by Hank Parker
She stared at the message, stark black letters on a white background, and tried to read more into the three words. She touched the smooth cold plastic, as if the device could transmit the message’s meaning through her fingers. Mariah had been waiting for word from her boss. They’d have had time by now to look at the syringe blood under the microscope, and maybe even to get results from the lab mice. But she was afraid to return the call.
Her head began to pound. It felt as if all the blood in her body had pooled up there and was trying to force its way out, all at once. Something wet and vaporous, tasting of stale cider, was bubbling up through her esophagus. Something darker and heavier, like a small dense cannonball, was pushing down on her abdomen. She felt dizzy. The letters on her phone began to blur and fade away as if written in disappearing ink. Was she breaking with Kandahar? Was this the beginning of the end of her life?
Control your imagination, she told herself. She’d felt fine until the phone buzzed, and she wanted to believe that Kennedy was right. As he’d shepherded her into quarantine he’d reminded her that even if any microbes had entered her bloodstream, they were likely to be Ehrlichia bacteria, basically harmless to humans. But what if he was wrong? What if she’d been exposed to the deadly virus? Would she ever set eyes again on the golden-green fields and hills and the ink-dark waters of the slow creeks of rural southeastern Pennsylvania, her home? Or would she remain in lonely isolation until she died?
Mariah looked back down at her phone. Get it together, she told herself. You can’t put this off any longer.
She punched in Hoffman’s number. “Mariah,” he said. “Good to hear from you. How are you feeling?”
“Okay,” she said, her heart racing. “Still no symptoms I’m aware of.” There was a pause that felt interminable and Mariah wondered if Hoffman wanted her to say more. You know how I’m feeling! Cut to the chase!
“My guess is you’ll be fine,” Hoffman finally said, with maddening nonchalance. “There’s no evidence you’ve been infected. Anyway, the reason I called is we’re having another meeting this afternoon. I’d like you to join, by phone. Just an update on what we’ve learned so far.”
“No problem,” Mariah said, incredulous and reeling from Hoffman’s bizarre lack of emotion. “What time?”
“Four,” said Hoffman. “We’ll call you and patch you in.”
“Thanks for including me,” said Mariah. But Hoffman had already rung off.
* * *
Doctor Vector sat on the edge of a decaying wooden bench on a forested hill overlooking Pennypack Park Creek in northeast Philadelphia. He ran his hand over a bald area on the top of his head as if brushing back a long-absent lock of hair. He retrieved a clean white handkerchief from his trouser pocket, removed his sunglasses, carefully wiped them, put them back on, and glanced at his watch. Where was Omar? The instructions he’d handed him in the pub were clear. He was already ten minutes late.
A beautiful summer day, birds chirping, flowers in bloom, soft gurgling of the creek over submerged rocks. It meant nothing to Vector. This was the last place he wanted to be right now. Where was that guy?
Suddenly he heard movement on the dirt trail beside the creek, the sound of crunching footsteps. His contact? No, moving too fast. A weekend jogger out for a run. Would the jogger look up and see him, wonder what a man in a suit was doing there, sitting all alone? He should have at least brought a newspaper. But the jogger passed by without a glance in his direction.
He eased back on the bench and casually crossed his legs, trying to look relaxed. Soon there was movement behind him and a low voice. Vector turned and found himself looking into dark, expressionless eyes. Thin build. Jeans and a T-shirt. Omar. Vector hadn’t even heard him approach.
Omar looked around carefully, ran his hands under the bottom of the bench, and sat down at the far end. “You have the material?” he asked.
Vector withdrew a small wrapped package from an inside coat pocket, and handed it over. “Guard this with your life—literally,” he said. “You’ll also find a plane ticket to Manila in there. Plus a passport. And a phone number. You leave tomorrow afternoon. Call the number after you arrive in Manila. The guy that answers will tell you your next destination.”
* * *
When Mariah checked in by phone to the four o’clock meeting, Hoffman announced that every team member had joined the meeting and that CDC’s Blumenthal was also on speakerphone. He then told the group that Mariah was in quarantine because of an accidental needle stick. Mariah heard expressions of alarm and concern from around the table, and a barrage of questions, but Hoffman cut them off.
