Chapter 18. News
The phone rang a few times before an African woman answered:
"Kigoma Baptist Missionary Hospital." Fortunately for Graciano, the people of Tanzania spoke either Swahili or English, and this woman obviously knew English. Graciano was fluent in English, so there would be no language barrier today.
"Dr. Beladar, please."
"One minute, please." A few minutes later, a voice answered on the other line.
"Dr. Beladar speaking."
"Dr. Beladar, we spoke last week. This is Matteo Graciano with the Insituto Nationale in Rome."
"Have you gotten the results yet?"
"Yes, I have, Doctor. Doctor, are you in a private place right now?"
"Not really. If you like, I can call you direct from my office."
"Yes, please do. You can reverse the charges if you like."
"Very well." Dr. Beladar hung up, terrified by the tone of the Italian scientist's voice. Dr. Beladar had delivered bad news to patients before. When you asked a patient to go to a private place to talk, it was invariably very bad news.
His hand trembled as he dialed the international number.
"Dr. Graciano."
"Yes, this is Dr. Beladar, calling from my office. What is the news?"
"First, Doctor, I need to tell you that this matter needs to be kept in the strictest of confidence. Can I count on you?"
"Yes, of course."
"Dr. Beladar, before I tell you what we found, I need to know if you have told anyone else about this?"
"No. Other than my nurse, you were my only call."
"Have you sent samples to anyone but our lab?"
"No, just the lab in Rome." Graciano was happy with the answer.
"OK, doctor, I believe your initial suspicions may have been correct. We may be dealing with a hemorrhagic illness, possibly a filovirus. But the chemical construction of this virus is very new. I will need you to send some additional samples to the Americans."
Dr. Beladar's hands began shaking when he heard "filovirus." He knew what that meant.
"Filovirus? You mean like Ebola?"
"Probably something like that, but I must stress that it is too early to tell."
Dr. Beladar's hands began to shake, and he felt faint. He knew very well that Ebola had an extremely high fatality rate. The blood from the boy's anus had washed all over him. And Marietta had received a bucket full of black vomit all over her body. They were clearly exposed to the virus and most likely infected.
There was a few seconds of silence. Graciano worried that he had lost the connection.
"Dr. Beladar, are you there?" asked Graciano.
"Yes, I am sorry. I am just shocked and terrified, quite frankly. That is terrible news. Are you absolutely sure?"
"We need to run more tests. The CDC has a special, brand new Level 4 Pathogen gene sequencing laboratory in Mexico. I will need you to send additional blood and tissue samples to them. Send me samples from the two boys, the parents, the uncle, you, your nurse, and anyone else you suspect may be infected. If you do not know, err on the side of sending the sample. In the meantime, I am assembling a team right now and we will be on the ground in Tanzania tomorrow to talk with you personally."
"OK, what is the address for the CDC lab in Mexico?"
"Address it to: CDC, Camino de Canario No. 5823, Undécimo Piso, Col. Polanco, Mexico City, 11560, Mexico."
Dr. Beladar wrote down the address.
"Dr. Graciano, is there any cure for Ebola?" asked Beladar.
"Yes, there may be. Until recently, there had been no known cure for Ebola. However, a research firm in America called AVI Biopharm has had some incredible success with a new drug called AVI-6002. In their tests with monkeys, the drug has had a 75% cure rate. The FDA has just licensed additional trials of the drug. We may be able to fly some samples of the drug to you from AVI and see if it works. But I need to know how many people have possibly been infected. You think the disease started with these boys, correct?"
"Yes, we are almost sure of it. They were bitten by a swarm of bats in a cave here, and about seven days after that, their symptoms began. They live in a very small village out in the forest, only thirty or so people, very secluded. The parents brought the boys to the hospital. I do not believe they have had contact with anyone else other than the people in their village and possibly people at our hospital. We kept them in the hospital, but their symptoms quickly got worse. As you know, they have both died. Both of the boys' parents and their uncle are now at the hospital with similar symptoms, and we think they will succumb soon."
"Is there anyone else that you know of who has symptoms?"
