“What trouble are you getting into this time?” She smiled at me, then eyed my bag. “I’m afraid to ask.”
“Possible product tampering,” I said. “I need to spray some on a slide, but it absolutely can’t get in the air or on me or anyone.”
“What is it?” She was very somber now, getting up.
“Possibly a virus.”
“As in the one on Tangier?”
“That’s my fear.”
“You don’t think it might be wiser to get this to CDC, let them . . .”
“Douglas, yes, it would be wiser,” I patiently explained as I coughed again. “But we haven’t got time. I’ve got to know. We have no idea how many of these might be in the hands of consumers.”
Her DNA lab had a number of closed air system hoods surrounded by glass bioguards, because the evidence tested here was blood. She led me to one in the back of a room, and we put on masks and gloves, and she gave me a lab coat. She turned on a fan that sucked air up into the hood, passing it through HEPA filters.
“Ready?” I asked, taking the facial spray out of the bag. “We’ll make this quick.”
I held a clean slide and the small canister under the hood and sprayed.
“Let’s dip this in a ten percent bleach solution,” I said when I was done. “Then we’ll triple bag it, get it and the other ten off to Atlanta.”
“Coming up,” Wheat said, walking off.
The slide took almost no time to dry, and I dripped Nicolaou stain on it and sealed it with a cover slip. I was already looking at it under a microscope when Wheat returned with a container of bleach solution. She dipped the Vita spray in it several times while fears coalesced, rolling into a dark, awful thunderhead as my pulse throbbed in my neck. I peered at the Guarnieri bodies I had come to dread.
When I looked up at Wheat, she could tell by the expression on my face.
“Not good,” she said.
“Not good.” I turned off the microscope and dropped my mask and gloves into biohazardous waste.
The Vita sprays from my office were airlifted to Atlanta, and a preliminary warning was broadcast nationwide to anyone who might have had such a sample delivered to him. The manufacturer had issued an immediate recall, and international airlines were removing the sprays from overseas travel bags given to business and first-class passengers. The potential spread of this disease, should deadoc have somehow tampered with hundreds, thousands of the facial sprays, was staggering. We could, once again, find ourselves facing a worldwide epidemic.
The meeting took place at one P.M. in the FBI’s field office off Staples Mill Road. State and federal flags fought from tall poles out front as a sharp wind tore brown leaves off trees and made the afternoon seem much colder than it was. The brick building was new, and had a secure conference room equipped with audio-visual capabilities, so we could see remote people while we talked to them. A young female agent sat at the head of the table, at a console. Wesley and I pulled out chairs and moved microphones close. Above us on walls were video monitors.
“Who else are we expecting?” Wesley asked as the special agent in charge, or S.A.C., walked in with an armload of paperwork.
“Miles,” said the S.A.C., referring to the Health Commissioner, my immediate boss. “And the Coast Guard.” He glanced at his paperwork. “Regional chief out of Crisfield, Maryland. A chopper’s bringing him in. Shouldn’t take him more than thirty minutes in one of those big birds.”
He had no sooner said this than we could hear blades thudding faintly in the distance. Minutes later, the Jay-hawk was thundering overhead and settling in the helipad behind the building. I could not remember a Coast Guard recovery helicopter ever landing in our city or even flying over it low, and the sight of it must have been awesome to people on the road. Chief Martinez was slipping off his coat as he joined us. I noted his dark blue commando sweater and uniform pants, and maps rolled up in tubes, and the situation only got grimmer.
The agent at the console was working controls as Commissioner Miles strode in and took a chair next to mine. He was an older man with abundant gray hair that was more contentious than most of the people he managed. Today, tufts were sticking out in all directions, his brow heavy and stern as he put on thick black glasses.
“You look a little under the weather,” he said to me as he made notes to himself.
“The usual stuff going around,” I said.
“Had I known that, I wouldn’t have sat next to you.” He meant it.
“I’m beyond the contagious stage,” I said, but he wasn’t listening.
Monitors were coming on around the room, and I recognized the face of Colonel Fujitsubo on one of them. Then Bret Martin blinked on, staring straight at us.
The agent at the console said, “Camera on. Mikes on. Someone want to count for me.”
“Five-four-three-two-one,” the S.A.C. said into his mike.
“How’s that level?”
“Fine here,” Fujitsubo said from Frederick, Maryland.
“Fine,” said Martin from Atlanta.
“We’re ready anytime.” The agent at the console glanced around the table.
“Just to make sure all of us are up to speed,” I began. “We have an outbreak of what appears to be a smallpox-like virus that so far seems to be restricted to the island of Tangier, eighteen miles off the coast of Virginia. Two deaths reported so far, with another person ill. It is also likely that a recent homicide victim was infected with this virus. The mode of transmission is suspected to be the deliberate contamination of samples of Vita aromatherapy facial spray.”
“That hasn’t been determined yet.” It was Miles who spoke.
“The samples should be getting here any minute,” Martin said from Atlanta. “We’ll begin testing immediately, and will hopefully have an answer by the end of tomorrow. Meanwhile, they’re being taken out of circulation until we know exactly what we’re dealing with.”
