by A. G. Riddle
The drive to the first cave took less than two hours, and the four men in the SUV mostly rode in silence. Millen and Kito discussed the map and the caves a little, but the two Kenyan army officers in the front seats merely gazed out the windows, scanning for any signs of trouble.
Millen was excited. To some degree, he had been training for this day his entire life. He was the son of Indian immigrants to America, and they had encouraged him to explore all his affinities as a child. He had gone through a number of phases, everything from music to dance. But he had always come back to his first love: animals. He was awestruck with the diversity and complexity of the creatures that shared the world with humans. He loved how unpredictable they were, how each species seemed to have a special ability. Seeing a new animal, interacting with it, never got old.
He was especially interested in exotic animals and their habitats. He read everything he could about them and watched animal documentaries repeatedly. He considered a career at a zoo, but decided he wanted to work with animals in their natural environments. He also wanted to do something that made a big impact, not just on animals, but on humans as well.
When he graduated from veterinary school, his parents strongly urged him to become a practicing veterinarian—a career with a reliable income, a return on the considerable investment they had made in his education. But their strong-willed son won out. Instead of opening his own practice, he joined EIS, committing to a career in applied epidemiology. It was the perfect path for Millen. He would have the opportunity to travel the country and world, investigating outbreaks, seeking out animal hosts for infections that jumped to humans. He assured his parents that he could always go into veterinary practice if things didn’t work out.
They had relented, and as he donned the PPE and looked into the mouth of the cave, he had never been more glad that they had. He was about to perform what might be one of the most important investigations of his career.
Kito wished Millen luck, and he began his march inside, a sample kit at his side. The dried, yellowing snake skins lying just beyond the mouth of the cave unnerved him, but he pushed on. The suit would provide good protection.
With each step, the dark cave swallowed him up. When the darkness was complete, he switched on his night vision goggles, bathing the scene before him in an eerie green glow. Kito pinged him with a comm check every minute, and Millen responded each time.
At the ten-minute mark, the transmission began breaking up. Millen had been dropping green chemlights each minute, but at the radio blackout point he sealed the bag of green sticks and began dropping orange markers. The tubes glowed in the dark cave, green and orange breadcrumbs tracing his path. They were military-grade, with a twelve-hour duration. He planned on collecting them on his way out, long before they went dark.
As he moved deeper into the cave, the ground became more rocky and damp. Ten seconds after dropping his twentieth orange marker, he spotted what he had come for: bat droppings.
He bent and took several samples, marking them with their depth within the cave, and placed a numbered blue marker and flag by the sample spot.
Excited to have collected his first sample, he stepped deeper into the cave, leaving the sample kit behind. He held a tranquilizer pistol in his right hand and a large net in his left. He felt his boots slipping on the wet rock, but he pushed forward. The bats had to be close by. If they were the carrier for the mysterious disease, it would be a huge breakthrough, possibly the key to finding the index patient, or even a cure. It would blow the entire investigation wide open, saving thousands, maybe millions of lives. He walked even faster.
As he turned a corner, his left foot slipped on a wet rock, sending him tumbling. The gun and net flew from his hands as he slammed into the rocky floor. The fall frightened him, but he was unharmed. He rose and searched for the gun.
Bat screeches—a sound somewhere between the call of a crow and the yelping of a rodent—sounded from not far away, followed by flapping noises.
He turned in time to see a swarm of bats barreling toward him.
The creatures enveloped him. He threw his arms up, covering his faceplate, and stepped to the side, trying to move out of their flight path. He felt claws ripping at the PPE, the bony wings brushing past his arms and legs. He turned and ran, his head down. Rock crumbled beneath his feet. He slipped and fell, but there was no ground beneath him.
Chapter 32
A yellow spot burned through the white tent fabric above Peyton, like a heat lamp boring into her. She squinted, wondering what it could be. Then she realized: the midday sun, high in the sky. She sat up quickly, reached for her phone, and gasped when she saw the time. Eleven thirty.
