Outbreak by Robin Cook. Part one

Dr. Bouchard radioed Kinshasa and requested emergency aid from the Zairean Air Force to airlift several patients from the mission hospital back to the capital. But by the time the infectious disease department at the university hospital was consulted about how to isolate the patients during transport, only the nurse still lived. Isolation techniques would have to be excellent, Bouchard pointed out, because they were obviously dealing with a highly contagious and very deadly disease.

September 30, 1976

The Belgian nurse airlifted to Kinshasa died at 3:00 A.M. despite six days of massive supportive therapy. No diagnosis was made, but after the autopsy, samples of her blood, liver, spleen and brain were sent to the Institut de Medicine Tropical in Antwerp, Belgium; to the Centers for Disease Control in Atlanta, U.S.A.; and to the Microbiological Research Establishment in Porton Down, England. In the Yambuku area there were now two hundred ninety-four known cases of the illness, with a fatality rate of approximately ninety percent.

October 13, 1976

The Yambuku virus was isolated almost simultaneously at the three international laboratories. It was noted to be structurally similar to the Marburg virus, first seen in 1967 in a fatal outbreak in laboratory workers handling green monkeys from Uganda. The new virus, considerably more virulent than Marburg, was named Ebola after the Ebola River north of Bumba. It was thought to be the most deadly microorganism seen since the bubonic plague.

November 16, 1976

Two months after the initial outbreak, the unknown disease in Yambuku was considered successfully contained since no new cases had been reported in the area for several weeks.

December 3, 1976

The quarantine of the Bumba region was lifted and air service reinstated. The Ebola virus had evidently returned to its original

source. Where that source was remained a complete mystery. An international team of professionals, including Dr. Cyrill Dubchek of the Centers for Disease Control who had played a big role in localizing the Lassa Fever virus, had scoured the area, searching for a reservoir for the Ebola virus within mammals, birds, and insects. The virologists had no success whatsoever. Not even a clue.

Los Angeles, California

January 14

Present Day

Dr. Rudolph Richter, a tall, dignified ophthalmologist originally from West Germany, and cofounder of the Richter Clinic in Los Angeles, adjusted his glasses and looked over the advertising proofs laid out on the circular table in the clinic’s conference room. To his right was his brother and partner, William, a business-school graduate, who was examining the proofs with equal attention. The material was for the next quarter’s drive for new prepaid subscribers to the clinic’s health-care plan. It was aimed at young people, who as a group were relatively healthy. That was where the real money was in the prepaid health-care business, William had been quick to point out.

Rudolph liked the proofs. It was the first good thing that had happened to him that day. It was a day that had begun badly with a fender-bender on the entrance to the San Diego freeway, resulting in a nasty dent in his new BMW. Then there was the emergency surgery that had backed up the clinic. Then there was the tragic AIDS patient with some weird complication who’d coughed in his face while he tried to examine the man’s retinas. And on top of everything else, he’d been bitten by one of the monkeys used in his ocular herpes project. What a day!

Rudolph picked up an ad scheduled for the L.A. Times Sunday Magazine. It was perfect. He nodded at William, who motioned for the ad man to continue. The next part of the presentation was a slick thirty-second TV spot slotted for the evening news. It portrayed carefree bikini-clad girls on a Malibu beach, playing volley ball with some handsome young men. It reminded Rudolph of an expensive Pepsi ad, though it extolled the concept of prepaid health maintenance as delivered by an organization like the Richter Clinic in contrast to conventional fee-for-service medicine.

Along with Rudolph and William were a handful of other staff

doctors, including Dr. Navarre, Chief of Medicine. They were all directors of the clinic and held small amounts of stock.

William cleared his throat and asked if there were any questions from the staff. There were none. After the advertising people had departed, the group voiced unanimous approval of what had been presented. Then, after a brief discussion about the construction of a new satellite clinic to deal with the increase in subscribers from the Newport Beach area, the meeting was adjourned.

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