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Ebola Elgon

Norman Marshall stretched and sighed, the bones in his shoulders and back cracking like gunshots. It had been a long flight and he needed a shower and a cup of coffee, but instead of sitting at his breakfast bar in his bathrobe, Norman found himself tucked in behind his desk facing into a stack of reports and an inbox heaving with messages. Rayanne, his assistant, had phoned him as he slipped into a taxi at the airport to say that Gert Brentner in Vermont had left three voicemails this morning already and there were two from McReady in USAMRID also – Norman knew McReady wasn’t calling for a catch-up. On his yellow pad he had written McR in big letters, filling nearly half the page. Above that he had written coffee, underlined twice. Norman may have been tired but he still had his priorities.

Shifting in his chair Norman caught sight of his reflection in the framed photo on his desk. He looked like hell, and felt it too – the red bags under his eyes stood out and the slight twinge in his lower back was starting to bother him. Damn airplane seats, he thought, massaging the spot with one hand, rubbing his red eyes with the other. The three-day conference in New York had hit him hard, long days and conversations that never seemed to want to end. Life is too short, except when you’re in the wrong company. That thought made Norman laugh, though he felt far from laughing. Loosening his tie, Norman pushed his glasses up onto his forehead and began rubbing the bridge of his nose, the tickle behind his eyeballs just waiting to become a headache. Maybe he was coming down with something?

“Superman is back in town.”

“Hi Rayanne,” Norman said before opening his eyes to greet his assistant. “How are you?”

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“I’m fine, chief, but shouldn’t you be at home, unconscious. Instead of being here, unconscious.” Norman relaxed back into his easy chair, the folds of his face slipping into a smile.

“Probably. Probably.”

“We can cope without you for a few hours more, you know.”

“Maybe it’s me that can’t cope without this old place” he said as Rayanne stepped into his office carrying a thin paper file and a steaming mug of coffee.

“Yeah right,” she said with a snort of laughter as she rounded his desk. “This I thought you’d need,” she said, placing the coffee in front of him (she knew him too well). “This I thought you wouldn’t,” she continued, slipping the file along the desktop. “I made this strong, because of this.” Rayanne’s manicured fingernail moved from the coffee cup to the file and she smiled again. Norman groaned. He read the heading embossed in dark blue bold lettering, For The Attention of Norman Marshall.

“McReady’s got a real bee in his bonnet about this. Apparently you’ve got to read that and call him, ASAP. Emphasis on the ASAP part.”

“Thanks Rayanne.”

“No problem, chief,” she said turning back towards the door.

“How were things when I was away, anything to report?” Norman asked as he broke the seal on the file.

“Things were fine, chief. A couple of guys have been down with the flu, but nothing serious.”

“The flu?”

“Yeah. Casey is due back today. I haven’t seen him yet, but he’s never in before 8am.”

“Okay Rayanne,” Norman said as he turned the first sheet. There were only two leafs in the file, the first being a brief cover note. He skimmed down through the three paragraphs of text on the second page and felt his stomach turn to water. Norman shook his head, then read it again.

“Rayanne,” he shouted. Rayanne appeared in his doorway a moment later, a little flushed. “Get me McReady,” he said, smacking his lips twice, his mouth suddenly dry. Rayanne stood in the doorway a half second too long, taken aback by the bold fear in Norman’s eyes. In fact, she was certain that he was sweating.

“Now Goddamn it Rayanne.” She moved, her shoes catching on the carpet as she went.

Pushing out from the desk, Norman turned in his swivel chair to face the morning breaking over Atlanta. He thought of his family. Annette would be sitting in morning traffic taking Charlie to school, maybe thinking about him and whether the flight had been on time; Charlie would be wondering what Norman had brought him back from New York. A jet crossed the sky in the distance, weaving thin white lines across the blue and as Norman watched the vapour trail disintegrate, one word burned in his mind, the last of the three-paragraph report.

