Pandemic pr-2

by James Barrington

  The Director nodded.

  ‘There are other problems as well, like nitrogen narcosis, and believe it or not even oxygen can become toxic in certain conditions. So for very long and deep dives the nitrogen is removed from the air you breathe and replaced with an inert exotic gas, usually helium. That won’t go into solution in your blood, so it doesn’t cause the same problems that nitrogen does.’

  ‘Any other problems with that sort of stuff, though?’

  Elias grinned. ‘Only one. While you’re breathing it, you sound like Mickey Mouse, because the helium affects the vocal chords. Professional divers use voice-alteration devices on their major underwater projects, so that they can be clearly understood.’

  ‘You mentioned saturation work. What’s that?’

  ‘It’s a technique which makes for more efficient use of divers. Instead of surfacing at the end of a deep dive, with all the decompression time that requires, saturation divers live for days at a time in a diving bell, or some other kind of underwater habitat, which is anchored to the seabed or in mid-water at the depth at which they’re working.

  ‘That means they can go out, work for a couple of hours, go back into the habitat, have a drink or a meal, get suited up again and go back out for another dive. They only need to decompress once, therefore, at the very end of their time underwater and before they finally surface.’ Elias smiled at a memory. ‘It’s not too much fun, actually. Everything you eat or drink down there seems to taste of either salt water or rubber – or both.’

  ‘OK,’ the Director said grimly, ‘I’m satisfied you’re competent.’ He wrote something on a slip of paper and passed it across the desk. Elias looked at it and read the words with increasing confusion. ‘Be there this morning,’ Nicholson said, ‘at ten fifteen. And take your passport.’

  Kandíra, south-west Crete

  Gravas was still standing irresolute in Spiros Aristides’s simple bedroom, staring down at the body. He looked around the room, then back at the corpse, and realized he had to decide soon. Normally, once he had certified that the victim was dead, photographs would be taken and drawings made of the position of the corpse, the hands would be bagged to preserve any trace evidence, and the body would then be placed in a fibreglass coffin and transported to the forensic suite back at Irakleío for the post-mortem examination.

  But something about the man’s death simply wasn’t making sense, and Gravas felt certain that he should look more closely here, in the place where the death had occurred, before moving the body. So he decided to break the rules.

  There was a glass tumbler beside the bed and Gravas picked it up and sniffed it. He detected the faint odour of Scotch, and guessed that Aristides had been drunk, or at least intoxicated, when he climbed the stairs to his bedroom the previous evening. The old man hadn’t even undressed, just lain down on the bed wearing his outdoor clothes.

  Gravas made a decision. He took a pair of eight-inch scissors from his bag and cut a more or less straight line down the front of the blood-sodden checked shirt, and peeled it away from the torso. He undid the old black leather belt on the jeans, then with some difficulty cut the denim down the top of each leg, and again peeled the material away from the body. Finally, the underpants got the same treatment.

  Now Aristides lay naked on his back, exposed to the early-afternoon sunlight streaming in through the window, and Gravas bent to examine the corpse minutely. He began, as he had been taught to do, at the top of the head, and worked his way steadily, and without haste, down along the entire body.

  Just below the left breast his sensitive fingertips detected a small lesion, and he carefully cleaned away the crusted blood to examine it more closely. It could, if it proved to be a knife thrust to the heart, explain the huge out-pouring of blood that had soaked the old man’s shirt and the bed sheet underneath the body. But after a few seconds Gravas realized that it wasn’t. The lesion was clearly an old scar, a skin tear from some sharp object years earlier, which had healed badly with a ragged edge.

  Gravas continued his examination, but found nothing else. Then he took hold of the right side of the body and gently turned it to allow him to examine the back. He followed exactly the same procedure, and found precisely nothing. No wounds, no lesions, no signs at all of external damage.

  He returned the body to its original position and gazed down at it. As far as he could tell, the blood on the chest appeared to have come from the Greek’s mouth, spewed out like crimson vomit. And the blood encrusting the sheet on which the body lay had a most unusual source – it had been ejected from Aristides’s anus. And still Gravas didn’t know what had killed him.

  His forensic team was elsewhere in the house, combing it room by room, but so far he had let nobody else into the bedroom. Something was niggling at the back of his mind. Something he’d read or heard somewhere, something that was relevant, that might explain what had killed this elderly man.

  He shook his head slowly. It would come to him in time. It always did, sooner or later. The autopsy might clarify things, he hoped. Meanwhile, there was nothing more he could do with the body. It was time to move it and then let his team begin their examination of the bedroom.

  He skirted the bed and reached up for the handle of the latch window, intending to call down to Inspector Lavat, when he suddenly stopped, freezing into immobility. The realization had come sooner rather than later, and suddenly he knew, or thought he knew, exactly how Aristides had died.

  Gravas walked away from the window, giving the body on the bed as wide a berth as possible and stepped out onto the landing. He turned and pulled the door closed behind him and called out to his forensic team.

  ‘This is Gravas. Listen, both of you, and stop whatever you are doing immediately. Put your equipment down and just leave it where it is. Ensure that your masks and gloves are securely in place, then stand up and walk out of the house, touching nothing else. Do not even touch each other, and wait for me in the street outside.’

