Pandemic (11 page)

The effects are usually first apparent in those organs where the membranes are the thinnest and most vulnerable: typically the lungs, eyes, mouth and nose. Tissues and organs become soggy as
they fill with blood; the lungs stop functioning properly; blood enters the digestive system; the throat becomes bloody and infected, making swallowing impossible; blood leaks from the eyes and
other orifices; in the latter stages brain functions become erratic and then cease almost entirely, as the skull fills with blood.

Again contrary to popular belief, a notable peculiarity of Ebola and the other viral haemorrhagic fevers is that the organs themselves are not destroyed. Despite the huge amounts of blood
present in them, the actual tissues of the organs remain perfectly healthy – in effect, they have ceased to function because they have drowned in blood. And if a patient does manage to
survive an attack by Ebola, he or she will normally suffer no lasting ill-effects: once the virus has been eliminated from the body, the organs will begin working normally once again.

In short, an attack by Ebola is essentially functional – the virus attacking the whole body through the circulatory system – rather than biochemical, in that there is no destruction
of cells or organs. The attack is always very fast but the recovery, if the patient is lucky enough to survive, is also both fast and complete.

But one other popular ‘fact’
is
true: in the latter stages of the infection, one drop – a single millilitre – of a victim’s blood can contain as many as one
hundred million virus particles.

The Ebola virus is an extremely simple yet very mysterious organism. Like the other filoviruses, it is a microscopic thread visible only at magnifications in excess of one hundred thousand, and
is characteristically very twisted and convoluted at one end – a feature that some virologists call the ‘shepherd’s crook’ or the ‘eyebolt’.

Structurally, it consists of a single strand of ribo-nucleic acid, containing the virus’s genetic code, encased in a sheath of structural proteins of seven different types. Three of these
proteins are partially understood, but virtually nothing is known about the other four. The structure and function of these four proteins is a mystery, but the combination in Ebola is lethal
– the virus appears specifically adapted to attack the circulatory system, and the human immune system seems completely incapable of fighting back.

It is also, using the tense terminology of the virologists, a
badly adapted
parasite. A well adapted parasite lives in some kind of harmony with its host: the relationship becomes almost
symbiotic, and both host and parasite will survive. Ebola can kill its human host within days, and will itself die unless it can migrate rapidly to another human being.

This fact suggests that Ebola has another host somewhere, some animal or bird living in the tropical rainforest in Zaïre which carries the virus but is essentially unaffected by it, yet
nobody has any idea what that host might be. It also implies that either Ebola has mutated naturally, or it has been manufactured, to become capable of attacking the human immune system.

In its effects, if not in its appearance, it does resemble some other viruses. It appears to be distantly related to those which cause mumps, measles and rabies, for example, and also pneumonia
and influenza. But these are all benign compared to Ebola and, unlike them, there is no known cure or even treatment for attack by a filovirus.

Marburg, Ebola Zaïre and its slightly less lethal cousin Ebola Sudan, which has only about a fifty per cent lethality, are all classed as Level Four Hot Agents – L4HA – hence
Hardin’s speed of reaction once he had read the message on his pager.

‘What have you got?’ Hardin demanded immediately, as he shouldered open the door.

‘It sounds quite like Ebola,’ Walter Cross explained, ‘but if the agent is a filovirus, it’s a hell of a long way from home.’

‘Where is it, then?’

‘Crete,’ Cross replied shortly.

‘That’s Crete as in Crete in the Mediterranean?’ Hardin’s surprise was obvious in his voice.

‘Yup. We – or to be accurate you – are going to have to go in to confirm it, but the message from the reporting doctor makes it sound pretty much like a filovirus infection of
some sort. Maybe even some kind of totally new strain.’

Hardin sat down, slid a sheet of notepaper across the desk and began scribbling on it. ‘Ebola in Crete is really scary,’ he continued. ‘An infection in a major holiday area
like that could scatter the virus over most of Europe. What about jurisdiction? Do we have an EPI One?’