“She’s doing fine,” he said. “No evidence she was infected, but we want to be on the safe side.”
“Yes, thank you—” Mariah said, but Hoffman was barreling on and it seemed as if no one had heard her.
“Thanks for coming together on short notice,” said Hoffman. “We’ve had some disturbing developments. First, it seems that we’re dealing with a very hot strain of Kandahar.” He quickly summarized results of the lab animals’ exposure to the virus, simply saying that more than half the monkeys had died but that the mice were unaffected. He fended off questions, saying that they planned to run more tests.
“I’ve got a question for our Penn Hospital doctor,” boomed Blumenthal’s unmistakable, authoritative voice. “How are the patients doing?”
“We’re guardedly optimistic with the dog owner,” said a voice Mariah remembered as Emily Rausch’s. “She’s stable and her condition hasn’t gotten worse. The woman’s kids are doing fine.”
“And the others?” asked Blumenthal.
Rausch seemed to hesitate. “The rest of the news isn’t good,” she said at last. “The woman’s husband died, as well as the vet’s lab assistant. Plus a doctor at the regional hospital in Buck’s Ford. Two of our own nurses and a doctor have come down with symptoms. We’ve taken in about two dozen new patients in the past couple of days. All the illnesses are consistent with Kandahar. And early this morning we admitted four very sick kids. Same symptoms.”
“Damn,” said Blumenthal. “I assume the kids are connected with the Middle Valley family?”
“Doesn’t look that way,” Rausch replied. “They live in the same town but don’t go to the same school or otherwise interact with them. But we found out that all four went to the Chester County Fair in Brandywine Heights last week—that’s a mile or two north of Middle Valley. Seems they attended a petting zoo there.”
Mariah cringed at the news. Kids. And a petting zoo. Of all the places for a deadly virus to set up camp. Not only did this imply that more people had been exposed than would have been if the infected animals had merely been part of someone’s private livestock, but it meant that a majority of those at risk would be children.
“Fortunately,” said Hoffman, “Brandywine Heights and Middle Valley are pretty rural, so we’re not dealing with a substantial human population. The animals are a different story. Large herds of livestock. Horses. Pets. Plus wild animals. The USDA wildlife folks have some preliminary results. The virus is pretty widespread in deer and smaller mammals in the vicinity of Middle Valley. Based on blood samples. And in deer ticks as well.”
“Looks to me like we’re on the verge of a major epidemic,” Blumenthal said. “This shouldn’t be just USDA’s show.”
“I think we need to proceed as we have been, Rick,” said Hoffman tentatively.
“Proceed as we have been?” Blumenthal bellowed. “One of the Barn’s investigators just stuck herself with a hot agent in the MCL. This kind of work has to proceed slowly and deliberately, and resources are too tight to spread so thin. We should divert more funds to CDC and let us manage the program.”
Mariah’s breath caught in her throat. In the solitude of her quarantine cell she pressed a hand over her eyes, trying to hold back her rage. The needle stick was a complete accid
ent. If Blumenthal had been in her place, the same thing would have happened when the bucket crashed to the floor—she was sure of that. She opened her mouth to defend herself when she heard someone else speak.
“I was there when Dr. Rossi had the accident,” a stern male voice said quietly. Was that Kennedy? Mariah’s pulse began to race.
“She was being extremely careful,” said Kennedy. “I watched her entire necropsy the day before. I’ve never seen a more skillful job. The accident the next morning was my fault. I knocked a sharps container off the table as she was injecting a mouse. Obviously it startled her and her hand slipped. So if you’re going to blame anyone, blame me. But it sure isn’t the first time exposures have occurred when handling infectious agents. CDC itself doesn’t have a great track record in that department.”
Blumenthal, along with everyone else, seemed to be at a loss for words in the face of Kennedy’s anger.
