Viral Intent: An Alexandra Destephano Novel Book #3

by Judith Lucci

  Viral

  Intent

  Also by Judith Lucci

  Alex Destephano Novels

  Chaos at Crescent City Medical Center

  The Imposter

  Toxic New Year (Summer 2015)

  Finding St. Germaine (2016)

  Others Books

  Ebola: What You Must Know to Stay Safe

  Meandering, Musing & Inspiration for the Soul

  Viral

  Intent

  A NOVEL BY

  JUDITH LUCCI

  Copyright © 2014 by Judith Lucci

  All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the author, except by a reviewer who may quote brief passages in a review.

  The characters and events in this book are fictitious. Any similarity to real persons, living or dead, is coincidental and not intended by the author.

  ISBN-13: 978-1512340334

  ISBN-10: 1512340332

  Book design by Eric Blumensen

  Acknowledgements

  I would sincerely like to thank all of my friends and family who helped me complete this manuscript. I would like to especially like to thank Cammie Tutwiler and Jennifer Mandell for their review and professional editing of the manuscript. I would also like to thank Eric Blumensen for his cover design. Also, I'd like to give a shout out to Lt. Tommy Kain (ret) of the Richmond Police Department and my friend, John Cassara, author of Demons of Guadara, for his review and assistance with the manuscript. Most of all, I would like to thank all of my readers of the Alexandra Destephano Series for their continued support and the success of this series.

  "And kill them wherever you find them, and drive them out from where they drove you out....and fight not with them at the Sacred Mosque until they fight with you in it, so if they fight you in it, slay them." and, "Such is the recompenses of the disbelievers."

  (Surah 2:191, the Quran)

  About the Author

  Judith Lucci is from Virginia and holds graduate and doctoral degrees from Virginia Commonwealth University and the University of Virginia. She has been a practicing clinical nurse for over 25 years and is currently a professor of Nursing at a Virginia University. She is the author of numerous academic and health-related articles and documents. When not teaching or writing, Judith is an avid silk painter and multi-media artist. She divides her time between the Shenandoah Valley of Virginia and the Mississippi Gulf Coast.

  Table of Contents

  Chapter 1

  Chapter 2

  Chapter 3

  Chapter 4

  Chapter 5

  Chapter 6

  Chapter 7

  Chapter 8

  Chapter 9

  Chapter 10

  Chapter 11

  Chapter 12

  Chapter 13

  Chapter 14

  Chapter 15

  Chapter 16

  Chapter 17

  Chapter 18

  Chapter 19

  Chapter 20

  Chapter 21

  Chapter 22

  Chapter 23

  Chapter 24

  Chapter 25

  Chapter 26

  Chapter 27

  Chapter 28

  Chapter 29

  Chapter 30

  Chapter 31

  Chapter 32

  Chapter 33

  Chapter 34

  Chapter 35

  Chapter 36

  Chapter 37

  Chapter 38

  Chapter 39

  Chapter 40

  Chapter 41

  Chapter 42

  Chapter 43

  Chapter 44

  Chapter 45

  Chapter 46

  Chapter 47

  Chapter 48

  Chapter 49

  Aftermath

  Chapter 1

  “Sandy! Sandy! You have got to come here right away! Something horrible’s happening to the guy in bed three. I have no idea what's up with him but I think he is going to die," Kelsey Saunders exclaimed, her voice shrill with anxiety as her vivid green eyes exploded with anxiety.

  Sandy Pilsner, emergency department nurse manager of Crescent City Medical Center’s level one emergency department, looked up from the nurses' station and said, "What's up, Kelsey? I just saw him 20 minutes ago when I was making rounds."

  Kelsey's face was white with fear. "It's awful. He has blood coming out of his eyes and his blood pressure is low. He’s also shaking all over. I don’t know if it is a seizure or his fever. He’s having trouble breathing too. ”

  Sandy rose from her seat so she was eye level with the almost hysterical Kelsey, her new nursing graduate intern from LSU, and said gently, “Kelsey, it’s OK. I just checked on him a few minutes ago. He seemed fine, except for his fever and the fact that his blood work is really screwed up.”

