The Anthrax Protocol

by James Thompson

  * * *

  Dr. Williams frowned, looking around the duct tape on Dr. Matos’s mask to examine the cut on his cheek in the light from one of the portable lamps resting on stands outside the mobile lab. Mason and Dr. Jakes had come outside to gather more samples while Lauren and Eduardo were in the tomb.

  “I’m afraid we can’t let you leave, Dr. Matos,” he said gravely. “You’ve potentially been exposed to the germ now, whether it’s airborne or transmitted by contact, and by leaving, you could carry it with you. Until we know what it is, you’ll have to be quarantined here.”

  “But I must get to a hospital immediately,” Eduardo said.

  “They won’t have the slightest idea what to treat you for,” Dr. Jakes remarked, after his own examination of Eduardo’s face. “We don’t know yet what this bug is. We’re working on it, but for now you’ll have a much better chance here with us.”

  Eduardo stiffened. “You have no authority in my country to tell me whether or not I can leave,” he said with the crisp air of one who knows his rights. “I want you to radio for a helicopter at once to take me to Mexico City to Sanato-rio Medico.”

  Dr. Williams wagged his head. “And do what? Spread this disease all over your capital city? Until we can identify what this is, there can be no treatment. I’m sorry, Dr. Matos, but you’ll have to stay until you’ve passed the longest possible incubation period, at least ten days, possibly longer. There is no other alternative.”

  When Matos opened his mouth to object, Mason added, “Of course, we’ll immediately start a course of every antibiotic that might possibly be effective against whatever bug this is, and hopefully in a week or so you’ll remain uninfected.”

  Lauren sank to a canvas stool, feeling faint. The noise of a portable generator buzzed faintly through her headset. Had Montezuma’s plague claimed yet another victim?

  “This is too much,” she said, staring at the ground where light from a halogen bulb cast eerie shadows among trimmed vines and stalks of cut brush in the clearing. “I can’t stand any more of this. I have to go home.”

  “We can send you back tomorrow, Lauren, after the last identification is made,” Mason promised. “Unfortunately, due to the violation of Dr. Matos’s suit and the cut on his face, he can’t leave until we identify the causative agent here and figure out how to treat it.”

  Lauren heard someone sob into a microphone on a headset as Eduardo took a step back from the two doctors.

  “Am I going to die?” Eduardo asked, holding out the knife as if he wished he’d never found it.

  “No one can say for sure, Dr. Matos.” It was Mason Williams who spoke. He glanced at Lauren. “Thanks to Dr. Sullivan’s quick action in putting duct tape over the crack in your faceplate, you may not even be infected.”

  Dr. Jakes turned to Mason. “This may give us an excellent chance to study the symptoms as they develop. We’ll have a better fix on the incubation period and an opportunity to perform blood work while the disease progresses if this subject has contracted . . .”

  “That’s enough, Sam,” Mason interrupted harshly, glancing over at Matos, who had surely heard the inconsiderate remark. “We can discuss this later. Now get back to work!”

  Eduardo slumped against one side of the mobile lab, looking down at the dagger. “Madre! What have I done?”

  Lauren’s thoughts bordered on total disbelief. This simply could not be happening. First Charlie and every student at the site, and now Charlie’s dear friend, Eduardo Matos, had come in contact with something so deadly inside Montezuma’s tomb it was apparently unstoppable.

  “As I said, we can’t say for sure you’ve contracted it,” Mason said to Eduardo. “We’re only playing it safe. Some of the top doctors and specialists in infectious diseases in the world are here. If anyone can do anything to help you, it will be a member of this team. Once we identify it. Right now, we haven’t the slightest idea what this bug is.”

  “A bug? You keep calling this monster a bug?” Eduardo asked incredulously, his voice breaking.

  “It’s a matter of terminology, Doctor. Under a microscope this thing, whatever it is, will be a living organism. We call them bugs. I suppose it’s medical slang.”

  “I must call my wife to explain,” Eduardo said, his voice calmer now, but Mason could see his face was covered with sweat and tears. “She will be worried if I am not home tomorrow.”