“You can do PCR to see if it’s the same virus,” Miles said to the video screens.
Martin nodded. “That we can do.”
Miles looked around the room. “So what are we saying here? We got some loonytune out there, some Tylenol killer who’s decided to use a disease? How do we know these little spray bottles aren’t the hell all over the place?”
“I think the killer wants to take his time.” Wesley began what he did best. “He started with one victim. When that paid off, he began on a tiny island. Now that’s paying off, so he hits a downtown health department office.” He looked at me. “He will go to the next stage if we don’t stop him or develop a vaccine. Another reason I suspect this is still local, is it appears the facial sprays are hand-delivered, with bogus bulk-rate postage on the tubes to give the appearance that they were mailed.”
“You’re definitely calling this product tampering, then,” Colonel Fujitsubo said to him.
“I’m calling this terrorism.”
“The point of it being what?”
“We don’t know that yet,” Wesley told him.
“But this is far worse than any Tylenol killer or Unabomber,” I said. “The destruction they cause is limited to whoever takes the capsules or opens the package. With a virus, it’s going to spread far beyond the primary victim.”
“Dr. Martin, what can you tell us about this particular virus?” Miles said.
“We have four traditional methods for testing for smallpox.” He stared stiffly at us from his screen. “Electron microscopy, with which we have observed a direct visualization of variola.”
“Smallpox?” Miles almost shouted. “You’re sure about that?”
“Hold on,” Martin interrupted him. “Let me finish. We also got a verification of antigenic identity using agar gel. Now, chick embryo chorioallantoic membrane culture, other tissue cultures are going to take two, three days. So we don’t have those results now, but we do have PCR. It verified a pox. We just don’t know which one. It’s very odd, nothing currently known, not monkeypox, whitepox. Not cl
assic variola major or minor, although it seems to be related.”
“Dr. Scarpetta,” Fujitsubo spoke. “Can you tell me what’s in this facial spray, as best you know?”
“Distilled water and a fragrance. There were no ingredients listed, but generally that’s what sprays like this are,” I said.
He was making notes. “Sterile?” He looked back at us from the monitor.
“I would hope so, since the directions encourage you to spray it over your face and contact lenses,” I replied.
“Then my question,” Fujitsubo went on via satellite, “is what kind of shelf life might we expect these contaminated sprays to have? Variola isn’t all that stable in moist conditions.”
“A good point,” Martin said, adjusting his ear piece. “It does very well when dried, and at room temperature can survive months to a year. It is sensitive to sunlight, but inside the atomizers, that wouldn’t be a problem. Doesn’t like heat, which, unfortunately, makes this an ideal time of year.”
“Then depending on what people do when they have these delivered,” I said, “there could be a lot of duds out there.”
“Could be,” Martin hoped.
Wesley said, “Clearly, the offender we’re looking for is knowledgeable of infectious diseases.”
“Has to be,” Fujitsubo said. “The virus had to be cultured, propagated, and if this is, in fact, terrorism, then the perpetrator is very familiar with basic laboratory techniques. He knew how to handle something like this and keep himself protected. We’re assuming only one person is involved?”
“My theory, but the answer is, we don’t know,” Wesley said.
“He calls himself deadoc,” I said.
“As in Doctor Death?” Fujitsubo frowned. “He’s telling us he’s a doctor?”
Again, it was hard to say, but the question that was most troublesome was also the hardest to ask.
“Dr. Martin,” I said as Martinez silently leaned back in his chair, listening. “Allegedly, your facility and a laboratory in Russia are the only two sources of the viral isolates. Any thoughts on how someone got hold of this?”
“Exactly,” Wesley said. “Unpleasant thought that it may be, we need to check your list of employees. Any recent firings, layoffs? Anybody quit during recent months and years?”
“Our source supply of variola virus is as meticulously monitored and inventoried as plutonium,” Martin answered with confidence. “I personally have already checked into this and can tell you with certainty that nothing has been tampered with. Nothing is missing. And it is not possible to get into one of the locked freezers without authorization and knowledge of alarm codes.”
No one spoke right away.
Then Wesley said, “I think it would be a good idea for us to have a list of those people who have had such authorization over the past five years. Initially, based on experience, I am profiling this individual as a white male, possibly in his early forties. Most likely he lives alone, but if he doesn’t or he dates, he has a part of his residence that is off limits, his lab . . .”
“So we’re probably talking about a former lab worker,” the S.A.C. said.
“Or someone like that,” Wesley said. “Someone educated, trained. This person is introverted, and I base this on a number of things, not the least of which is his tendency to write in the lower case. His refusal to use punctuation indicates his belief that he is not like other people and the same rules do not apply to him. He is not talkative and may be considered aloof or shy by associates. He has time on his hands, and most important, feels he has been mistreated by the system. He feels he is due an apology by the highest office in the land, by our government, and I believe this is key to this perpetrator’s motivation.”
“Then this is revenge,” I said. “Plain and simple.”
“It’s never plain or simple. I wish it were,” Wesley said. “But I do think revenge is key, which is why it is important that all government agencies that deal with infectious diseases get us the records of any employees reprimanded, fired, laid off, furloughed or whatever, in recent months and years.”
