Chapter 16. Worms
The next morning, Graciano woke at 7:00 a.m. on the floor of his office. He was cold, and had muscle aches on his right flank where he had slept on the hard floor. Graciano went back to the room with the flasks and looked at the solution. The solution did not look right. It was the color of milk. Many of the cells looked blown away and destroyed beyond recognition. There were small black dots like pepper in the mix that he did not immediately recognize. He extracted small clumps of cells from the bottom of the flasks, placing them each in tiny green plastic plugs. Graciano took the plugs to the Crewe SF-7, the latest, most state-of-the-art electron microscope in the world, with margins of error less than 50 millionths of an inch.
Wearing blue surgical scrubs, surgical cap, two sets of rubber gloves duct-taped to his scrubs, and a surgical mask, Matteo Graciano carefully removed from the glass case the tiny dot of human spleen cells taken from the younger Tanzanian boy, marked TZ-2. The collection of cells was the size of a period at the end of a sentence and was embedded in a small piece of green plastic. He removed from a locked container the one-inch long, razor-sharp, diamond-tipped cutting knife and inserted it into the large cutting machine, being careful not to touch the tip with his fingers. This instrument had the sharpest cutting surface of any instrument on the planet, and could cut through a finger as easily as a chain saw through butter. The diamond knife was pivoted like a pendulum back and forth by the cutting machine, acting like a supermarket roast beef slicer, slicing the dot of cells into a myriad of tiny circular pieces. Each newly cut slice of cells landed atop a small water droplet. When Graciano was finished cutting the slices, he took a small wooden stick, which had a woman's eyelash glued to the tip. Using the eyelash, and fixing his brown eyes through the lenses of the microscope, he gently separated the clumped cell slices on the water's surface, spreading them out across the pond in his view scope. Next, again peering through the microscope, he slid under each sliced batch of cells a tiny piece of copper mesh, catching the slice like a ladle picking up soup. Using a pair of tweezers, he then inserted the copper mesh into a small box, which he placed into the fitting arm for the eight foot-tall, two-ton electron microscope. Locking the arm in place, Graciano turned on the machine, which hummed rhythmically. In the center of the machine was a viewing screen, which emitted a green light. Graciano's soft brown eyes, tucked under a curl of wavy black hair, peered into the viewing screen. He scanned across the tiny world which now flew up at him from the viewing screen. Looking through the view scope of the electron microscope always reminded Graciano of Dr. Seuss' story, Horton Hears a Who --a tiny world similar to our own, with all its complexities, resting just under the wisps of clouds on a tiny dust speck. Seeing this world inside a world always amazed Graciano and filled him with awe for the beauty of creation. He scanned across the landscape of cells and pieces of cells, looking at nuclei, mitochondria and organelles. As he focused on different parts of the screen, he saw a group of cells that had been blown to bits. He zoomed in the magnification on the group of destroyed cells.
He heart caught in his throat when he saw what was inside the remnants of these cells. Worms. Lots of worms. Like maggot worms crawling over rotten beef. There was only one type of virus in the world that looked like that.
The thirty-five year old scientist pulled out his head from the scope quickly, breathing in heaves, and repressing a gag reflex. He ran from the electron microscope down the hall to his desk and pulled out his Microbiology Textbook. He quickly scanned to the page on Filoviruses. There were two pages of the wormy viruses. Each looked like a small thread with a pinhole or circle at the top. He put his finger in the page and ran with the book back down the hall. He went back to his chair in front of the viewing scope, looking first at his textbook and then at the scope. It was a filovirus all right. Judging from his prior tests, it must be something new, something very similar to Ebola Zaire. Ebola Zaire had a 90% fatality rate. But the one thing about Ebola Zaire that you could count on was that it was not an airborne virus. You could only contract the disease by having contact with blood, bodily secretions, vomit, possibly saliva. But it did not fly through the air. Then Graciano got a terrible thought. This thing was new. What if it was airborne? He backed his chair away from the microscope. He felt his head for a fever. That was stupid, he thought to himself. The incubation period for a filovirus was usually something like ten days. He would not have anything yet. How had he handled the samples? He thought back. Yes, he had worn two sets of gloves and a mask the entire time he was near the samples. He had not put his nose into the flask to smell it. Even if it was airborne, he should be okay. God, what if he was infected?
He hit the button on the side of the machine, and a few minutes later, 8x10 glossy photographs slid out of the machine into a rack. He held up the photographs and looked at them. It sure looked like Ebola Zaire. He looked back through the viewing screen of the machine, inspecting the specks of pepper he had seen before in the flask. He now realized what these were--"inclusion bodies," or big bricks of virus, like thousands of black carbonated worms packed tightly in a soda can, ready to explode the minute the tab top was released. Graciano removed the small box from the electron microscope, put it in a sealed biohazard bag, and went back down the hall. He needed to compare the Tanzanian boy's blood with known copies of existing versions of Ebola. Then he could be sure this was something new. But that would require a trip into the Hot Zone.
