by Bobby Akart
The other female member of the team was Cantore’s girlfriend, Amanda Sharpe. She worked in Denver’s Immigration and Customs Enforcement Office but frequently came to Atlanta to visit Cantore. As an ICE agent, she trained frequently with firearms and was asked to be a reoccurring instructor at the ICE Law Enforcement Training Program located in Brunswick, Georgia.
“I don’t think it was close, Mac,” said Amanda proudly. This was her second outing with the group and she was hooked. Like Mac, she held her own. “Look at all of that blood splatter!”
“Yeah, we did pretty well,” added Mac. She led Amanda over to her Jeep Grand Cherokee and popped the rear hatch. “How about a beer?”
“Got any Coors?” asked Amanda, a Colorado native.
“Very funny.” Mac chuckled. “This is the South. Have a Bud.”
They popped the tops and enjoyed a swig before leaning against the open tailgate. The guys were in a cluster, bragging on their exploits, which left the girls alone for a few minutes.
“It’ll have to do.” Amanda laughed. “If you ever get out my way, I’ll treat you to a Coors and some Rocky Mountain oysters.”
“Not my first rodeo, Amanda. Yes on the former and no way on the latter. I know what Rocky Mountain oysters are. You can forget it.”
Amanda offered her longneck to toast Mac’s. “It’s a Colorado thing. We have to try to trick people into eating bulls’ balls.”
“Yeah, I get it. Actually, my parents have a place in Breckenridge. I’ve been out there a few times since my mom’s retirement. I tried my hand at skiing but quickly realized that I’d enjoy the cool summers much better.”
“I bet she’s enjoying her retirement,” said Amanda.
Mac hesitated and looked down for a moment and said, “Not really.”
Amanda shrugged, then fumbled through her black 5.11 tactical pants and pulled out her business card. She found a pen and scribbled her cell number on the back. “Anytime you’re headed my way, don’t hesitate to call me. There’s a lot to do around Denver.”
“I will,” said Mac as she tucked the card in her pants pocket.
“Danny tells me you work at the CDC,” started Amanda. “Do they have a law enforcement arm? You’re a heckuva shot.”
Mac laughed. “No, we don’t have the pleasure of using firearms to fight diseases. I’m a senior health scientist and associate director of the Office of Infectious Diseases.”
“Girl, you don’t look old enough to be a senior anything.” Amanda laughed. “Did you skip high school or something?”
“When people looked at my résumé, they thought I was lying,” Mac replied. “I completed undergrad in three years; then I received my dual master’s degree in molecular biology and applied genetics. I got my PhD in microbiology from MIT.”
“Good lord, you were busy.” Amanda laughed.
“I guess I was. I’ve always been an overachiever. I was the youngest doctor hired by the CDC in thirty years. With all of that, I guess that makes me senior.”
Amanda polished off her beer and reached for another one. She was about to offer a second beer to Mac when a cell phone rang.
“Yours or mine?” asked Amanda.
“It’s mine,” said Mac as she looked down at the display. “I’ve gotta take this.”
Mac walked away from the truck for a moment and listened to her counterpart within the OID. She was needed at the lab immediately. There were developments.
Chapter 12
Day Five
CDC
Atlanta, Georgia
It was a forty-mile drive to the CDC campus in Druid Hills, a neighborhood of roughly fifteen thousand residents and the home to Emory University and the CDC. On a typical day in Atlanta, the trip would take more than an hour, but Mac pressed her luck with the speed limits and avoided any traffic snarls. The urgency of the call prevented Mac from stopping by her place in Buckhead to change.
Druid Hills, dubbed Atlanta’s second suburb, was designed by the renowned city planner Frederick Law Olmsted, who laid out Central Park in New York, the Biltmore Estate in Asheville, North Carolina, and the U.S. Capitol grounds. Located five miles east of Atlanta’s downtown business district, the homes of Druid Hills, approaching several million dollars in value, were spread out among the many parks and lakes. The CDC and Emory University were clustered in the middle of the neighborhood and stood in stark contrast to the Georgian and Victorian architecture prominent in the surrounding neighborhood.
