“Well, sir, I am no plow horse!” she roared at him, and slammed her resume on his desk. He reconsidered the matter and allowed her to join the group.
When you begin working with biological agents, the Army starts you in Biosafety Level 2, and then you move up to Level 3. You don’t go into Level 4 until you have a lot of experience, and the Army may never allow you to work there. In order to work in the lower levels, you must have a number of vaccinations. Nancy had vaccinations for yellow fever, Q fever, Rift Valley fever, the VEE, EEE, and WEE complex (brain viruses that live in horses), and tularemia, anthrax and botulism. And, of course, she had a serious of shots for rabies, since she was a veterinarian. Her immune system reacted badly to all the shots; they made her sick. The Army therefore yanked her out of the vaccination program. At this point, Nancy Jaax was essentially washed up. She couldn’t proceed with any kind of work with Level 3 agents, because she couldn’t tolerate the vaccinations. There was only one way she could continue working with dangerous infectious agents. She had to get her assigned to work in a space suit in Level 4 areas. There aren’t any vaccines for Level 4 hot agents. A Level 4 hot agent is a lethal virus for which there is no vaccine and no cure.
Ebola virus is named for the Ebola River, which is the headstream of the Mongala River, a tributary of the Congo, or Zaire, River. The Ebola River empties tracts of rain forest, winding past scattered villages. The first known emergence of Ebola Zaire—the hottest type of Ebola virus—occurred September 1976, when it erupted simultaneously in fifty-five villages near the headwaters of the Ebola River. It seemed to come out of nowhere, and killed nine out of ten people it infected. Ebola Zaire is the most feared agent at the Institute. The general feeling around USAMRIID has always been “Those people who work with Ebola are crazy.” to mess around with Ebola is an easy way to die. Better to work with something safer, such as anthrax.
Eugene Johnson, the civilian biohazard expert who was running the Ebola research program at the Institute, had a reputation for being a little bit wild. He is something of a legend to the handful of people in the world who really know about hot agents and how to handle them. He is one of the world’s leading Ebola hunters. Gene Johnson is a large man, not to say massive, with a broad, heavy face and loose-flying disheveled brown hair and bushy brown beard and a gut that hangs over his belt, and glaring, deep eyes. If Gene Johnson were to put on a black leather jacker, he could pass for a roadie with Grateful Dead. He does not look at all like a man who works for the Army. He has a reputation for being a top-notch field epidemiologist (a person who studies viral diseases in the wild), but for some reason he does not often get around to publishing his work. That explains his somewhat mysterious reputation. When people who know Johnson’s work talk about him, you hear things like “Gene Johnson did this, Gene Johnson did that,” and it all sounds clever and imaginative. He is a rather shy man, somewhat suspicious of people, deeply suspicious of viruses, I think I have never met someone who is more afraid of viruses than Gene Johnson, and what makes his fear impressive is the fact that it is a deep intellectual respect, rooted in knowledge. He spent years traveling across central Africa in search of the reservoirs of Ebola and Marburg viruses. He had virtually ransacked Africa looking for these life forms, but despite his searches he had never found them in their natural hiding places. No one knew where any of the filoviruses came from; no one knew where they lived in nature. The trail had petered out in the forests and savannas of central Africa. to find the hidden reservoir of Ebola was one of Johnson’s great ambitions.
No one around the Institute wanted to get involved with his Ebola project. Ebola, the slate wiper, did things to people that you did not want to think about. The organism was too frightening to handle, even for those who were comfortable and adept in space suits. They did not care to do research on Ebola because they did not Ebola to do research on them. They didn’t know what kind of host the virus lived in—whether it was a fly or a bat or a tick or a spider or a scorpion or some kind of reptile, or an amphibian, such as a grog or a newt. Or maybe it lived in leopards or elephants. And they didn’t know exactly how virus spread, how it jumped from host to host.
Gene Johnson had suffered recurrent nightmares about Ebola virus ever since he began to work with it. He would wake up in a cold sweat. His dreams went more or less the same way. He would be wearing his space unit while holding Ebola in his gloved hand, holding some kind of liquid tainted with Ebola. Suddenly the liquid would be running all over his glove, and then he would realize that his glove was full of pinholes, and the liquid was dribbling over his bare hand and running inside his space suit. He would come awake with a start, saying to himself, My God, there’s been an exposure. And then he would find himself in his bedroom, with his wife sleeping beside him.
In reality, Ebola had not yet made a decisive, irreversible breakthrough into the human race, but seemed close to doing that. It had been emerging in microbreaks here and there in Africa. The worry was that a microbreak would develop into an unstoppable tidal wave. If the virus killed nine of ten people it infected and there was no vaccine or cure for it, you could see the possibilities. The possibilities were global. Johnson liked to say to people that we don’t really know what Ebola has done in the past, and we don’t know what it might do in the future. Ebola was unpredictable. An airborne strain of Ebola could emerge and circle around the worked in about six weeks, like the flu, killing large numbers of people, or it might forever remain a secret feeder at the margins, taking down humans a few at a time.
Ebola is a rather simple virus—as simple as a firestorm. It kills humans which swift efficiency and with a devastating range of effects. Ebola is distantly related to measles, mumps, and rabies. It is also related to certain pneumonia viruses: to the parainfluenza virus, which causes colds in children, and to the respiratory syncytial virus, which can cause fatal pneumonia in a person who has AIDS. In its own evolution through unknown hosts and hidden pathways in the rain forest, Ebola seems to have developed the worst elements of all the above viruses. Like measles, it triggers a rash all over the body. Some of its effects resemble rabies—psychosis, madness. Other of its effects look eerily like a bad cold.
The Ebola virus particle contains only seven different proteins—seven large molecules. Three of these proteins are vaguely understood, and four of the proteins are completely unknown—their structure and their function is a mystery. Whatever these Ebola proteins do, they seem to target the immune system for special attack. In this they are like HIV, which also destroys the immune system, but unlike the onset of HIV, the attack of Ebola is explosive. As Ebola sweeps through you, you immune system fails, and you seem to lose your ability to respond to viral attack. Your body becomes a city under seize, with its gates thrown open and hostile armies pouring in, making camp in the public squares and setting everything on fire; and from the moment Ebola enters your blood stream, the ware is already lost; you are almost certainly doomed. You can’t fight off Ebola the way you fight off a cold. Ebola does in ten days what it takes AIDS ten years to accomplish.
It is not really known how Ebola is transmitted from person to person. Army researchers believed that Ebola virus traveled through direct contact with blood and bodily fluids (in the same way the AIDS virus travels). Ebola seemed to have other routes of travel as well. Many of the people in Africa who came down with Ebola had handled Ebola-infected cadavers. It seems that one of Ebola’s paths goes from the dead to the living, winding in trickles of uncoagulated blood and slimes that come out of the dead body. In Zaire during the 1976 outbreak, grieving relatives kissed and embraced the dead or prepared the body for burial, and then, three to fourteen days later, they broke with Ebola.