The Demon in the Freezer

by Richard Preston

  THE MAIN THING that stands between the human species and the creation of a supervirus is a sense of responsibility among individual biologists. Given human nature and the record of history, it seems possible that someone could be playing with the genes of smallpox right now. And what if a fire began to flicker in the hay in the barn, and we poured a glass of water on it, but the water could not put the fire out? No nation that wanted to have nuclear weapons had a problem finding physicists willing to make them. The international community of physicists came of age in a burst of light over the sands of Trinity in New Mexico. The biologists have not yet experienced their Trinity.

  A Child

  IN THE YEARS just before the Eradication began, two million people a year were dying of smallpox. The doctors who ended the virus as a natural disease have effectively saved fifty to sixty million human lives. This is the summit of Everest in the history of medicine, and yet they have never received the Nobel Prize. These days, several times a year, Dr. Stanley O. Foster takes a trip to revisit places he’s worked at before. In 2000, he decided to take a cruise aboard the Rocket. He arrived at the landing at Dhaka, carrying a small knapsack, and there she was at the dock, the steam paddle wheeler, completely unchanged, looking exactly as she had in 1975, stained with rust and jammed with humanity. He spent the night aboard her, leaning on the rail and watching the islands pass, smelling the river and the rising scent of the sea, and shortly after sunrise he disembarked at Berisal, where he rented a speedboat and crossed the bay to Bhola Island. He went inland by Land Rover, threading his way among crowds of people, until he came to the house of Rahima.

  The young woman had moved to a different village when she had married. She was now twenty-five years old, and she was most happy to see him, though she was just about as shy as she had been on the day when she had dived into the burlap sack. Rahima had two daughters, was expecting a third child, and was hoping for a son. She presented Dr. Foster with a small gift, and he gave her kids some crayons.

  AT SUNRISE one day in November 2001, a month after the anthrax attacks, I drove south through Gettysburg, past the Gettysburg battlefield. It is an open country of rolling farms, and it looks not very different than it did at the time of the Civil War. The earth was a rich brown, dotted with crows, which flew up into a yellow sky. Little Round Top passed, the hill where Joshua Chamberlain and his men from Maine turned the tide with a charge. It was just another hump of bare trees. The road took me to Frederick, and I walked through the corridors of USAMRIID, along with Peter Jahrling, Lisa Hensley, and Mark Martinez. The light was sickly green, and the air smelled of roasting equipment—giant autoclaves baking things to sterilize them. Corridors branched to the left and right. Martinez was dressed in fatigues, with a black beret tucked in his belt. He swiped his security card over a sensor and pushed open a door, and we walked into the pathology suite—a cold suite, where there are no dangerous pathogens. Martinez took us into a small, windowless room with green walls. It was a bare-bones room, with some filing cabinets, some work counters, and a hood.

  “I’ll be right back,” Martinez said and left the room.

  We leaned up against the cabinets and waited. He was going to a storage area that was, apparently, a secret.

  “What you are about to see is a national resource,” Jahrling remarked.

  “I’ve never seen it,” Hensley commented.

  Martinez returned, carrying a white plastic bucket. He popped open the lid and removed something that was wrapped in a yellow disposable surgical gown inside a plastic bag. He placed the bag inside the hood, opened it, and slid out the lump wrapped in the gown. Very slowly and carefully, he peeled the gown away and revealed it.

  It was the arm of a child, covered with smallpox pustules. The arm had been severed during autopsy.

  The child had been American, white, three to four years old, and had died of variola major. That was about all the information the Army scientists had been able to come up with.

  In the spring of 1999, a professor at the Indiana University School of Dentistry had been exploring a dark basement corridor of the school with a flashlight, and he had come across a collection of jars that had belonged to William Schaffer, a long-dead pathologist. One of them was a jar with the arm in it, labeled “M 243 Smallpox.” No one knew where Professor Schaffer had obtained it. The professor had phoned officials at the CDC and had asked them if they wanted it. The CDC did not want a pickled arm covered with smallpox, so the professor gave it to a pharmaceutical company that was working on drugs for smallpox. Jahrling had shown up at the company one day to talk about smallpox drugs, and company scientists had mentioned to him that they had a smallpox arm, and did he want it?

