CHAPTER 44
Beads of sweat lined Connie Morgan’s hairline as she checked her watch for the thousandth time. She was just about to pull her bus into the terminal for the day, and there was still time to get over to the walk-in clinic on her way home.
She’d never felt so terrible in all her life. The day hadn’t started out all that great, and as the hours wore on, she felt sicker and weaker, like some really vicious bug had a grip on her. What’s more, there was that painful itching under her uniform that she hadn’t been able to shake all day. Unable to really get at it, she’d been rubbing her back against her driver’s seat. At first she’d worried the passengers might notice. By the end of the day, she didn’t care about the passengers at all, and only wanted to get out of her uniform and scratch and claw at her skin directly. Even if it bled.
With a sigh, she pulled into the parking spot reserved for her bus. She wiped her forehead with the back of her sleeve, tottered out the door and locked it. She hurried on unsteady legs to her car, tossed her purse onto the seat and got in. She leaned her head on the steering wheel for a moment as she fought off a wave of dizziness. She hoped it didn’t get any worse before she could see a doctor.
She started the car, eased out of the parking lot, then turned onto the road behind the bus terminal. She was grateful that it wasn’t yet dark and the way to the clinic was a pretty straight shot from the terminal. She didn’t trust herself to do battle with heavy traffic or a long drive. Driving the bus around all day had taken everything she had.
The honk of a horn startled her as she realized she had begun drifting into the oncoming lane. She gripped the wheel tighter and tried to focus all her attention on driving. She wanted desperately to scratch her back, and nearly pulled over to do it, but she didn’t dare delay herself.
Teeth gritted and shoulders hunched, Connie felt a small wave of relief when she spotted the Urgent Care sign up on the next block. Surely they would give her something that would make her feel better. Whatever she got last time she was sick sure worked like a charm. She turned into the driveway and took the first open parking spot.
Connie grabbed her purse, got out of the car and locked it. A sudden blackness encroached at the sides of her vision. She leaned against her car for support, resting her head against the door frame. She struggled to muster the strength to get herself in the door of the clinic. That was all she needed to do. They would take care of her and make this misery stop.
After a few moments, she felt stable enough to try again. She headed for the clinic door, opened it, and made her way to the reception desk.
“Hi, I need to see a doctor—”
The receptionist gave her a startled look, stood, and pressed a button on her desk. “Stay right there.”
The door beside the reception desk opened. Two white-uniformed men wearing surgical masks and gloves came out and approached her.
“Come with us, ma’am,” said the one on her left.
Before she could protest or even react, they each took one of her arms. They half carried her into the treatment area, even though the waiting room was full of other patients.
The next thing she knew, she was seated on a gurney in an examination area, the curtain drawn around her. One of the men left, and the one who remained informed her he was one of the doctor’s assistants. Moments later, the doctor arrived, also wearing a surgical mask and gloves.
He nodded to the assistant and said, “Vitals.”
The assistant helped her to recline on the gurney, then placed a cuff around one arm and a sensor in her ear. “BP 90 over 60, temperature 104.”
“CBC and blood chemistries, then set up an IV.” The doctor stepped closer and looked at her sharply as the assistant left to get the needed items. “When did this start, what else are you experiencing?”
“This morning. Been getting worse all day. I feel feverish and just sick all over. Everything hurts. My stomach’s kind of upset, too.” Connie licked her dry, cracked lips. “And the itching. On my back. It’s been horrible all day, worse now.”
“Let’s take a look at that.” The doctor helped her to sit up so she could remove her uniform shirt. He handed her a paper gown, which she clasped to her chest as he stepped around to take a look at her back. The doctor gasped.
“What is it?”
Without responding to her, the doctor pressed a button on the wall beside the gurney and shouted, “IsoStat kit for Room 4, NOW!”
The doctor positioned himself as far as possible from her within the curtained-off area that surrounded them. Remaining on the gurney, she put on the paper gown in a clumsy and ineffectual attempt to feel less vulnerable.
“What’s going on?”
“Your back. It looks to me like a MRSA-II infection. That’ll have to be confirmed, of course, but we can’t take a chance that it is. It’s highly contagious, so we’re going to put you in a portable isolation unit right away. And if it is MRSA-II, you’ll need to be transferred to a full-service hospital. We can’t keep you here for the necessary treatment.”
“Well, it can’t be that. It must just be some rash. I feel feverish, so it must just be a breakout of some sort from that.”
The look on his face silenced her. “I wish it were only that…Ms., um… They didn’t take your information at the front desk, did they?”
“No, I must look like hell. They took one look at me and just whisked me in here before I could say much of anything. It’s Morgan. Connie Morgan. Look, I just had some other sort of bug recently. I got some medicine for it and got better really fast. Maybe it’s just a relapse of that.”
“Ms. Morgan, I’m sorry, but I’ve seen a number of MRSA-II cases and I know what it looks like. There is a relatively new drug—Lucracillin—that is extremely effective in treating it. But the disease remains contagious even while the drug regimen is administered, so we have to take precautions. A hospital stay is required, I’m afraid. We’re not set up to admit patients to stay here.”
