Milton Frantig, the man who had thrown up on the lawn, had now been kept in isolation at Fairfax Hospital for several days. He was feeling much better, his fever had vanished, he had not developed any nosebleeds, and he was getting restless. Apparently he did not have Ebola. At any rate, it did not show up in his blood tests. Apparently he had a mild case of flu. The C.D.C. eventually told him he could go home.
• • •
By day nineteen after the whiffing incident, when they hadn’t had any bloody noses, Peter Jahrling and Tom Geisbert began to regard themselves as definite survivors. The fact that Dan Dalgard and the monkey workers had so far shown no signs of breaking with Ebola also reassured them, although it was very puzzling. What on earth was going on with this virus? It killed monkeys like flies, they were dripping virus from every pore, yet no human being had crashed. If the virus wasn’t Ebola Zaire, what was it? And where had it come from? Jahrling believed that it must have come from Africa. After all, Nurse Mayinga’s blood reacted to it. Therefore, it must be closely related to Ebola Zaire. It was behaving like the fictional Andromeda strain. Just when we thought the world was coming to an end, the virus slipped away, and we survived.
The Centers for Disease Control focused its efforts on trying to trace the source of the virus, and the trail eventually led back to the Ferlite Farms monkey-storage facility near Manila. All of the Reston monkeys had come from there. The place was a way station on their trip from the forests of Mindanao to Washington. Investigators found that monkeys had been dying in large numbers there, too. But it looked as though no Philippine monkey workers had become sick either. If it was an African virus, what was it doing in the Philippines? And why weren’t monkey handlers dying? Yet the virus was able to destroy a monkey. Something very strange was going on here. Nature had seemed to be closing in on us for a kill, when she suddenly turned her face away and smiled. It was a Mona Lisa smile, the meaning of which no one could figure out.
DECEMBER 18, MONDAY
The decon team scrubbed the building with bleach until they took the paint off the concrete floors, and still they kept scrubbing. When they were satisfied that all of the building’s inside surfaces had been scoured, they moved on to the final stage, the gas. The decon team taped the exterior doors, windows, and vents of the building with silver duct tape. They taped sheets of plastic over the exterior openings of the ventilation system. They made the building airtight. At various places inside the monkey house, they set out patches of paper saturated with spores of a harmless bacterium known as Bacillus subtilis niger. These spores are hard to kill. It is believed that a decon job that kills niger will kill almost anything.
The decon team brought thirty-nine Sunbeam electric frying pans to the monkey house. Sunbeam electric frying pans are the Army’s tool of choice for a decon job. The team laid an electric cable along the floor throughout the building, strung with outlets, like a cord for Christmas-tree lights. At points along the cable, they plugged in the Sunbeam frying pans. They wired the cable to a master switch. Into each Sunbeam frying pan they dropped a handful of disinfecting crystals. The crystals were white and resembled salt. They dialed the pans to high. At 1800 hours on December 18, someone threw the master switch, and the Sunbeams began to cook. The crystals boiled away, releasing formaldehyde gas. Since the building’s doors, windows, and vents were taped shut, the gas had nowhere to go, and it stayed inside the building for three days. The gas penetrated the air ducts, soaked the offices, got into drawers in the desks, and got inside pencil sharpeners in the drawers. It infiltrated Xerox machines and worked its way inside personal computers and inside the cushions of chairs and fingered down into the floor drains until it touched pools of lingering bleach in the water traps. Finally the decon team, still wearing space suits, went back inside the building and collected the spore samples. The Sunbeam treatment had killed the niger.
There is an old piece of wisdom in biohazard work that goes like this: you can never know when life is exterminated. Life will survive almost any blitz. Total, unequivocal sterilization is extremely difficult to achieve in practice and is almost impossible to verify afterward. However, a Sunbeam cookout that lasts for three days and exterminates all samples of niger implies success. The monkey house had been sterilized. Ebola had met opposition. For a short while, until life could re-establish itself there, the Reston Primate Quarantine Unit was the only building in the world where nothing lived, nothing at all.
