The Hot Zone
By Richard Preston
PART THREE
SMASHDOWN
INSERTION
DECEMBER 1, FRIDAY
THE ALARM WENT off at four-thirty. Jerry Jaax got up, shaved, brushed
his teeth, threw on clothes, and was out of there. The teams were going to
wear civilian clothes. No one wanted to attract attention. Soldiers in uniform
and camouflage, putting on space suits ... it could set off a panic.
It was five o'clock by the time he arrived at the Institute.
There was no sign of dawn in the sky. A crowd of people had already
gathered by a loading dock on the side of the building, under flood-lights.
There had been a hard freeze during the night, and their breath steamed in
the air. Gene Johnson, the Ajax of this biological war, paced back and forth
across the loading dock among a pile of camouflaged military trunks – his
stockpile of gear from Kitum Cave. The trunks contained field space suits,
battery packs, rubber gloves, surgical scrub suits, syringes, needles, drugs,
dissection tools, flashlights, one or two human surgery packs, blunt scissors,
sample bags, plastic bottles, pickling preservatives, biohazard bags marked
with red flowers, and hand-pumped garden sprayers for spraying beach on
space suits and objects that needed to be decontaminated. Holding a cup of
coffee in his fist, Gene grinned at the soldiers and rumbled, "Don't touch my
trunks."
A white unmarked supply van showed up. Gene loaded his trunks into the
van by himself and set off for Reston. He was the first wave.
By now, copies of The Washington Post were hitting driveways all over the
region. It contained a front-page story about the monkey house:
DEADLY EBOLA VIRUS FOUND
IN VA. LABORATORY MONKEY
One of the deadliest known human viruses has turned up for the first time in
the United States, in a shipment of monkeys imported from the Philippines
by a research laboratory in Reston.
A task force of top-level of yesterday devising a detailed program to trace
the path of the rare Ebola virus and who might have been exposed to it. That
includes interviews with the four or five laboratory workers who cared for
the animals, which have since been destroyed as a precaution, and any other
people who were near the monkeys.
Federal and state health officials played down the possibility that any people
had contracted the virus, which has a 50 to 90 percent mortality rate and can
be highly contagious to those coming into direct contact with its victims.
There is no known vaccine. "There's always a level of concern, but I don't
think anybody's panicked," said Col. C.J. Peters, a physician and expert on
the virus.
C.J. knew that if people learned what this virus could do, there would be
traffic jams heading out of Reston, with mothers screaming at television
cameras, "Where are my children?" When he talked to the Washington Post
reporters, he was careful not to discuss the more dramatic aspects of the
operation. ("I thought it would not be a good idea to talk about space suits,"
he explained to me much later.) He was careful not to use scary military
terms such as amplification, lethal chain of transmission, crash and bleed, or
major pucker factor. A military biohazard operation was about to go down in
a suburb of Washington, and he sure as hell didn't want the Post to find out
about it.
Half of this biocontainment operation was going to be news containment.
C.J. Peter's comments to The Washington Post were designed to create an
impression the situation was under control, safe, and not all that interesting.
C.J. was understating the gravity of the situation.
But he could be very smooth when he wanted, and he used his friendliest
voice with the reporters, assuring them over the telephone that there really
was no problem, just kind of a routine technical situation.
Somehow the reporters concluded that the sick monkeys had been
"destroyed as a precaution" when in fact the nightmare, and the reason for
troops, was that the animals hadn't been destroyed.
As to whether the operation was safe, the only way to know was to try it.
Peters felt that the larger danger could come from sitting back and watching
the virus burn through the monkeys. There were five hundred monkeys
inside that building. That was about three tons of monkey meat – a
biological nuclear reactor having a core meltdown. As the core of monkeys
burned, the agent would amplify itself tremendously.
C.J. ARRIVED AT the loading dock of the Institute at five o'clock in the
morning. He would accompany the group down to the monkey house to see
Jerry's team inserted, and then he would drive back to the Institute to deal
with the news media and government agencies.
At six-thirty, he gave an order to move out, and the column of vehicles left
Fort Detrick main gate and headed south, toward the Potomac River. It
consisted of a line of ordinary automobiles – the officer's family cars, with
the officers inside wearing civilian clothes, looking like commuters. The line
of cars followed behind two unmarked military vehicles. One was a snow white ambulance and the other was a supply van. It was an unmarked Level
4 biocontainment ambulance. Inside it there were an Army medical evacuation team and a biocontainment pod known as a bubble stretcher. This
was a combat medical stretcher enclosed by a biocontainment bubble made
of clear plastic. If someone was bitten by a monkey, he would go into the
bubble, and from there he would be transferred to the Slammer, and perhaps
from there he would go to the Submarine, the Level 4 morgue. The supply
van was a white unmarked refrigerator truck. This was to hold dead
monkeys and tubes of blood.
There was not a uniform in the group, although a few members of
ambulance team wore camouflage fatigues. The caravan crossed the
Potomac River at Point of Rocks and hit Leesburg Pike just as rush hour
began.
The traffic became bumper to bumper, and the officers began to get
frustrated. It took them two hours to reach the monkey house, contending
the whole way with ill-tempered commuters. Finally the column turned into the office park, which by that time was filling up with workers. The supply
van and the ambulance were driven along the side of the monkey house, up
onto a lawn, and were parked behind the building, to get them out of sight.
The back of the building presented a brick face, some narrow windows, and
a glass door. The door was the insertion point. They parked the supply van
up close to the door.
At the edge of the lawn, behind the building, there was a line of underbrush
and trees sloping down a hillside. Beyond that, there was a playground next
to a day-care center. They could hear shouts of children in the air, and when
they looked through the underbrush, they could see bundled-up four-year olds swinging on swings and racing around a playhouse. The operation
would be carried out near children.
Jerry Jaax studied a map of the building. He and Gene Johnson had decided
to have all the team members put on their space suits inside the building
rather than out on the lawn so that if any television crews arrived there
would be nothing to film. The men went through the insertion door and
found themselves in an empty storage room. It was the staging room. They
could hear faint cries of monkeys beyond a cinder-block wall. There was no
sign of any human being in the monkey house.
Jerry Jaax was going to be the first man in, the point man. He had decided to
take with him one of his officers, Captain Mark Haines, a former Green
Berets' scuba-diving school. He had jumped out of airplanes at night into the
open sea, wearing scuba gear. ("I'll tell you one thing," Haines once said to
me. "I don't do scuba diving as a civilian. The majority of my diving has
been in the Middle East.") Captain Haines was not a man who would get
claustrophobia and go into a panic in a space suit. Furthermore, Captain
Haines was a veterinarian. He understood monkeys.
Jaax and Haines climbed into the supply van and pulled a plastic sheet
across the van's back door for privacy, and stripped naked, shivering in the
cold. They put on surgical scrub suits and then walked across the lawn,
opened the glass door, and went into the storage room, the staging area,
where an Army support team – the ambulance team, led by a captain named
Elizabeth Hill – helped them into their space suits. Jerry knew nothing about
field biological suits, and neither did Captain Haines.
The suits were orange Racal suits, designed for field use with airborne
biological agents, and they were the same type of suit that had been used in
Kitum Cave – in fact, some of them had come back from Africa in Gene
Johnson's trunks. The suit has a clear, soft plastic bubble for a helmet. The
suit is pressurized. Air pressure is supplied by an electric motor that sucks
air from outside and passes it through virus filters and then injects it into the
suit. This keeps the suit under positive pressure, so that any airborne virus
particles will have a hard time flowing into it. A Racal suit performs the
same job as a heavy-duty Chemturion space suit. It protects the entire body
from a hot agent, surrounds the body with super filtered air. Army people
generally don't refer to Racals as space suits. They call them Racals or field
biological suits; but they are, in fact, biological space suits.
Jaax and Haines put on rubber gloves, and the support team taped the gloves
to the sleeves of the suits while they held their arms out straight. On their
feet, they wore sneakers, and over the sneakers they pulled bright yellow
rubber boots. The support team taped the boots to the legs of the suits to
make an airtight seal above the ankle.
Jerry was terribly keyed up. In the past he had lectured Nancy on the
dangers of working with Ebola in a space suit, and now he as leading a team
into an Ebola hell. At the moment, he didn't care what happened to himself,
personally. He was expendable, and he knew it. Perhaps he could forget
about John for a while in there. He switched on his electric blower, and his
suit puffed up around him. It didn't feel too bad, but it made him sweat
profusely. The door was straight ahead. He held the map of the monkey
house in his hand and nodded to Captain Haines. Haines was ready. Jerry
opened the door, and they stepped inside. The sound of the monkeys became
louder. They were standing in a windowless, lightless, cinder-block corridor
that had doors had either end: this was the makeshift air lock, the gray zone.
The rule inside the air lock was that the two doors, the far door and the near
door, could never be open at the same time. This was to prevent a backflow
of contaminated air from coming into the staging room. The door closed
behind them, and the corridor went dark. It went pitch-dark. Aw, son of
bitch. We forgot to bring flashlights. Too late now. They proceeded forward,
feeling their way down the walls to the door at the far end.
NANCY Jaax WOKE up her children at seven-thirty. She had to shake
Jason, as always, to get him out of bed. It didn't work, so she turned one of
the dogs loose on him. He hit the bed flying and climbed all over Jason.
She put on sweatpants and a sweat shirt and went downstairs to the kitchen
and flipped on the radio and turned it to a rock-and-roll station and popped a
Diet Coke. The music fired up the parrot. Herky began to scream along with
John Cougar Mellencamp. Parrots really respond to electric guitar, she
thought.
The children sat at the kitchen table, eating instant oatmeal.
She told them that she would be working late, so they would be on their own
at suppertime. She looked in the freezer and found a stew. It would do fine
for kids. They could defrost it in the microwave. She watched from the
kitchen window as they walked down the driveway to the bottom of the hill
to wait for the school bus ... "This work is not for a married female. You are
either going to neglect your work or neglect your family" were the words of
a superior officer long ago.
She cut a bagel for herself, and brought along an apple, and ate them in the
car on the way to Reston. By the time she arrived at the monkey house, Jerry
had already suited up and gone inside.
The staging room was crowded, warm, loud, confused. The experts on the
use of space suits were giving advice to team members as they suited up.
Nancy herself had never worn a Racal field suit, but the principles are the
same as with a heavy-duty Chemturion. The main principle is that the
interior of the space suit is a cocoon housing the normal world, which you
bring with you into the hot area. If there were a break in the suit, the normal
world would vanish, merging with the hot world, and you would be exposed.
She spoke to the soldiers as they suited up. "Your suits are under pressure,"
she said. "If you get a rip in your suit, you have to tape it shut right away, or
you'll lose your pressure, and contaminated air could flow inside the suit."
She held up a roll of brown sticky tape. "Before I go in, I wrap extra tape
around my ankle, like this." She demonstrated how to do it: she wound the
roll around her ankle several times, the way you tape up a sprained ankle.
"You can tear off a length of tape from you ankle and use it to patch a hole in your suit," she said. "A hundred chancy things can happen to rip your
suit."
She told them about Ebola in monkeys. "If these monkey are infected with
Ebola, then they are so full of virus that a bit from one of them would be a
devastating exposure," she said. "Animals that are clinically ill with Ebola
shed a lot of virus. Monkeys move real quick.
A bite would be a death warrant. Be exquisitely careful. Know where your
hands and body are at all the times. If you get blood on your suit, stop what
you are doing and clean it off right away. Don't let blood stay on your
gloves. Rinse them off right away. With bloody gloves, you can't see a hole
in the glove. Also, one other thing. You really don't want to drink a lot of
coffee or liquids before going in. You will be in your space suit for a long
time."
The batteries that pressurized the suit had a life span of six hours. People
would have to leave the hot area and be deconned out before their batteries
failed, or they would be in trouble.
JERRY JAAX AND Captain Mark Haines felt their way down the dark
corridor, toward the door that led into the hot zone. They opened it and
found themselves standing at the junction of two corridors, bathed in a
cacophony of monkey cries. The air-handling equipment still wasn't
working, and the temperature in the place seemed as if it was above ninety
degrees. Jerry's head bubble fogged up. He pushed the bubble against his
face to rub the moisture off the faceplate, and now he could see. The walls
were gray cinder block, and the floor was painted concrete.