Jonas’s cot was empty. She raced to the main tent.
Jonas and Hannah sat at a table, a large map pinned up on a board behind them. There was a lot more red on the map than there had been yesterday.
“Report,” she said, trying to catch her breath.
“Want some breakfast?” Jonas asked, ignoring her order.
“I want to know what’s happening.”
Jonas glanced at Hannah, who stood and left. “I think you’d better sit down, Peyton.”
“That bad?”
“Pretty bad.”
Jonas brought Peyton up to speed on the reports from the teams in the field. Fifteen more villages were infected. Including the fatalities from the Dadaab refugee camps, the death toll had climbed to over six thousand.
Peyton shook her head. “It’s impossible.”
“What?”
“Let’s assume Dr. Kibet was infected around the time the two Americans walked into his clinic.”
“Okay.”
“He broke with the disease within seventy-two hours.”
“Right.”
“But he never had the respiratory symptoms. His progression to the hemorrhagic stage of the disease was too fast—much faster than this village.”
“True,” Jonas said.
“Why?”
“Maybe because he contracted the disease from someone who was already in the hemorrhagic phase. Maybe he skipped the respiratory phase.”
“Which means the disease has two separate courses, depending on whom you contract it from—and what stage they’re in.” Peyton thought for a moment. “There’s something else: the Dadaab refugee camps were being infected at roughly the same time as this village.”
Jonas nodded.
“The Americans couldn’t have infected them,” Peyton said. “From their travel log, they were pretty far north of Dadaab.”
“Maybe they interacted with a trucker who was heading south?”
“Could be. But for the pathogen to amplify this much in such a short period of time strikes me as wrong.” She pointed to the map. “It’s like it’s erupting everywhere in the region at the same time. How is that possible?”
Jonas stared at the map. “An index patient who infected a large group of travelers, maybe attendees at a funeral, or a meeting of representatives from dozens of villages? Could be infected food.”
Peyton’s mind flashed to Desmond Hughes. He had sent the package of food to the two Americans. What if the villagers had received similar packages? Desmond’s call a few nights ago ran through her mind. It had ended with the words: I think you’re in danger.
She looked around to be sure she and Jonas were alone in the tent. Her voice barely above a whisper, she said, “I know it sounds crazy, but I still think this is bioterror.”
Jonas exhaled. “Okay, let’s assume it is, and play it out. Al-Shabaab is the resident terror group in the area. If they could get a biological agent, it would certainly accomplish their goal of destabilizing Kenya. They want to take over the government and set up a fundamental Islamic state. The outbreak is a pretty drastic way to go about it, but it could set up an opportunity for them.”
“So the motive is there.”
“Yeah, but let’s face it, this is way over their head.”
“Maybe they had help,” Peyton said.
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br /> “Maybe. But from whom, and why?” Jonas studied the map. “Look, I think it’s within the realm of possibility, but I don’t count it as likely. Maybe we’re just looking for a group of five people who were infected at the same time. They could have set off the outbreaks at Dadaab, the airport, Mandera, and the surrounding villages. That seems more likely to me.”
Hannah stepped inside the tent and handed Peyton a warm MRE and a bottle of water, both of which she badly needed. She thanked the young physician, who nodded and stepped back. While Peyton and Jonas studied the map, Hannah took out her satphone, dialed, and waited.
She spoke softly, then raised her voice. “How long?” She paused. “Hold the line.”
Hannah put the phone to her shoulder. “Millen has been in the first cave for an hour and a half. He hasn’t checked in for over an hour.”
“Who’s on the line?” Peyton asked.
“Kito, the local guide.”
“Put him on speaker.”
Hannah hit a button on the phone. “Kito, I’ve got Doctors Shaw and Becker here.”
“Hello, doctors.”
“Kito, did Millen bring an extra hazmat suit?” Peyton asked.