  “I know, I know. But I'm telling you that things have changed quickly.”

  Sandy shook her blonde hair emphatically. “Hurry up. I think he’s gonna die any minute. There is just something very wrong! He is totally going bad.” Kelsey’s green eyes were huge and Sandy could see anxiety and worry reflected in them.

  “All right, let’s go check him out,” Sandy said as she thought of the ideal teaching moment they would have.

  An urgent voice barked over the hospital voice system, “CODE BLUE, CODE BLUE, ED, Bed 3.”

  Sandy grimaced and said, “Well, Kelsey, you called that one right! Let’s see what we can do.” Both nurses rushed toward the opposite end of the ED, pushing an extra crash cart.

  The code team was in action, and two amps of bicarb had already been administered with no response. The patient was blue, with circumoral cyanosis surrounding his mouth. His nails looked as though someone had painted them with a pearly blue nail polish. His eyes, open and staring, were blood red from petechiae and broken blood vessels. A bloody drainage seeped from the right eye, staining his cheek.

  Sandy noticed the flat red rash on his chest. She could swear he hadn’t had that rash 30 minutes ago.

  The ED doc in charge, Dr. Fred Patterson, saw Sandy and hollered, “What the hell is happening to this guy? He’s bleeding from everywhere and I have no idea what’s wrong with him! Give me a history and for God’s sake, get us some protective gear in here."

  Sandy stood quietly, transfixed. She had never seen Dr. Patterson anxious or even tense. She panicked for a moment but didn't know why. A dark sense of foreboding fell over her and she was afraid.

  Dr. Patterson glared at her. "For God’s sake, Sandy! Give me something. What’s the history? He’s bleeding out and I don’t know why. This is, at the very least, malaria, typhoid or perhaps one of the hemorrhagic viruses - maybe even something worse. Holy Shit, I don’t like this! Get us some protective gear, NOW!”

  Sandy’s stress soared exponentially. Fred Patterson was their calmest ED doc and he was freaked. She grabbed the chart from the medication nurse and said, “Fred, not much to tell. The guy came in several hours ago from the Hotel Burgundy in the Quarter. He’s part of the staff for the Democratic Caucus that starts tomorrow. The friend who bought him here said he starting feeling sick last night, had some nausea, some vomiting and a sore throat. Then, this morning, his temperature got higher and he couldn’t stop vomiting, so he brought him in. We started some IV fluids and gave him some Tofran for his nausea. That was several hours ago. He was OK an hour ago.”

  “Well, he sure isn’t OK now. I think he is in liver failure at the very least and probably multi-system failure. Any recent blood work? Does he
have any friends or family here other than the guy who bought him in? Any idea where he’s been? Do you know if he has been traveling?”

  Sandy shook her head, watching the Code Team continue CPR compressions as the Respiratory Team intubated the patient. There was no cardiac response at all. Flat line! A nurse rolled the defibrillator closer.

  “I’ve no idea. His friend stayed about 30 minutes and took off. Said he had a bunch of stuff to do. You know the politicians are here for the next few days, right? They are trying to clean up their act in Washington, you know, Operation Fix America,” Sandy added in explanation.

  “Yeah, goody, goody and the President is coming over the weekend, right?”

  Sandy could detect the sarcasm in Fred’s voice. She really couldn’t blame him for his jaded and sarcastic nature. Just this year his twin brother Ron, also at ED doc for CCMC had died working in the ED. No one had recovered from it, particularly Fred. Nevertheless, he was a great ED doc and he knew his stuff. Besides, almost everyone in America had lost respect for the politicians in Washington D.C., and Fred wasn't any different.

  “Yep, that’s what the papers say,” Sandy responded as she addressed Fred’s jaded remarks and continued, “I think a food service worker from the same hotel was admitted earlier with similar symptoms. I’ll need to check.”