UNCONFIRMED OUTBREAK…CHICAGO…MAY BE MARBURG OR HEMORRHAGIC FEVER, TOO EARLY TO TELL…NEED ADVICE…OTHER STATES REPORTING SAME…CANNOT RULE OUT EBOLA.

***

Rosette Grier lived in Dunning, Chicago, a small suburb that was home to 41,000 people. She owned a modest two-storey house on West Roscoe Street, two blocks from Denver Elementary School, the largest in the area. West Roscoe Street stood less than 15 minutes from Shabbona Park to the East and Hiawatha Park to the West, both popular with morning joggers, parents with toddlers and office workers when it came to lunchtime. Rosette Grier often spent her sunny afternoons feeding the ducks, reading or listening to the children play in Shabbona. Rosette was a widow. Her husband Stuart had owned Full O’ Beans, a small and successful café in neighbouring Norridge. On July 18, 2009, he rang Rosette at 7.15pm to say he’d be home shortly as he was closing up for the evening. Stuart made his way home around 7.30pm. On the corner where North Canfield Avenue feeds onto West Montrose, opposite a vacant unit Stuart had once viewed with plans of opening a second Full O’ Beans, a 17 year old kid on his Learner’s Permit in his father’s Dodge Ram took the corner too sharp, lost control and slammed into Stuart’s Toyota, practically cutting the car in two. Stuart was killed outright. The kid walked away with nothing more than a torn shirtsleeve.

On the morning of his fifth anniversary, as she fussed around the house Rosette decided she needed a vacation. After several hours of Google searches and phone calls Rosette decided that she would like to see Africa.

 

Rosette Grier left Chicago on a 6am flight on August 2nd.

 

Not much is known of how Rosette spent her five weeks in Africa, other than she travelled west to east along the Kinshasa Highway. She made her way through the Congo picking Kenya as her last port of call, her intention to spend five days in Nairobi. No one knows for sure why, but at the last minute she changed her plans and for three days Rosette Grier double-backed and pushed northwest along the Rift Valley to Kisumu, settling on the lush slopes of Mount Elgon on the border where Kenya and Uganda meet. She took a guest room in an old colonial hotel within the National Park and fell in with a bunch of fellow tourists, spending her last days in Africa in Mount Elgon National Park and the territory around Kitum Cave. Made of brittle salt rich rock, Kitum Cave was formed over millennia by salt starved elephants tusking the rock, breaking it down into chewable chunks. Over the course of several thousand years the cave grew as the elephant population swelled, providing a natural shelter for more than just the elephants. Kitum Cave, a deep, dark and dry opening in the foothills of Mount Elgon provided the perfect breeding ground for the Ebola virus.

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Day One

 

It is only speculation whether Rosette Grier first came into contact with Ebola in Kitum Cave. No one is, or ever will be, certain. What is certain is that she was there on September 6th and that of the one hundred and four people who visited Kitum Cave that day, ninety-one went inside. Of that ninety-one, eighty-eight contracted Ebola. Within eighteen days all were dead. September 6th is recognised as Day One, the origin of the outbreak.

 

Day Seven

 

Rosette Grier began to show signs of infection on September 13th, four days after returning from Kenya, seven days after leaving Mount Elgon and Kitum Cave. Unaware though she was, Rosette Grier was right on schedule as Ebola has an incubation period of between three to eighteen days, victims usually displaying signs of infection within seven days. These signs are at first gentle, almost benign. You develop a headache and a pain in your lower back; your eyes go puffy and/or bloodshot. You start to cough and struggle against a fatigue that you can’t seem to shake. You’d be forgiven for thinking you’ve been hit by the flu. Within two days the headaches have increased in intensity and become excruciating. The pains in your lower back spread through your whole body and you develop dark lesions and bruises around your joints. Your skin becomes sore to the touch and pocked with blood blisters. Soon after this the connective tissue that holds the body together begins to decay, the skin starting to sag like a piece of fabric pulled out of shape. Blood clots soon begin forming in the vital organs, pushing the victim into mini strokes. The flow of blood to the liver, kidneys and bowel is restricted and eventually shut off and the victim begins to decompose on the inside. At this point an Ebola victim is still several days from death, the internal body cavities filling with blood and partially liquidised organs, blood and tissue hot with the Ebola virus.