Just then, he noticed a blur of motion on his left, and he turned and saw two
Hazleton workers walking towards him. They weren't supposed to be in
here! The area was supposed to be sealed off, but they had come in by
another route that led through a storeroom. They wore respirators, but
nothing covered their eyes. When they saw the two men in space suits, they
froze, speechless. Jerry could not see their mouths, but he could see their
eyes, wide with astonishment. It was as if they had suddenly discovered that
they were standing on the moon.
Jerry didn't know what to say. Finally he said, "WHICH WAY TO ROOM
H?" – shouting to be heard over his blowers.
The workers led him down the corridor to the infected room. It was at the far
end of the hall. Then they retreated to the front of the building and found
Dan Dalgard, who had been sitting in an office, waiting for the Army to
come in. He showed up at Room H moments later, wearing a respirator, to
find out what was going on. Jerry looked at him as if he was insane. It was
as if you went to a meeting with someone, and the person showed up naked.
Dalgard was not happy with the space suits. Apparently he had not realized
how the Army would be outfitted. Dalgard gave them a tour of Room H,
feeling exceptionally nervous. "Looks like we have some sick monkeys in
here," he said. Some of the monkeys went berserk when they saw the space
suits. They spun in circles in their cages or cowered in the corners. Others
stared at the humans with fixed expressions on their faces.
"You see the clinical signs," Dalgard said, pointing to a monkey.
"I feel pretty confident I can tell when a monkey is getting sick. They got a
little bit depressed, they go off their feed, and in a day or two they are dead."
Jerry wanted to look at all the monkeys in the monkey house. He and
Captain Haines went back out into the corridor and went from room to room
through the entire building. They found other monkeys that seemed
depressed, with the same glazed expression on their faces. Jaax and Haines,
both of whom knew a lot about monkeys, didn't like the feel of this whole
building. Something lived in here other than monkeys and people.
NANCY Jaax GOT ready to go inside. She changed into a scrub suit in the
van, ran across the lawn, and entered the staging area. The support team
helped her suit up. She gathered several boxes of syringes and went in with
Captain Steven Denny. They walked down the air-lock corridor and came to
the far door. She opened the door and found herself in the long corridor. It
was empty. Everyone was down the hall in Room H. Jerry thought his wife
looked like the Pillsbury dough boy. Her suit was too large for her, and it
billowed around her when she walked.
Nancy noticed mucus and slime on the noses of some of the monkeys.
That scared her, because it seemed so much like the flu or a cold, when it
wasn't. Dan Dalgard, wearing a respirator and a jumpsuit, selected four sick
monkeys for sacrifice, the ones he thought looked the sickest.
He reached into the cages and gave the monkeys their shots. When they
crumpled and fell asleep, he gave them a second round of shots, and that
stopped their hearts.
The room was jammed with people in space suits. They kept coming in
pairs, and they milled around with nothing to do. One of them was Sergeant
Curtis Klages. He turned to someone and said, "WELL, THIS IS A BIG
CHARLIE FOXTROT." That's code for CF, which means "cluster fuck".
This is an Army operation that winds up in confusion, with people bumping
into one another and demanding to know what's going on.
Nancy happened to glance at the sergeant, checking his suit instinctively,
and she saw that he had a tear across hip. She touched the sergeant's arm and
pointed. She reached down to her ankle, where she kept her extra tape, and
taped the hole for him.
She removed the four dead monkeys from their cages, holding them by the
backs of the arms, and loaded them into plastic biohazard bags.
She carried the bags to the entry door, where someone had left a garden
sprayer full of Clorox bleach along with more bags. She double-bagged the
monkeys, spraying each bag with bleach, and then she loaded the bags into
cardboard biohazard containers – hatboxes – and sprayed them to decon
them.
Finally she loaded each hatbox into a third plastic bag and spray it. She
pounded on the door. "IT'S NANCY Jaax. I'M COMING OUT." The door
was opened by a sergeant standing on the other side, a member of the decon
team. He was wearing a Racal suit, and he had a pump sprayer filled with
bleach. She went into the air lock, pushing the hatboxes ahead of her.
In the darkness and in the whine of their blowers, he shouted to her,
"STAND WITH YOUR ARMS OUT, AND TURN AROUND SLOWLY."
He sprayed her for five minutes, until the air lock stank of bleach. It felt
wonderfully cool, but the smell leaked through her filters and made her
throat sting.
He also sprayed the bags. Then he opened the door to the staging area, and
she blinked at the light and came out, pushing the bags ahead of her.
The support team peeled off her suit. She was drenched with sweat. Her
scrubs were soaked. Now it was freezing cold. She ran across the lawn and
changed into her civilian clothes in the back of the van.
Meanwhile, people loaded the bags into boxes, and loaded the boxes into the
refrigerator truck, and Nancy and a driver headed off for Fort Detrick. She
wanted to get those monkeys into Level 4 and opened up as fast as possible.
JERRY JAAX COUNTED sixty-five animals in the room, after the four that
Nancy had removed. Gene Johnson had brought a special injector back from
Africa. Jerry used this device to give shots to the monkeys. It was a pole that
had a socket on one end. You fitted a syringe into the socket, and you slid
the pole into the cage and gave the monkey a shot. You also needed a tool to
pin the monkey down, because monkeys don't like needles coming at them.
They used a mop handle with a soft U-shaped pad on the end. Captain
Haines held the mop handle against the monkey to immobilize it, and Jerry
ran the pole into the cage and hit the monkey's thigh with a double dose of
ketamine, a general anesthetic. They went through the room from cage to
cage, hitting all the monkeys with the drug. Pretty soon the monkeys began
to collapse in their cages. Once a monkey was down, Jerry gave it a shot of a
sedative called Rompun, which put it into a deep sleep.
When all the monkeys were down and asleep, they set up a couple of
stainless-steel tables, and then, one monkey at a time, they took blood
samples from the unconscious monkeys and gave them a third injection, this
time of a lethal drug called T-61, which is a euthanasia agent. After a
monkey was clinically dead, it was opened by Captain Steve Denny. He
took samples of liver and spleen, using scissors, and he dropped the samples
into the plastic bottles. They bagged the dead monkeys, loaded them into
hatboxes, and piled the hatboxes along the corridor. Dan Dalgard,
meanwhile, left the room and remained in an office at the front of the
building for the rest of the day.
By late afternoon, all the monkeys in Room H had been put to death. Behind
the building, through the trees and down the hill, children ran in circles
around their playhouse. Their shouts carried far in the December air. The
mothers and fathers arrived in cars and picked them up.
The team exited from the hot zone in pairs, and stood around on the grass in
their civilian clothes, looking pale, weak, and thoughtful. In the distance,
floodlights began to light up the monuments and buildings of Washington. It
was the Friday evening at the end of the week following Thanksgiving, the
start of a quiet weekend that precedes the Christmas season. The wind
strengthened and blew paper cups and empty cigarette packs in eddies
around the parking lots. In a hospital not far from there, Jarvis Purdy, the
monkey worker who had a heart attack, rested comfortably, his condition
stable.
BACK AT THE Institute, Nancy Jaax again stayed up until one o'clock in
the morning, dissecting monkeys with her hot-zone buddy, Ron Trotter.
When they had suited up and gone in, there had been five monkey carcasses
waiting for them in the air lock.
This time, the signs of Ebola were obvious. Nancy saw what she described
as "horrendous gut lesions" in some of the animals, caused sloughing of the
intestinal lining. That sloughing of the gut was a class sign. The intestine
was blitzed, completely full of uncoagulated, runny blood, and at the same
time the monkey had massive blood clotting in the intestinal muscles. The
clotting had shut off blood circulation to the gut, and the cells in the gut
subsequently died – that is, the intestines had died – and then the gut had
filled up with blood. Dead intestine – this is the kind of thing you saw in a
decayed carcass. In her words, "It looked like the animals had been dead for
three or four days." Yet they had been dead only for hours. Some of the
monkeys were so badly liquefied that she and Trotter didn't even bother to
do a necropsy, they just yanked samples of liver and spleen from the dead
animal. Some of the monkeys that were dying in Room H had become
essentially a heap of mush and bones in a skin bag, mixed with huge
amounts of amplified virus.
DECEMBER 4, 0730 HOURS, MONDAY
MONDAY ARRIVED COLD and raw, with a rising wind that brought a
smell of snow from a sky the color of plain carbon steel. In the shopping
malls around Washington, Christmas lights had been hung. The parking lots
were empty, but later in the day they would fill up with cars, and the malls
would fill up with parents and children, and the children would line up to see Santa Clauses. Dan Dalgard drove to the primate building, one more
commuter in a sea of morning traffic.
He turned into the parking lot. As he got closer to the building, he saw a
man was standing by the front door near the sweet-gum tree, wearing a
white Tyvek jumpsuit. It was one of the monkey caretakers.
Dalgard was furious. He had instructed them not to come out of the building
wearing a mask or a protective suit. He jumped out of his car, slammed the
door, and hurried across the parking lot. As he got closer, he recognized the
man as someone who will be called Milton Frantig.
Frantig was standing bent over with his hands on his knees. He didn't seem
to notice Dalgard – he was staring at the grass. Suddenly Frantig's body
convulsed, and liquid spewed out of his mouth. He vomited again and again,
and the sound of his retching carried across the parking lot.
A MAN DOWN
AS DAN DALGARD watched the man spill his stomach out onto the lawn,
he felt, in his words, "scared shitless". Now, perhaps for the first time, the
absolute horror of the crisis at the primate building washed over him.
Milton Frantig was doubled over, gasping and choking. When his vomiting
subsides, Dalgard helped him to his feet, took him indoors, and made him lie
down on a couch. Two employees were now sick – Jarvis Purdy was still in
the hospital, recovering from a heart attack. Milton Frantig was fifty years
old. He had a chronic, hacking cough, although he didn't smoke. He had
been working with monkeys and with Dalgard at Hazleton for more than
twenty-five years. Dalgard knew the man well and liked him. Dalgard felt
shaken, sick with fear and guilt. Maybe I should have evacuated the building
last week. Did I put the interests of the monkeys ahead of the interest of the
human beings?
Milton Frantig was pale and shaky, and felt faint. He developed the dry
heaves. Dalgard found a plastic bucket for him. Between heaves, interrupted
by coughing speels, Frantig apologized for leaving the building while
wearing a jump suit. He said he had just been putting on his respirator to go
inside a monkey room when he began to feel sick to his stomach. Perhaps
185
the bad smell in the building had nauseated him, because the monkey room
weren't cleaned as regularly as usual. He could feel he was about to vomit,
and he couldn't find a bucket or anything to throw up into, and it was
coming on so fast that he couldn't get to the rest room, so he had run
outdoors.
Dalgard wanted to take Frantig's temperature, but nobody could find a
thermometer that hadn't been used rectally on monkeys. He sent Bill Volt to
a drugstore to buy one. When he returned, they discovered that Frantig had a
fever of a hundred and one. Bill Volt hovered in the room, almost shaking
with fear. Volt was not doing well – "almost spastic in his terror," Dalgard
would later recall, but it wasn't any different from the way Dalgard felt.
Milton Frantig remained the calmest person in the room. Unlike Dalgard and
Volt, he did not seem afraid. He was a devout Christian, comfortable with
telling people that he had been saved. If the lord saw fit to take him home
with a monkey disease, he was ready. He prayed a little, remembering his
favorite passages in the Bible, and his dry heaves subsided. Soon he was
resting quietly on the couch and said he felt a little better.
"I want you to stay where you are," Dalgard said to him. "Don't leave the
building." He got into his car and drove as fast as he could to the Hazleton
Washington offices on Leesburg Pike. The drive didn't take long, and by the
time he got there, he had made up his mind: the monkey facility had to be
evacuated. Immediately.
There had been four workers employed in the building, and two of them
were now going to be in the hospital. One man had heart problems, and now
the other had a fever with vomiting. From what Dalgard knew about Ebola
virus, either of these illnesses could be signs of infection. They had shopped
at malls and visited friends and eaten in restaurants.