  “We’ll ask Joel to arrange it in the morning,” Mason assured him.

  Lauren sat on her stool remembering the moment when Eduardo found the dagger. While she could never make herself believe in curses, it was as if Montezuma himself had arisen from the grave to bury his jeweled knife into the heart of Charlie’s friend, Eduardo Matos. Although she was not a believer in the supernatural, it certainly seemed as if there was a curse surrounding this ancient tomb.

  A moment later she stared at the dark jungle, recalling the face of the boy she’d seen through a lab window. She was sure it wasn’t her imagination. How could anyone survive here without a space suit? she wondered, if the illness were as dangerous as Mason made it sound.

  Funny, she thought, that she was thinking of him as Mason now instead of Dr. Williams.

  She glanced over at him as he rapidly gave orders for the isolation and medical treatment of Matos. Yep, he was quite an impressive man.

  Chapter 12

  Mason felt like a mother hen trying to keep all her chicks in line. Working with a team of brilliant, egocentric scientists is like trying to herd cats, he thought. Just when you get them all going in one direction, something happens and they scatter.

  Mason, Jakes, and Shirley Cole were in their Racals in the Cytotec lab, all trying to process blood serum samples, stain tissue sections with exotic dyes to make different forms of bacteria illuminate under microscopes, and generally getting in each other’s way.

  To make matters worse, Shirley and Jakes had been sniping at one another all evening. Mason wished the two wouldn’t be so competitive, but then he reasoned, if they weren’t, they probably wouldn’t be as effective as they were at ferreting out secrets of the microscopic world.

  Shirley said, “Why don’t you quit fooling with that electron microscope, Sam? I’m telling you, this smells like a bacterial illness to me and I don’t think we need to waste our time looking for viruses.”

  Jakes grimaced while fiddling with dials and buttons on a large electron microscope built into a corner of the lab. “You think everything on earth is bacterial, Shirley, including men. You remind me of a carpenter whose only tool is a hammer, so he thinks every problem is a nail.”

  “And what is that supposed to imply, Mister Wizard?”

  “Just that most cases of hemorrhagic fever, especially ones caused by organisms that are airborne and transmissible from person to person and having a one hundred percent mortality rate, are caused by viruses. I can’t think of a single bacterium that has an onset of action as fast as this bug seems to have.”

  “Tell you what, Sam. I’ll make you a bet this agent is a bacteria and not a virus.”

  “Precisely what are you willing to wager, Dr. Cole?” Jakes asked, wiggling his eyebrows suggestively.

  “If it turns out to be a virus, I’ll personally treat you and every friend you’ve got to a round of drinks at that male chauvinist pig hangout you frequent, the Recovery Room. I won’t have much at stake since you have virtually no friends since you’ve driven them off with those damn cigars.”

  Jakes glared at her. Everyone knew the bar she mentioned near the Emory University Medical School campus, a favorite of his. He spent most nights there schmoozing with medical school professors and drinking while smoking his vile cigars.

  “Okay, Shirley, and I’ll bet it’s a virus. If I’m wrong, you can bring all your friends to the bar, which will also probably only amount to one or two old maid fem-libbers, and I’ll buy all three of you as many drinks as you think you can metabolize without falling down.”

  Mason shook his
head, attempting to concentrate on his work through all this banter. The Cytotec lab chamber, stuffed from floor to ceiling with every piece of scientific apparatus imaginable, was small to begin with. When three people, encased in bulky, cumbersome Racals, were all trying to work at once, each feeling his particular task was the most important, there was predictable conflict.

  After a brief pause in the conversation, Jakes straightened in front of the large vacuum tube of an electron microscope where he’d been laboring for the past twenty minutes.

  “Goddammit, Mason, this piece of crap is still not adjusted properly. I told you the aiming electron focusing beams were knocked out of alignment when those fools dropped it in Australia, and you told me it had been fixed!” He turned to glare at Mason, his hands on his hips and his expression sour.

  Mason sighed deeply. He was in the middle of Gram staining tissue slides and didn’t have time to argue at the moment. The delicate process, wherein slides were dipped in methylene blue dye, followed by iodine, scarlet red, and finally washed in acetone, was fairly simple, but if the correct sequence was not followed the tissue sections would be ruined.