Connie scratched her forearm, then noticed a new lesion there. It was already a couple of inches across and was oozing a mix of yellowish serum and blood. Heart pounding, she thrust it toward the doctor. “Is this what’s on my back, too?”
“Yes, it is. How long has that one been there?”
“I just now noticed it, and it’s so big already.”
The doctor crept a little closer for a better view, then stepped back, nearly tripping on himself. “Hurry up with that IsoStat!”
“What’s the matter?”
“I’ve never seen it move that fast. I saw it enlarge just in the moment I took to look at it.”
Connie looked down at her forearms. Not only was it visibly larger in just minutes, but now there was a lesion on her other forearm that hadn’t been there even moments ago. “Oh my God, what is this?” She held her arms out away from her, repulsed. Her arms, her back—it was spreading so fast!
The assistant arrived with a metal cart that held what looked like a stack of clear plastic sheeting. “Lie down flat for a moment, please. This won’t take a minute. He draped the plastic over her and the gurney.
“What are you doing?” She lay down, then started to flail at the plastic, feeling like she would suffocate with it pressing her down.
“Hang on just a minute.”
The assistant flipped a switch, then the plastic rose and took shape as the air baffles in its walls inflated. In a matter of moments, the plastic sheeting formed an enclosure around her and the gurney.
“What’s happening? What are you doing?”
The doctor approached. “Try not to let it upset you. It’s just a disposable, portable enclosure that sets up a barrier to keep the disease from spreading. It protects us and the other patients—though we will need to disinfect ourselves and the area to eliminate whatever contamination has already occurred.”
“Contamination? You can’t be serious.”
“I’m quite serious. It’s a precaution we have to take because this looks s
o much like MRSA-II. We’ll run labs right away to determine that.” He nodded at the assistant.
The assistant approached the plastic enclosure from the side and inserted his gloved hands and the blood draw supplies through the double barrier port nearest her arm. He quickly drew the blood and removed the samples through the port. After wiping the outside of the tubes with a disinfectant, he left the room.
“We’ll have the results in only a few minutes,” said the doctor as he stared down at her through the plastic. “Do you feel any itching or pain anywhere else right now?”
Connie thought for a moment, then realized her legs itched as well. She sat up inside her enclosure and hiked up the lower edges of her pant legs. “Oh my God.”
Lesions like the ones on her arms covered her calves. She looked again at her forearms. The lesions had continued to spread even in the short time since she first noticed them.
The doctor scowled at her calves. “You say you only started feeling ill this morning?”
Moments later, the assistant reappeared. “Looks like MRSA-II. The lab wants to run another test on the sample to be 100% sure, though.”
“We’ll have to assume it’s MRSA-II for now in the interest of time. It’s spreading incredibly fast on her. Arrange for transportation to the hospital, and in the meantime, let’s get her started on Lucracillin.”
“Right.” The assistant hurried from the room.
The doctor turned to Connie. “Don’t worry. Lucracillin is amazing. You’ll see.” He smiled. “I’ve never seen a drug act so quickly and so effectively. Try to stay calm.”
“How could this have happened? I felt perfectly fine just yesterday, but I barely made it through work today before coming here.”
The doctor frowned. “You were at work all day today? Where do you work?”
“I drive a muni bus—downtown and back.”
The assistant returned with a small vial and a syringe on a metal tray. “They’re arranging for transportation now. Shouldn’t be too long.”
“Good. Give her 2 cc’s. When you’re done, we need to get Triage working on this. She drives a bus, drove it all day today. That bus requires decontamination before it’s used again, and all of today’s passengers are at risk of exposure. Need to see what can be done about that once we get her stable and on her way.”
“Got it.” The assistant drew the dose into the syringe, then reached through the double barrier port to inject the drug into her vein. He removed the syringe and sealed it in plastic for disposal. “I’ll go talk to Triage to get things moving.” He left Connie and the doctor alone.
The doctor stepped over and gazed down at her. “It’ll take several doses to complete the treatment regimen, but I’ve found that even the first dose makes a world of difference pretty quickly for patients.”
Connie lay on the gurney and hoped he was right. So far, she didn’t feel one bit better. If anything…suddenly her back burned like nothing she’d ever felt before. Searing pain attacked her arms and legs, starting from where the lesions had been, and radiating out to consume her limbs entirely. She screamed as the burning spread across her chest and belly, then up her neck to her face.
The assistant ran back into the room, and he and the doctor stared down at her through the plastic barrier.
“Her skin! The lesions are consuming her right before our eyes! What can we do?”
The doctor shook his head and shifted from foot to foot. “I don’t know—I’ve never seen MRSA-II move this fast. Never.”
Connie looked up at them, trying to form a question, but the pain was too great for her to do anything but scream. Then her eyes began to burn and the room darkened. She felt herself screaming, but could no longer hear it. Her heart hammered in her chest, then slowed, then she no longer felt it at all.
Like a wave receding on the beach, the pain released its grip on her.
CHAPTER 45
Vince Calhoun sat in his lab dressed in a full hazmat suit. Usually he felt confined by the suit and so he minimized his physical time in the lab. Today, his work consumed him so completely, he forgot his discomfort.