Dalgard thought they were probably having sexual intercourse with their
wives. He didn't even want to think about the consequences.
When he arrived at Hazleton Washington, he went directly to the office of
the general manager. He intended to brief him about the situation and get his
approval to evacuate the monkey house. "We've got two guys who are sick,"
Dalgard said to him. He began to describe what had happened, and he
started crying. He couldn't control it. He broke down and wept. Trying to pull himself together, he said, "I recommend that – the entire operation – we
close it down and turn it over to the Army.
We've had this god-damned disease since October, we haven't gotten
injured, and all of a sudden we've got two guys sick, one in the hospital, one
who's going there. I kept on thinking that if there was a real human risk, we
would have seen something by now. We've played with fire for too long."
The general manager sympathized with Dalgard and agreed with him that
the monkey facility ought to be evacuated and shut down. Then, holding
back his tears, Dalgard hurried to his own office, where he found a group of
officials from C.D.C. waiting for him. He felt as if the pressure would never
let up. The C.D.C. people had arrived at Hazleton to begin surveillance of all
employees who had been exposed to the virus.
Dalgard told them what had just happened at the monkey house, that a man
had gone down with vomiting. He said, "I have recommended that the
facility be evacuated. I feel that the building and the monkeys should be
turned over to the people from USAMRIID, who have the equipment and
personnel to handle it safely."
The C.D.C. people listened and did not disagree.
Then there was the question of what to do with Milton Frantig, who was still
lying on the couch under orders from Dalgard not to move. Since the C.D.C.
was in charge of the human aspects of the outbreak, the C.D.C. was in
charge of Frantig – and the C.D.C. wanted him taken to Fairfax Hospital,
inside the Washington Beltway.
It was now nine-twenty in the morning. Dalgard sat in his office and
sweated it out, managing the crisis by telephone. He called C.J. Peters at
Fort Detrick and told him that he had a monkey caretaker who was sick. In
his dry, calm voice, now without any hint that he had recently been weeping,
he said to Peters, "You have permission to consider the facility and all the
animals to be the responsibility of USAMRIID."
Colonel C.J. Peters was a little distrustful of the phrase "the responsibility of
USAMRIID." It implied that if anything went wrong and people died, the
Army could be held responsible and could be sued. He wanted to take
control of the building and nuke it, but he didn't want lawsuits. So he said to Dalgard that the safety of his people and the safety of the general public
were the most important things to him but that he would have to clear this
with his command. He said he would get back to Dalgard as soon as
possible.
Then they talked about the sick man, and C.J. learned that he was being
taken to Fairfax Hospital. That disturbed him greatly. He felt that it should
be assumed that the guy was breaking with Ebola – and do you really want
to bring a guy like that into a community hospital? Look at what Ebola had
done in hospitals in Africa. C.J. thought the man belonged in the Slammer at
the Institute.
As soon as he got off the line with Dalgard, C.J. Peters telephoned Joe
McCormick, who was in charge of the C.D.C. effort. He said to Mccormick
something like, "I know you have this idea that a surgical mask and gown
are all you need to handle an Ebola patient, but I think you need to use a
higher level of containment," and he offered to pick up the sick man in an
Army ambulance – put him in an Army biocontainment pod – and carry the
pod to the Army's facilities at the Institute. Put him in the Slammer.
C.J. Peters recalls that McCormick said to him something like, "I want the
guy at Fairfax Hospital." C.J. replied, "All right, I believe this, Joe, and you
believe that, and we don't agree. Regardless – what is going to happen to the
medical personnel at Fairfax Hospital or to you.
Joe, if Ebola virus gets into that hospital?"
187S
McCormick would not budge on his decision: he had been face-to-face with
Ebola in Africa, and he hadn't gotten sick. He had worked for days inside a
mud hut that was smeared with Ebola blood, on his knees among people
who were crashing on and bleeding out. You didn't need a space suit to
handle an Ebola patient. They could be handled by skilled nurses in a good
hospital. The guy was going to Fairfax Hospital. C.J. Peters, in spite of his
strong dislike for McCormick, found himself admiring him for making
strong decisions in a very difficult situation.
A TELEVISION-NEWS VAN arrived at the monkey house from Channel 4
in Washington. The workers peered through curtains at the van, and when
the reporter came to the door and pushed the buzzer, no one answered.
188
Dalgard had made it clear to them that no one was to talk to the media. Just
then, an ambulance from Fairfax Hospital arrived to take Frantig away.
Channel 4's timing could not have been better. The news team turned on
their lights and started filming the action. The door of the monkey house
swung open and Milton Frantig stumbled out, still wearing his Tyvek suit,
looking embarrassed. He walked over to the ambulance, the medical team
opened the back doors of the vehicle, and Frantig climbed in by himself and
lay down on the gurney. They slammed the doors and took off with Channel
4 following them. A few minutes later, the ambulance and Channel 4 pulled
into Fairfax Hospital. Frantig was put in an isolation room, with access
restricted to doctors and nurses wearing rubber gloves, gowns, and surgical
masks. He said he felt better. He prayed to the Lord and watched a little
television.
Back at the monkey house, the situation had become unbearable for the
remaining workers. They had seen people in space suits, they had seen their
colleague puking the grass, they had seen Channel 4 chasing the ambulance.
They left the building in a real hurry, locking it after themselves.
There were four hundred and fifty monkeys alive in the building, and their
hoots and cries sounded in the empty hallways. It was eleven o'clock in the
morning. A snow flurry came and went. The weather was turning colder. In
the monkey house, the air-handling equipment had failed for good. The air
temperature in the building had soared beyond ninety degrees, and the place
had turned steamy, odorous, alive with monkey calls. The animals were
hungry now, because they had not been fed their morning biscuits. Here and
there, in rooms all over the building, some of the animals stared from glazed
eyes in mask like faces, and some of them had blood running from their
orifices. It landed on metal trays under their cages ... ping, ping, ping.
91-TANGOS
1030 HOURS, MONDAY
THE CRISIS WAS getting worse at Reston. Dan Dalgard felt he was losing
control of everything. He set up a conference call with all the senior
managers in his company and informed them of the situation – two
189
employees were down, and the second man could be breaking with Ebola –
and he told the managers that had offered to turn the monkey house over to
the Army. They approved his action, but they said they wanted the oral
agreement with the Army to be put in writing. Furthermore, they wanted the
Army to agree to take legal responsibility for the building.
Dalgard then called C.J. Peters and asked that the Army assume
responsibility for any liability that would arise after the Army took over. C.J.
flatly rejected that proposal. He saw a need for clarity, speed, and no
lawyers. He felt that the outbreak had ballooned to the point where a
decision had to be made. Dalgard agreed to fax him a simple letter turning
the monkey over to the Army. They worked up some language, and C.J.
carried the letter by hand to the office of General Philip Russell. He and the
general pored over the letter, but they did not choose to show it any Army
lawyers. Russell said, "We have to convince the lawyers of the path of
righteousness." They signed the letter, faxed it back to Dalgard, and the
monkey house fell into the hands of the Army.
Jerry Jaax would have to lead a much larger biohazard team back into the
monkey house. The number of animals that needed to be dealt with was
staggering. His troops were untested, and he himself had never been in
combat. He didn't know, couldn't know, how he or his people would perform
a chaotic situation involving intense fear of an unpleasant death.
Jerry was the commanding officer of the 91-Tangos at the Institute. The
Army's animal-care technicians are classified 91-T, which in Army jargon
becomes 91-Tango. The younger 91-Tangos are eighteen years old and
privates. While the ambulance was taking Milton Frantig to the hospital,
Jerry called a meeting of his 91-Tangos and civilian staff in a conference
room in the Institute. Although most of the soldiers were young and had
very little or no experience in space suits, the civilians were old men, and
some were Level 4 specialists who had worn Chemturions on a daily basis.
The room was jammed, and people sat on the floor.
"The virus is Ebola or Ebola-like agent," he said to them. "We are going to
be handling large amount of blood. And we will be handling sharp
instruments. We are going to use the disposable biocontainment suits."
The room was silent while he spoke. He didn't mention that a man was
down, because he didn't know about it – C.J. Peters hadn't told him about
that. For the time being, Peters was staying quiet about the development.
Jerry said to his people, "We are looking for volunteers. Is there anyone in
this room who does not want to go? We can't make you go."
When no one backed out, Jerry looked around the room and picked his
people: "Yep, he's going. She's going, and, yep, you're going." In the crowd,
there was a sergeant named Swiderski, and Jerry decided that she could not
go because she was pregnant. Ebola has particularly nasty effects on
pregnant women.
No combat unit in the Army could handle this work. There would be no
hazard pay, as there is in a war zone. The Army has a theory regarding
biological space suits. The theory is that work inside a space suit is not
hazardous, because you are wearing a space suit. Hell, if you handled hot
agents without a space suit, that would be hazardous work. The privates
would get their usual pay: seven dollars an hour. Jerry told them that they
were not to discuss the operation with anyone, not even members of their
families. "If you have any tendency to claustrophobia, consider it now," he
said. He told them to wear civilian clothes and to show up at the Institute's
loading dock at 0500 hours the next morning.
DECEMBER 4-5, MONDAY-TUESDAY
THE SOLDIERS DIDN'T sleep much that night, and neither did Gene
Johnson.
He was terrified for the "kids", as he called them. He had fair share of scares
with hot agents. Once in Zaire, he had stuck himself with a bloody needle
while taking blood from a mouse. There was reason to believe the mouse
was hot, and so they had airlifted him to the Institute and put him in the
Slammer for thirty days. "That was not a fun trip," as he put it.
"They treated me as if I would die. They wouldn't give me scissors to cut my
beard because they thought I would be suicidal. And they locked me in at
night." At Kitum Cave, while wearing a space suit and dissecting animals,
he had been nicked three times with bloody tools. Three times his space suit
191
had been punctured and his skin broken and cut smeared with animal blood.
He regarded himself as lucky not to have picked up Marburg or something
else at Kitum Cave. Having had some close calls, he was deeply afraid of
what had invaded the monkey house.
Johnson lived in a rambling house on the side of Catoctin Mountain. He sat
in his study most of the night, thinking about procedures. Every movement
of the body in a hot area has to be controlled and planned. He said to
himself, Where's this virus going to get you?
It's going to get you through the hands. The hands are the weak point.
Above all, the hands must be under control.
He sat in an easy chair and held up one hand and studied it. Four fingers and
an apposed thumb. Exactly like a monkey's hand. Except that it was wired to
a human mind. And it could be enclosed and shielded by technology. The
thing that separated the human hand from Nature was the space suit.
He stood up and went through motions in the air with his hands.
Now he was giving a monkey an injection. Now he was carrying the
monkey to a table. He was putting the monkey on the table. He was in a hot
zone. He was opening the monkey up, and now he was putting his hands
into a bloody lake of amplified hot agent. His hands were covered with three
layers of rubber and then smeared with blood and hot agent.
He paused and jotted notes on paper. Then he turned back to his imaginary
hot zone. He inserted a pair of scissors into the monkey and clipped out part
of the spleen. He handed it to someone. Where would that person be
standing? Behind him? Now he imagined himself holding a needle in his
hand. Okay, I have a needle in my hand. It's lethal object. I'm holding it in
my right hand if I'm right-handed. Therefore, my buddy should stand to my
left, away from the needle. Now my buddy's hands. What will my buddy's
hands be doing? What will everyone's hands be doing? By early in the
morning, he had written many pages of notes.
It was a script for a biohazard operation.
JERRY JAAX LEFT home at four o'clock in the morning, while Nancy was
still asleep. He met Gene Johnson at the loading dock, where they went over Gene's script. Jerry memorized it, and meanwhile the team members began
to show up, soldiers in Jerry's unit. Many of them arrived on foot, having
walked over from their barracks. They stood around, waiting for their orders.