  Of course, Jakes never bothered to consider anyone else’s duties could possibly be as important as his. Mason answered without raising his head. “The lab tech at CDC assured me it was repaired, Sam. What’s wrong with it?’

  “Hell, nothing’s wrong with it except it won’t focus the goddamn beam. Other than that, it’s just fine. You understand my electron micrographs look like they were taken through frosted glass.”

  “That’s probably because you’ve adjusted the focus and depth of field knobs incorrectly,” Shirley mumbled snidely, just loud enough for Sam to hear.

  Jakes glanced at her and just shook his head, as if such a possibility didn’t bear consideration. “If we’re dealing with a virus here it’d better be a big bastard, because I can’t get my resolution below one hundred microns,” he said. “That means if this bug is a filovirus like I suspect, we’re gonna be shit outta luck finding it.”

  Mason was forming a reply when he was halted by an exclamation from Shirley. “Wait a minute, guys! I think I may have something here! Mason, come take a look at the slide of this lung section.”

  Mason took a few seconds to wash his slides with acetone, his hands shaking slightly from fatigue. They’d been working continuously without a break since arriving at the site.

  He put the slides in a rack to dry, and then he moved over to the counter where Shirley was working. She made a slight adjustment to the focusing knobs on the Zeiss binocular microscope, bringing an image into sharper view on the computer VDT hooked to the Zeiss.

  It was impossible to get close enough to the scope’s double eyepieces while wearing a Racal hood, so the equipment was set up to send images to a thirteen-inch computer screen built into the wall of the lab.

  On the screen, tiny air sacs of lung tissue appeared in the background like a large pink honeycomb. The air sacs themselves were filled with pink-stained proteinaceous debris, ruptured red blood cells, and clumped leukocytes, surrounded by literally thousands of tiny dark blue, almost violet cigar-shaped bacteria. The honeycomb shapes of the air sacs showed massive disruption with large areas where the lung tissue itself had been completely absorbed and destroyed by the bacteria.

  “Jesus,” Mason whispered, awed by the amount of tissue destruction and the large number of bacteria present in the specimen. “This is the most fulminant case of pneumonia I’ve ever seen.”

  “Yeah,” Shirley replied. “This kid was one sick puppy all right. And unless I miss my guess, those bad boys there are our hot-bug.”

  “Sam, come over here,” Mason said. “I don’t think we need to worry about the electron microscope now. It looks like we’re dealing with a bacterial etiology for the deaths, a Gram-positive rod of some sort.” He stepped aside so Jakes could see the monitor.

  “It does appear to be a bacillus,” Jakes agreed, causing Shirley to roll her eyes, as if she couldn’t believe he’d ever doubted her. “And look up there, in the upper left corner of the field—it looks like spores of some sort I don’t recognize,” Jakes muttered, pointing to a section of the screen containing what looked like tiny balls, some of which had ruptured, spilling out hordes of violet bacteria.

  “Seems as if I was right, Sam,” Shirley said, with poorly concealed enjoyment. “The only Gram-positive rod I know of that forms spores and can cause pneumonia this aggressive, along with hemorrhagic fever, is Bacillus anthracis.”

  Jakes turned to her. “But that doesn’t make sense,” he said in a bewildered voice, almost as if he spoke to himself. “We both know woolsorter’s disease, respiratory or inhalation anthrax, has never been shown to be transmissible from person to person. It is inconceivable that so many people could have independently contracted respiratory anthrax in such a short time short of some sort of terrorist attack with powdered anthrax, such as we saw in the postal service back in the early 2000s.”

  “A terrorist attack out here in bug-fuck Mexico, that’s your explanation?” Shirley asked incredulously.

  Jakes shook his head, distractedly. “No, of course not, but besides that, the typical mortality rate of untreated anthrax pneumonia is only seventy to eighty percent, not one hundred percent like it appears to have been here.”

  Shirley shrugged, the shoulders of her Racal bunching with her movements. “I know you’re right. But if tissues from the others show this pattern, I don’t know what else it could be.”