The victim’s family had been cooperative, and so Dr. Riley had been able to get him a sample shortly after their phone conversation. Vince had allowed the sample to grow in a culture for several days so he’d have a sufficient quantity to conduct whatever tests he might need. Anxious to get started, he removed the petri dish containing the culture from his specially modified Pathosym’s incubation slot and set it on the counter before him.
He placed a sample of the culture in each of two fresh petri dishes. Then he placed a dose of Lucracillin in one of the petri dishes, and inserted each dish into a slot in the Pathosym. One sample would be tested to determine the nature of pathogen and the disease it produced, while the other would be tested for sensitivity to the drug.
As he waited for the Pathosym to do its work, he congratulated himself on the modifications he had made to the baseline Pathosym III model. Those changes enabled this particular machine to complete its tests in half the time required by the unmodified model. All the other BigPharma companies undoubtedly had Pathosyms—but none were as fast as his.
The Pathosym sounded a soft chime to indicate the profile testing was complete. He scowled as he reviewed the results on the screen. The pathogen caused a disease that looked very similar to MRSA-II on the surface, but was indeed far more virulent and dangerous. It attacked a victim on the outside with the familiar lesions—and from the inside, with lesions forming inside the intestinal tract and spreading to the vital organs when the GI tract eventually perforated.
The results correlated with the disease’s course as Dr. Riley had observed it in his patient. There was apparently nothing uniquely vulnerable about his patient—the disease was really that vicious.
The remainder of the analysis showed the pathogen was of more recent origin than MRSA-II. Indeed, it appeared to combine portions of MRSA-II’s genetic sequence with some other highly contagious bacteria that produced much milder symptoms. It also had a significant propensity to mutate. He wondered if Denali’s MRSA-II had mutated in the population—or if some other mechanism had spawned this particular pathogen.
The Pathosym chimed to indicate the culture and sensitivity results were ready. He glanced at them and flinched. Not only was the bacteria resistant to Lucracillin, it actually thrived on it.
He activated his PortiComm with a voice command and called Dan to explain what he’d found.
“You know what this means. This thing looks so much like MRSA-II that the first-line treatment will be Lucracillin. Precisely the thing that will put it into overdrive.”
Dan let out a low whistle. “That’s quite the profile. I’d much rather we’d developed this ourselves so we could have had total control over the release of a companion drug.” He paused, then began to speak at a manic pace. “You know, if this thing spreads and word gets out, there’ll be panic in the streets. We’d better be ready with the cure, ASAP. We’ll be able to name our price on this one. Given that profile, no one would dare quibble, even if the government has to step in to subsidize treatment. This is great news. Thanks for letting me know.”
Vince ended the call and sat for a moment in amazement. Dan was a marketing genius, no doubt about it. Who else could take news like that and spin it into a new business opportunity without batting an eye?
SUPERBUG
CHAPTER 46
President Coleridge sat in the Oval Office, staring at the wall of flat-panel screens and wishing he wasn’t experiencing a nasty case of déjà vu. Even though the peak of the crisis had passed months ago, the MRSA-II outbreak remained a fresh and painful memory. They’d solved the problem before too many people died, but not without massive expenditures. And not without risk. Damned good thing Denali Labs had managed to find the cure so quickly, before the epidemic got out of hand and created global implications.
Now there was some other bug out there—far more deadly and far more co
ntagious than even MRSA-II. Just out of the blue, it seemed, reports started coming in of people being stricken with a disease that looked a lot like MRSA-II initially, but did not respond to Lucracillin. Like MRSA-II, it attacked and ate flesh. But unlike MRSA-II, it attacked from the inside as well as the outside, and so had been named Acute Somatic Autolysis, or ASA. Thousands had died from ASA in a matter of weeks, and the Homeland had been thrown into hysteria.
The stock market had plummeted to levels not seen this century. Some days, the volatility was so great that the automatic trading curbs kicked in. He wondered about those curbs, and whether they helped stabilize the markets—or whether they just fueled more panic by their mere presence. The economic pundits had all taken great pains to avoid the words free fall, but any idiot could see what was happening. Other nations’ markets had taken significant hits as well, prompting a worldwide ban on incoming flights from the U.S. Flights to the U.S. weren’t banned, but nearly all had been cancelled because no one in their right mind wanted to travel into what was quickly becoming viewed as a hot zone.
Citizens were frightened, and justifiably so. They were hiding in their homes, not going to work, not shopping. Schools had shuttered their doors until further notice. Hospitals and anyone associated with health care were begging for a cure. Now.
A knock sounded on his door.
“Come in.”
John Humphrey, his secretary of Health and Human Services, plodded in and took a seat. His normally neat hair was disheveled and dark circles lay beneath his eyes. “Good afternoon, Mr. President. I have the latest—”
“Never mind the stats, John. I’ve heard enough just watching the news.”
Humphrey closed his mouth and waited with a worn, defeated look on his face.
“I’m sure it’s going to be expensive, but I think we need to do what we did to address the MRSA-II outbreak.”
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