  “Heck, yes,” Jahrling said to them.

  There weren’t any living people with the disease, and an arm covered with variola pustules was a magnificent clinical specimen. He had wanted to wrap the arm in plastic and bring it back in his carry-on luggage, but he began to wonder what airport security people would do if they found it, so he made arrangements to have the arm shipped to USAMRIID by express delivery.

  The WHO forbids any laboratory except the CDC and Vector to have more than ten percent of the DNA of the smallpox virus. The chemicals in the jar had caused the smallpox DNA to fall apart into tiny fragments, and thus it was a legal smallpox arm.

  THE ARM was lying palm downward. Mark Martinez turned it slowly, holding it with great care, until the palm came upward. He took the index finger and bent it ever so slightly, opening the palm, revealing the erupting centrifugal rash. The arm was covered with dark brown pustules. The child had died at the moment the pustules were beginning to crust over. The crusts were very dark.

  Lisa Hensley stared at it through the glass. “I never had any idea how bad smallpox was until I saw the lesions in the monkeys. You can see the same lesions here.”

  Martinez stood up, leaving the arm inside the hood. I put on a pair of latex gloves, sat down on the stool, reached into the cabinet, and picked up the arm. I could smell a faint, sweet smell of preserved human flesh. For a moment, I wondered if it was the foetor of smallpox. I turned the arm over and scabs began falling onto my hands. The lifeboats of variola were coming off.

  THE APPEARANCE of a child’s arm covered with smallpox pustules was something that our ancestors knew, but the arm had become a relic of history and an object of horror, alien to us. That we had never seen an arm like this in our lives was an extraordinary thing, a gift, unasked for, unexpected, and now unnoticed. A handful of doctors had given it to us, joined by thousands of village health workers. They had forged themselves into an army of peace. With a weapon in their hands, a needle with two points, they had searched the corners of the earth for the virus, opening every door and lifting every scrap of cloth. They would not rest, they would not stand aside, and they gave all they had until variola was gone. No greater deed was ever done in medicine, and no better thing ever came from the human spirit.

  As I reflected on the death of variola, I thought also about our future. More and more people are living in cities. Soon more than half of the people in the world will be city dwellers. According to projections made by the United Nations, by the year 2015, the earth will likely contain twenty-six extremely big cities. Twenty-two of those cities will be in developing nations. Perhaps four of them will be in industrial countries. New York and Los Angeles will be medium-sized cities then.

  These big cities will be in tropical nations. Bombay will have twenty-six million people living in it by 2015, Lagos twenty-four million. The population of California is currently thirty-five million. Take two thirds of the people in California and cram them into one city, with poor sanitation and inadequate health care and ineffective government. Twenty-five million people living within a couple of hours of one another . . . this is a leap beyond any sort of crowding a poxvirus would have found in ancient Egypt. If there is not enough vaccine to stop an outbreak of smallpox in a giant city, or if the virus cuts through the vaccine bec
ause human beings have done something to its genes, then the virus will move fast. The cities of the world are linked through a web of airline routes. A virus that appears in Bangladesh will soon arrive in Beverly Hills. An engineered virus could bring a bit of invisible bad news to every community on earth.

  I OPENED the child’s hand and spread the fingers out on my palm. The child’s palm was one entire pustule. The fingers had gone confluent, so that there was almost no skin left that was not pustulated. I could see the whorls of the fingerprints, the mounts of fate and the future. The line of life and the line of love had been broken.

  What was not present any longer in this hand was the suffering of the child who had endured it. I recalled when my son had been born, and how, minutes afterward, I had held his tiny hand, impressed with its perfection. I recalled the times when my children had been sick or had needed comforting, and I had held their hands. I recalled the sense of time slipping by as I noted how their hands were growing, gradually filling more of my hand. They might one day hold my hand when the life had left it.