At the end of the hall of concrete, non-descript walls was the Level 4 changing room. He put his clothes and underwear in a locker. He went to a sink and re-scrubbed, like a surgeon going in for an operation. He put on a new set of surgical scrubs, tying the pants at the waist. Graciano opened a door into a second room, which contained a shower area. The entire room was bathed in blue ultraviolet light. He noted the time on the wall and proceeded into a third room, which contained his orange biohazard space suit. First he applied baby powder to his hands, and put on two pairs of latex rubber gloves. Then he taped his gloves to the sleeve of his scrubs and his scrub pants to his socks. Removing the Chemturion space suit from the hanger, he put his feet and then his arms in, finally closing the tall face helmet over his head. As the space suit sealed over his body with a zip sound, his air was cut off and his helmet fogged up. But Graciano did not panic. He had done this hundreds of times before. He calmly took the coiled yellow air hose from the wall and plugged it into his suit, which pumped in clean, wonderful oxygen. He could breathe again. Then he took a pair of big yellow rubber rain boots and slid the feet of his space suit into the boots. Properly suited up, he opened the airlock door to the small Decon Room, which contained numerous shower nozzles in the wall and was designed to give a decontamination shower to anyone leaving the Level 4 Suite. Proceeding to the far side, he opened the second airlock door to the Biohazard Level 4 Suite. Once inside, Graciano moved down the hall, walking slowly and making sure that he did not rip his space suit. He had heard horror stories of Level 4 workers ripping their suits, and he was not going to let that happen to him. Proceeding down the hall, he first went to the air-locked wall cabinet which temporarily housed the stoppered flasks of samples which had arrived from Tanzania. He took the flasks and placed them in a room which looked like a walk-in closet. The only thing in the room was a chair, a table, and a microscope. As he walked in the room, he had to disconnect his curled yellow hose from the ceiling, and reconnect with a different yellow hose in the closet. Graciano walked in the closet and left the Tanzanian samples on the table. Then he left the closet, switching back to the first yellow hose. He was now ready to go to the freezer. Graciano approached the Instituto Nationale Level 4 Freezer room, where the most dangerous blood samples in the world were stored. Using his ID card, he scanned his ID, opened the door lock, and, after entering a six digit code, opened the freezer door for the six dangerous frozen blood serum samples--one named "Mayinga" (for a nurse who was infected with Ebola Zaire), one named "Musoke," (for a doctor who was infected with Marburg Virus); one named "Boniface" (for a man who had died from Ebola Sudan); one named "Jibinino" (named for a man who contracted but survived the most recent Ugandan Bundibugyo Ebola strain); one named "Cote" (for the Swiss chimpanzee researcher who contracted but survived the rare Ivory Coast Ebola strain); and one named "Monkey O53" (for a lab monkey shipped from the Philippines to a lab in Reston, Virginia, which had been infected with a strain of filovirus called Reston, a virus which was similar in structure and appearance to Ebola Zaire but which was only lethal to monkeys). He took the six serum samples down to the walk-in closet, again switching air hoses. Closing the door of the closet behind him, he switched on the light. Taking care, he gingerly took a pipette and placed some of the cells taken from the boy in Tanzania onto six glass slides. He applied chemicals so the cells dried on the slide. Then, proceeding carefully, he placed a drop of serum from the Mayinga sample, putting it on the first glass slide over the dried tissue cells. He did the same procedure for the other five blood samples. Then he placed the first slide under the microscope. He turned out the lights, plunging the closet room into darkness. The room was now as pitch black as the heart of a cave. If the Tanzanian boy had been infected with one of these six viruses, there would be a faint greenish glow on the slide. Pressing his face and nose against the glass of the space suit, Graciano peered into the lenses of the microscope. As he looked inside, he switched from slide to slide. He was puzzled by what he saw. The Marburg slide did not glow. The Ebola Sudan slide and the Reston slide did not glow. The Ebola Ivory Coast slide and the Ebola Bundibugyo slide were glowing very faintly. But the Ebola Zaire slide was glowing brightly!
That supported the young scientist's conclusion that the virus was a new strain very similar to Ebola Zaire. The final test could not be done in his lab. The samples' nucleotides had to be sequenced, a process which was similar to determining the virus' "serial number." Instead of numbers, however, this virus would be composed of a combination of four letters: "A" (for adenosine), "C" (for cytosine), "G" (for guanine) and "T" (for thymine). A chemical formula might look like this: AAAGCTTTACCGGTTATGGCGCG... and so on. Each virus had a different serial number, or a different combination of A's, C's, G's and T's. There were DNA Sequencing Labs in Switzerland, California, and England which could easily perform the job quickly. Graciano turned on the light in the Microscope Closet and placed all six Tanzanian samples in the Destruction Unit. The scientist then returned to the air-locked wall storage cabinet and removed all of the flasks, blood tubes and tissue samples which came from Tanzania. He placed all of the material in the Destruction Unit, incinerating them all.
Graciano left the Level 4 Suite, removed his space suit, and took a decon shower, pondering the possibilities as the liquid ran down his body. After he toweled off, he hustled back to the locker room, where he put on his gray T-shirt, jeans, and tennis shoes. He took the photographs of the filovirus from the electron scanner with him and went back to his desk, where he put the photos in his briefcase. He opened a file cabinet drawer marked "Filoviruses" and removed files marked "EHF--General," "Ebola Zaire," "Ebola Sudan," "Ebola Buggy," "Ebola Cote d'Ivoire," "Reston," "2003 Trials," "AVI BioPharma," "AVI-6002," "AVI-6003," "PMOs," and "Antisense Therapies," shoving the files into his briefcase. He opened another file cabinet drawer marked "Africa" and removed a number of maps, including a map of Tanzania, and a Swahili-to-American dictionary, which he put in the briefcase. He clicked the briefcase shut and put it on the floor. Sitting at his desk, Graciano nervously tapped his pen and pulled out the legal pad with the name of the local doctor from Kigoma. He would be delivering some very bad news.