Fujitsubo cleared his throat. “Well, let’s talk logistics, then.”
It was the Coast Guard’s turn to present a plan. Martinez got up from his chair and fastened large maps to flip charts, as camera angles were adjusted so our remote guests could see.
“Can you get these in?” Martinez asked the agent at the console.
“Got them,” she said. “How about you?” She looked up at the monitors.
“Fine.”
“I don’t know. Maybe if you could zoom in more.”
She moved the camera in closer as Martinez got out a laser pointer. He directed its intense pink dot at the Maryland-Virginia line in the Chesapeake Bay that cut through Smith Island, just north of Tangier.
“We got a number of islands going up this way toward Fishing Bay and the Nanticoke River, in Maryland. There’s Smith Island. South Marsh Island. Bloodsworth Island.” The pink dot hopped to each one. “Then we’re on the mainland. And you got Crisfield down here, which is only fifteen nautical miles from Tangier.” He looked at us. “Crisfield’s where a lot of watermen bring in their crabs. And a lot of Tangier folks have relatives in Crisfield. I’m real worried about that.”
“And I’m worried that the Tangiermen are not going to cooperate,” Miles said. “A quarantine is going to cut off their only source of income.”
“Yes, sir,” Martinez said, looking at his watch. “And we’re cutting it off even as we speak. We got boats, cutters coming in from as far away as Elizabeth City to help us circle the island.”
“So as of now, no one’s leaving,” Fujitsubo said as his face continued to reign over us from the video screen.
“That’s right.”
“Good.”
“What if people resist?” I asked the obvious question. “What are you going to do with them? You can’t take them into custody and risk exposure.”
Martinez hesitated. He looked up at Fujitsubo on the video screen. “Commander, would you like to field this one, sir?” he asked.
“We’ve actually already discussed this at great length,” Fujitsubo said to us. “I have spoken to the secretary of the Department of Transportation, to Vice Admiral Perry, and of course, the Secretary of Defense. Basically, this thing is speeding its way up to the White House for authorization.”
“Authorization for what?” It was Miles who asked.
“To use deadly force, if all else fails,” Martinez said to all of us.
“Christ,” Wesley muttered.
I listened in disbelief, staring up at doomsday gods.
“We have no choice,” Fujitsubo spoke calmly. “If people panic and start fleeing the island and do not heed Coast Guard warnings, they will—not if—but will bring smallpox onto the mainland. And we’re talking about a population which either has not been vaccinated in thirty years. Or an immunization done so long ago it’s no longer effective. Or a disease that has mutated to the extent that our present vaccine is not protective. There isn’t a good scenario, in other words.”
I didn’t know if I felt sick to my stomach because I wasn’t well or because of what I’d just heard. I thought of that weather-beaten fishing village with its leaning headstones and wild, quiet people who just wanted to be left alone. They weren’t the sort to obey anyone, for they answered to a higher power of God and storms.
“There must be another way,” I said.
But there wasn’t.
“By reputation, smallpox is a highly contagious infectious disease. This outbreak must be contained,” Fujitsubo exclaimed the obvious. “We’ve got to worry about houseflies hovering around patients, and crabs headed for the mainland. How do we know we don’t have to worry about the possibility of mosquito transmission, as in Tan-apox, for God’s sake? We don’t even know what all we’ve got to worry about since we can’t fully identify the disease yet.”
Martin looked at me. “We’ve already got teams out there,
nurses, doctors, bed isolators so we can keep these people out of hospitals and leave them in their homes.”
“What about dead bodies, contamination?” I asked him.
“In terms of United States law, this constitutes a Class One public health emergency.”
“I realize that,” I said, impatiently, for he was getting bureaucratic on me. “Cut to the chase.”
“Burn all but the patient. Bodies will be cremated. The Pruitt house will be torched.”
Fujitsubo tried to reassure us. “USAMRIID’s got a team heading out. We’ll be talking to citizens, trying to make them understand.”
I thought of Davy Crockett and his son, of people and their panic when space-suited scientists took over their island and started burning their homes.
“And we know for a fact that the smallpox vaccine isn’t going to work?” Wesley said.
“We don’t know that for a fact yet,” Martin answered. “Tests on laboratory animals will take days to weeks. And even if vaccination is protective in an animal model, this may not translate into protection for humans.”
“Since the DNA of the virus has been altered,” Fujitsubo warned, “I am not hopeful that vaccinia virus will be effective.”
“I’m not a doctor or anything,” Martinez said, “but I’m just wondering if you could vaccinate everyone anyway, just in case it might work.”
“Too risky,” Martin said. “If it’s not smallpox, why deliberately expose people to smallpox, thereby possibly causing some people to get the disease? And when we develop the new vaccine, we’re not going to want to come back several weeks later and vaccinate people again, this time with a different pox.”
“In other words,” Fujitsubo said, “we can’t use the people of Tangier like laboratory animals. If we keep them on that island and then get a vaccine out to them as soon as possible, we should be able to contain this thing. The good news about smallpox is it’s a stupid virus, kills its hosts so fast it will burn itself out if you can keep it restricted to one area.”
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