Outbreak by Robin Cook Read Free Book Online

everything, including the nurses' notes. On a separate sheet in her notebook, she listed every bit of information that could possibly have significance, including the fact that the man had presented with an episode of hematemesis, vomiting blood. That certainly didn't sound like influenza. The whole time she was working her mind kept returning to the fact that Dr. Richter had been in Africa six weeks previously. That had to be significant even though a month's incubation was unlikely, given the symptomology, unless he had malaria, which apparently he did not. Of course there were viral diseases like AIDS with longer incubation periods, but AIDS was not an acute viral infectious disease. The incubation period for such a disease was usually about a week, give or take a few days. Marissa painstakingly went through all the charts amassing diverse data on age, sex, life-style, occupation and living environment, and recording her findings on a separate page in her notebook for each of the patients. Rather quickly, she realized that she was dealing with a diverse group of people. In addition to Dr. Richter, there was a secretary, a woman who worked in medical records at the Richter Clinic; two housewives; a plumber; an insurance salesman and a real estate broker. Opportunity for commonality seemed remote with a group this diverse, yet all of them must have been exposed to the same source.
    Reading the charts also gave Marissa a better clinical picture of the illness she was dealing with. Apparently it began rather suddenly, with severe headaches, muscle pain and high fever. Then the patients experienced some combination of abdominal pain, diarrhea, vomiting, sore throat, cough and chest pain. A shiver went down Marissa's spine as she thought about having been exposed to the disease.
    Marissa rubbed her eyes. They felt gritty from lack of sleep. It was time to visit the rest of the patients whether she wanted to or not.
    There were a lot of gaps, particularly in activities of each patient in the days directly preceding their illness.
    She started with the medical secretary, who was located in a room next to Dr. Richter's in the ICU, and then worked her way through to the last patient to be admitted. Before seeing each case, she carefully dressed in full protective clothing. All the patients were seriously ill, and none felt much like talking. Still, Marissa went through her list of questions, concentrating on whether each patient was acquainted with any of the other people who were di. The answer was always no, except that each one knew Dr. Richter, and all were members of the Richter Clinic health plan! The answer was so obvious she was surprised that no one seemed to have spotted it. Dr. Richter might have spread the disease himself since he might even have been in contact with the medical secretary. She asked the ward clerk to call for all the patients' clinic outpatient records.
    While she was waiting, Dr. Navarre called. "I'm afraid we have another case," he said. "He's one of the lab techs here at the clinic. He's in the emergency room. Do you want to come down?"
    "Is he isolated?" asked Marissa.
    "As well as we can do it down here," said Dr. Navarre. "We're preparing an isolation wing upstairs on the fifth floor. We will move all the cases there the moment it is ready."
    "The sooner the better," said Marissa. "For the time being, I recommend that all nonessential lab work be postponed."
    "That's okay by me," said Dr. Navarre. "What about this boy down here? Do you want to see him?"
    "I'm on my way," said Marissa.
    En route to the ER, Marissa could not shake the feeling that they were on the brink of a major epidemic. Concerning the lab tech, there were two equally disturbing possibilities: the first was that the fellow had contracted the illness in the same fashion as the others, i.e., from some active source of deadly virus in the Richter Clinic; the second, more probable in Marissa's estimation, was that the lab tech had been