THE MOST
DANGEROUS STRAIN
1990 JANUARY
The strain of Ebola virus that had erupted near Washington went into hiding somewhere in the rain forest. The cycling went on. The cycling must always go on if the virus is to maintain its existence. The Army, having certified that the monkey house had been nuked, returned it to the possession of Hazleton Research Products. Hazleton began buying more monkeys from the Philippines, from the same monkey house near Manila, and restocked the building with crab-eating monkeys that had been trapped in the rain forests of Mindanao. Less than a month later, in the middle of January, some of the monkeys in Room C began dying with bloody noses. Dan Dalgard called Peter Jahrling. “Looks like we’re affected again,” he said.
The virus was Ebola. It had come from the Philippines. This time, since there had been no human casualties during the first outbreak, the Army, the C.D.C., and Hazleton jointly decided to isolate the monkeys—leave them alone and let the virus burn. Dan Dalgard hoped to save at least some of the monkeys, and his company did not want the Army to come back with space suits.
What happened in that building was a kind of experiment. Now they would see what Ebola could do naturally in a population of monkeys living in a confined air space, in a kind of city, as it were. The Ebola Reston virus jumped quickly from room to room, and as it blossomed in the monkeys, it seemed to mutate spontaneously into something that looked quite a lot like influenza. But it was an Ebola flu. The monkeys died with great quantities of clear mucus and green mucus running from their noses, mixed with blood that would not clot. Their lungs were destroyed, rotten and swimming with Ebola virus. They had pneumonia. When a single animal with a nosebleed showed up in a room, generally 80 percent of the animals died in that room shortly afterward. The virus was extraordinarily contagious in monkeys. The Institute scientists suspected that they were seeing a mutant strain of Ebola, something new and a little different from what they had seen just a month before, in December, when the Army had nuked the monkey house. It was frightening—it was as if Ebola could change its character fast—and could look like the flu. As if a different strain could appear in a month’s time. The clinical symptoms of the disease served as a reminder of the fact that Ebola is related to certain kinds of flu-like illnesses seen in human children. It seemed that the virus could adapt quickly to new hosts, and that it could change its character spontaneously and rapidly as it entered a new population.
Ebola apparently drifted through the building’s air-handling ducts. By January 24, it had entered Room B, and monkeys in that room started going into shock and dying with runny noses, red eyes, and masklike expressions on their faces. In the following weeks, the infection entered Rooms I, F, E, and D, and the animals in these rooms virtually all died. Then, in mid-February, a Hazleton animal caretaker who will be called John Coleus was performing a necropsy on a dead monkey when he cut his thumb with a scalpel. He had been slicing apart the liver, one of the favorite nesting sites of Ebola. The scalpel blade, smeared with liver cells and blood, went deep into his thumb. He had had a major exposure to Ebola.
The liver that he had been cutting was rushed to USAMRIID for analysis. Tom Geisbert looked at a piece of it under his microscope and, to his dismay, found that it was “incredibly hot—I mean, wall to wall with virus.” Everyone at the Institute thought John Coleus was going to die. “Around here,” Peter Jahrling told me, “we were frankly fearful that this guy had bought the farm.” The C.D.C. decided not to put him into isolation. So Coleus visited bars and drank beer w
ith his friends. While he was incubating the virus.
“Here at the Institute,” Peter Jahrling said, “we were absolutely appalled when that guy went out to bars, drinking. Clearly the C.D.C. should not have let that happen. This was a serious virus and a serious situation. We don’t know a whole lot about the virus. It could be like the common cold—it could have a latency period when you are shedding virus before you develop symptoms—and by the time you know you are sick, you might have infected sixteen people. There’s an awful lot we don’t know about this virus. We don’t know where it came from, and we don’t know what form it will take when it appears next time.”
John Coleus had a minor medical condition that required surgery. Doctors performed the operation while he was in the incubation period after his exposure to Ebola. There is no record indicating that he bled excessively during the surgery. He came through fine, and he is alive today, with no ill effects from his exposure.