  Two very puzzled men emerged rapidly from the spare bedroom and walked in single file down the narrow stairs. Gravas first checked that all the upstairs windows and doors were closed, then followed them down. On the ground floor he checked too that all the windows were secured, then he himself walked out of the house, pulling the door firmly shut behind him.

  ‘Dr Gravas?’ Lavat called to him as he watched this procession emerge.

  ‘Inspector,’ Gravas said, his voice slightly muffled by his mask, ‘don’t come near me or my team. Ensure that nobody else approaches the house. Set up a cordon around the whole village. Nobody must be allowed in or out until we have this situation under control.’

  ‘Situation? What situation? This is a murder, clearly a brutal murder, but to cordon the whole village? Is that really necessary?’

  Gravas almost smiled. ‘I wish it were that easy,’ he replied, ‘but I’m afraid this particular killer can slip through any cordon you are able to erect.’

  Lavat looked startled. ‘You mean you know who killed Aristides?’

  Gravas nodded. ‘It’s not a who, Inspector, it’s a what. If I’m right, what killed the Greek was a thing called Ebola.’

  Chapter 5

  Tuesday

  Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia

  Tyler Q. Hardin – the ‘Q’ wasn’t short for anything; his middle name really was ‘Q’, which Hardin presumed had been his father’s idea of a joke – had actually got one foot in the shower stall when his pager went off. He snapped off the shower, which he’d just spent nearly five minutes getting to precisely the right temperature, picked up the pager and looked at the display. It showed a single acronym: ‘L4HA’.

  ‘Oh, shit,’ he muttered, forgot all about his shower and climbed back into the clothes he’d just taken off. He ran out of the house, slamming the door behind him, got into his two-year-old Grand Cherokee Jeep, started the V8 engine, pulled the shift lever into ‘drive’ and raced off down the s
treet.

  Traffic was heavy at the intersection, so Hardin reached down and flicked a couple of switches on the dashboard. Two red lights fitted behind the radiator grille began alternately flashing, and a two-tone siren started its discordant wailing. Traffic parted, Hardin hauled the steering wheel around to the right and floored the gas pedal.

  Eighteen minutes later he walked into the CDC and three minutes after that he opened the door to Walter Cross’s office. Cross was Hardin’s immediate superior and head of the Special Pathogens Branch, but the two men had worked together for so long that they were firm friends.

  They had to some extent been thrown together by their qualifications. Although the Centers for Disease Control is a major organization, employing around seven thousand people and with an annual budget in excess of two billion dollars, there are exactly eight employees who are qualified to work in the Bio-Safety Level 4 laboratory. One was Walter Cross, the Head of Special Pathogens – a highly specialized department within the Division of Viral and Rickettsial Diseases – and another was Tyler Hardin.

  The CDC BSL4 laboratory is one of two maximum-safety biological research laboratories in America, and one of only six in the entire world. Entry is by ID card and a personal identification code punched into a keypad by a scientist wearing a totally sealed biological spacesuit, who even then has to enter through a negative-pressure airlock, to ensure that air can only bleed into the laboratory and never out of it, and a powerful decontamination shower.

  Only inside one of these secure laboratories is it safe to examine any of the handful of microscopic and utterly lethal species-killer viruses.

  Viruses are usually named after the places where they were discovered, and the first of what became known as the species-killers emerged in 1967 in Marburg in Northern Germany. The Marburg virus arrived at the Behring Works factory inside an infected African green monkey, the kidney cells of these animals being used by Behring to produce vaccines. Somehow, the Marburg virus jumped from the monkey into the immediate human population working at the factory. By the time the outbreak was over, thirty-one people had been infected and seven were dead. Marburg proved it had about a twenty-five per cent lethality.

  Marburg is a type of organism known as a filovirus, one of a small and highly lethal family of haemorrhagic fever viruses, which closely resemble one another but which bear little resemblance to other known viruses. Under the impartial gaze of an electron microscope, the reason for the appellation filovirus (from the Latin filo, meaning ‘thread’ or ‘threadlike’) becomes immediately obvious, the shape of the virus being just that.

  Marburg was the first, but unfortunately it wasn’t the last.

  The Ebola River is a tributary of the Congo or Zaïre River and, just under ten years after Marburg began its rampage in Germany, a new and even more deadly filovirus emerged from the rainforest. Named Ebola Zaïre after the river and the country, it appeared almost simultaneously in over fifty native villages scattered near the headwaters of the Ebola River, and killed nine out of every ten people who became infected.

  Ebola Zaïre was and is the most lethal fast-acting virus the world has ever seen, killing its victims in a matter of days, spreading easily and swiftly through any close-knit population through body-fluid exchange. A drop of infected blood on a cut finger is quite enough to start the infection.

  It is popularly believed that Ebola attacks every organ in the body apart from skeletal muscle and bone, multiplying at a terrifying rate and converting body tissues into active virus particles. It is reported to liquefy the internal organs, resulting in uncontrollable bleeding from every orifice.