Despite the upscale surroundings, and as a sign of the times, the entrance to the CDC involved more than a nod and a smile at a security guard seated behind a desk. Like all public buildings, visitors and employees alike were required to enter through an X-ray machine and agree to a random pat down. Having CDC credentials and being familiar to the security personnel didn’t grant you a waiver. As Mac patiently waited her turn throughout the process, she thought of the bureaucratic challenges ahead, especially in dealing with a relatively new installment into the CDC organizational chart.
The CDC, like any government agency, had a hierarchy. Her immediate superior, Dr. Kelly Daniel, was a part of the Senior Executive Service, which was charged with executive, managerial, and governmental policy functions. Many of these executives rose through the ranks of the CDC and had hands-on experience dealing with infectious disease.
Donald Baggett, who acted as an ombudsman of sorts, was a political appointee loyal to the administration that put him in his position more than the overall goal of making the world a healthier place.
Baggett was a former accountant with a large pharmaceutical company. His job was to keep the lid on what was perceived to be an out-of-control CDC budget. Admittedly, in recent years, the CDC had been dubbed the Centers for Everything but Disease Control.
Media reports blistering the CDC, which was seen as squandering government subsidies on everything but its core mission, had taken their toll. Congress, in its typical knee-jerk reaction, had slashed their budget considerably in recent years, culminating with a new health care law that reduced their budget by hundreds of millions.
Baggett, whom Mac referred to not so affectionately as D-Bag, was instrumental in cutting such projects as studying video games and television violence, social norming of children in schools, and the implementation of a multimillion-dollar study of the effectiveness of motorcycle helmet laws.
In some respects, he performed his job as instructed. In other ways, he was a failure as an administrator. He had no respect among his staff, especially the women within his charge. He was a shameless flirt who crossed the lines of decency daily. Mac, both single and attractive, bore the brunt of his sexual innuendo on more than one occasion. Her tough exterior shook it off, but it didn’t prevent her from despising D-Bag for what he was—a douchebag.
Mac made her way to the lab and found Janie studying a specimen under a microscope. She waved through the thick, protected glass and got Janie’s attention, who immediately jumped out of her chair and headed for the decontamination chamber.
Cocooned within the complex was a biosafety level 4 laboratory that was built like a submarine. Over ten thousand square feet of airtight, carefully pressurized space housed as many as thirty doctorate-level scientists wearing protective suits and hoods, trying to determine how lethal infectious diseases kill their hosts.
To enter the BSL-4 lab, a scientist must pass through two stainless-steel doors into an air-locked chamber. The air pressure changed in both spaces through the building’s automation system to ensure that high-pressure air in the air lock flowed into the low-pressure, high-security lab, thus trapping airborne pathogens.
Once inside the BSL-4, you were immediately overwhelmed by the feeling of sterility. The walls had a glistening sheen from the many layers of epoxy compound that formed a continuous seal across every surface. Light fixtures and electrical outlets that penetrated the seal were housed in airtight boxes and lathered in protective epoxy. Even the wires that emerged through the walls were str
ipped of their insulation and sealed with the epoxy compound.
The microorganisms that made up a deadly bacterium were many million times smaller than the eye could see. It didn’t take much for one to escape and wreak havoc on the human population.
Janie emerged with her award-winning smile and her hair pulled back neatly into a bun. The smooth contours of her youthful face made Mac slightly jealous. At thirty-four, Mac sometimes wished she could be as perky as Janie and wondered if she’d ever have a chance to feel young again. Her mother said Mac needed the right partner to spark her personality. Mac told her mother to mind her own business.
“Come see, Mac!” Janie slid behind a computer terminal outside the BSL-4 and immediately began to bang on the keyboard. “The results are preliminary, but I find them conclusive. You look like a ninja, by the way.”
