Outbreak by Robin Cook Read Free Book Online Page B

note pad. She sensed that Dubchek was particularly interested in the fact that two of the patients had vomited blood, that another had passed bloody diarrhea and that three had conjunctival hemorrhages in their eyes. When Marissa said that Dr. Richter had been to an ophthalmology meeting in Africa, Dubchek exclaimed, "My God, do you know what you are describing?"
    "Not exactly," said Marissa. It was an old medical-school ploy: try to stay on neutral ground rather than make a fool of yourself.
    "Viral hemorrhagic fever," said Dubchek, ". . . and if it came from Africa, it would be Lassa Fever. Unless it was Marburg or Ebola. Jesus Christ!"
    "But Richter's visit was over six weeks ago."
    "Darn," said Dubchek, almost angrily. "The longest incubation period for that kind of fulminating illness is about two weeks. Even for quarantine purposes, twenty days is considered adequate."
    "The doctor was also bitten by a monkey two days before he became di," offered Marissa.,
    "And that's too short an incubation period. It should be five or six days. Where's the monkey now?"
    "Quarantined," said Marissa.
    "Good. Don't let anything happen to that animal, particularly if it dies. We've got to test it for virus. If the animal is involved, we have to consider the Marburg virus. In any case, the illness certainly sounds like a viral hemorrhagic fever, and until proven otherwise, we'd better consider it as such. We've worried about something like this happening for some time; the problem is that there's no vaccine and no treatment."
    "What about the mortality rate?" asked Marissa.
    "High. Tell me, does Dr. Richter have a skin rash?"
    Marissa couldn't remember. "I'll check."
    "The first thing I want you to do is draw bloods, obtain urine samples, and do throat swabs for viral culture on all seven cases, and have them rushed to the CDC. Use Delta's small-package service. That will be the fastest way. I want you personally to draw the blood, and for Christ's sake be careful. From the monkey, too, if you can. Pack the samples in dry ice before shipping them."
    "I've just seen what might be another case," said Marissa. "One of the clinic's lab techs."
    "Include him, too, It sounds increasingly serious. Make sure that all the patients are totally isolated with complete barrier nursing. And tell whoever is in charge not to do any lab work until I get there."
    "I have," said Marissa. "You're coming yourself?"
    "You bet I am," said Dubchek. "This could be a national emergency. But it is going to take some time to prepare the Vickers Mobile Lab. Meanwhile, start setting up a quarantine for contacts, and try to get in touch with the people who sponsored that eye meeting in Africa and see if any of the other doctors who went are di. And one other thing: don't say anything to the press. With all the publicity about AIDS, I don't think the public could deal with the threat of another fatal viral disease. There could be widespread panic. And Marissa, I want you to wear full protective clothing, including goggles, when you see the patients. The pathology department should have them if no one else does. I'll be there as soon as possible."
    Hanging up, Marissa experienced a rush of anxiety. She wondered if she'd already exposed herself to the virus. Then she worried about having already talked to Clarence Hems from the L.A. Times. Well, what was done was done. She was glad that Dubchek was coming.
    She knew she'd been in over her head from the moment she'd arrived in L.A.
    After putting in a call for Dr. Navarre, Marissa had one of the nurses help her get the materials ready to draw blood from the patients. She needed vacu-containers with anticoagulants, plastic bags, and sodium hypochlorite to decontaminate the outside of the bags. She also needed urine containers and throat swabs. Then she phoned the micro lab and asked to have containers of viral transport media sent up, along with shipment containers and dry ice. When Dr. Navarre called, she related what