In the end stages the victim ‘crashes and bleeds out’- you haemorrhage from every orifice in your body, mouth, nose, ears, eyes and anus. You shed the lining of your gut and intestines. You vomit dark, rich blood incessantly. This is the virus’s means of staying alive. It has killed one host and now must find another to survive. This cycle, from start to finish, takes between 2 – 3 weeks, on average.

Prior to September 6th, the Ebola virus could only be contracted through direct human contact such as touching and sexual intercourse, thus making a pandemic of plague-like proportions almost impossible. Ebola victims are only contagious in the latter stages of infection, when you display the physical effects of the disease. Once you “come down” with Ebola, quarantine is the only effective way of stopping the spread, allowing the virus to burn itself out. Strange as it may sound, the human race was especially lucky for this, as Ebola has no cure. It has no treatment. While quarantine almost certainly means death for the victim, it limits the transmission of the disease to almost zero. But if that were to change, if quarantine was removed as a possible response to an Ebola outbreak and if the Ebola virus was to evolve, to mutate, what would it mutate into? If it was to maintain its incredibly high mortality rate but become airborne and as easily transmitted as the common cold or the flu, how could we contain that? Whatever mutation occurred in Kitum Cave, Ebola Elgon – as it came to be known – broke loose. And it was airborne.

 

Rosette Grier returned to the US on September 9th tired, with a niggling little pain in her lower back. She had developed back pain in her late forties and thought nothing of this little twinge, an annoyance that kept her from her comfort. Three days after returning, with the Ebola virus rapidly gaining a foothold, Rosette decided to make the short journey to St. Catherine’s Shelter for the Homeless, no doubt believing that sitting at home feeling sorry for herself wasn’t going to make her any better. Since Stuart’s passing Rosette had started volunteering a few hours every week at St. Catherine’s. She was one of thirty-six volunteers and entertained several dozen people with stories of her trip to Africa, no doubt recounting details of her time in Kitum Cave and Mount Elgon National Park. Doubling up also as a soup kitchen, it is believed that St. Catherine’s Shelter for the Homeless was visited on a daily basis by close to 700 people.

By this stage of the infection, the fourth day, Rosette was developing a cough and her eyes were turning red. She probably told the staff and patrons of St. Catherine’s that it was delayed jet lag or some bug she had picked up on the plane (all that recycled air, you know) and of course they would have believed her as, at this stage, no one was talking about Ebola. Rosette returned the following day, the pain in her back now beyond the point of ignoring and a headache that was beginning to obscure her vision. She stayed only an hour before excusing herself, allegedly joking that she must have picked something up in Africa. Her intention must have been to see Dr. Elizabeth Adams, her physician, but she never did. Rosette Grier took a taxicab and returned to West Roscoe Street to rest. She never left her home or was seen alive again.

 

Day Nine

 

Oscar Felder was a petty thief, in and out of juvenile prison all through his teens. He was also more than familiar with West Roscoe Street. He had burgled at least two of Rosette’s neighbours and he knew her house well. It’s believed that Oscar, on noticing the drawn curtains over the course of a few days, thought the house to be empty (during her time on vacation Rosette’s neighbours had collected her mail, drawn and un-drawn her curtains and turned on her lights to create the illusion that she was still at home). On September 18th, approximately, Oscar Felder broke into Rosette Grier’s house. Slipping into her back yard through a vacant property her house backed onto, Oscar Felder broke a small windowpane in the patio doors and forced his way in. Did Oscar cut his hand on a sharp shard of glass? Maybe. Was Rosette’s home hot with Ebola? Absolutely. Did Oscar touch her body? No one knows for sure. One thing is certain – this is undoubtedly where Oscar Felder contracted Ebola. By September 18th Rosette was dead and had been for several days, the smell of her putrefying body must have been rich and cloying. Even if Oscar saw Rosette in death then it did not stop him from looting the house, taking some money and jewellery.