  We will never find an explanation for the suffering etched in that child’s hand, or for the evils done by people against other people, or for the love that drove the doctors to bring smallpox to an end. Yet after all they had done, we still held smallpox in our hands, with a grip of death that would never let it go. All I knew was that the dream of total Eradication had failed. The virus’s last strategy for survival was to bewitch its host and become a source of power. We could eradicate smallpox from nature, but we could not uproot the virus from the human heart.

  Glossary

  amplification. Multiplication of a virus. See replication.

  anthrax. Bacillus anthracis, a rod-shaped, spore-forming bacterium that grows profusely in lymph and blood. Name comes from the Greek word for black, after the blackening of the skin caused by an anthrax infection of the skin.

  anthrax spores. Tiny ovoid spores, one micron long, produced when anthrax bacterial cells encounter adverse conditions and are unable to keep growing. About two hundred spores would span the thickness of a human hair.

  antiviral drug. A type of drug that stops or slows a virus infection.

  biological weapon or bioweapon. Disease-causing pathogen dispersed into a human population as a weapon. Usually prepared and treated in special ways in order to be dispersed in the air.

  Biosafety Level 4. Also BL-4 or Level 4. Highest level of biocontainment; requires the wearing of a bioprotective space suit.

  black pox. See flat hemorrhagic smallpox.

  blue suit. A bioprotective full-body space suit, typically blue.

  BWC. The Biological Weapons and Toxin Convention, an international treaty, signed by more than one hundred and forty nations, which forbids the development, possession, and use of offensive biological weapons. Signed by the United States in 1972.

  CDC. The federal Centers for Disease Control and Prevention, in Atlanta.

  chains of transmission. Chains of infection, which typically branch through a population.

  construct. A recombinant virus made in the laboratory.

  cytokine. A signaling compound, released by cells, that circulates in the blood and lymph and regulates a system in the body. Many cytokines serve as signals in the immune system.

  cytokine storm. Derangement and collapse of the immune system and other systems in the body.

  DNA. The long, twisted, ladderlike molecule that contains the genetic code of an organism. The rungs of the ladder, or nucleotide bases, are the letters of the code.

  dumbbell core. Dumbbell-shaped body in the center of a poxvirus particle, which contains the virus’s DNA or genome. Also known as the dogbone of pox. Unique to poxviruses.

  engineered virus. A recombinant virus or construct virus that contains foreign genes in its DNA or RNA.

  epidemiology. The science and art of tracing the origin and spread of diseases in populations with the goal of controlling or stopping them.

  flat hemorrhagic smallpox. Also known as black pox. The most malignant form of smallpox disease, characterized by hemorrhages and darkening (purpuric) skin. It is essentially one hundred percent fatal.

  gene. A short stretch of DNA that contains the genetic code for a single protein or a related group of proteins in an organism.

  genetic engineering. The science and art of inserting genes into or removing them from the DNA of an organism, changing the organism’s inherited characteristics as a life-form.

  genome. The entire amount of DNA in a cell or virus particle, which contains the complete genetic code of the organism. (Some viruses use RNA for their genomes.)

  Harper strain. Hot strain of smallpox in the smallpox repository at the CDC.

  HMRU. The Hazardous Materials Response Unit of the FBI. A rapid-response team for incidents of chemical or biological terrorism; stationed at the FBI Academy in Quantico, Virginia.

  host. An organism that a parasite lives inside or on.

  hot. Virulent; infective; lethal.

  IL-4 gene. The gene that codes for interleukin-4, which is a common cytokine that regulates the immune system.

  IL-4 smallpox. A genetically engineered smallpox not known to exist, though some experts fear it might easily be created in a laboratory by the insertion of the human IL-4 gene into natural smallpox virus. Recent experiments suggest that IL-4 smallpox might evade the vaccine and be superlethal in humans. See mousepox and IL-4 gene.