“Yes, ma’am.”
“Are you comfortable putting the suit on and going into the cave to see if you can make radio contact with him or find him?”
“Yes, ma’am,” the man said instantly. “I will do my best.”
“Good. We appreciate that very much. Millen should have left chemlights along his path. If the trail of lights stops, search the area for him. He may have been injured during a cave-in or accident.”
“All right.”
“Keep us posted, Kito. Thank you.”
Hannah hung up, and Peyton looked into the young EIS officer’s eyes. “We’ll find him, Hannah.”
The three physicians spent the early afternoon coordinating with teams in other villages and prepping the camp for disassembly. They planned to leave at dawn the next morning.
By two p.m., they still hadn’t heard anything from Kito or Millen. Hannah had tried to call Kito’s satphone, but had gotten no answer. Hannah was growing increasingly worried. So were Peyton and Jonas, though neither of the older epidemiologists voiced their fears. Peyton decided to send another SUV loaded with four of Colonel Magoro’s men to the first cave Millen was supposed to search—just in case Kito found Millen injured and needed help transporting him out of the cave.
At two thirty, Peyton called Elliott Shapiro’s cell phone. Even after five years in the field without him, she had to admit that it calmed her to hear his voice. And going over the situation with him would help her get her head around what was happening.
She stood outside the large tent, out of earshot of Jonas and the staff.
“What are you thinking?” Elliott asked. “How could it have spread so quickly?”
“We’ve got a few theories. There could have been a group of four to ten people the index patient infected; they would have been traveling throughout the region and would have quickly spread the pathogen.”
“Makes sense.”
“However, I can’t help thinking it could be another method of transmission.”
“Like what? Infected blood? A burial?”
“Maybe. I don’t know.” Peyton watched the Kenyan soldiers patrolling the camp. “What’s happening on your end?” She badly wanted to know how Lucas Turner was doing, but she resisted asking specifically.
“A lot,” Elliott said. “The US has suspended all travel to Kenya, Ethiopia, and Somalia. We’ve also banned anyone from that region, and anyone who has recently traveled in that region, from entering the US. We’re not alone: Europe has followed suit, Australia, most of Asia as well. They say it will be the death nail in the Kenyan economy.”
“True. But I think it needs to be done.”
“I agree. Also, there’s been a new development here. We’re tracking another outbreak.”
Peyton began pacing. “Really? What are the symptoms?”
“It presents similar to the flu but with less initial intensity. It’s intermittent, too. One day the symptoms are in full swing: headache, cough, fever, exhaustion, the next the patient feels almost fine. The mortality rate is exceptionally low—so far.”
A chill ran through Peyton’s body. He had just described exactly the symptoms the two Americans had experienced before developing the viral hemorrhagic fever that had killed one of them and the British man.
She fought to keep her voice even. “How many cases?”
“Over a million in Asia, another million in Europe. Maybe two hundred thousand in South America so far. But we think there are a lot more. We’ve got half a million cases here in the US, but we’re getting updated stats from state health departments so we expect that number to climb.”
It was officially a pandemic. Peyton wanted to present her theory, but she needed to get all the facts first.
“How could it spread that far so fast? How did GPHIN miss it? How did we miss it?”
“The symptoms aren’t differentiated enough from a cold or flu. When health departments realized that patients who had gotten the flu vaccine were still getting sick, they started tracking it more closely. The intermittent nature of the disease also made it hard to establish a pattern. But we’ve got a sample in the lab, and we’ll have it sequenced soon. Whatever the virus is, we think it must be throwing off a lot of viral escape vectors. It’s pretty tough. The good news is that out of the almost three million known cases, we’ve only seen a few dozen deaths. It’s remarkably non-lethal.”
“Interesting.” Since Thanksgiving was tomorrow, Peyton asked the next logical question: “Is the director considering a travel advisory?”
