Ricci looked at him.
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“Maybe not,” he said. “But I tell you something, nil. He doesn’t show bright and early, I want to know i home address. Because wherever he lives, I’m head- rover there to see what’s up.”
|. Eric Oh thought they resembled water lilies. Clusters of beautiful, perfectly formed lilies floating t the surface of a quiet pond.
quality of simple structural perfection was the ; of the virus’s enduring success as a life form. It also what made them ideally suited for comparison with an electron microscope. Every virion of a was identical. An intact specimen of a virus from [ blood of a patient in Mozambique would be the mir- image of a specimen of the same family, genus, and grown in culture at a California research labora- assuming it was likewise undamaged. To an ex- ced researcher it would look as though they had manufactured at a single factory, on a single, or- iy assembly line. You saw one, you’d seen them all. to three o’clock in the morning, Eric was still at the nford lab, examining the photographs he’d snapped its state-of-the-art Hitachi instrument beside those fd called up on his computer from the vast database I EM pictures compiled and shared by medical and bi-
?ical research facilities around the globe. |*As with any sort of photography, setting up the shot . the difficult part of the process; once you got to the utter click, you were home free. From the moment B’d scanned Gordian’s case report, Eric’s mind had whispering virus. After he’d inspected the first- neration X rays sent by Lieberman, that whisper be: an urgent shout. But the problem in taking pictures
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of viruses was that they tended to be camera shy. The tiniest were dwarfed even by common bacteria. Scientists measured their size in nanometers-billionths of a meter. On this infinitesimal scale, a single droplet of blood became a vast, unmapped sea of crests and troughs where they could remain undetected unless present in great numbers. And the greater their numbers, the worse the infection. It was therefore easier when investigating deadly viral illnesses to find colonies in samples from autopsies of the dead or patients in late-stage disease than in samples taken from less advanced cases.
Eric had hoped from the start that Roger Gordian wasn’t going to make life easy for him. When his viewing of an unconcentrated drop of serum failed to reveal any viruses after nearly two hours, he considered it a break. Better he’d needed to take the extra step of placing a sample in a centrifuge to pack as many organisms as possible into a concentrate than have an abounding population instantly jump out at his eyes. Viruses were unsparing, mechanistic parasites that used up the living cells of their hosts as they bred. Given Eric’s fears about the nature of Gordian’s infection, a sample that teemed with virus particles might have suggested a bleak prognosis indeed.
After centrifugation, Eric had used filter paper to drain the circular grid bearing his concentrated sample, then stained it with a solution of 2 percent phosphotungstate that was conductive to electrons. He had known that his processing would damage whatever viruses might be displayed, and that further deterioration could be expected from the ionizing effect of the microscope’s electron beam. But while there were methods of cryogenic preparation that could have substantially reduced, if not
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gether eliminated, the loss of a specimen’s structural ity, these techniques were finicky and took time. Eric’s goal was to aid in Gordian’s diagnosis and ent, not his postmortem, which meant he had to Inexpedient. He had weighed the two options against other and decided to go ahead with conventional reasoning that an adequate amount of the sample lined for the lab’s regular staff to perform cryo EM ” on, should his own examination indicate it was ad- ble.
ow Eric removed his glasses and sat rubbing his s, strained from too many long, sleepless hours fixed Ithe visual panel of the EM, The only reminder that ; stomach wasn’t completely empty was an occasional ng of the ketchup-sopped burgers he’d picked up dinner. He knew he ought to go home, pop some cid tablets, and climb into bed. But the pictures ildn’t let him budge.
put the glasses back on and looked at his micros. Then at the electronic library shots on his computer n. His gaze moving between them again and again. lies. On a quiet pond. ^s an epidemiologist with the CDC in the midnine- 8, Eric had been one of the primary investigators who 1 worked to identify the mystery illness that scourged (Four Corners Navajo tribal reservation in the South- and then gradually made its way eastward, killing er than half its victims-many of them young, othise healthy individuals-within days of their first toms. The infections began with mild flulike res- problems and rapidly progressed toward sys- crash, the walls of the capillaries in the lungs ing down, developing tiny leaks that bled out into
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the surrounding tissues until they became inundated with fluid and sometimes swelled to double their normal size. In many of the fatal cases there was a similar breakdown of stomach membranes. The external signs of terminal- stage disease were especially horrible as the blood vessels in the body’s mucous membranes and subcutaneous tissues deteriorated, causing petechiae, pinpoint hemorrhages of the eyes, mouth, and skin.
In the early days of the contagion’s spread, the inhabitants of Four Corners came to refer to the epidemic simply-and for Eric chillingly-as sin nombre. Without a name. That designation stuck with it after intensive scientific detective work eventually determined the disease was a new strain of hantavirus, a lethal hemorrhagic fever whose occurrence was never previously recorded in North America.
The tingles Eric had felt on first perusal of Gordian’s case report had stemmed from the combination of his respiratory problems and the abnormal lymphocytes and diving platelet count in his bloodstream. Platelets were essential to the body’s healing factor, minuscule patches that gathered to stop bleeding and release clotting agents. A normal platelet count averaged 150,000 to 350,000 per microliter of blood. Gordian’s count had been 120,000 per microliter when he was admitted to San Jose Mercy-borderline low. It had then fallen to 90,000 Monday morning. On the most recent workup, it declined even more pronouncedly to 50,000 per microliter.
Eric had seen nearly the same profile in sin nombre patients entering the pulmonary edema phase of the disease. And changes in Gordian’s chest X rays had also been discomfortingly familiar. The vague skeins of shadow across his lungs evident on Sunday’s pictures
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become linear opacities of the airspaces within Bty-four hours, visible as short perpendicular white i at their bases. By Tuesday afternoon, there were lines developing from the hilum, the crowded in- nge where the blood vessels, nerves, and bronchi ged into the lungs. : notnbre, he thought. Without a name.
liliform viruses now on Eric’s computer screen : micrographs that he and his colleagues on the CDC tigative team had taken eight years ago … and the i he’d gotten out of the EM’s photographic chamber hi bore an undeniably striking similarity to them. \& in the original series, the organisms were circular tiape. As in the originals, their envelopes were ringed i binding proteins that enabled them to attach to the membranes of host cells. But the architecture of nucleocapsids-the core material within the viral slopes that held the genomic code for their replica- i and entry into the cell-showed a subtle variance, dying the set of images he’d isolated from Roger ‘s bloodstream, Eric could see none of the ndedness typical of the nucleocapsids on the database Eimens of sin nombre, or for that matter in any of svrelated old-world hantavirus strains he’d encountered scientific career. Instead, they appeared long and fight, almost filamentous, even when computer- need.
ric couldn’t go beyond guessing whether this anomIrepresented a difference in the genetic makeup of the ate specimens until a polymerase chain reaction, or probe was conducted on Gordian’s samples, and ‘ actual RNA sequences could be compared against
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the codes of all other known hantaviruses. But his im- munogobulin capture assays-fluorescent dye screening tests developed in the late 1980s that produced results within three or four hours-had shown weak positives for several catalogued strains of the disease, with the brightest green glow on his lab slide appearing for sin nombre. While that, too, had been relatively pale, it had made Eric nervous as hell once added to the rest of the evidence before him.
His eyes hurting, his stomach hollow, he sat there tensely in the lab, frozen behind his computer as dawn crept its slow way into the sky outside. He could say very little absolutely except that Roger Gordian was in serious trouble. But he believed in his bones that if Gordian didn’t have sin nombre, he’d contracted something very much like it.