  “What else do we need to do to be sure this bug is anthrax and that it did indeed cause the disease we see here?” Mason asked Shirley.

  “Well, it’s kinda hard to explain . . .”

  “Trust us, Shirley,” Jakes said sarcastically, “we’re doctors too.”

  She shrugged within her Racal, “Okay, then, to be one hundred percent certain, we’ll need to do pleural biopsies and subject them to immunohistochemical staining or IHC. Then we’ll need to get some tissue samples from the bodies and check the levels of serum antibody or IgG to protective antigen or PA component of Bacillus anthracis using enzyme-linked immunosorbent assay or ELISA.”

  In spite of the seriousness of the situation, Mason had to smile. “Oh, is that all?”

  Shirley smiled back. “Actually, no. To be absolutely certain, I’d also like to do a polymerase chain reaction or PCR on some tissue samples from different bodies, and we’ll need to do specific staining for anthrax to make sure, but that’ll only take a couple of hours. The rest of the tests, however, could take days to complete with the equipment I have here.”

  “Shirley,” Jakes asked, his voice more reasonable now, “in light of what I said earlier about anthrax not being passed person to person, do you think it could be some mutant form of anthrax, one that jumped species or something, one we’ve never seen before?”

  She hesitated. “Well, that would almost have to be the case if this is anthrax, since like you say, modern anthrax has never been shown to be transmissible from person to person or to be this aggressive or to have such a high mortality rate.”

  “Moreover,” she continued, her forehead wrinkled in thought, “this bacterium is almost certainly four hundred or more years old, and has been isolated in an airtight, sealed burial chamber and has had to form spores and encapsulate itself in order to survive for so long without living tissue to replicate in, sort of like suspended animation. Anything’s possible, I guess. The way bacteria mutate with exposure to antibiotics, viruses, and bacteriophages, it’s certainly not outside the realm of possibility the strains we have today are totally different from those present in the early 1500s.”

  “I guess so,” Jakes agreed, although he sounded doubtful.

  “Don’t you gentlemen remember your Bible?” Shirley asked, warming to her subject and looking back and forth between the two men.

  “The Bible? What the hell’s the Bible got to do with this bug, or anything else?” Jakes demanded, his irritation at having been p
roven wrong showing now.

  Shirley grinned, her teeth flashing in the light from the monitor screen. “The book of Genesis talks about the fifth plague of Egypt in which hundreds of thousands of animals and people died over the course of a few years, and Moses mentions a disease with symptoms remarkably similar to anthrax in Exodus 9:9.

  “It has always been suspected by biblical scholars that the hot-bug that caused the fifth Egyptian plague was anthrax, but the mortality rate and number of deaths was thought to be too high for anthrax as we know it today. Maybe an older species, or perhaps subspecies would be a better term for it, was this super virulent type that could be spread person to person.”

  “You’re really reaching now, Shirley, quoting an obscure plague, described by people ignorant of the basic rudiments of environmental theory,” Jakes replied, his tone thick with sarcasm.

  Mason tried to end their argument. “Okay, people, let’s calm down.”

  Shirley wasn’t so easily stopped. She continued. “In the eighteenth and nineteenth centuries, a plague of anthrax swept over the southern part of Europe, taking a heavy toll in both human and animal life.” She paused to remember details of the epidemic. “Make no mistake about it, gentlemen, and you too, Sam, we’re dealing with a heavy hitter here. This bug is a real bad actor, and if you’d look at the evidence of history, it may have been around for a very long time.” She glared at Dr. Jakes defiantly.

  “Bullshit,” Jakes snapped, making Mason wish he could turn down the volume of his earpiece. “I think it’s good news, if it does turn out to be anthrax.”

  “How so?” Mason asked, curious how bacteria that had just wiped out an entire archaeological expedition could be classified as good news.

  “It’s simple,” Jakes said, spreading his arms. “Anthrax is treatable by penicillin and ciprofloxacin, if my memory serves me, and we have a vaccine against it. In fact, it was the first infectious disease in which a vaccine was found to be effective. We can thank Louis Pasteur for that.”