“We have a huge job in front of us if we’re going to stop this outbreak before it becomes an epidemic,” Kennedy went on. “Every agency involved, every facility, every individual has an important role to play. We have to work together, we have to support each other, but we also have to move fast. All due respect, Rick, but this slow, deliberate stuff from the CDC playbook is bullshit. Lives are at stake. People are dying. Time is death.”
Mariah raised an eyebrow. She already knew Curt Kennedy wasn’t a man to mince words, but obviously he also didn’t care who he ripped into.
The conference room was quiet.
Blumenthal finally broke the silence. “I’m sorry,” he said. “That was wrong of me to say what I did. We do need to be working as a team.”
“Apology accepted,” Hoffman said, sounding uncomfortable. “Here’s the bottom line: this agent’s obviously hot as hell and it’s spreading fast. We’ll have to move quickly to contain it. Is there any treatment for Kandahar, Rick?”
“Ribavirin can be effective,” said Blumenthal. Mariah thought he sounded contrite, but also noncommittal. She wondered what Kennedy was doing now. Quietly raging? Playing it cool?
“Okay, here’s our plan of attack,” said Hoffman. “We’ll set up a five-mile-radius containment zone around Middle Valley. The area will incorporate Brandywine Heights. Nothing—people, animals—moves in or out until further notice. All pets, domestic animals, and livestock will be rounded up and euthanized. USDA sharpshooters and trappers will cull all mammalian wildlife in the quarantine zone. We’ll collect and analyze as many ticks as possible, and continue close surveillance of people to monitor any further spread of the virus. We’ll need to try to track down the infected animal in the petting zoo—hopefully there’s only one. And we’ll commandeer all the ribavirin that’s available and begin administering it to symptomatic patients. If we work quickly enough we should be able to keep this from spreading much more.”
“I assume we’re talking about military enforcement,” said Kennedy.
“Right,” replied Hoffman. “National Guard. We’ll have to get the governor’s office involved, and the White House. I’ll get a call in to the president’s chief of staff. They’ll need to call the governor. The sooner we can get the Guard in place the better.”
CHAPTER ELEVEN
AUGUST 23
SOUTHEASTERN PENNSYLVANIA
It was a Sunday morning at the Barn and Mariah was finally beginning to shake off the looming specter of a gruesome death. She’d experienced no symptoms since she’d stuck herself—not even a mild headache. She figured that if she’d been infected with Kandahar virus, signs of disease should be evident by now.
She heard a knock on the door and the first thing she saw upon peering through the glass were Curt Kennedy’s blue-gray eyes. She opened the door.
“Glad to see you’re awake,” said Kennedy. “I was in the neighborhood and thought I’d stop by.”
Mariah noted with optimism that he wasn’t fully suited up but instead was only wearing a simple mask and gown. “Have a seat,” she said. She pointed to a black metal folding chair.
“I wanted to be the first person to tell you,” he said. “After we got you into quarantine, I checked the syringe you stuck yourself with. The reservoir was full. It doesn’t look like you depressed the plunger.”
Mariah realized that she’d been holding her breath and slowly exhaled. “I hope you’re right,” she said, but she knew that Kennedy’s reassurance was hardly solid evidence that she hadn’t been infected. “You were great in the containment lab,” she said. “Not just professionally. You really calmed me down after the needle stick. I appreciate it.”
Kennedy nodded professionally, but added an unmistakable arch of his eyebrow. “So did Hoffman tell you anything besides what he said at the meeting?”
“No. He barely told me he thought I’d be okay. He’s not the chattiest guy.”
“Well, I think you’ll be okay too, but I need to be up front with you,” Kennedy said. “The news isn’t great. After you went into the slammer, I finished the animal injections. Got a technician to help me. I checked on the animals first thing yesterday morning. Really wasn’t expecting anything yet. The mice were fine, but almost all the monkeys were already showing symptoms. Off their feed, feverish, runny noses, agitated. I looked in on them again this morning. Most of them were dead. I called Fort Detrick to find out their results from the blood from the human victims. Same story.”
