The Z Contingency

Chapter 5 - CDC

Gary stared at the large manila envelope containing the micrographs that had just been delivered from the ESEM lab. Turning it over and over in his hands, Gary stared at the envelope intently, as if trying to uncover secrets hidden in the folds or even in the paper itself. Maybe, by not opening it, he could stave off the inevitable. Maybe... if he didn't get confirmation, his suspicion wouldn't come true.

Jack's samples had arrived from CDC-Uganda a few days ago along with his case notes and photos. Gary sent them to Dr. Robert Dobbs, who ran the Scanning Electron Microscope lab, SEM for short, to have micrographs made after carefully studying the notes from Jack's observations, making sure everything was accurately entered into the system. His colleague Bob, and the others in CDC's SEM lab was no stranger to samples Gary's team brought home from the field, and could usually count on an interesting challenge to occupy their hours. In addition to the standard SEM, the CDC was home to the ESEM, the Environmental SEM, one of only three in the southeast region that allowed samples to be prepared faster, without the time consuming staining and preparation techniques required for biological samples viewed with the standard SEM. Gary spent a lot of time with the older SEM himself and picked up a thing or two over the years. He tried to keep up with the literature on this vital tool in the study and discovery of emerging viruses, and when time allowed, he practiced on routine samples, usually a strain from the previous flu season. He would go through his procedures and analysis, and then compare them with what the experts found.

This time, he relied solely on the experts for the images. These samples were too important to trust to his less skilled hands. The results had come back from the lab, so Gary reopened Jack's file, partly to refresh his memory, and partly to delay opening the envelope.

As Jack had commented over the phone, Patient Zero was a woman. Usually the first patients were men working in the wilderness areas of the region – miners, and forest workers. And poachers. Like the current Patient Zero. The prey are killing the hunters. How about that for poetic justice? Black female, age 27 years, height 5'2", weight 110 pounds, with most of that being lean muscle mass. She exhibited the classic signs of a viral hemorrhagic fever, but Gary had never seen or heard of a disease progression like this before. The symptoms included delirium, shock, and massive hemorrhaging, typically with blood oozing from the patient's eyes, nose, and other orifices, followed by failure of the liver and other organs. All of this typically took from five to ten days. Death usually followed, unless very aggressive treatment was administered early on.

Patient Zero followed the normal progression through organ failure, only she didn't die. Based on Jack's best estimates, she had been exposed more than two weeks prior to being found and taken to the hospital. Jack had been doing this for too long, and had seen too many cases from beginning to end for Gary to question Jack's estimates. From cradle to grave. Gary chuckled grimly. Man, I've got to shake this before my humor gets morbid. While she was being given the most aggressive of treatments, no one really expected her to live. Only she did. Usually, when the treatments worked, the patient made a full recovery. Patient Zero, though, wasn't getting any better. On the other hand she wasn't getting any worse. Not from the disease at any rate. Her tissues continued to slowly deteriorate from lack of nutrition in spite of the feeding tube.

The doctors didn't think it was the treatment or the hospital's machines that were keeping her alive, so they unhooked her and stopped administering therapy. Nothing changed in her status. To say that her doctors were perplexed would be a huge understatement.

Gary was perplexed too, but at the same time, he had a strong suspicion he knew exactly what it was... or at least what it started out as.

He could delay no longer. The answer was in the manila envelope. Finally, after what seemed to be a lifetime, Gary could put it off no longer. Slowly, but deliberately, he unwound the red thread from the two white disks which held the envelope closed, and lifted the flap.

Gary stared at the image, just as Bob sauntered into Gary's office. "Lunch?" he asked, and noting the open envelope, he added "Oh good, you got the pics. I hope they're clear enough." Turning back to Gary, he asked, "Heard anything new on the budget talks?"

"Yes, thanks. I was just studying them. And no, nothing worth mentioning. It just seems to be the same song and dance every year. The two sides are firmly entrenched. They both want to spend, spend, spend, but only one of them is willing to pay for it up front. So we get stalemate. And who pays for that? We do. I wouldn't be surprised if we get RIF notices next," referring to the Reduction-in-Force letters that the Office of Personnel Management sent to government employees when it was about to do a layoff.

It was immediately evident that Bob regretted bringing up the politically touchy subject. Gary knew he had a tendency to talk a person's ear off if given the chance. "Another Filovirus?" Bob asked, clearly attempting to change the subject.

Bob had seen hundreds of these same images over the decade and a half he had been working in the various labs preparing samples and creating the beautifully detailed micrographs that were his trademark. Electron microscopy of viruses was as much art as science, and it took a special eye coupled with the scientific and technical knowledge to capture the images most useful to the researchers. But even having done it for so long, Bob had never really learned to recognize the pathogens whose images he was capturing.  But it was enough to get Gary back on track.  Viruses were Gary's one true passion.

Gary held the micrograph up to get better light. The image was magnified 100,000 times and showed the classic filamentous particles of the filovirus family.

"Marburg," Gary muttered under his breath. His suspicions about what might be happening to Patient Zero were becoming a reality. Sometimes, he really hated being right. Marburg was the first of the filoviruses to be identified. It was discovered in a lab in Marburg, Germany in 1967 when a number of laboratory workers who were handling tissues from green monkeys, developed hemorrhagic fever. A total of thirty-one cases and seven deaths were associated with these outbreaks. The virus was named after the site of the outbreak.

As Gary continued to stare at the micrograph his trained eye noticed the subtle alterations. "But what do we have here...?" He was now certain this one had mutated, just as he had predicted it would years ago. He would have to sequence it to figure out the ramifications, but a feeling of dread swept over him. He was pretty sure of what he would find, and what that would mean. One, maybe two more mutations to go, before we have a full-blown zombie virus on our hands. He chose not to share that with Bob. Natalie already knew, and it was enough that one person already suspected that he might be crazy.

"Thanks for processing the samples so quickly, Bob, and thanks for the lunch offer, but I think I'll be working through lunch for the foreseeable future. You go on ahead. I have to go find Natalie."

Dr. Natalie Wyler was one of CDC's top virologists. Reflecting back on the conversation he had with Natalie a few years back, he started getting that panicky feeling again. The last time he had tried to convince Natalie to protect the public against the zombie threat, things had not gone very smoothly.

Gary suddenly realized Bob had said something, and was staring at him expectantly. "Sorry Bob, what were you saying?"

"I said I'll try catching up with Norman. I'm pretty sure he was heading for the cafeteria when I left my office."

"Good luck with that. The cafeteria was really crowded this morning, so I sat down at his table. I asked if he minded if I joined him, just to be polite, but he just stared at his eggs and ignored me. I thought maybe he didn't hear me, so I asked again. He just stared at me for a long time, and I swear he was making some kind of growling sound. I got the hell away from there. I'd stay clear of him today, if I were you, but if you do decide to talk with him, would you remind him that the lock on the -80Cfreezer in my lab is acting up?"

"Sure thing. I'll catch you later."