monkey rooms.

  They found Bill Volt and told him they wanted to scout the building to determine the best way for the teams to enter tomorrow. Volt offered them a chair in his office while they talked. They didn’t want to sit down, didn’t want to touch any surfaces in his office with their bare hands. They noticed that Volt had a candy habit. He offered them a box full of Life Savers, Bit-O-Honeys, and Snickers bars—“Help yourselves,” he said. Sergeant Klages stared at the candy with horror and mumbled, “No, thank you.” He was afraid to touch it.

  Gene wanted to go into the monkey area and see Room H, the hot spot. It was at the back of the building. He did not want to walk through the building to get to that room. He did not want to breathe too much of the building’s air. Poking around, he discovered another route to the back of the building. The office space next door was empty and had been vacated some time ago; the electric power was cut off, and ceiling panels were falling down. He got a flashlight and around through these dark rooms. This is like a bombed-out area, he thought.

  He found a door leading back into the monkey house. It led to a storeroom, and there was a closed corridor that headed deeper into the monkey house. Now he could see it all in his mind’s eye. The closed corridor would be the air lock. The storeroom would be the staging area. The team could put on their space suits in this storeroom, out of sight of the television cameras. He drew a map on a sheet of paper.

  When he understood the layout of the building, he circled to the front and told the monkey workers that he wanted the back areas of the building completely sealed off—airtight. He didn’t want an agent from Room H to drift to the front of the building and get into the offices. He wanted to lower the amount of contaminated air flowing into those offices.

  There was a door that led to the back monkey rooms. They taped it shut with military brown sticky tape: the first line of defense against a hot agent. From now on, as Gene explained to the monkey workers, no one was to break the sticky tape, no one was to go inside those back rooms except Army people until Room H had been cleaned out. What Gene did not realize was that there was another way into the back rooms. You could get there without breaking the sticky tape on the door.

  • • •

  At eleven-thirty that morning, Lieutenant Colonel Nancy Jaax and Colonel C. J. Peters arrived at the corporate offices of Hazleton Washington on Leesburg Pike to meet with Dan Dalgard and to speak to a group of Hazleton lab workers who had been exposed to tissues and blood from sick monkeys. Since the C.D.C. now had charge of the human aspects of the Ebola outbreak, Joe McCormick also arrived at the Hazleton offices at the same time as Jaax and Peters.

  The lab employees had been handling tissue and blood from the monkeys, running tests on the material. They were mainly women, and some of them were extremely frightened, nearly in a panic. That morning, there had been radio reports during rush hour, as the women were coming to work, that Ebola virus had killed hundreds of thousands of people in Africa. This was a wild exaggeration. But the radio newscasters had no idea what was going on, and now the women thought they were going to die. “We’ve been hearing about this on the radio,” they said to Jaax and McCormick.

  Nancy Jaax claims that Joe McCormick did his best to calm them down, but that as he talked to the women about his experiences with Ebola in Africa, they seemed to become more and more frightened.

  A woman got up and said, “We don’t care if he’s been to Africa. We want to know if we’re going to get sick!”

  McCormick doesn’t have any recollection of speaking to the women. He said to me, “I never talked to them. Nancy Jaax talked to them about Ebola.”

  Nancy thinks that they began to calm down when they saw a female Army colonel in a uniform. She asked the women, “Did any of you break a test tube? Do we have anyone here who stuck himself with a needle or cut himself?”

  No one raised a hand.

  “Then you’ll be all right,” she said to them.

  A few minutes afterward, Dan Dalgard turned to C. J. Peters and, in a low voice, said something like, “Why don’t you come over to the primate facility with me to look at the monkeys?”

  Conspicuously, he did not invite McCormick of the C.D.C.

  The Army was finally getting its foot in the door of the building.

  They drove to the monkey house. By this time, Gene Johnson had closed off the back rooms and sealed the main entry door with sticky tape. Nancy and C. J., along with Dan Dalgard, circled around to the back of the building, put on rubber gloves and paper surgical masks, and went into Room H to look at the sick monkeys. Nancy and C. J. noticed with some concern that the monkey workers around the building were not wearing respirators, despite Dalgard’s order. No one offered a respirator to Nancy or C. J. either. This made them both nervous, but they did not say anything. When in a monkey house, do as the monkey workers do. They did not want to give offense by asking for breathing equipment, not at this delicate moment, not when they had finally gotten their first chance to look at the building.

  In Room H, Dalgard picked out the sick animals, pointing to them. “This one is sick, this one looks sick, this one over here looks sick,” he said. The monkeys were quiet and subdued, but they rattled their cages now and then. Nancy stood well back from the cages and took shallow breaths, not wanting to let the smell of monkey get too deep into her lungs. A number of the animals had already died—there were many empty cages in the room—and many of the other animals were obviously sick. They sat at the backs of their cages, passive and blank faced. They were not eating their monkey biscuits. She saw that some had runny noses. She averted her eyes and behaved respectfully around the monkeys, because she did not want a monkey to get a notion in its head to spit at her. They have good aim when they spit, and they aim for your face. She worried more about her eyes than anything else. Ebola has a special liking for the eyes. Four or five virus particles on the eyelid would probably do it.

  She noticed something else that made her fearful. These monkeys had their canine teeth. The company had not filed
down the monkeys’ fangs. The canines on these hummers were as big as the canines on any guard dog you’ll ever see, and that was a rude awakening. A monkey can run amazingly fast, it can jump long distances, and it uses its tail as a gripper or a hook. It also has a mind. Nancy thought, An angry monkey is like a flying pit bull terrier with five prehensile limbs—these critters can do a job on you. A monkey directs its attacks toward the face and head. It will grab you by the head, using all four limbs, and then it will wrap its tail around your neck to get a good grip, and it will make slashing attacks all over your face with its teeth, aiming especially for the eyes. This is not a good situation if the monkey happens to be infected with Ebola virus. A six-foot-tall man and a ten-pound monkey are pretty evenly matched in a stand-up fight. The monkey will be all over the man. By the end of the fight, the man may need hundreds of stitches, and could be blinded. Jerry and his team would have to be exquisitely careful with these monkeys.

  That evening, Jerry drove home alone. Nancy had put on a space suit and gone back into her lab to continue analyzing the monkey samples, and he had no idea when she would finish. He changed out of his uniform, and the telephone rang. It was Nancy’s brother on the line, calling from Kansas, saying that Nancy’s father was slipping, and that it looked as if the end was near. Nancy might be called home at any time for her father’s funeral. Jerry said that he would pass the word along to Nancy, and explained that she was working late.