The Centers for Disease Control is a federal agency. That means before the CDC can send anyone to investigate something within America, the state in which the outbreak occurs or its local health
authority has to formally request assistance from the CDC. Outside the United States, exactly the same rules apply: the CDC has to be officially invited to assist by the government or its health
ministry.

The form known as EPI 1 is basically a movement order for a CDC officer or team. It confirms that assistance has been requested from the agency, provides a brief summary of the investigation
which the CDC intends to undertake, and what it hopes to achieve, lists the names of the CDC personnel who will be involved, and specifies which authorities in the destination government’s
health department are to be contacted on arrival.

‘It’s being typed right now,’ Cross replied. ‘We’ve been formally requested to assist by the Cretan health ministry, but the contact list is real short. It’s
just one man – Dr Theodore Gravas – and he’s actually now on the scene at this village called Kandíra.’

‘What else have you done so far?’ Hardin asked.

‘I’ve faxed the Cretan health guys the standard list of instructions and warnings. I’ve got people making airline bookings right now, and others recalling the staff
you’ll need with you. And I paged you, of course. Good response time, by the way.’

‘Thanks,’ Hardin grunted, abstractedly.

Kandíra, south-west Crete

It had taken Inspector Lavat some three hours to set up the cordon, and would have taken a lot longer if the village hadn’t sat almost on the edge of the cliff.
Therefore the seaward side fortunately required no action, but summoning the men he needed from Chaniá and Irakleío had taken time, and even then they were too thinly spread for his
liking around the hastily created perimeter.

Gravas had been adamant: nobody was entering or leaving Kandíra until he said so. And that would not occur until he knew for sure exactly what had killed Aristides. The big problem was
that he couldn’t perform the diagnosis himself. He and his men would need expert help and specialist equipment, not least biological space suits, just to go anywhere near Aristides’s
body again.

When he had telephoned the Cretan Ministry of Health, requesting they contact the Centers for Disease Control and Prevention for urgent assistance, the officials there hadn’t argued for
long. Most health professionals would know about Ebola, and the consequences of any kind of a filovirus outbreak erupting in a highly populated tourist destination like Crete simply didn’t
bear thinking about. And even that might be the least of their worries. If tourists, returning home to America, Britain and Europe, began incubating any filovirus with a lethality similar to Ebola,
they could soon spread an uncontrollable plague that would make the Black Death seem like an attack of head colds.

With the Ministry of Health informed, and the wheels set in motion, Gravas had turned his attention back to his more immediate problem – Kandíra and the people who called the small
isolated community home.

There were now several problems he had to address. First, he had to ensure that anyone who had already stepped inside Aristides’s house was fully quarantined. He realized this could be
overkill, because Ebola and Marburg are normally spread by body-fluid exchange from an infected victim. But there was a third, little-known, Ebola variant called Ebola Reston, which was lethal to
monkeys but for some reason appeared not to affect human beings, and was believed to be transmitted by airborne particles. So it was better not to take any chances.

He also needed, urgently, to find out where exactly the Greek had been, and who he had been with, over the last few days – especially the previous day. Those who had last seen him could
provide valuable clues to his physical appearance, which might give Gravas some pointers indicating how fast the disease had progressed. And of course there was the real possibility that some of
the people who had been in Aristides’s company were now also incubating the virus, in which case there would be more deaths, possibly a lot more, over the next few days.

His final problem was the biggest: he had to find out exactly how and where Aristides had become infected by the virus that had killed him. And, as he looked up and down the dusty street, baking
in the afternoon sunshine, Gravas had no idea how he was going to determine that.

Irakleío, Crete

The faxed message from the Centers for Disease Control to the Cretan Ministry of Health was in English and ran to some eight pages of single-spaced typing, but what it
said could be condensed into a simple five-word instruction: ‘Touch nothing. Wait for us.’

It also contained a request for two large chest freezers, and if necessary a generator to power them, to be shipped to the site of the outbreak if such facilities weren’t already available
there. The duty officer at the Ministry made two telephone calls, got no sense out of either party, shrugged, and then made another two calls. The first went to a domestic appliance supplier in
Irakleío, the second to an industrial equipment company.