  “Find out where he’s been from his friend that brought him in. Call the hotel too. I think he has some kind of lethal virus. Get the infectious disease people in here too. I'm bringing in Tim Smith in Tropical Medicine over at Tulane as well. Those people over at the Tropical Medicine department are good with this stuff.”

  Sandy could hear the tension in Fred's voice. She paused for a second to respond.

  He glared at her and said, “STAT, Sandy, we need to know what we are dealing with. If it’s bad, we need to contain it. Be sure we have gathered all available blood samples for diagnostic testing. Get a tube of everything.”

  Sandy, an old hat ED nurse who thought she had seen everything working while in New Orleans, was disturbed and frightened by Fred’s behavior and the wild look in his eyes. She could feel her anxiety escalating, something she hardly ever experienced as an expert practitioner.

  “Got it Fred, I’ll take care of it,” she calmly replied, pushing a reluctant Kelsey forward so they could get to work. Sandy could feel the slow but increasing thud of her heart. Oh my God, she thought, suppose we have an outbreak of Ebola or some unknown hemorrhagic virus.

  She looked at Kelsey, who was, once again, white with fear and said, "Have central supply bring in full gowns, masks and booties for all staff in the ED. Get face shields as well. We need to start isolation on all patients and close the ED to further traffic. We’ll have to close down, and transfer what we can, and divert to other local EDs. I'll call and let administration know. This could be bad. We don't know what this guy's got."

  Kelsey recovered and responded quickly. “I’ll take care of the gear, call the CCMC infectious disease docs here at the hospital and report back tom you.”

  “Thanks, Kelsey. You’re the best,” Sandy said as she patted the shoulder of the young graduate and rushed toward her office to call administration and report a potentially biological threat to the medical center. En route, she had a near-collision with general surgeon Robert Bonnet, the interim chief of medicine at CCMC.

  Robert smiled brightly at Sandy, “Whoa! What’s up, girl! Why all the rush? I heard the CODE BLUE so I came down. What’s going on?"

  “Come into my office, Robert, so we can talk. We have a guy, the code, who looks like he has some type of really weird virus. Fred said typhoid or malaria at the best and perhaps something much worse. Maybe even a hemorrhagic virus of some kind. The patient works for the Democratic Party. He was bleeding out, has a significant trunk rash, and high fever. Also, his kidneys and liver are shutting down."

  Robert’s smile disappeared as he processed the information Sandy gave him. His handsome face reflected his concern and he said, “This could be bad. Get me Dave Broderick, head of infectious disease here at CCMC. If it looks like a hemorrhagic fever, we will need to call the CDC as well. Has anyone else been admitted with similar symptoms?”

  "Yeah, but he was transferred to Intensive Care, which is where this guy was headed before he coded. I think the guy in the ICU is South African and I believe he was food service staff at the Hotel Burgundy. He had a temp of 103.2, as well as nausea and vomiting. His blood platelets were whacked and WBCs were way up. Short of breath, too, but we treated that with oxygen. Just like the guy that coded, but the South African guy stabilized and was transferred to ICU an hour or so ago.”

  “Find out how he is and call me. I think we have a serious situation, a viral outbreak at the very least."

  Sandy nodded, noting the etched lines of concern on Robert’s handsome face as he left her office and started down the hall.

  Damn, that man is hot...If I were a few years younger...Sandy had just picked up her phone to call infectious disease when Robert returned.

  Framed in her doorway Robert asked, “Sandy, when does the political convention start, Operation Fix America? Do you know?”

  Sandy shrugged her shoulders and said, “I don’t know, sometime this weekend. I think it's mainly Friday and Saturday, but I think the President speaks on Saturday.” She gave him a reproachful look and added, "Really, Dr. Bonnet, you should know. Your father is a Senator!"

  Robert cracked a half smile. “Find out,” he said as he stared at her steadily, his eyes unwavering and holding hers.

  After several seconds, Sandy got the message and asked, "Dr. Bonnet, you don’t think someone is..?"