Mac, in her all-black paintball attire, struck a model’s pose like the girls on the Price is Right and then focused her attention on the computer monitor. Janie produced the first slide on the screen. Mac shook her head, hoping to deny what her eyes told her.
“Pneumonic plague,” whispered Mac. Even within the confines of the CDC, the commonly used term for Yersinia pestis wasn’t thrown around often. The Black Death, the label given to bubonic plague in the fourteenth century, was a less lethal counterpart to the perfect killer—pneumonic plague.
“It is, without a doubt,” added Janie.
Mac pulled up a chair and joined Janie at the computer station. “Janie, please humor me on this and know I’m asking this with absolutely no disrespect. Please walk me through your processing of the specimens.”
“I understand fully, Mac. This is big.”
“It sure is,” Mac said under her breath. “Now, talk to me.”
“Okay, first I confirmed proper transportation from Guatemala with Dr. Farrow. They followed your instructions to the letter. We alternately inoculated the blood and tissues specimens with the maximum amount of fluids and incubated at optimal temps.”
Mac needed to hear this, but she was becoming both excited and concerned about the ramifications of the lab’s findings. “What about the agar plates?”
“As is typical, the Y. pestis grew as gray-white, translucent colonies initially. In the first twenty-four hours, they were too small to be seen as individual colonies.”
“Of course,” Mac interrupted. “Janie, look at those plump bacilli. Amazing!”
“Now you know how I felt. After forty-eight hours, the colonies grew to two millimeters in diameter and their color changed from gray white to slightly yellow. At that point, there was no doubt.”
“You ran the enzyme tests?” asked Mac.
“Yes, ma’am. They were positive for catalase and negative for urease, indole, and oxidase.”
Mac leaned back in her chair and studied the screen. The ramifications of Janie’s findings would be far-reaching. Suddenly, a sense of dread came over her. How many people had come in contact with the villagers? Where was the boy who discovered the sick? What about the monkeys? Did the Guatemalan pathologist take the necessary precautions to protect himself?
“Janie, we may have a real problem on our hands.”
Chapter 13
Day Five
CDC
Atlanta, Georgia
Over the next hour, Mac contacted LaWanda Sanford, an emergency management specialist in the CDC’s Division of Emergency Operations. Initially, she asked Mrs. Sanford to set up a small ops center so Mac could gather her team. Throughout the CDC complex, specific outbreaks were given their own level of importance depending on size and locale. Mac felt like a plague outbreak would be considered a high priority.
While Mac was coordinating with the Office of Public Health Preparedness, Janie was gathering the team of scientists and field investigators who would conduct the ground game in dealing with the CDC’s response.
Mac also activated the CDC Laboratory Response Network, an integrated network of state and local public health, federal, and international labs. They were put on notice of the outbreak in Guatemala and were required to notify hospitals to watch for unusual cases involving plague-like symptoms.
Organizations like the CDC and the WHO came under criticism for their inability to prevent outbreaks altogether. Situations like the village in Guatemala proved how prevention was nearly impossible in many cases. The CDC adopted a posture that if you couldn’t prevent an infectious disease from spreading, the next best thing was to identify it as quickly as possible.
In the U.S., the CDC might be working a continually modified list of infectious disease outbreaks from A to Z—AIDS to Zika. If a local health care provider came across any of these eighty or more diseases that require notification to the CDC, he must act quickly to set the wheels of detection and containment into motion. Of paramount importance in preventing the spread of an outbreak was containment.
When an outbreak had the potential to cross national borders, then the World Health Organization got involved. At this point, Mac didn’t have any evidence that would suggest international borders would be compromised. She’d leave the decision as to notification to the WHO in the laps of people higher up the CDC organizational chart.