As for the monkey house, the entire building died. The Army didn’t have to nuke it. It was nuked by the Ebola Reston virus. Once again, there were no human casualties. However, something eerie and perhaps sinister occurred. A total of four men had worked as caretakers in the monkey house: Jarvis Purdy, who had had a heart attack; Milton Frantig, who had thrown up on the lawn; John Coleus, who had cut his thumb; and a fourth man. All four men eventually tested positive for Ebola Reston virus. They had all been infected with the agent. The virus had entered their bloodstreams and multiplied in their cells. Ebola proliferated in their bodies. It cycled in them. It carried on its life inside the monkey workers. But it did not make them sick, even while it multiplied inside them. If they had headaches or felt ill, none of them could recall it. Eventually the virus cleared from their systems naturally, disappeared from their blood, and as of this writing none of the men was affected by it. They are among the very, very few known human survivors of Ebola virus. John Coleus certainly caught the virus when he cut himself with a bloody scalpel, no question about that. What is more worrisome is that the others did not cut themselves, yet the virus still entered their bloodstreams. It got there somehow. Most likely it entered their blood through contact with the lungs. It infected them through the air. When it became apparent to the Army researchers that three of the four men who became infected had not cut themselves, just about everyone at USAMRIID concluded that Ebola can spread through the air.
Dr. Philip Russell—the general who made the decision to send in the Army to stop the virus—recently said to me that although he had been “scared to death” about Ebola at the time, it wasn’t until afterward, when he understood that the virus was spreading in the air among the monkeys, that the true potential for disaster sank in for him. “I was more frightened in retrospect,” he said. “When I saw the respiratory evidence coming from those monkeys, I said to myself, My God, with certain kinds of small changes, this virus could become one that travels in rapid respiratory transmission through humans. I’m talking about the Black Death. Imagine a virus with the infectiousness of influenza and the mortality rate of the black plague in the Middle Ages—that’s what we’re talking about.”
The workers at Reston had had symptomless Ebola virus. Why didn’t it kill them? To this day, no one knows the answer to that question. Symptomless Ebola—the men had been infected with something like an Ebola cold. A tiny difference in the virus’s genetic code, probably resulting in a small structural change in the shape of one of the seven mysterious proteins in the virus particle, had apparently changed its effects tremendously in humans, rendering it mild or harmless even though it had destroyed the monkeys. This strain of Ebola knew the difference between a monkey and a person. And if it should mutate in some other direction …
One day in spring, I went to visit Colonel Nancy Jaax, to interview her about her work during the Reston event. We talked in her office. She wore a black military sweater with silver eagles on the shoulder boards—she had recently made full colonel. A baby parrot slept in a box in the corner. The parrot woke up and squeaked.
“Are you hungry?” she asked it. “Yeah, yeah, I know.” She pulled a turkey baster out of a bag and loaded it with parrot mush. She stuck the baster into the parrot’s beak and squeezed the baster bulb, and the parrot closed its eyes with satisfaction.
She waved her hand at some filing cabinets. “Want to look at some Ebola? Take your pick.”
“You show me,” I said.
She searched through a cabinet and removed a handful of glass slides, and carried them into another room, where a microscope sat on a table. It had two sets of eyepieces so that two people could look into it at the same time.
I sat down and stared in the microscope, into white nothingness.
“Okay, here’s a good one,” she said, and placed a slide under the lens.
I saw a field of cells. Here and there, pockets of cells had burst and liquefied.
“That’s male reproductive tissue,” she said. “It’s heavily infected. This is Ebola Zaire in a monkey that was exposed through the lungs in 1986, in the study that Gene Johnson and I did.”
Looking at the slice of monkey testicle, I got an unpleasant sensation. “You mean, it got into the monkey’s lungs and then moved to its testicles?”
“Yeah. It’s pretty yucky,” she said. “Now I’m going to make you dizzy. I’m going to show you the lung.”
The scene shifted, and we were looking at rotted pink Belgian lace.
“This is a slice of lung tissue. A monkey that was exposed through the lungs. See how the virus bubbles up in the lung? It’s Ebola Zaire.”
I could see individual cells, and some of them were swollen with dark specks.
“We’ll go to higher magnification.”