Of the items he stole, one was a crucifix that Rosette Grier had been given by her mother. It was solid gold and studded with tiny diamond chips. Oscar took this crucifix to a pawnshop in North Cranston, several miles from Rosette Grier’s home. Crossing the city by bus, how many people did Oscar meet or come in contact with? Was he contagious? No one knows but what is certain is that the explosion of the Ebola virus in Chicago started here, with Oscar Felder and this pawnshop.

 

Bill Grant, the owner of Grant’s Pawn and Loan dealt with Oscar directly, taking in the crucifix, fixing a price and sending Oscar on his way. Four days after his visit to the pawnshop, Oscar broke with Ebola, the first signs hitting him hard and fast. By day seven Oscar could not walk from the pains in his legs and back. By day ten Oscar began to suffer gushing nosebleeds, his skin rupturing at the slightest touch. Within hours of crashing, Oscar Felder was dead. Three days after Oscar and Bill Grant met, Grant also began to complain of headaches and back pains. He succumbed rapidly, crashing and bleeding out four days later. This meant nothing at the time, it was only as the virus established a foothold in North America that scientists in the CDC and USAMRID realised that this particular strain of Ebola had mutated further – its incubation period was shortening.

 

Two days after Bill Grant bought the crucifix – at this stage he would have been barking sharp coughs – Victoria Anders, a divorcee with two children, enquired about it. She intended to give it to her sixteen-year-old daughter, Samantha, for her birthday in two weeks’ time (Victoria Anders would not live to see her daughter’s birthday. Neither would Samantha). Victoria Anders, Vicki to her friends, was a single mother who worked at a local fast food restaurant. While Oscar Felder and Bill Grant provided the air and the material for the Ebola explosion, Vicki Anders provided the spark, as Vicki, struggling with mortgage repayments, did not stop working until her nosebleeds became uncontrollable, five days after meeting with Bill Grant. Thirty-two other people worked with Vicki and they all came down with Ebola, each of them dying within two weeks of infection.

It is estimated, from figures correlated by the CDC, that this one location directly infected upwards of 7,000 people in the week before management closed the doors. At this stage the authorities knew they were dealing with an epidemic of unprecedented scale. Ebola was being spoken about along the corridors of power and boardrooms of health facilities across the United States and Europe.

 

Day Fifteen

 

It is here that figures and counting become redundant. A few days after Rosette Grier broke with Ebola the first signs of infection were recorded in Africa. Within one week of Rosette Grier slipping off the radar in Dunning, Chicago, signs of infection began to emerge across mainland Europe and Australia. The River Ganges contributed enormously to the spread across Asia, almost single-handedly introducing Ebola Elgon to India, Pakistan, China, Tibet and Burma. These countries in turn infected Thailand, Laos, Vietnam, Cambodia, Malaysia, Mongolia, Russia, The Philippines and the Middle East.

Less than two weeks after Rosette left St. Catherine’s for the last time, thirty-two states had officially reported cases of an Ebola or an Ebola-like disease. Within three weeks all fifty states had contacted the CDC, requesting help for a problem rapidly escalating out of control. Before the CDC had 100% certainty that what was affecting the Eastern United States was a virulent and heretofore unseen strain (bear in mind, Ebola Elgon had been loose in the US for only 25 days), every country on the continent of Europe had reported outbreaks of an airborne strain of Ebola virus.

Ebola has no cure.