“He is, but I count it as unlikely. The White House has already come out against it. Better to let a lot of people get the sniffles than kill the economy—that’s the thinking on their end. If the mortality rate was higher, the calculus might be more complicated.”
“Yeah. Figured. Listen, I know this is probably a long shot, but I want to mention it. The Kenyan physician who initially treated the Americans took a detailed history. Both of these guys had flu-like symptoms before they broke with the hemorrhagic fever.”
A long pause, then Elliott said, “You think…”
“I think we should compare the genomes of both viruses to see if they’re related—just to be safe.”
The unspoken implication was that millions around the world were already infected with the deadly virus that was killing so many in Kenya.
Elliott’s voice remained calm. “It’s a good idea. I’ll make it a priority.”
Peyton exhaled and stopped pacing. “Great.”
Curiosity finally overcame her. “How about the kid?”
Elliott’s hesitation gave her the news before he spoke. “I’m really sorry, Peyton. He died in the air a few hours ago.”
The words were a punch in the gut. Less than twenty-four hours ago, she had walked into Lucas Turner’s hospital room and promised him she was going to do everything she could for him. She wondered if she had.
“So much for ZMapp,” she said, trying to sound objective but failing to hide the emotion in her voice.
“You did everything you could, Peyton. And you sent us samples to work with. Let us do our part.”
Peyton thought about the young man’s note to his parents, which Dr. Kibet had transcribed in the notebook. Lucas Turner had been brave. And selfless. And too young to die. Dr. Kibet had taken good care of him—the best he could. She hoped Kibet would fare better than Lucas Turner, but she wasn’t optimistic.
She returned her focus to the phone call. “Right. Also, we’ve got another situation here: a missing EIS agent named Millen Thomas. He was exploring some nearby caves today, and we haven’t heard anything from him for a couple of hours. I’ve sent out a search team.”
“Understood. He’ll turn up, Peyton. Probably lost his phone or batteries went dead.”
“Yeah, I hop
e so.”
“Anything I can do?”
“No, we’re working on it here.”
“All right. Call me if you need anything. And keep your head up, okay?”
Back at the tent, Jonas was typing on his laptop.
“Lucas Turner passed away en route to Emory,” Peyton said, trying to sound unemotional.
Jonas looked up, his big brown eyes focusing on Peyton. “I’m really sorry.”
“Yeah. Me too.”
A few hours later, Hannah ducked through the tent flaps, the satphone held to her ear. “The second team is at the cave site. The SUV is gone. Kito hasn’t made radio contact.”
“Signs of a struggle?” Peyton asked.
“No,” Hannah replied; she had apparently already asked.
Peyton thought for a moment. “Maybe their phone is dead. They could be on their way back here, or they may have moved on to the second cave.”
“Or they’re trapped in the cave,” Hannah said.
“It’s certainly a possibility. Have two of the men suit up and go in. Tell them not to separate and to make radio contact on the minute. Call the Kenyan MOH. Request a medevac helicopter be sent to the location; we have reason to believe that one of our personnel and one or more of theirs is injured. If we don’t find any signs of Millen, we’ll move to the next location on their itinerary.”
To Colonel Magoro, Peyton said, “Can you send more men?”
Magoro looked uneasy. “Yes, but we’re spreading ourselves too thin.”
“Do it,” Peyton said. “And let’s get reinforcements here asap.”
“Understood.”
At six p.m. the team cleared some of the clutter off the long conference table and sat down to eat. They had still heard nothing from Colonel Magoro’s second team. The third team would arrive within another hour.
The sunlight was fading fast, and the lights were on in the main tent. The army men were changing shifts, and about a dozen soldiers made their way into the tent, seeking their evening meal.
Outside, Peyton thought she heard a faint popping noise, like an air rifle. Jonas glanced at the flaps leading out of the tent. He had heard it too. Together, they walked to the opening. Just beyond the camp’s perimeter, two helicopters kicked up dust from the dry terrain as they landed.