It was pitch-dark, and only the floodlights illuminated the scene. Jerry had
decided to use a buddy system inside the building, and he began deciding
who would be paired with whom. On a piece of paper, he drew up a roster of
buddies, and he wrote down the order of entry, the sequence in which they
would be inserted into the building. He stood before them and read the
roster, and they got into their vehicles – a white refrigerator truck, a couple
of unmarked passenger vans, an unmarked pickup truck, the white
ambulance containing the bubble stretcher, and a number of civilian cars –
and headed for Reston. They became trapped in rush-hour traffic again,
surrounded by half-asleep yuppies in suits who were sucking coffee from
foam cups and listening to traffic reports and easy rock and roll.
WHEN ALL THE vehicles had arrived at the back of the monkey house, the
teams assembled on the lawn, and Gene Johnson asked for their attention.
His eyes were sunken and dark, suggesting he had not slept in days. "We are
not playing games here," he said. "This is the real thing. A biological Level
4 outbreak is not a training session. There's been a development I want you
all to know about. There is a possibility that transmission of this virus to
human has taken place. There are two people who are ill and are
hospitalized. Both of them are animal caretakers who worked in this
building. There is one guy we are especially worried about. Yesterday
morning, he became sick. He vomited and spiked a fever.
He is now in the hospital. We don't know if he is breaking with Ebola.
The thing I want you to understand is that he was not bitten by an animal
and he did not cut himself or stick himself with a needle. So if he has Ebola,
there is a possibility he got it through airborne transmission."
Jerry Jaax listened to the speech with a rising sense of horror.
He hadn't known about this man getting sick! Nobody had told him about
this! Now he had a feeling that there were going to be casualties.
It was an icy, gray day. The trees behind the monkey house had lost their
leaves, and dead leaves rustled across the lawn. At the day-care center down the hill, parents had been dropping off their children, and the children were
playing on swings. Gene Johnson continued his speech. "Everyone is to
proceed on the assumption risks, and you are experienced" – and his eyes
rested on a private first class named Nicole Berke. She was quite beautiful,
long blond hair, eighteen years old – and he thought, Who is she? I've never
seen her before. Must be one of Jerry's people. They're just kids, they don't
know what they're up against. "You must follow the procedures exactly," he
went on. "If you have any questions, you must ask."
Jerry got up and said to them, "No question is too stupid. If you have a
question, ask."
Private Nicole Berke was wondering if she would get a chance to go into the
building. "How long are we going to be doing this, sir?" she asked him.
"Until the monkeys are dead," he replied. "There are four hundred and fifty
monkeys in there."
Oh, God, she thought, four hundred fifty monkeys – this is going to take
forever.
The questions were few. People were tense, silent, turned inward.
Jerry Jaax entered the staging room, and the support team helped him put on
his Racal Suit. They fitted the bubble over his head, and his blowers started
to roar. He told the teams he'd see them inside, and he and his buddy,
Sergeant Thomas Amen, entered the air lock. The door closed behind them,
and they stood in darkness. They felt their way down the dark air-lock
corridor, opened the far door, and crossed over to the hot side.
The area was trashed. It had not been cleaned in many days. The workers
had left in a big hurry. There were monkey biscuits scattered all over the
floor, and papers were scattered everywhere, and there were overturned
chairs in the offices. It looked as if the humans had fled from here. Jerry and
the sergeant began exploring the building. They moved slowly and carefully
in their suits, as if they were wreck divers operating in deep water. Jerry
found himself in a small corridor that opened into more monkey rooms. He
saw a room full of monkeys, and every one of the animals was looking at
him. Seventy pairs of monkey eyes fixed on a pair of human eyes in a space
suit – and the animals went nuts. They were hungry and were hoping to be
194
fed. They had trashed their room. Even locked inside cages, monkey could
really do a job on a room. They had been throwing their biscuits all over the
place, and they had been finger-painting the walls with dung. The wall were
scribbled all the way up to the ceiling with monkey writing. It was a cryptic
message to the human race that came out of the primate soul.
Jerry and the sergeant found some bags of monkey biscuits and went into
each room in the building, and fed the monkeys. The animals were going to
die soon, but Jerry didn't want them to suffer more than they had to. While
he fed them, he inspected them for signs of Ebola. In many of the rooms, he
found animals that seemed dull-eyed and listless. Some of them had runny
noses, or there was a kind of blood-spattered green crust caked around the
nostrils. He saw puddles of blood in some of the pans under their cages.
These sights disturbed him deeply because they told him that the agent had
gone all through the building. He could see some of the animals coughing
and sneezing, as if they had the flu. He wondered if he was seeing a mutant
form of Ebola – a kind of airborne Ebola flu. He shrank from the idea and
tried to turn his mind away from it, for it was too awful to contemplate. You
could no more imagine it than you could imagine a nuclear war. A layer of
sweat built up inside his plastic head bubble, making it difficult for him to
see the monkeys clearly. But he could hear them, shrieking and calling
distantly beyond the sound of his blowers. So far, he had not felt any
claustrophobia or panic. He wasn't going to lose it in here.
SEVERAL MEMBERS OF the team spent the next half hour in staging
room.
They were shucking syringes, removing them from a sterile envelope, and
fitting each syringe with a needle. Now the syringes were ready to be filled
with drugs.
A few feet from the soldiers, Captain Mark Haines began to suit up. While
the support team got him dressed, he gave a speech. He wanted the soldiers
to keep certain things in mind as they followed him in. He said, "You are
going to euthanize a whole building full of animals. This is not a fun
operation. Don't get attached to the animals. They are going to die anyway.
They're all going to have to go, every last one of them. Don't think of it as
killing something. Think of it as stopping the virus here without letting it get
anywhere else. Don't play with the monkeys. I don't want to hear laughing and joking around the animals. I can be hard. Remember the veterinarian's
creed: you have a responsibility to animals, and you have a responsibility to
science. These animals gave their lives to science. They were caught up in
this thing, and it's not their fault. They had nothing to do with it. Keep an
eye on you buddy.
Never hand a used needle to another person. If a needle comes out of its cap,
it goes straight into an animal. Put the used syringe into a sharps container.
If you get tired, tell your supervisor, and we'll decon you out." He turned
away from them and went in with his buddy.
"Who's next?" Gene Johnson said, reading the roster, "Godwin! You're
next."
A private first class named Charlotte Godwin hurried outdoors to the van
and climbed inside, and took off all her clothes, and put on a surgical scrub
suite, socks, sneakers, and a hair cap. It was brutally cold in the van. She felt
embarrassed and vulnerable.
In the staging room they began to suit her up. Someone said to her, "You're
kind of small. We've got a special suit for you." It wasn't special. It was a
large suit, sized for a big man, and she was five feet tall. It hung around her
like a bag. The supper team was taping her now, running brown sticky tape
around her ankles and wrists, and her blowers came on.
An Army photographer took some photographs for the action file, and as the
flash went off she thought, God, I would be swearing a hair cap. It's a clown
cap. It's a Bozo hat. You won't see my hair in the picture, and my space suit
is too large for me. Makes me look fat. Just my luck to be the one looking
like a dork in the action photographs.
She staggered into the gray zone, carrying boxes of supplies, and felt a
sweeping adrenal rush, and thought. I'm too young to be going through this.
She was eighteen. Then she noticed the smell. A really bad smell was
creeping through her filters. Her buddy pounded on the far door, and they
entered. Ripples in the faceplate of her head bubble distorted the view, as if
she was in a house of mirrors. The smell of monkey was overpowering
inside her space suit. It was also too quiet, and monkey houses are not quiet
places. The quiet bothered her even more than the smell or the heat.
A door swung open, and Colonel Jaax appeared. He said, "START
LOADING SYRINGES. DOUBLE DOSES OF KETAMINE."
"YES, SIR," she replied.
"THE SERGEANT AND I WILL BE KNOCKING DOWN MONKEYS IN
HERE," he said.
Charlotte started filling syringes with ketamine, the anesthetic.
Jerry Jaax carried a loaded syringe into the monkey room and fitted it to the
socket of a pole syringe. The sergeant fished his mop handle into a cage and
pinned a monkey. Then Jerry opened the door of the cage.
Watching the monkey carefully to make sure it didn't try to rush at him, he
slid the pole syringe through the open door and gave the monkey an
injection of anesthetic, and then pulled out the syringe, and slammed the
door shut. It was the most dangerous job because of the open door. The
animal could attack or try to escape. Jerry and the sergeant went from cage
to cage, and the monkeys began to go to sleep under the anesthesia.
The rooms contained double banks of monkey cages. The lower bank was
near the floor and was dark. Jerry had to get down on his knees to peer
inside. He could hardly see anything through his head bubble. His knees
were killing him. He would open a cage door, and the sergeant would slide
the mop handle into the cage. The monkey would scrabble around, try to
escape, and the sergeant would say, "OKAY, I GOT HIM. HE'S PINNED."
Jerry would slide the pole syringe toward the monkey, aiming the needle for
the thigh. There would be screeches and a wild commotion, the monkey
shrieking "Kra! Kra!" and the needle would sink in. This was turning out to
be one of the hardest things he'd ever done in his career as a veterinarian.
More team members came into the building, Jerry assembled them in the
hallway and said to them: "STOP EVERY FIVE OR TEN MINUTES AND
CHECK YOUR NEIGHBOR'S SUIT FOR RIPS. BE VERY CAREFUL.
MAKE SURE YOU TAKE REST BREAKS. I WANT YOU TO REST
FOR TEN MINUTES EVERY HOUR. WHEN YOU GET TIRED, YOU
GET CARELESS." Every time he looked into a monkey room, he saw a room full of eyes looking back at him. Some of the monkeys rattled their
cages, and the wave of noise swept up and down the room.
Jerry decided to set up a bleed area in a small room near the front of the
building, right next to the offices. In the bleed area there was a shower with
a drain hole in the floor. They would need to use the drain hole for washing
down blood and for rinsing down objects with bleach. Every time blood
went down the drain, they would pour bleach after it – they didn't want this
thing getting into Reston sewage system.
They found a metal examination table on wheels and rolled it into the bleed
area. Jerry divided the people into subteams: a bleed team (to work at the
bleed table), a euthanasia team (to put monkeys to death), and a necropsy
team (to open up the monkeys and take samples and bag the carcasses in
biohazard bags).
They got an assembly line going. Every five minutes or so, Jerry Jaax would
carry an unconscious monkey out of a room and down the corridors to the
bleed area, holding the animal with its arms pinned behind its back. He
would lay it down on the bleed table, and then Captain Haines, the Green
Beret, would insert a needle into the animal's thigh and draw off a lot of
blood into various tubes. Then he'd hand the unconscious animal to Major
Nate Powell, and he would give it an injection of T-61, the euthanasia agent.
He'd put the needle right into the heart.
When the animal was clearly dead, he would hand it to Captain Steve
Denny, who did the necropsy. Captain Denny opened the animal with
scissors and snipped out parts of the liver and spleen. The livers of these
animals were gray, eroded, nasty looking.
Private Charlotte Godwin stood beside Captain Denny and handed him
tools. She thought he looked nervous, jumpy, inside his space suit. He pulled
a spleen out of a monkey. It was speckled with white spots, as hard as a
rock, a biological bomb ticking with hot agent. After a while, he handed the
scissors to her and gave her a chance to open up a monkey.
It frightened her and gave her a big rush. She was doing a hot necropsy in
Level 4, perhaps the most dangerous work in a space suit. This was a rocket
ride, and it thrilled her. Her hands worked within a membrane's thickness of a death worse than any death in combat. She found herself racing to finish
the job. She noticed that the monkey's eyes were open.
It was as if the monkey was looking at her while she worked. She wanted to
reach out and close the monkey's eyes. She thought, Is my face the last thing
they see?
INSIDE
EARLY EVENING, TUESDAY
THE DAY WORE ON, and people began using up their batteries. They
could see that the daylight was starting to go, because some windows at the
ends of the hallways were getting dark. Jerry Jaax made people rest every
now and then. They sat on the floor with blank looks on their faces,
exhausted, or they loaded syringes with drugs. Meanwhile, Jerry went from
person to person, trying to gauge the level of exhaustion. "HOW ARE YOU
DOING? ARE YOU TIRED? DO YOU WANT TO GO OUT?"