By September 17th all international air travel was suspended, quickly followed by all internal air travel and public transport systems across North America and Canada. Stock markets around the world began to crash. Economies faltered and governments fell; the global import/export trade imploded. On September 28th the military stepped into every city and town in the US, sealing roads and closing bridges, effectively quarantining every town and village in the country. By November 12th 85 million people had died across the 50 states alone. There were now more dead bodies than there were people to bury them. Each state, city and town had their own Ebola Mountain or Ebola Pit, a designated place to bring the dead. Soon huge tracts of land were choked with corpses. Suicide cults appeared like weeds; it is estimated that over 10 million people, either infected or not, took their own lives between November 1st and December 12th.

By the middle of December, martial law itself broke down. On New Year’s Eve 2014, two thirds of the population of North America and Canada had contracted and were dead or dying of Ebola; mouldering bodies lay in the streets, corpses littered the barricades and barriers. Hope disappeared like water down a plughole. Experimental drugs and serums were tried with varying results but time was now the biggest enemy. By the time they had a treatment, EBV208 (which itself did not cure Ebola Elgon, merely slowed it down), there were no people left to make it, no systems to distribute it and few left to give it to. In the early days of 2015 the major utilities failed; none of the predicted scenarios and stress tests could cope with the burning Ebola pandemic. Power, running water and sanitation were things of the past. Hygiene, now mankind’s only and best defence against the spread of the Ebola Elgon virus was no more. Without hygiene, by January 28th 2015 North America ceased to be.

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Post Script

— Excerpt taken from a CDC report, dated October 14th, 2016 —

‘Ebola Elgon has a mortality rate of nine out of every ten infected. On August 1st 2014, the population of the world was believed to be seven billion. By April 21st 2015 the best estimate of the global population numbered eight hundred million people, or roughly 9% of the earths population, pre Ebola Elgon. It is understood that, with no reoccurrences of Ebola Elgon, the human population should pass 1 billion by 2025.’

 

Author’s Note

This is, of course, a work of fiction but the Ebola outbreak affecting Western Africa at present highlights the danger of the Ebola virus. There are three main strains of Ebola virus – Ebola Zaire, Ebola Sudan and Ebola Reston. Take a look at those names, you may recognise two of them, Zaire and Sudan, as countries. Reston, the third, is the one that may stump you, but it is the one you should pay the closest attention to. Ebola virus strains are named after the places they were first discovered; Ebola Zaire and Sudan were discovered in those respective countries but Ebola Reston is named after a small town in Washington DC. It was first discovered in 1989, in a research facility in Reston, a small suburb of DC, where Crab-eating Macaques began to die from a haemorrhagic-type disease. Clinical investigations found this to be a new, mutated strain of the Ebola virus.

Ebola virus is spread through physical contact with either those in the final stages of Ebola or the dead bodies of Ebola virus victims. What frightened the CDC in 1989 was that the monkeys stored in the Reston research facility were contracting Ebola virus without direct physical contact, indeed some were not even in the same room or the same wing of the facility. This could mean only one thing – Ebola Reston was airborne. Of the 178 animal handlers in the Reston facility, 6 contracted Ebola Reston – however they remained asymptomatic (meaning they did not display any symptoms of the disease) and all 6 survived. Separately, performing an autopsy on one of the infected animals, a handler cut himself – a direct blood-to-blood infection. The handler was immediately quarantined but when no symptoms were reported, it was concluded that the virus did not affect humans at all. Humans were carriers of Ebola Reston, not victims of it.

Ebola Reston is lethal only to animals, yet the strain of Ebola Reston is almost exactly identical to that of its Zaire and Sudanese cousins, both of which are deadly to humans. From its first discovery in Africa in the 1976 to now, the Ebola virus has mutated over 300 times, subtly changing into new and frightening strains. Some would say the Ebola virus is evolving, protecting itself against extinction but one thing has remained constant – Ebola Zaire and Sudan are not airborne, they can only be spread through direct contact. Yet, it is not beyond the realm of possibility that somewhere, in a jungle or a cave, or perhaps a street corner or a dumpster in your neighbourhood lies the mutated offspring of Zaire, Sudan and Reston – a very real Ebola Elgon.

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