Mariah was silent. Kennedy was still looking at her. She thought she saw sadness in his eyes, or perhaps it was weariness. He probably hadn’t had much sleep since they left the lab yesterday. “You told me the other day that the Afghanistan Kandahar strain had a fifty percent case fatality rate,” she finally said. “Hoffman reported yesterday that ‘over half’ of the injected test monkeys had died. Now you just said most had died. So which is it?”
“The fifty percent rate is accurate for humans in Afghanistan,” said Kennedy. “But the rate was much higher for the test monkeys here.”
“So this strain is much more virulent?” asked Mariah.
Kennedy nodded. “That’s if we extrapolate the monkey results to all primates, including humans. But we still don’t have enough data to know for sure.”
Mariah looked down at the floor, and was silent. When she looked up again she asked, “Any possibility it can be transmitted through the air?”
“We’re checking on that,” said Kennedy. “We put the surviving animals in an isolation room with nonexposed ones, separated by varying distances. We’ll keep a close watch.”
“Hoffman knows all this?”
“I briefed him,” said Kennedy. “That was the reason for yesterday’s meeting, even if he didn’t share all of this info. Look, I know you’re worried. But I repeat that there’s no evidence you were exposed. My guess is you’ll be out of here in a couple of days. If you’d been infected, chances are you’d be showing symptoms by now.”
Mariah knew Kennedy was probably right, but she just couldn’t shake the notion that her time was limited.
“Listen,” he said. “For what it’s worth, I’ve been through something like this myself.”
Mariah looked sharply at Kennedy. “You were exposed to Kandahar?”
“No. Ebola,” he said. “About twenty years ago, when I was fresh out of grad school. I spent a week in quarantine in a hospital in Africa. I was part of a team that had been searching for the index case for an Ebola outbreak that was burning through the Democratic Republic of Congo. I was being as careful as I could—scrubs, gloves, mask, safety glasses. But the clinic’s protective gear was pretty cheap—really inadequate for a hot virus. And they hadn’t had any previous experience with Level Four agents.
“It was getting toward the end of the first day of interviews. I came up to the bed of an old man, obviously dying, wasting away. Bleeding from his mouth, nose, even his eyes. When I bent over to check him, he went into a coughing fit. Before
I could back away, he reared up and sprayed bloody spittle all over my face. I was wearing the glasses and mask, but the stuff still got on my forehead and I worried about the flimsy mask. I hoped that I hadn’t been inhaling when the guy coughed. I flushed my face and eyes with tap water. And I did a little praying.”
Mariah waited and watched Kennedy’s face. His expression was set, impassive, similar to when she’d first met him in Hoffman’s office. But today she had the feeling that he was trying to control his emotions.
“Two days later I came down with a headache and chills,” he said. “Temperature of a hundred two. I got a team member to drive me to Kinshasa—we both wore protective gear the whole way. I checked into the hospital there. They put me straight into quarantine. I waited for the hemorrhaging to begin. But I got better, not worse. They discharged me on the eighth day. Turned out to be a mild case of flu. So, bottom line: exposure doesn’t necessarily mean infection.”
“I’m surprised you don’t have nightmares,” Mariah said, quietly.
“Who says I don’t?” he said.
Mariah and Kennedy sat across from each other in the small isolation room and didn’t speak.
“I’d better get back,” he said at last. “Hang in there. It won’t be long. I know it’s got to be boring as hell. I’d be climbing the walls.”
Mariah watched him open the door and walk out.
* * *
That afternoon Curt Kennedy stood near a makeshift stage at a community playground in Middle Valley, Pennsylvania, as a large crowd gathered. It looked to him as though the entire town had turned out. He estimated the group at about three hundred people.
He saw farmers in coveralls, teenagers with bicycles, mothers pushing strollers, soccer-playing middle schoolers wearing high socks, shorts, and brightly colored T-shirts, young lovers holding hands, stooped grandfathers leaning on canes, and middle-aged men with large paunches that strained against long-sleeved green jerseys bearing the logo of the Philadelphia Eagles and the number and name of a favorite player. To Kennedy, it looked like a cross section of rural America that might have gathered for an annual bull roast sponsored by the volunteer fire department.
