Dubchek put the paper down on the counter top. “This is a wonderful exercise for you, but you are forgetting one important fact:
Ebola is not a food-borne disease.”
“I know that,” said Marissa. “But you cannot ignore the fact that this outbreak started with an avalanche of cases, then slowed to a trickle with isolation.”
Dubchek took a deep breath. “Listen,” he said condescendingly, “Dr. Layne has confirmed your finding that one of the initial patients had been to the San Diego conference with Richter and Zabriski. That fact forms the basis of the official position: Richter brought the
virus back from its endemic habitat in Africa and spread it to other doctors in San Diego, including the unfortunate ophthalmologist here at the Medica Hospital.”
“But that position ignores the known incubation period for hemorrhagic fever.”
“I know there are problems,” admitted Dubchek tiredly, “but at the moment that’s our official position. I don’t mind you following up the food-borne possibility, but for God’s sake stop talking about it. Remember that you are here in an official capacity. I don’t want you conveying your personal opinions to anyone, particularly the press. Understood?”
Marissa nodded.
“And there are a few things I’d like you to do,” continued Dubchek. “I’d like you to contact the Health Commissioner’s Office and ask that they impound the remains of some of the victims. We’ll want some gross specimens to be frozen and sent back to Atlanta.”
Marissa nodded again. Dubchek started through the door, then hesitated. Looking back he said more kindly, “You might be interested to know that Tad has started to compare the Ebola from the L.A., St. Louis and Phoenix outbreaks. His preliminary work suggests that they are all the same strain. That does support the opinion that it is really one related outbreak.” He gave Marissa a brief, self-satisfied expression, then left.
Marissa closed her eyes and thought about what she could do. Unfortunately, no custard had been left over from the fatal lunch. That would have made things too easy. Instead, she decided to draw blood on all the food staff to check for Ebola antibodies. She also decided to send samples of the custard ingredients to Tad to check for viral contamination. Yet something told her that even if the custard were involved she wasn’t going to learn anything from the ingredients. The virus was known to be extremely sensitive to heat, so it could only have been introduced into the custard after it had cooled. But how could that be? Marissa stared at her stacks of papers. The missing clue had to be there. If she’d only had a bit more experience, perhaps she’d be able to see it.
8
May 16
IT WAS NEARLY A month later, and Marissa was finally back in Atlanta in her little office at the CDC. The epidemic in Phoenix had finally been contained, and she, Dubchek and the other CDC doctors in the hospital had been allowed to leave, still without any final answers as to what caused the outbreak or whether it could be prevented from reoccurring.
As the outbreak had wound down, Marissa had become eager to get home and back to work at the Center. Yet now that she was there, she was not happy. With tear-filled eyes, due to a mixture of discouragement and anger, she was staring down at the memo which began, “I regret to inform you . . .” Once again Dubchek had turned down her proposal to work with Ebola in the maximum containment lab, despite her continued efforts to develop laboratory skills in relation to handling viruses and tissue cultures. This time she felt truly discouraged. She still felt that the outbreak in Phoenix had been connected to the custard dessert, and she desperately wanted to vindicate her position by utilizing animal systems. She thought that if she could understand the transmission of the virus she might develop an insight into where it came from in the first place.
Marissa glanced at the large sheets of paper that traced the transmission of the Ebola virus from one generation to another in all three U.S. outbreaks. She had also constructed less complete but similar diagrams concerning the transmission of Ebola in the first two out-