  India-1 strain. A strain of smallpox, believed to be exceedingly virulent in humans, possibly vaccine resistant, weaponized, and produced in tonnage quanties by the Soviet Union for loading into ICBMs.

  laminar-flow hood or simply hood. A laboratory cabinet with a sliding glass front, similar in principle to an exhaust hood over a kitchen stove, used to protect samples from becoming contaminated and researchers from becoming infected.

  micron. One millionth of a meter. An anthrax spore is one micron long. Bioweapons particles are ideally one to five microns in size, so as to be inhaled deeply into the lungs.

  mirrored smallpox. A doubled collection of smallpox, kept in identical, or “mirror,” freezers designated A and B. If one freezer is lost, the smallpox collection remains intact in the other freezer.

  mousepox virus. Also called ectromelia. A poxvirus of mice that is related to smallpox. IL-4 mousepox is a genetically engineered mousepox that breaks through some vaccine-induced immunity in some types of mice. See IL-4 smallpox.

  multiplier. An estimate of the number of secondary cases that will be caused by one infectious case. Known technically as R-zero.

  nanopowder silica. Extremely fine particles of silica glass, which can be mixed into a biological weapon to make it better able to become easily airborne and thus more infective in the lungs.

  parasite. An organism that lives inside or on a host organism and typically harms the host.

  pipette. Handheld push-button device used for moving small amounts of liquid.

  plaque picking. Method of using a pipette to suck cells infected with a virus out of a well plate. Technique for purifying a strain of engineered virus.

  plasmid. A short piece of DNA, in the shape of a ring, that multiplies inside bacteria as they grow. A plasmid can be engineered with foreign genes and then recombined with a virus to make an engineered virus.

  poxvirus. A large family of viruses, found in mammals, reptiles, amphibians, birds, and insects. Poxvirus particles are among the largest and most complex virus particles in nature.

  Rahima strain. A strain of smallpox in the repository at the CDC, taken from scabs of Rahima Banu, a three-year-old girl in Bangladesh who was the last person on earth to be naturally infected with variola major.

  replication. Self-copying. See amplification.

  ring vaccination. Prophylactic technique of vaccinating every susceptible person within a ring around an outbreak.

  trans-species jump. The process whereby a virus changes types of hosts, moving from one species to another.

/>   USAMRIID. United States Army Medical Research Institute of Infectious Diseases, at Fort Detrick, Maryland. Also known as the Institute or Rid.

  vaccine. A compound or virus that, when introduced into the body, provokes immunity to a disease.

  vaccine breakthrough. A (typically lethal) infection that breaks through a person’s vaccine-induced immunity.

  vaccinia. A poxvirus closely related to smallpox. It is much less virulent than smallpox in humans and is used as the vaccine for it.

  variola. Scientific name for smallpox virus; comes in two natural subtypes, variola major and variola minor.

  Vector. The State Research Center of Virology and Biotechnology, near Novosibirsk, Siberia.

  virion. Virus particle.

  virulence. Ability to cause disease; lethality.

  virus. The smallest form of life, a parasite that can replicate only inside cells, using the cell’s machinery. Viruses are small particles made of proteins, with a core containing DNA or RNA.

  virus weapon. A virus that has been prepared for use as a weapon. May be made through genetic engineering.

  well plate. A plastic plate divided into cups or wells, where viruses are grown inside living cells; essential tool for virus engineering.

  World Health Organization (WHO). International body associated with the United Nations; headquartered in Geneva.

  Acknowledgments

  I am most grateful for the enthusiastic support and guidance of many people at Random House: Ann Godoff, Joy de Menil, Carol Schneider, Liz Fogarty, Daniel Rembert, Carole Lowenstein, Sybil Pincus, Laura Wilson, Allison Heilborn, Timothy Mennel, Robin Rolewicz, Evan Camfield, Lynn Anderson, Laura Goldin, and Laura Wilson (Random House Audio Books).

  At Janklow & Nesbit Associates, Lynn Nesbit, Cullen Stanley, Tina Bennett, Bennett Ashley, Amy Howell, and Kyrra Rowley have been incredibly supportive and effective.