The cells got bigger. The dark specks became angular, shadowy blobs. The blobs were bursting out of the cells, like something hatching.
“Those are big, fat bricks,” she said.
They were Ebola crystalloids bursting out of the lungs. The lungs were popping Ebola directly into the air. My scalp crawled, and I felt suddenly like a civilian who had seen something that maybe civilians should not see.
“These lungs are very hot,” she said in a matter-of-fact voice. “You see those bricks budding directly into the air spaces of the lung? When you cough, this stuff comes up your throat in your sputum. That’s why you don’t want someone who has Ebola coughing in your face.”
“My God, it knows all about lungs, doesn’t it?”
“Maybe not. It might live in an insect, and insects don’t have lungs. But you see here how Ebola has adapted to this lung. It’s budding out of the lung, right straight into the air.”
“We’re looking at a highly sophisticated organism, aren’t we?”
“You are absolutely right. This hummer has an established life cycle. You get into that what-if? game. What if it got into human lungs? If it mutates, it could be a problem. A big problem.”
• • •
In March 1990, while the second outbreak at Reston was happening, the C.D.C. slapped a heavy set of restrictions on monkey importers, tightening the testing and quarantine procedures. The C.D.C. also temporarily revoked the licenses of three companies, Hazleton Research Products, the Charles River Primates Corporation, and Worldwide Primates, charging these companies with violations of quarantine rules. (Their licenses were later reinstated.) The C.D.C.’s actions effectively stopped the importation of monkeys into the United States for several months. The total loss to Hazleton ran into the millions of dollars. Monkeys are worth money. Despite the C.D.C.’s action against Hazleton, scientists at USAMRIID, and even some at the C.D.C., gave Dalgard and his company high praise for making the decision to hand over the monkey facility to the Army. “It was hard for Hazleton, but they did the right thing,” Peter Jahrling said to me, summing up the general opinion of the experts.
Hazleton had been renting the monkey house from a commercial landlord. Not surprisingly, relations between the landlord and Hazleton did not flourish happ
ily during the Army operation and the second Ebola outbreak. The company vacated the building afterward, and to this day it stands empty.
Peter Jahrling, a whiffer of Ebola who lived to tell about it, is now the principal scientist at USAMRIID. He and Tom Geisbert, following tradition in the naming of new viruses, named the strain they had discovered Reston, after the place where it was first noticed. In conversation, they sometimes refer to it casually as Ebola Reston. One day in his office, Jahrling showed me a photograph of some Ebola-virus particles. They resembled noodles that had been cooked al dente. “Look at this honker. Look at this long sucker here,” Jahrling said, his finger tracing a loop. “It’s Reston—oh, I was about to say it’s Reston, but it isn’t—it’s Zaire. The point is, you can’t easily tell the difference between the two strains by looking. It brings you back to a philosophical question: Why is the Zaire stuff hot for humans? Why isn’t Reston hot for humans, when the strains are so close to each other? The Ebola Reston virus is almost certainly transmitted by some airborne route. Those Hazleton workers who had the virus—I’m pretty sure they got it through the air.”
“Did we dodge a bullet?”
“I don’t think we did,” Jahrling said. “The bullet hit us. We were just lucky that the bullet we took was a rubber bullet from a twenty-two rather than a dumdum bullet from a forty-five. My concern is that people are saying, ‘Whew, we dodged a bullet.’ And the next time they see Ebola in a microscope, they’ll say, ‘Aw, it’s just Reston,’ and they’ll take it outside a containment facility. And we’ll get whacked in the forehead when the stuff turns out not to be Reston but its big sister.”
• • •
C. J. Peters eventually left the Army to become the chief of the Special Pathogens Branch at the Centers for Disease Control. Looking back on the Reston event, he said to me one day that he was pretty sure Ebola had spread through the air. “I think the pattern of spread that we saw, and the fact that it spread to new rooms, suggest that Ebola aerosols were being generated and were present in the building,” he said. “If you look at pictures of lungs from a monkey with Ebola Zaire, you see that the lungs are fogged with Ebola. Have you seen those pictures?”