"A nurse and I took care of the boys when they arrived, and one of the boys aspirated bloody, hot black vomit all over the nurse. Some vomit sprayed in her face. I had my hands in blood which had ejected from the boy's anus. We do not have symptoms yet."
"What is the nurse's name?"
"Nurse Marietta Gondube. She is here at the hospital today."
"How many other nurses or hospital personnel helped treat the boys?"
"Just us two. Almost immediately, when I saw the boys' bright red bulging eyes, yellowish skin, red starlike face speckles, massive heaves of black, bloody vomit, and a fever of 104 degrees, I began to suspect a hemorrhagic fever. I quarantined them in a separate room about an hour after they arrived, and only allowed in the parents, and later when he arrived, the uncle. I instructed the hospital staff that only myself and Nurse Gondube were to be allowed in the room to treat them. Then, when the boys died, I sent those tissue samples and blood samples off to you. And Nurse Gondube and myself have not treated any other patients at the hospital since this started. I instructed another nurse to treat the other patients. So we believe our barrier nursing protocols were quite effective."
"That was quick thinking, Dr. Beladar. What is the status of the parents and the uncle?"
"Their eyes are all bright red, they have high fevers. Their faces are covered in purple blotches. They vomit frequently. The uncle looks like he is about a day behind the parents in terms of symptoms. I feel like they are going to die very soon. We are just trying to keep them comfortable. We tried antibiotics, but that had no effect."
"Dr. Beladar, have you or Nurse Gondube had any contact with anyone else since you first saw the boys?"
"Dr. Graciano, you should know that Nurse Gondube is my girlfriend. We live together by ourselves. We have no children. We have no pets. And since this all occurred, the only place we have been is our house and the hospital. We have not gone to the market. We have not gone into town. Frankly, we have been too terrified to go anywhere. We have spent most of our time on the Internet, trying to figure out what this thing is. That's how we found you."
"Have any patients been discharged since the boys came into the hospital?"
"Um, I do not know. I will have to ask Nurse Gondube."
"OK, that is enough information for now. I am getting on a plane tonight and will be at your hospital in the morning. Here is what I want you to do. None of those patients gets discharged until I give the OK. No family members are to be allowed into the hospital until I give the OK. Make up whatever you have to, but do not tell them this is a hemorrhagic virus or you will have a massive panic on your hands. I need you continue to stay away from the other hospital staff and patients. I need you to call a meeting of the entire hospital staff tomorrow morning at 9 a.m. Everyone must attend. No exceptions. I will give them instructions when I get there. In the meantime, I want you and Nurse Gondube to remain at the hospital. Do not go back to your house. Do not go to the market. Do not go anywhere or you will risk spreading this thing. And Doctor, whatever you do, do not call anyone outside the hospital on your telephone. This must be absolutely confidential. I will make the necessary contacts with the CDC and so on. Make sure you get those samples out to Mexico today. In the meantime, I will contact AVI about getting you some of the AVI-6002, and I will contact you sometime late tonight from the air when my team is airborne. OK?"
"Yes, that sounds fine. Doctor, how quickly do you think we could get the drug?"
"I do not know. All I can tell you is that we will move heaven and earth to get it there for you in time."
"Very well. I will see you later. Oh, Dr. Graciano, one more thing."
"Yes?"
"What should we do with the bat?"
"The bat?"
"Yes, the father brought in a cage with the bat that bit his son. It is here at the hospital."
Graciano thought about the ramifications of that new discovery.
"Dr. Beladar, whatever you do, do not lose that bat!"
Dr. Matteo Graciano hung up the phone, grabbed his briefcase, and went downstairs to the break room. Two of his lanky research subordinates, Guido Macchione and Antonio Paciello, were huddled around the coffee machine. Graciano stuck his head in the doorway.
"Guido! Antonio! You have thirty minutes to get your RACAL Fieldsuits and your HAZMAT gear and meet me at the airfield. We have a Hot Level 4 Filovirus in the Field! We are flying to Africa tonight! Do not tell ANYONE, not even your wives, where you are going. We'll be gone for three or four days probably. Don't forget your duct tape!"