Nobody wanted to go out.
The team inside the building maintained radio contact with Gene Johnson
outside the building. He had supplied them with hand-held short-wave
radios that operated on a military band. He hadn't given them ordinary
walkie-talkies because he didn't want anybody listening to the talk,
especially the news media, who might make a tape recording of the chatter.
It seemed less likely that anyone would listen to these radios.
Something went wrong with one of the soldiers' suits. She was a specialist
named Rhonda Williams. Her blower cut off, and her suit began to go limp
until it stuck to her sweaty scrub suit, and she felt contaminated air creeping
around her. "MY AIR'S GOING OFF," she shouted.
She kept working. She couldn't leave her post. Her battery was failing. She
discovered that she did not have a spare battery on her belt. All the others
had used their spare batteries.
When Rhonda announced that her air was shutting down, it caused a
commotion. Jerry wanted to evacuate her from the building. He ran down the hall to the air-lock door, where a soldier was stationed with a short-wave
radio. Jerry grabbed the radio, and called Gene Johnson, shouting through
his helmet, "WE'VE GOT A LADY WHO'S LOSING HER BATTERY."
Gene answered, "We need to get a battery and send it in with someone. Can
you wait?"
"NO, SHE'S COMING OUT. SHE'S LOSING HER AIR," Jerry said.
Abruptly, the soldier by the door told Jerry that he had an extra battery. Jerry
said over the radio: "WAIT – WE HAVE AN EXTRA ONE."
The soldier ran down the hallway to Rhonda, grinned at her, and said,
"YOUR BATTERY IS HERE."
People started laughing. He clipped it to Rhonda's belt.
She thought, Oh, my God, they're going to unlock my old battery, it's going
to stop my blowers. She said, "WAIT A MINUTE! MY AIR'S GOING TO
GO OFF!"
"DON'T WORRY. IT'S JUST FOR A SECOND WHILE WE SWITCH
YOU OVER," he said. Rhonda was rattled and was ready to leave. She was
wondering if she had caught the virus during the moments when her air
pressure had been lost. Jerry decided to send her out with Charlotte Godwin,
who seemed to be getting tired. On the radio, he said to Gene, "I HAVE
TWO COMING OUT."
On Gene's side, a near panic was occurring. A television van had just
showed up. Gene was appalled. He didn't want the cameras to start rolling
just as two women in space suits were extracted from the building.
He said to Jerry, "We're jammed. We can't move them out. We've got TV
cameras out here."
"I'LL BE SENDING THEM OUT," Jerry said.
"All right. Send them out," Gene said. "We'll give the cameras a show."
Jerry pounded on the door of the gray area, and the decon man opened it. He
was a sergeant. He wore a space suit. He held a pump sprayer filled with
bleach, and a flashlight. Rhonda and Charlotte walked into the gray area, and the sergeant told them to hold their arms straight out at their sides. He
played the flashlight over their space suits, checking for damage or leaks.
Rhonda noticed that he had a strange look on his face.
"YOU HAVE A HOLE IN YOUR SUIT," he said.
I knew this was going to happen, she thought.
"WHERE DID YOU GET IT?" he asked.
"I DON'T KNOW!"
He slapped a piece of tape over the hole. Then he washed the two soldiers
down with bleach, spraying it all over them, and pounded on the door that
led to the staging room. Someone opened it, and they went out.
Immediately the support team opened their head bubbles and peeled off their
suits.
Their scrub suits, underneath, were soaked with sweat. They began to shiver.
"There's a television-news van out front," Gene said.
"I had a hole in my suit," Rhonda said to him. "Did I get the virus?"
"No. You had enough pressure in your suit to protect you the whole time."
He hurried them outdoors. "Get into the van and lie down," he said. "If
anybody asked you any questions, keep you mouths shut."
They couldn't find their clothes in the van. They rolled themselves up in
some overcoats to keep warm and lay down on the seats, out of sight.
The television crew parked their van near the front door of the monkey
house, and the reporter began to poke around, followed by a cameraman.
The reporter knocked on the front door and rang the buzzer – no answer. He
peered in the front windows – the curtains were drawn, and he couldn't see
anything. Well, nothing was happening in there. This place was deserted. He
and the cameraman didn't notice the white vehicles parked behind the
building, or if they noticed them it didn't seem interesting. There was
nothing going on here.
The television men returned to their van and sat in it for a while, hoping that
something would happen or that someone would show up so that they could
get some sound bites for the evening news, but this was getting to be boring,
it was an awfully cold day, and the light was fading. It did not occur to them
to go around the side of the building and point their video camera toward a
window. If they had done that, they would have gotten enough footage to fill
the entire evening news, with something left over for CBS's 60 minutes.
They would have gotten footage of soldiers in space suits smeared with
Ebola blood, engaged in the first major biohazard mission the world ever
knew, and they would have gotten shots of biohazard buddies coming out
into the staging area in pairs and being stripped of their suits by the
supporting team. But the news crew didn't walk around the building, and so
far as I know, there is no video footage of the Reston action.
Meanwhile, the two women lay on their back in the van for many minutes.
Suddenly the television crew left. Gene Johnson, poking his head around the
corner of the building, reported that the coast was clear.
The women got dressed and then hurried off to relieve themselves in the
wooded area behind the building. That was where they found the needles –
two used hypodermic syringes with needles attached to them. The needles
were uncapped and bare, obviously used. It was impossible to tell how long
they had been lying in the grass. Some of the safety people put on gloves
and picked up the needles, and as they searched the area, they found more
needles in the grass.
The last person to come out was Jerry Jaax. He emerged around six in the
evening, having lost between five and ten pounds of weight. It was fluid loss
from sweating, and his face was ashen. His hair, instead of look silver,
looked white.
There was no food for the soldiers, and they were hungry and thirsty. The
soldiers took a vote on where to eat, and it came out in favor of Taco Bell.
Gene Johnson said to them, "Don't tell anyone why we are here. Don't
answer any question."
The caravan started up, engines roaring in the cold, and headed for Taco
Bell. The soldiers ordered soft tacos with many, many jumbo Cokes to
replace the sweat they'd lost inside their space suits. They also ordered a vast number of cinnamon twists – everything to do – yeah, put it in boxes, and
hurry, please. The employees were staring at them. The soldiers looked like
soldiers, even in jeans and sweat shirts – the men were bulked up and hard –
looking, with crew cuts and metal-framed military eyeglasses and a few zits
from too much Army food, and the women liked as if they could do fifty
push-ups and break down a weapon. A man came up to Sergeant Klages
while he was waiting for his food and said, "What were you doing over
there? I saw those vans." Sergeant Klages turned his back on the man
without saying a word.
AFTER MIDNIGHT ON the water bed in the master bedroom of Jaax house
on the slopes of Catoctin Mountain, Nancy and Jerry Jaax caught up on the
news while their daughter, Jaime, slept beside them. Jerry told her that the
day's operation had gone reasonably well and that no one had stuck himself
or herself with a needle. He told her he hadn't realized how lonely it is inside
biohazard suit.
Nancy wrapped herself around him and rested her head against his neck in
the way they had held each other since college. She thought he looked
shrunken and thin. He was physically more exhausted than she had seen him
in years. She picked up Jaime and carried her to bed, then returned and
folded herself around her husband. They fell asleep holding each other.
A BAD DAY
DECEMBER 6, WEDNESDAY
FOR THE PAST several days and nights, an Army scientist named Thomas
Ksiazek had been working in his space suit in a Level 4 lab trying to develop
a rapid test for Ebola virus in blood and tissue. He got the test to work. It
was called a rapid Elisa test, and it was sensitive and easy to perform. He
tested urine and blood samples from Milton Frantig, the man who had
vomited on the lawn and who was now in an isolation room at Fairfax
Hospital. Frantig came up clean. His urine and blood did not react to the
Ebola test. It looked as if he had the flu. This was a mystery. Why weren't
those guys breaking with Ebola?
The weather warmed up and turned sunny, and the wind shifted around until
it blew from the south. On the second day of the massive nuking –
Wednesday – the Army caravan flowed with commuter traffic to Reston
and deployed behind the monkey house. Things went more smoothly. By
eight o'clock in the morning, the teams had begun their insertions. Gene
Johnson brought a floodlight, and they set it up in the gray corridor.
Jerry Jaax went in first and fed the monkeys. He made his rounds with
Sergeant Amen, checking each room, and here and there they found
monkeys dead or in terminal shock. In a lounge, they found some chairs, and
dragged them into a hallway and arranged them in a semicircle so that the
soldiers could sit on them while they took their rest breaks and filled up
syringes. As the day wore on, you could see exhausted soldiers and civilians
in orange space suits, men and women, their head bubbles clouded with
condensation, sitting on the chairs, in the hallway, loading syringes with T61 and sorting boxes full of blood tubes. Some talked with each other by
shouting, and others just stared at the walls.
At midmorning, Jerry Jaax was working in Room C. He decided to take a
break to rest and check up on his people. He left the room in charge of
Sergeants Amen and Klages while he went out into the hallway.
Suddenly there was a commotion in Room C, and the monkeys in that room
burst out in wild screeches. Jerry ran back to the room, where he found the
sergeants outside the door, looking in, in a state of alarm.
"WHAT HAPPENED?"
"A MONKEY ESCAPED, SIR."
"AW, SHIT!" Jaax roared.
The animal had bolted past Sergeant Amen as he opened the cage, and the
sergeants had immediately run out of the room and shut the door behind
them.
A loose monkey – this was what Jerry had feared the most. They can leap
long distances. He had been bitten by monkeys himself, and he knew what
that felt like. Those teeth went in deep.
They looked into the room through the window in the door. The whole room
had exploded in activity, monkeys whirling in their cages and shaking them
violently, giving off high, excited whoops. There were about a hundred
screaming monkeys in that room. But where was the loose monkey?
They couldn't see it.
They found a catching net, a pole with a baglike net at the end.
They opened the door and edged into the room.
The events that followed have a dreamlike quality in people's memories, and
the memories are contradictory. Specialist Rhonda Williams has a clear
memory that the monkey escaped from the room. She says she was sitting
on a chair when it happened, that she heard a lot of shouting and suddenly
the animal appeared and ran under her feet. She froze in terror, and then
burst out laughing – nervous, near-hysterical laughter.
The animal was a small, determined male, and he was not going to let these
people get near him with a net.
Jerry Jaax insists that the monkey never got out of the room. It is possible
that the monkey ran under Specialist Williams's feet and then was chased
back into the room again.
The loose monkey was very frightened and the soldiers were very
frightened. He stayed in the room for a while, running back and forth across
the cages. The other monkeys apparently grew angry at this and bit at the
monkey's toes. The monkey's feet began to bleed, and pretty soon it had
tracked blood all over the room. Jerry got on the radio and reported that a
monkey was loose and bleeding. Gene Johnson told him to do whatever had
to be done. How about shooting the monkey? Bring in a handgun, like an
Army .45. Jerry didn't like that idea. Looking into the room, he noticed that
the loose monkey was spending most of its time hiding behind the cages. If
you tried to shoot the monkey, you'd be firing into the cages, and the bullet
could hit a cage or a wall and might ricochet inside the room. Getting a
gunshot wound in this building might be fatal. He decided that the safest
procedure would be to go into the room and capture the monkey with the
net. He took Sergeant Amen with him.
As they entered the room, they could not see the monkey. Jerry proceeded
forward slowly, holding the net up, ready to swipe it at the monkey. But
where was it? He could not see very well. His faceplate was covered with
sweat, and the light was dim in the room. He might as well have been
swimming underwater. He edged slowly forward, keeping his body away
from the cages on either side, which were filled with hysterical, screaming,
leaping, bar-rattling monkeys. The sound of monkeys raising hell was
deafening. He was afraid of being bitten by a monkey if he came too close to
a cage. So he stayed in the middle of the room as he went forward, while
Sergeant Amen followed him, holding a syringe full of drugs on a pole.
"BE CAREFUL, SERGEANT," he said. "DON'T GET BITTEN. STAY
BACK FROM THE CAGES."