  In fact, it does nothing of the sort. Almost all these ‘facts’ – repeated in countless books, magazines, television programmes and films – are either simply fiction or misconceptions promulgated by writers who haven’t bothered to do their research. True, Ebola does multiply at a terrifying rate, and uncontrollable bleeding from every orifice does frequently occur during the terminal stages of the disease.

  But Ebola actually attacks only the circulatory system, and merely two components of that. It targets the platelets responsible for blood clotting, and the endothelial cells that line the inside of veins and arteries and essentially keep the blood contained inside. It launches, in effect, a two-pronged attack: the circulatory system begins to leak as the endothelial cells fail to function, and the blood that then leaks out doesn’t clot.

  The effects are usually first apparent in those organs where the membranes are the thinnest and most vulnerable: typically the lungs, eyes, mouth and nose. Tissues and organs become soggy as they fill with blood; the lungs stop functioning properly; blood enters the digestive system; the throat becomes bloody and infected, making swallowing impossible; blood leaks from the eyes and other orifices; in the latter stages brain functions become erratic and then cease almost entirely, as the skull fills with blood.

  Again contrary to popular belief, a notable peculiarity of Ebola and the other viral haemorrhagic fevers is that the organs themselves are not destroyed. Despite the huge amounts of blood present in them, the actual tissues of the organs remain perfectly healthy – in effect, they have ceased to function because they have drowned in blood. And if a patient does manage to survive an attack by Ebola, he or she will normally suffer no lasting ill-effects: once the virus has been eliminated from the body, the organs will begin working normally once again.

  In short, an attack by Ebola is essentially functional – the virus attacking the whole body through the circulatory system – rather than biochemical, in that there is no destruction of cells or organs. The attack is always very fast but the recovery, if the patient is lucky enough to survive, is also both fast and complete.

  But one other popular ‘fact’ is true: in the latter stages of the infection, one drop – a single millilitre – of a victim’s blood can contain as many as one hundred million virus particles.

  The Ebola virus is an extremely simple yet very mysterious organism. Like the other filoviruses, it is a microscopic thread visible only at magnifications in excess of one hundred thousand, and is characteristically very twisted and convoluted at one end – a feature that some virologists call the ‘shepherd’s crook’ or the ‘eyebolt’.

  Structurally, it consists of a single strand of ribo-nucleic acid, containing the virus’s genetic code, encased in a sheath of structural proteins of seven different types. Three of these proteins are partially understood, but virtually nothing is known about the other four. The structure and function of these four proteins is a mystery, but the combination in Ebola is lethal – the virus appears specifically adapted to attack the circulatory system, and the human immune system seems completely incapable of fighting back.

  It is also, using the tense terminology of the virologists, a badly adapted parasite. A well adapted parasite lives in some kind of harmony with its host: the relationship becomes almost symbiotic, and both host and parasite will survive. Ebola can kill its human host within days, and will itself die unless it can migrate rapidly to another human being.

  This fact suggests that Ebola has another host somewhere, some animal or bird living in the tropical rainforest in Zaïre which carries the virus but is essentially unaffected by it, yet nobody has any idea what that host might be. It also implies that either Ebola has mutated naturally, or it has been manufactured, to become capable of attacking the human immune system.

  In its effects, if not in its appearance, it does resemble some other viruses. It appears to be distantly related to those which cause mumps, measles and rabies, for example, and also pneumonia and influenza. But these are all benign compared to Ebola and, unlike them, there is no known cure or even treatment for attack by a filovirus.

  Marburg, Ebola Zaïre and its slightly less lethal cousin Ebola Sudan, which has only about a fifty per cent lethality, are all classed as Level Four Hot Agents – L4HA – hence Hardin’s speed of reaction once he had read the message on his pager.

  ‘Wh
at have you got?’ Hardin demanded immediately, as he shouldered open the door.

  ‘It sounds quite like Ebola,’ Walter Cross explained, ‘but if the agent is a filovirus, it’s a hell of a long way from home.’

  ‘Where is it, then?’

  ‘Crete,’ Cross replied shortly.

  ‘That’s Crete as in Crete in the Mediterranean?’ Hardin’s surprise was obvious in his voice.

  ‘Yup. We – or to be accurate you – are going to have to go in to confirm it, but the message from the reporting doctor makes it sound pretty much like a filovirus infection of some sort. Maybe even some kind of totally new strain.’

  Hardin sat down, slid a sheet of notepaper across the desk and began scribbling on it. ‘Ebola in Crete is really scary,’ he continued. ‘An infection in a major holiday area like that could scatter the virus over most of Europe. What about jurisdiction? Do we have an EPI One?’

  The Centers for Disease Control is a federal agency. That means before the CDC can send anyone to investigate something within America, the state in which the outbreak occurs or its local health authority has to formally request assistance from the CDC. Outside the United States, exactly the same rules apply: the CDC has to be officially invited to assist by the government or its health ministry.

  The form known as EPI 1 is basically a movement order for a CDC officer or team. It confirms that assistance has been requested from the agency, provides a brief summary of the investigation which the CDC intends to undertake, and what it hopes to achieve, lists the names of the CDC personnel who will be involved, and specifies which authorities in the destination government’s health department are to be contacted on arrival.