Within thirty minutes of the telephone call received from Dr Gravas, an urgent meeting had been convened to decide on necessary action before the CDC team arrived. It was short and fairly
acrimonious. The Minister of Tourism, concerned primarily with the island’s image as a holiday resort, had opposed almost everything pending confirmation of exactly what had happened in
Kandíra, but had been over-ruled every step of the way.

Fifteen minutes after stepping out of the conference room, the Minister of Health issued a series of instructions that only reinforced the isolation of Kandíra. An hour after that, he
finally issued a short statement to a handful of waiting pressmen, but refused to answer any of their questions.

Aeroporto di Brindisi, Papola-Casale, Puglia, Italy

Looking pink and well fed, Simpson returned to the squadron building just after four in the afternoon, and noted the two empty sandwich wrappers and a paper cup –
evidence of Richter’s rather less than gourmet lunch – with a certain amount of dissatisfaction.

‘Why don’t you ever eat properly?’ he demanded.

‘Unlike you,’ Richter retorted, ‘I don’t have an unlimited expense account. And food is just food: protein, carbohydrate, starch and fat. As long as you get enough of it
inside you, it doesn’t much matter what the source of it is.’

‘God, you’re a Philistine, and a scruffy one at that.’ Simpson glared at Richter’s faded jeans and T-shirt.

‘These are the clothes you brought out for me,’ Richter observed.

‘Yes, but you’re the one wearing them, and they were pretty much all we could find usable in your flat.’

‘I prefer jeans, and T-shirts are comfortable.’ Richter was tiring of the subject. ‘I take it you had a good lunch? Largely liquid, perhaps?’

‘None of your business,’ Simpson replied sharply.

The door opened behind him, and Giancarlo Perini entered the briefing-room. He carried a large plastic bag which he placed on the table only after Richter had removed the debris he had left
there.

‘What’s this?’ Simpson asked.

‘A Kevlar jacket,’ Perini replied. ‘We have no idea if Lomas – if it is him – will be armed, though we’re assuming he will be. I want everyone who gets close
to him to be protected – including Mr Richter here.’ Richter himself thought this was an excellent idea. ‘You, Mr Simpson, will presumably not be at the scene yourself?’

Simpson shook his head firmly. He was an organizer, not an operative. ‘When do we leave?’ he asked.

‘In half an hour or so,’ Perini replied, and gestured out of the window at the sleekly pointed shape of the Agusta 109 helicopter squatting outside on the tarmac. ‘We’ll
fly to a location a mile or so from the villa, and meet the DCPP officers there.’

The SISDE, like Britain’s Security Service, has no law enforcement powers, and relies on a division of the police force – the
Direzione Centrale Polizia di Prevenzione
–
to carry out arrests on its behalf. In the United Kingdom, the Metropolitan Police Special Branch fulfils the same function for MI5.

‘How many men are you using?’ Richter asked.

‘Ten including the drivers,’ Perini said. ‘They’ll all be armed with automatic weapons and side-arms, and wearing body armour.’

That was pretty much what Richter had expected, so he didn’t foresee too much trouble.

Simpson nodded approval. ‘That should be enough for getting just one man.’

‘More than enough,’ Richter said, though he was agreeing with what Simpson had said, rather than what he meant.

Fifteen minutes later Richter pulled on the Kevlar vest and secured it around his torso. The vest was, in fact, a bonus that Richter hadn’t anticipated. He’d expected that the DCPP
officers themselves would enter the property to arrest Lomas, then call him in later to carry out the identification, but it now looked as if he would actually be on the scene when they first
entered the villa, which might make things a lot easier for him.

Richter and Simpson headed out of the building towards the Agusta 109, following Perini. The pilot was strapped in and running through his pre-take-off checks. A ground marshaller and fireman
stood in front of the helicopter waiting for engine start. Richter increased his stride to fall into step beside Perini. ‘Could I ask a favour?’ he said.

‘Of course, Mr Richter, what is it?’