He edged his way from cage to cage, looking into each one, trying to see
through it toward the shadowy wall behind. Suddenly he saw a flicker of
movement out of the corner of his eye, and he turned with the net, and the
monkey went soaring through the air over him, making a twelve-foot jump
from one side of the room to the other.
"GET HIM! HE'S OVER HERE!" he said. He waved the net, slammed it
around over the cages, but the monkey was gone.
He walked through the room again, slowly. The monkey leaped across the
room, a huge, tail-swing leap. This animal was airborne whenever it moved.
Jerry waved his net and missed. "SON OF A BITCH!" he shouted. The
monkey was too fast for him. He would spend ten or fifteen minutes
searching the room, squinting past the cages. If he found the monkey, the
monkey would leap to the order side of the room. It was a small monkey,
built for life in the trees. He thought. This environment favors the monkey
over us. We don't have the tools to handle this situation. We are not in
control here – we are along for the ride.
OUTSIDE THE BUILDING, Colonel C.J. Peters stopped by to observe the
operation. He was dressed in Levi's and a sweater, along with sandals and
socks, even thought it was a cold day. With his sandals and mustache, he
appeared to be a sixties type or some sort of a low-grade employee, may be a
janitor. He noticed a stranger hanging around the front of the building. Who
was it? Then the man started to come around the side of the building. He was obviously after something, and he was getting too close to the action.
C.J. hurried forward and stopped the man and asked him what he was doing.
He was a reporter from The Washington Post. "What's happening around
here?" he asked C.J.
"Well – aw – nothing much is happening," C.J. replied. He was suddenly
very glad he had not worn his colonel's uniform today – for once, his bad
habits had paid off. He did not encourage the reporter to come around to the
side of the building and have a look in through the window.
The reporter left shortly afterward, having seen and heard nothing of
interest. The Washington Post suspected that something funny was
happening at the monkey house but the reporters and editors who worked on
the story couldn't quite get to the bottom of it.
"THIS MONKEY KNOWS NETS," Jerry shouted to the sergeant. The
monkey was not going to let himself be caught by some fool of a human
wearing a plastic bag. They decided to leave him in the room overnight.
Meanwhile, the surviving monkeys were becoming increasingly agitated.
The teams killed most of the monkeys this day, working straight through
until after dark. Some of the soldiers began to complain that they were not
being given enough responsibility, and so Jerry let them take over more of
the hazardous work from the officers. He assigned Specialist Rhonda
Williams to duty at the euthanasia table with Major Nate Powell. The major
had a drugged monkey on the table, holding its arms behind its back in case
it woke up, while Rhonda uncapped a syringe and gave the monkey a heart
stick – plunged the needle into the chest between the ribs, aiming for the
heart. She pushed the plunger, sending a load of drugs into the heart, which
killed the monkey instantly. She pulled the needle out, and a lot of blood
squirted out of the puncture wound. That was a good sign; it meant she had
punctured the heart. If she got blood on her gloves, she rinsed them in a pan
of bleach, and if she got blood on her space suit, she wiped it down with a
sponge soaked in bleach.
It was awful when she missed the heart. She pushed the plunger, the poison
flooded the animals' chest around the heart, and the monkey jumped. It
doubled up, its eyes moved, and it seemed to struggle. This was only a death
reflex, but she gasped and her own heart jumped.
Then Colonel Jaax put her to work at the bleed table with Captain Haines,
and presently she began drawing blood from unconscious monkeys.
She inserted a needle into the animals' leg vein and drew the blood.
Their eyes were open. She didn't like that. She felt they were staring at her.
She was bleeding a monkey when suddenly she thought its eyes moved, and
it seemed to be trying to sit up. It was awake. It looked at her in a daze and
reached out and grabbed her by the hand, the one that was holding the
syringe. The monkey was very strong. The needle came out of its thigh, and
blood spurted out. Then the animal started pulling her hand towards its
mouth! It was trying to bit her hand! She screamed:
"GRAB HIM, SOMEBODY, PLEASE! HE'S GETTING UP!" Captain
Haines caught the monkey's arms and pinned it to the table, shouting, "WE
HAVE ONE THAT'S AWAKE! NEED KETAMINE!"
The needle, in coming out of the monkey, had cut the monkey's leg vein.
Immediately a ball of blood the size of a baseball formed in the monkey's
leg. It just got bigger and bigger, the blood pouring under the skin, and
Rhonda almost burst into tears. She pressed her hands on the blood ball to
stop the internal bleeding. Through her gloves, she could feel the blood
swelling. A ball of Ebola blood.
A soldier hurried over and hit the monkey with a double load of ketamine,
and the monkey went limp.
DURING THE CRISIS, Peter Jahrling spent every day wearing a space suit
in his lab, running tests on monkey samples, trying to determine where and
how the virus spreading, and trying to get a pure sample of the virus
isolated. Meanwhile, Tom Geisbert pulled all-nighters, staring at the
cellscapes through his microscope.
Occasionally they met each other in an office, and closed the door.
"How are you feeling?"
"Tired, but otherwise I'm okay."
"No headache?"
"Nope. How are you feeling?"
"Fine."
They were the discoverers of the strain, and it seemed that they would have
the chance to give it a name, provided they could isolate it, and provided it
didn't isolate them first.
Jahrling went home for dinner with his family, but later he had read his
children their stories and put them to bed, he returned to the Institute and
worked until late. The whole Institute was lit up with activity, all the hot
labs full of people and operating around the clock.
Soon he had stripped nude in the locker room, and he was putting on his
scrubs, and then he was wearing his space suit, feeling sleepy, warm, and
full of dinner, as he faced the steel door blazed with the red flower, reluctant
to take another step forward. He opened the door and went through to the
hot side.
He had been testing his and Geisbert's blood all along, and he wondered if
the virus would suddenly show up in it. He didn't think it was likely. I didn't
stick the flask close to my nose. I kind of just waved my hand over it. They
used to do that all the time in hospital labs with bacteria. It used to be
standard procedure to sniff cultures in a lab – that was how you learned what
bacteria smelled like, how you learned that some kinds smell like Welch's
grape juice. The question of whether he, Peter Jahrling, was infected with
Ebola had become somewhat more pressing since the animal caretaker had
puked on the lawn. That guy had not cut himself or stuck himself with a
needle. Therefore, if that guy was breaking with Ebola, he might have
caught it by breathing it in the air.
Jahrling carried some slides containing spots of his own blood serum into
his closet, shut the door, turned out the light. He let his eyes adjust to the
darkness, and had the usual struggle to see anything in the microscope
through his faceplate. Then the panorama swam into view.
It was the ocean of his blood, stretching in all directions, grainy and
mysterious, faintly glowing with green. This was a normal glow, nothing to
get excited about, that faint green. If the green brightened into a hotter glow,
that would signify that his blood was inhabited by Ebola.
And what if his blood glowed? How would he judge if it was really
glowing? How green is green? How much do I trust my tools and my
perceptions? And if I'm convinced my blood is glowing, how am I going to
report the results? I'll need to tell C.J. May be I won't have to go to the
Slammer. I could be bio-contained right here in my own lab. I'm in Biosafety
Level 4 right now. I'm already in isolation. Who can I infect here in my lab?
Nobody. I could live and work in here if I go positive for Ebola.
Nothing glowed. Nothing reacted to his blood. His blood was normal. Same
with Tom Geisbert's blood. As to whether their blood would glow tomorrow
or the next day or the day after that, only time would tell, but he and
Geisbert were climbing out of the incubation period.
At eleven o'clock at night, he decided it was time to go home, and he entered
the air lock and pulled the chain to start the decon cycle. He was standing in
gray light in the gray zone, alone with his thoughts. He couldn't see much of
anything in here, in the chemical mist. He had to wait seven minutes for the
cycle to complete itself. His legs were killing him. He was so tired he
couldn't stand up. He reached up with his hands and grabbed the pipes that
fed chemicals into the shower, to hold himself up. The warm liquid ran over
his space suit. He felt comfortable and safe in here, surrounded by the
sloshing noises of virus-killing liquids and the hiss of air and the ruffling
sensation across his back as the chemical played over his suit. He fell asleep.
He jerked awake when the final blast of water jets hit him, and he found
himself slumped against the wall of the air lock, his hands still gripped
around the pipes. If it hadn't been for that last jet of water, he would not
have woken up. He would have slid down the wall and curled up in the
corner of the air lock, and probably would have stayed there all night, sound
asleep, while the cool, sterile air flowed through his suit and bathed his
body, nude inside its cocoon, at the heart of the Institute.
SPECIALIST RHONDA WILLIAMS was standing in the main corridor of
the monkey house, afraid she would end up in the Slammer. There was no
sound except the roar of air in her helmet. The corridor stretched in both
directions to infinity, strewn with cardboard boxes and trash and monkey
biscuits.
Where were the officers? Where was Colonel Jaax? Where was everybody?
She saw the doors leading to the monkey rooms. Maybe the officers were in
there.
Something was coming down the corridor. It was the loose monkey.
He was running toward her. His eyes were staring at her. Something
glittered in his hand – he was holding a syringe. He waved it at her with
gesture that conveyed passionate revenge. He wanted to give her an
injection. The syringe was hot with an unknown agent. She started to run.
Her space suit slowed her down. She kept running, but the hallway stretched
on forever, and she couldn't reach the end. Where was the door out of here?
There was no door! There was no way out! The monkey bounded toward
her, its terrible eyes fixed on her – and the needle flashed and went into her
suit ... She woke up in her barracks room.
DECON
DECEMBER 7, THURSDAY
NANCY Jaax AWOKE at four o'clock in the morning to the sound of the
telephone ringing. It was her brother, calling from a pay telephone at the
hospital in Wichita. He said that their father was dying. "He's very, very bad,
and he's not going to make it," he said. Their father was in cardiac failure,
and the doctor had been asking if the family wanted him to undertake
extreme lifesaving measures. Nancy thought only briefly about this and told
her brother not to do it. Her father was down to ninety pounds, just skin and
bones, and he was in pain and miserable.
She woke up Jerry and told him that her father would probably die today.
She knew she would have to go home, but should she try home today?
She could arrive in Wichita by afternoon, and he might still be alive.
She might be able to have a last farewell with him. She decided not to fly
home. She felt that she couldn't leave her job in the middle of Reston crisis,
that it would be a dereliction of her post.
The telephone rang again. It was Nancy's father calling from his hospital
room. "Are you coming home, Nancy ?" he asked. He sounded wheezy and
faint.
"I just can't get away right now, Dad. It's my work. I'm in the middle of a
serious outbreak of disease."
"I understand," he said.
"I'll see you at Christmas, Dad."
"I don't think I'll make it that long, but well, you never know."
"I'm sure you will make it."
"I love you, Nancy ."
"I love you, too."
In the blackness before dawn, she and Jerry got dressed, she in her uniform,
he in civilian clothes, and he headed off for the monkey house. Nancy stayed
at home until after the children had awaken up, and she fixed them some
cereal. She sent the children off on the school bus and drove to work. She
went to Colonel C.J. Peters and told him that her father was probably going
to die today.
"Go home, Nancy ," he said.
"I'm not going to do that," she replied.
The dead monkeys began coming in after lunch. A truck would bring them
twice a day from Reston, and the first shipment would end up in Nancy's air
lock while she was suiting up. Usually there would be ten or twelve
monkeys in hatboxes.
The rest of the monkeys that came out of the monkey house – the vast
majority of them, two or three tons' worth – were placed in triple biohazard
bags, and the bags were decontaminated, taken out of the building, and
placed in steel garbage cans. Hazleton employees then drove them to an
incinerator owned by the company, where the monkeys were burned at a
high temperature, high enough to guarantee the destruction of Ebola
organisms.
Some of the monkeys had to be examined, however, to see if and where the
virus was spreading inside the building. Nancy would carry the hatboxes
into suite AA-5 and work on the monkeys until after midnight with her
partner and a civilian assistant. They hardly spoke to one another, except to
point to a tool or a sign of disease in a monkey.