  Robert interrupted her, “I don’t know, Sandy, but we have to think proactively. There are gonna be a lot of very powerful people in the city this weekend. We've got to consider it."

  “Oh my God, Robert. We’ve had enough this year, please not this.” Sandy's voice was shrill with fear.

  “Yes, we have, but I have a bad feeling that this may be the worst. Close the ED to further traffic, have everyone wear protective gear, and for God’s sake, don't allow anyone to leave until we figure out what we are dealing with. Implement our full biocontainment protocol and close the ED to all incoming traffic, except patients with flu-like symptoms. It's better to be safe than sorry," Robert added.

  Sandy stared at him, her eyes wide. She nodded and said, "I've already closed the ED and we are transferring everyone out that we can. I just need to contact administration."

  Robert smiled and said, "You have. These days I am administration and trust me, I'd much rather be in the operating room. I'll talk to Alex. We're the administrators in charge while Don is away on vacation. Keep this viral thing under your hat. It may be nothing more than a bad bug. But just to be safe, I'm calling CDC.”

  Sandy watched Robert leave for the second time as a dark, ominous feeling of dread permeated her body. Oh my God, what are we in for, she thought as she wiped the chill bumps from her arms.

  Chapter 2

  In the back of a shotgun house off Chartes Street in the Faubourg Marigny, a colorful revitalized neighborhood close to the French Quarter and the Mississippi River, Ali, a thin, frail, 23 year old Muslim graduate student stared at his older brother, 31 year old Nazir. Ali asked, “Nazir, are you sure we know what we are doing? I don’t trust Vadim at all." Ali's hair was a mess of tousled dark curls and his expressive brown eyes were intense.

  "Ever since I hacked into his email and saw the exit plans he sent to his comrades in Russia, I have been suspicious,” Ali continued. “Maybe you should abort this mission or at least, postpone it." His young face looked scared and uncertain.

  Nazir's face remained unchanged and he rolled his eyes with impatience. He looked at his little brother and said condescendingly, “Ali, stop it. I thought you were ready for this. I thought I could trust you to be strong. We are doing the work of Allah.”

  Ali seemed to shrink in stature, to retreat into his skin, at his brother's cri
ticism and impatience. He felt very small as he stared at his feet. “I am ready, I really am,” Ali replied with all the bravado in his voice he could muster. “I just don’t like working with others, those that are not dedicated to our cause."

  Nazir’s impatience continued and it was clear in his voice. “You have been training for over three years, and I have been planning for a mission such as this for many more. Sometimes, in order to get the job done, we have to work with others. This is one of those times.”

  Ali still looked doubtful, uncertain. His brother's words did not sway him.

  Nazir moved toward his little brother and put his arm around his thin shoulders. Ali certainly wasn’t a warrior, but he was a brilliant scientist and computer genius. “Vadim is OK. He’s just different from us. He is Russian, just as we are, and they do things differently. But he is a Muslim and worships as we do. He is one of our highest, most revered leaders in the Red Jihad movement in Eastern Europe," he said gently.

  Ali nodded as Nazir continued, "Remember, we needed Vadim and his connections to get us the virus. The Russians have been holding that strain for decades. It would have taken us years to produce a similar strain with the same kill rate. In fact, as I may have told you, the virus was mutated here in New Orleans in the 1960s. The Russians stole it, so the story goes.”

  Ali nodded. He remembered the story well. There was even information on the famous virus in the archives in the schools of Medicine and Tropical disease at Tulane University.

  “You more than anyone know we haven’t been able to produce the more virulent strain in our laboratories.” Nazir eyed him reprovingly.

  “I know, I know,” lamented Ali. “But we were very close. If you had just given me six more months, I could have had the very same thing or perhaps something even better, with an even higher kill rate. Maybe even a virus that would be harder to detect. Nazir, you have to understand these things take time, believe me. I haven’t been doddering.” Ali’s dark eyes were brooding and angry.