Mac stood at the head of the room, studying the reports created by Janie and the rest of the research scientists from CDC-Guatemala City. She looked at the pathology reports to make sure nothing was omitted. It was all there, and it was conclusive—pneumonic plague.
She began. “As you all know, bubonic plague is the most commonly recognized strain of Y. pestis. It occurs with regular frequency around the world and in the United States, especially in New Mexico, which reports half of the bubonic plague cases every year.”
Mac paused as Baggett entered the room with his assistant. All of the seats were full and none of her staff offered to give up their spot, an indicator of the lack of respect they had for the bureaucrat. Baggett found a place at the rear of the room and leaned against the wall before nodding for Mac to continue.
“But the pneumonic variant is rare and much more virulent. And, unlike its bubonic sister, it can be spread via airborne particles. Think about the bubonic plague in Europe of the thirteenth and fourteenth century. That’s the typical scenario that you should think of.”
Mac, ironically still dressed in all black, continued her introductory remarks. “At the time, the Black Death started as the bubonic plague, but then it morphed into the pneumonic plague and one-third of the population died. So the consequences for today’s modern society could be enormous.”
Baggett interrupted. “It’s my understanding that this outbreak is isolated to one remote village in the Guatemalan jungle. Isn’t it overkill to declare this to be a five-alarm fire?”
“It depends,” responded Mac, bristling at his insinuation that she was overreacting. “We don’t know how many people and animals have come in contact with the disease, even though it was remote. We haven’t identified patient zero. The monkey population in the jungle is an issue as well. They may have become exposed to the disease for days before our CDC-Guatemala associates took control of the scene.”
“Well, I have a decision to make as to whether we involve the WHO,” Baggett interjected. “That will trigger a whole chain of events that involves the State Department, Homeland Security, and possibly the White House. When those heavy hitters get involved, the press gets a whiff of the action, and it becomes a five-alarm fire whether we like it or not.”
Mac was incredulous. D-Bag was basing his decision on whether to protect people from a deadly disease on who would be troubled by the revelation and media scrutiny. She wasn’t sure how to respond to his statement, so she didn’t. It was a lesson she’d learned from her mother.
“We’ve verified the diagnosis and established the existence and locale of the outbreak,” Mac continued. She looked down at Janie, who had a knack for knowing what Mac was thinking. She provided Mac a wink as encouragement. “Our working hypothesis has to be that the transmission was
airborne and possibly zoonotic. Typically, plague is transmitted by rodents and fleas to other animals or humans. But the large spider monkey population in the region cannot be discounted as a possible source.”
Janie raised her hand. “Our Guatemala facility just started analyzing the specimens drawn from the six captured primates. They’ll be able to give us something definitive in a few days.”
“Good,” said Mac. “What about implementation of the control and prevention measures I suggested before I left the country?”
“I wish I had better news there,” replied Janie. “The military personnel were reluctant to cordon off the area, so the village was razed and then burned. They haven’t produced the boy who discovered the sick villagers either.”
Mac pulled her hair behind her ears and closed her eyes. Don’t these people understand? “Janie, please follow up on this. We’ve got to see if the young man is infected.”
“I will.”
Then Mac thought of something else. “This may or may not be connected, but there was an outbreak a year ago on Madagascar of pneumonic plague. If I’m not mistaken, the research on that strain was assigned to the BSL-4 in Gabon. I need someone to get the data on their findings. It’s a long shot, but I wanna do a quick comparison to rule out any correlation between the two outbreaks.”
“That’s not going to be possible, Dr. Hagan,” stated Baggett from the rear of the room. “The facility was destroyed by an explosion two days ago. The cause is still being investigated, but in any event, the lab and its contents were obliterated.”
The room burst into muffled conversation at this news. Many of the scientists had friends and acquaintances who worked in labs around the world.
“Okay,” started Mac, raising her voice slightly to bring the room back to attention. “I’ll consider whether it’s worth the effort to send a team to Madagascar in search of new specimens. More on that later.”