Thoughts about her father and her childhood came to Nancy that day. Years
earlier, as a girl, she had helped him during plowing season, driving his
tractor from afternoon until late at night. Moving at a pace not much faster
than a mule, it plowed furrows along a strip of land a half a mile long. She
wore cutoff shorts and sandals. It was loud and hot on the tractor, and in the
emptiness of Kansas she thought about nothing, drowned in the roar of the
engine as the sun edged down to the horizon and the land grew dark and the
moon appeared and climbed high. At ten o'clock her father would take over
and plow for the rest of the night, and she would go to bed. At sunrise, he
would wake her up, and she would get back on the tractor and keep on
plowing.
"SPONGE," she mouthed to her buddy.
He mopped up some blood from the monkey, and Nancy rinsed her gloves
in the pan of green EnviroChem.
Her father died that day, while Nancy worked in the hot suite.
She flew home to Kansas and arrived by taxi on Saturday morning at her
family's plot at a graveyard in Wichita just as the funeral service began.
It was a cold, rainy day, and a tiny knot of people holding umbrellas huddled
around a preacher by a stone wall and a hole in the earth.
Lieutenant Colonel Nancy Jaax moved forward to see more clearly, and her
eyes rested on something that she had not quite anticipated. It was a flag
draped over the casket. He had been a veteran, after all. The sight broke her
down, and she burst into tears.
AT FOUR O'CLOCK in the afternoon, Thursday, December 7, the last
monkey was killed and bagged, and people began deconning out. They had a
bad time trying to catch the little monkey that had escaped; it took hours.
Jerry Jaax had entered the room where it was hiding and spent two or three
hours chasing it in circles with a net. Finally the monkey got itself jammed
down in a crack behind a cage with its tail sticking out, and Sergeant Amen
hit the tail with a massive dose of anesthetic. In about fifteen minutes, the
monkey became still, and they dragged it out, and it went the way of the
other monkeys, carried along in the flow of material.
They radioed Gene Johnson to tell him that the last monkey was dead. He
told Sergeant Klages to explore the building, to make sure that there were no
more live monkeys in any rooms. Klages discovered a chest freezer in a
storage room. It looked sinister, and he radioed to Johnson:
"GENE, I'VE GOT A FREEZER HERE."
"Check it out," Johnson replied.
Sergeant Klages lifted the lid. He found himself staring into the eyes of
frozen monkeys. They were sitting in clear plastic bags. Their bodies
streamed with blood icicles. They were monkeys from Room F, the original
hot spot of the outbreak, some of monkeys that had been sacrificed by Dan
Dalgard. He shut the lid and called Johnson on the radio:
"GENE, YOU'RE NOT GOING TO BELIEVE WHAT I'VE FOUND IN
THIS FREEZER. I'VE GOT TEN OR FIFTEEN MONKEYS."
"Aw, shit, Klages!"
"WHAT SHOULD I DO WITH THEM?"
"I don't want any more problems with monkeys? No more samples!
Decon them!"
"I ALSO FOUND SOME VIALS OF SEDATIVE."
"Decon it, baby! You don't know if any dirty needles have been stuck in
those bottles. Everything comes out of this building!
Everything comes out!"
Sergeant Klages and a civilian, Merhl Gibson, dragged the bags out of the
freezer. They tried to cram the monkeys into the hatboxes but they didn't fit. They were twisted into bizarre shapes. They left them in the hallway to
thaw. The decon teams would deal with them tomorrow.
The 91-Tangos shuffled out through the air-lock corridor, two by two, numb
and tired beyond feeling, soaked with sweat and continual fear.
They had collected a total of thirty-five hundred clinical samples. They
didn't want to talk about the operation with each other or with their officers.
When the team members left Fort Detrick, they noticed that Gene Johnson
was sitting on the grass under the tree in front of the building.
He didn't want talk to anyone, and they were afraid to talk to him. He looked
terrible. His mind was a million miles away, in the devastated zone inside
the building. He kept going over and over what the kids had done. If the guy
has the needle in his right hand, you stand on his left.
You pin the monkey's arms behind so it can't turn around and bite you.
Did anyone cut a finger? So far, it looked as if all the kids had made it.
The decon team suited up immediately while the soldiers were coming out
of the building. It was now after dark, but Gene Johnson feared Ebola so
much that he did not want to let the building sit untouched overnight.
The decon team was led by Merhl Gibson. He put on a space suit and
explored the building to get a sense of what needed to be done. The rooms
and halls were bloodstained and stewn with medical packaging.
Monkey biscuits lay everywhere and crunched underfoot. Monkey feces lay
in loops on the floor and was squiggled in lines across the walls and printed
in the shapes of small hands. He had a brush and a bucket of bleach, and he
tried to scrub a wall.
Then he called Gene on the radio,
"GENE, THE SHIT IN HERE IS LIKE
CEMENT, IT WON'T COME OFF."
"You do what's best. Our orders are to clean this place up."
"WE'LL TRY TO CHIP IT OFF," Gibson said.
The next day, they went to a hardware store and bought putty knives and
steel spatulas, and the decon team went to work chipping the walls and floor.
They almost suffocated from the heat inside their suits.
Milton Frantig, the man who had thrown up on the lawn, had now been kept
in isolation at Fairfax Hospital for several days. He was feeling much better,
his fever had vanished, he had not developed any nosebleeds, and he was
getting restless. Apparently he did not have Ebola. At any rate, it did not
show up in his blood tests. Apparently he had a mild case of flu. The C.D.C.
eventually told him he could go home.
BY DAY NINETEEN after the whiffing incident, when they hadn't had any
bloody noses, Peter Jahrling and Tom Geisbert began to regard themselves
as definite survivors. The fact that Dan Dalgard and the monkey workers
had so far shown no signs of breaking with Ebola also reassured them,
although it was very puzzling. What on earth was going on with this virus?
It killed monkeys like flies, they were dripping virus from every pore, yet no
human being had crashed. If the virus wasn't Ebola Zaire, what was it? And
where had it come from? Jahrling believed that it must have come from
Africa. After all, Nurse Mayinga's blood reacted to it.
Therefore, it must be closely related to Ebola Zaire. It was behaving like the
fictional Andromeda strain. Just when we thought the world was coming to
an end, the virus slipped away, and we survived.
The Centers for Disease Control focused its efforts on trying to trace the
source of the virus, and the trail eventually led back to the Ferlite Farms
monkey-storage facility near Manila. All of the Reston monkeys had come
from there. The place was a way station on their trip from the forests of
Mindanao to Washington. Investigators found that monkeys had been dying
in large numbers there, too. But it looked as though no Philippine monkey
workers had become sick either. If it was an African virus, what was it doing
in the Philippines? And why weren't monkey handlers dying? Yet the virus
was able to destroy a monkey.
Something very strange was going on here. Nature had seemed to be closing
in on us for a kill, when she suddenly turned her face away and smiled.
It was a Mona Lisa smile, the meaning of which no one could figure out.
DECEMBER 18, MONDAY
THE DECON TEAM scrubbed the building with bleach until they took the
paint off the concrete floors, and still they kept scrubbing. When they were
satisfied that all the building's inside surfaces had been scoured, they move
on to the final stage, the gas. The decon team taped the exterior doors,
windows, and vents of the building with silver duct tape. They taped sheets
of plastic over the exterior openings of the ventilation system. They made
the building airtight. At various places inside the monkey house, they set out
patches of paper saturated with spores of a harmless bacterium known as
Bacillus Subtilis Niger will kill almost anything.
The decon team brought thirty-nine Sunbeam electric frying pans to the
monkey house. Sunbeam electric frying pans are the Army's tool of choice
for a decon job. The team laid an electric cable along the floor throughout
the building, strung with outlets, like a cord for Christmas-tree lights. At
points along the cable, they plugged in the Sunbeam frying pans. They wired
the cable to a master switch. Into each Sunbeam frying pan they dropped a
handful of disinfecting crystals. The crystals were white and resembled salt.
They dialed the pans to high. At 1800 hours on December 18, someone
threw the master switch, and the Sunbeams began to cook. The crystals
boiled away, releasing formaldehyde gas. Since the building's doors,
windows, and vents were taped shut, the gas had nowhere to go, and it
stayed inside the building for three days.
The gas penetrated the air ducts, soaked the offices, got into drawers in the
desks, and got inside pencil sharpeners in the drawers. It infiltrated Xerox
machines and worked its way inside personal computers and inside the
cushions of chairs and fingered down into the floor drains until it touched
pools of lingering bleach in the water traps. Finally the decon team, still
wearing space suits, went back inside the building and collect the spore
samples. The Sunbeam treatment had killed the Niger.
There is an old piece of wisdom in biohazard work that goes like this: you
can never know when life is exterminated. Life will survive almost any blitz.
Total, unequivocal sterilization is extremely difficult to achieve in practice
and is almost impossible to verify afterward.
However, a Sunbeam cookout that lasts for three days and exterminates all
samples of Niger implies success. The monkey house had been sterilized.
Ebola had met opposition. For a short while, until life could re-establish
itself there, the Reston Primate Quarantine Unit was the only building in the
world where nothing lived, nothing at all.
THE MOST DANGEROUS STRAIN
1990 JANUARY
THE STRAIN OF Ebola virus that had erupted near Washington went into
hiding somewhere in the rain forest. The cycling went on. The cycling must
always go on if the virus is to maintain its existence. The Army, having
certified that the monkey house had been nuked, returned to the possession
of Hazleton Research Products. Hazleton began buying more monkeys from
the Philippines, from the same monkey house near Manila, and restocked the
building with crab-eating monkeys that had been trapped in the rain forests
of Mindanao. Less than a month later, in the middle of January, some of the
monkeys in Room C began dying with bloody noses. Dan Dalgard called
Peter Jahrling. "Looks like we're affected again," he said.
The virus was Ebola. It had come from the Philippines. This time, since
there had been no human casualties during the first outbreak, the Army, the
C.D.C., and Hazleton jointly decided to isolate the monkeys – leave them
alone and let the virus burn. Dan Dalgard hoped to save at least some of the
monkeys, and his company did not want the Army to come back with space
suits.
What happened in that building was a kind of experiment. Now they would
see what Ebola could do naturally in a population of monkeys living in a
confined air space, in a kind of city, as it were. The Ebola Reston virus
jumped quickly from room to room, and as it blossomed in the monkeys, it
seemed to mutate spontaneously into something that looked quite a lot like
the common cold. But it was an Ebola cold. The monkeys died with great
quantities of clear mucus and green mucus running from their nose, mixed
with blood that would not clot. Their lungs were destroyed, rotten and
swimming with Ebola virus. They had pneumonia.
When a single animal with a nosebleed showed up in a room, generally 80
percent of the animals died in that room shortly afterward. The virus was
extraordinarily infective in monkeys. The Institute scientists suspected that
they were seeing a mutant strain of Ebola, something new and a little
different from what they had seen just a month before, in December, when
the Army had nuked the monkey house. It was frightening – it was as if
Ebola could change its character fast. As if a different strain could appear in
a month's time. The clinical symptoms of the disease served as a reminder of
the fact that Ebola is related to certain kind of colds seen in human children.
It seemed that the virus could adapt quickly to new host, and that it could
change its character rapidly as it entered a new population. Ebola apparently
drifted through the building's air-handling ducts.
By January 24, it had entered Room B, and monkeys in that room started
going into shock and dying with runny noses, red eyes, and mask like
expressions on their faces. In the following weeks, the infection entered
Room I,F,E, and D, and the animals in these rooms virtually all died.
Then, in mid-February, a Hazleton animal caretaker who will be called John
Coleus was performing a necropsy on a dead monkey when he cut his thumb
with a scalpel. He had been slicing apart the liver, one of the favorite nesting
sites of Ebola. The scalpel blade, smeared with liver cells and blood, went
deep into this thumb. He had had a major exposure to Ebola.
The liver that he had been cutting was rushed to USAMRIID for analysis.
Tom Geisbert looked at a piece of it under his microscope and, to his
dismay, found that it was "incredibly hot – I mean, wall to wall with virus."
Everyone at the Institute thought John Coleus was going to die.
"Around here," Peter Jahrling told me, "we were frankly fearful that this guy
had bought the farm." The C.D.C. decided not to put him into isolation. So
Coleus visited bars and drank beer with his friends.
"Here at the Institute," Peter Jahrling said, "we were absolutely appalled
when that guy went out to bars, drinking. Clearly the C.D.C. should not have
let that happen. This was a serious virus and a serious situation. We don't
know a whole lot about the virus. It could be like the common cold – it
could have a latency period when you are shedding virus before you develop
symptoms – and by the time you know you are sick, you might have infected sixteen people. There's an awful lot we don't know about this virus. We don't
know where it came from, and we don't know what form it will take when it
appears next time."
John Coleus had a minor medical condition that required surgery.
Doctors performed the operation while he was in the incubation period after
his exposure to Ebola. There is no record indicating that he bled excessively
during the surgery. He came through fine, and he is alive today, with no ill
effects from his exposure.
AS FOR THE MONKEY HOUSE, the entire building died. The Army didn't
have to nuke it. It was nuked by the Ebola Reston virus. Once again, there
were no human casualties. However, something eerie and perhaps sinister
occurred. A total of four men had worked as caretakers in the monkey
house: Jarvis Purdy, who had a heart attack; Milton Frantig, who had thrown
up on the lawn; John Coleus, who had cut his thumb; and a fourth man. All
four men eventually tested positive for Ebola Reston virus. They had all
been infected with the agent. The virus had entered their bloodstreams and
multiplied in their cells. Ebola proliferated in their bodies. It cycled in them.
It carried on its life inside the monkey workers. But it did not make them
sick, even while it multiplied inside them. If they had headaches or felt ill,
none of them could recall it. Eventually the virus cleared from their systems
naturally, disappeared from the blood, and as of this writing none of the men
was affected by it. They are among the very, very few human survivors of
Ebola virus. John Coleus certainly caught the virus when he cut himself with
a bloody scalpel, no question about that. What is more worrisome is that the
others had not cut themselves, yet the virus entered their bloodstreams. It got
there somehow. Most likely it entered their blood thought contact with the
lungs. It infected them through the air. When it became apparent to the
Army researchers that three of the four men who became infected had not
cut themselves, just about everyone at USAMRIID concluded that Ebola can
spread through the air.
Dr. Philip Russell – the general who made the decision to send in the Army
to stop the virus – recently said to me that although he had been "scared to
death" about Ebola at the time, it wasn't until afterward, when he understood
that the virus was spreading in the air among the monkeys, that the true
potential for disaster sank in for him. "I was more frightened in retrospect," he said. "When I saw the respiratory evidence coming from those monkeys,
I said to myself, My God, with certain kinds of small changes, this virus
could become one that travels in rapid respiratory transmission through
humans. I'm talking about the Black Death. Imagine a virus with the
infectiousness of influenza and the mortality rate of black plague in the
Middle Ages – that's what we're talking about."
The workers at Reston had symptomless Ebola virus. Why didn't it kill
them? To this day, no one knows the answer to that question.
Symptomless Ebola – the men had been infected with something like an
Ebola cold. A tiny difference in the virus's genetic code, probably resulting
in a small structural change in the shape of one of the seven mysterious
proteins in the virus particle, had apparently changed its effect tremendously
in humans, rendering it mild or harmless even though it had destroyed the
monkeys. This strain of Ebola knew the difference between a monkey and a
person. And if it should mutate in some other direction...
ONE DAY IN spring, I went to visit Colonel Nancy Jaax, to interview her
about her work during the Reston event. We talked in her office. She wore a
black military sweater with silver eagles on the shoulder boards – she had
recently made full colonel. A baby parrot slept in a box in the corner. The
parrot woke up and squeaked.
"Are you hungry?" she asked it. "Yeah, yeah, I know." She pulled a turkey
baster out of a bag and loaded it with parrot mush. She stuck the baster into
the parrot's beak and squeezed the baster bulb, and the parrot closed it eyes
with satisfaction.
She waved her hand at some filing cabinets. "Want to look at some Ebola?
Take your pick."
"You show me."
She searched through a cabinet and removed a handful of glass slides, and
carried them into another room, where a microscope sat on a table. It had
two sets of eyepieces so that two people could look into it at the same time.
I sat down and stared in the microscope, into white nothingness.
"Okay, here's a good one," she said, and placed a slide under the lens.
I saw a field of cells. Here and there, pockets of cells had burst and
liquefied.
"That's male reproductive tissue," she said. "It's heavily infected. This is
Ebola Zaire in a monkey that we exposed through the lungs in 1986, in the
study that Gene Johnson and I did."
Looking at the slice of monkey testicle, I got an unpleasant sensation. "You
mean, it got into the monkey's lungs and moved to its – ?"
"Yeah. it's pretty yucky," she said. "Now I'm going to make you dizzy. I'm
going to show you the lung."
The scene shifted, and we were looking at rotted pink Belgian lace.
"This is a slice of lung tissue. A monkey that was exposed through the lungs.
See how the virus bubbles up in the lungs? It's Ebola Zaire."
I could see individual cells, and some of them were swollen with dark
specks.
"We'll go to higher magnification."
The cells got bigger. The dark specks became angular, shadowy blobs. The
blobs were bursting out of the cells, like something hatching.
"Those are big, fat bricks," she said.
They were Ebola crystalloids bursting out of the lungs. The lungs were
popping Ebola directly into the air. My scalp crawled and I felt suddenly like
a civilian who had seen something that maybe civilians should not see.
"These lungs are very hot," she said in a matter-of-face voice.
"You see those bricks budding directly into the air spaces of the lung?
When you cough, this stuff comes up your throat in your sputum. That's why
you don't want someone who has Ebola coughing in your face."
"My God, it knows all about lungs, doesn't it?"
"Maybe not. It might live in an insect, and insects don't have lungs. But you
see here how Ebola has adapted to this lung. It's budding out of the lung,
right straight into the air."
"We're looking at a highly sophisticated organism, aren't we?"
"You're absolutely right. This hummer has an established life cycle. You get
into what-if? game. What if it got into human lungs? If it mutates, it could
be a problem. A big problem."
IN MARCH 1990, while the second outbreak at Reston was happening, the
C.D.C. slapped a heavy set of restrictions on monkey importers, tightening
the testing and quarantine procedures. The C.D.C. also temporarily revoked
the license of three companies, Hazleton Research Products, the Charles
River Primates Corporation, and Worldwide Primates, charging these
companies with violations of quarantine rules. Their licenses were later
reinstated. The C.D.C.'s action effectively stopped the importation of
monkeys into the United States for several months. The total loss to
Hazleton ran into the millions of dollars. Monkeys are worth money.
Despite the C.D.C.'s action against Hazleton, scientists at USAMRIID, and
even some at the C.D.C., gave Dalgard and his company high praise for
making the decision to hand over the monkey facility to the Army. "It was
hard for Hazleton, but they did the right thing," Peter Jahrling said to me,
summing up the general opinion of the experts.
Hazleton had been renting the monkey house from a commercial landlord.
Not surprisingly, relations between the landlord and Hazleton did not
flourish happily during the Army operation and the second Ebola outbreak.
The company vacated the building afterward, and to this day it stands empty.
Peter Jahrling, a whiffer of Ebola who lived to tell about it, is now the
principal scientist at USAMRIID. He and Tom Geisbert, following tradition
in the naming of new viruses, named the strain they had discovered Reston,
after the place where it was first noticed. In conversation, they sometimes
refer to it casually as Ebola Reston. One day in his office, Jahrling showed
me a photograph of some Ebola-virus particles. They resembled noodles that
had been cooked al dente. "Look at this honker. Look at this long sucker
here," Jahrling said, his finger tracing a loop. "It's Reston – oh, I was about
to say it's Reston, but it isn't – it's Zaire. The point is, you can't easily tell the difference between the two strains by looking. It brings you back to a
philosophical question: Why is the Zaire suffer hot for humans? Why isn't
Reston hot for humans, when the strains are so close to each other? The
Ebola Reston virus is almost certainly transmitted by some airborne route.
Those Hazleton workers who had the virus – I'm pretty sure they got it
through the air."
"Did we dodge a bullet?"
"I don't think we did," Jahrling said. "The bullet hit us. We were just lucky
that the bullet we took was a rubber bullet from a twenty-two rather than a
dumdum bullet from a forty-five. My concern is that people are saying,
"Whew, we dodged a bullet.' And the next time they see Ebola in a
microscope, they'll say, 'Aw, it's just Reston,' and they'll take it outside a
containment facility. And we'll get whacked in the forehead when the stuff
turns out not to be Reston but its big sister."
C.J. PETERS EVENTUALLY left the Army to become the chief of the
Special Pathogen Branch at the Centers for Disease Control. Looking back
on the Reston event, he said to me one day that was pretty sure Ebola had
spread through the air, "I think the pattern of spread that we saw, and the
fact that it spread to new rooms, suggest that Ebola aerosols were being
generated and were present in the building," he said. "If you look at pictures
of lungs from a monkey with Ebola Zaire, you see that the lungs are fogged
with Ebola. Have you seen those pictures?"
"Yes, Nancy Jaax showed them to me."
"Then you know. You can see Ebola particles clearly in the air spaces of the
lung."
"Did you ever try to see if you could put Ebola Reston into the air and
spread it among monkeys that way?" I asked.
"No," he replied firmly. "I just didn't think that was a good idea. If anybody
had found out that the Army was doing experiments to see if the Ebola virus
had adapted to spreading in the respiratory tract, we would have been
accused of doing offensive biological warfare – trying to create a doomsday
germ. So we elected not to follow it up."
"That means you don't really know if Ebola spreads in the air."
"That's right. We don't know. You have to wonder if Ebola virus can do that
or not. If it can, that's about the worst thing you can imagine."
SO THE THREE sisters – Marburg, Ebola Sudan, and Ebola Zaire – have
been joined by a fourth sister, Reston. A group of researchers at the Special
Pathogens Branch of the C.D.C. – principally Antony Sanchez and Heinz
Feldmann – have picked apart the genes of all the filoviruses. They
discovered that Zaire and Reston are so much alike that it's hard to say how
they are different. When I met Anthony Sanchez and asked him about it, he
said to me, "I call them kissing cousins. But I can't put my finger on why
Reston apparently doesn't make us sick. Personally, I wouldn't feel
comfortable handling it without a suit and maximum containment
procedures." Each virus contains seven proteins, four of which are
completely unknown. Something slightly different about one of the Reston
proteins is a probably the reason the virus didn't go off in Washington like a
bonfire. The Army and C.D.C have never downgraded the safety status of
Reston virus. It seems classified as a Level 4 hot agent, and if you want to
shake hands with it, you had better wearing a space suit. Safety experts feel
that there is not enough evidence, yet, to show that the Reston strain is not
an extremely dangerous virus. It may be, in fact, the most dangerous of all
the filovirus sisters, because of its seeming ability to travel rather easily
through the air, perhaps more easily than the others. A tiny change in its
genetic code, and it might turn into a cough and take out the human race.
Why is the Reston virus so much like Ebola Zaire, when Reston supposedly
comes from Asia? If the strains come from different continents, they should
be quite different from each other. One possibility is that the Reston strain
originated in Africa and flew to the Philippines on an airplane not long ago.
In other words, Ebola has already entered the net and has been traveling
lately. The experts do not doubt that a virus can hop around the world in a
matters of days. Perhaps Ebola came out of Africa and landed in Asia a few
years back.
Perhaps – this is only a guess – Ebola traveled to Asia inside wild African
animals. There have been rumors that rain forest have been importing
African animals illegally, releasing them into the Philippine jungle, and
hunting them. If Ebola lives in African game animals – in leopards or lions or in Cape buffalo – it might have traveled to Philippines that way. This is
only a guess. Like all the other thread virus, Ebola Reston hides in a secret
place. It seems quite likely, however, that the enter Reston outbreak started
with a single monkey in the Philippines. One sick monkey. That monkey
was the unknown index case. One monkey started the whole thing. That
monkey perhaps picked up four or five particles of Ebola that came
from...anyone's guess.
source
https://ia801202.us.archive.org/24/items/THEHOTZONE/THE_HOT_ZONE_Richard_Preston.pdf
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