Summary
Still reeling from his discovery, Tom Geisbert takes photographic evidence of the possible filovirus to Peter Jahrling. Jahrling and Geisbert both compare the photographs with textbook images of the Marburg virus, and they become convinced that they are dealing with a Level 4 hot agent. Jahrling decides to notify the chief of the disease-assessment division at the Institute, Colonel C. J. Peters. Peters is initially skeptical but admits that signs of a filovirus are present in the sample. Jahrling decides to confirm the virus by testing the cells with blood samples infected with Ebola and Marburg. In the meantime, Peters orders Geisbert to find proof that the agent is actually growing in monkey tissue from the Reston facility.
After Colonel Peters leaves, Geisbert and Jahrling privately discuss their possible exposure to the agent. Ten days have passed since they sniffed the flask, but the incubation period for the virus can last as long as 18 days. Rather than risk being isolated in the Slammer, they decide not to tell Colonel Peters about the incident. Instead, they will test their blood for the virus and hope for the best.
Geisbert collects some sterilized pieces of monkey liver from the same animal used for the initial test. After letting the samples sit overnight, Geisbert slices the pieces open with his diamond knife and takes photographs with the electron microscope. The photographs prove definitively that the unknown virus is replicating in the monkey tissue. Geisbert shows the photographs to Colonel Peters and Peter Jahrling; all three now wait for the results of Jahrling’s test.
For the test, Jahrling uses blood serum from three individuals who were infected with a filovirus strain: Shem Musoke for Marburg, Mayinga N. for Ebola Zaire, and Boniface, a man who died from Ebola Sudan. Jahrling combines the monkey cells with blood serum from each individual. If the monkey sample tests positive for one of the three strains, the cells will glow under ultraviolet light. When Jahrling examines the slides, he is dismayed to see the Mayinga N. sample glowing brightly. He performs the test again, but with the same result. Jahrling immediately calls Colonel Peters, who decides to inform the commander of USAMRIID, Colonel David Huxsoll.
Anxious to contain a possible biohazard disaster, Huxsoll calls a meeting with Jahrling, Peters, Nancy Jaax, and Major General Philip Russell. Jahrling confirms that his test proves that the virus at the Reston facility is Ebola Zaire, or at the very least, closely related to the virus. Nancy Jaax also informs the group that the virus may have the ability to travel through the air, as she discovered during Gene Johnson’s Ebola experiments. Without the possibility of a vaccine or cure, the only way to address the outbreak is through biocontainment.
The group decides on two options for biocontainment: first, to let the virus run its course, or second, to euthanize all of the monkeys in the facility. Both options require major field operations with SWAT personnel trained in biohazard work. Colonel Peters agrees to serve as team leader. While Major General Russell calls Frederick Murphy at the C.D.C. and the rest of the group members contact other official channels, Colonel Peters calls Dan Dalgard and sets a meeting for the next morning.
Dan Dalgard has never heard of the Ebola virus and is hesitant to give Colonel Peters full access to the facility until he can meet him in person. When Dalgard calls Bill Volt for an update on the monkeys, he learns that one of the animal caretakers, Jarvis Purdy, is the hospital after suffering a heart attack. Dalgard wonders if Jarvis Purdy might have been infected with Ebola. He orders Bill Volt to suspend all operations in the monkey house except for feeding, cleaning, and observation. He also calls the hospital and asks Purdy’s doctor to contact Colonel Peters immediately if Purdy begins to exhibit any strange symptoms.
The next morning, Nancy Jaax accompanies Colonel Peters and Gene Johnson to meet Dan Dalgard at the Hazelton offices. Nancy examines a sample of monkey liver from the monkey house and identifies extreme virus amplification in the cells. Dalgard is still unwilling to take them to the monkey house but provides them with seven dead monkeys, all double-wrapped in plastic garbage bags. Back at the Institute, Nancy Jaax and Colonel Ron Trotter dissect the monkeys in a Level 4 laboratory, but the results are inconclusive. Nancy can only conclude that the monkeys are suffering from SHF, Ebola, or both.
Meanwhile, Colonel Peters calls a meeting with General Russell, Peter Jahrling, Dan Dalgard, Gene Johnson, Joe McCormick, and officials from the C.D.C. and the Virginia Board of Health. Upon the recommendation of General Russell, the group agrees to split management of the operation: while the C.D.C. will coordinate the potential human effects of the outbreak, the Army will manage the monkey house, beginning with the formation of a team to be led by Jerry Jaax. The following day, Jerry Jaax calls the first meeting of his team and outlines a plan to enter the monkey house, euthanize the monkeys in one of the rooms, and take tissue samples back to USAMRIID.
Analysis
In this section of the book, Preston details the testing and initial planning phase of the USAMRIID and the C.D.C. in addressing the outbreak at the Reston facility. During the outbreak of Ebola Zaire in 1976, the government of Zaire takes immediate steps to quarantine the hospital and isolate the infected villages in the Bumba district. The process at USAMRIID is much more deliberate, with various meetings and discussions occurring before Jerry Jaax takes his team to the facility. While it is clear that the operation will be well-funded, Preston notes many bureaucratic obstacles, including the lengthy list of which organizations must be officially informed, including the Fairfax County Health Department, the U.S. Department of Agriculture, the Environmental Protective Agency, and the Assistant Secretary of Defense.
Preston also highlights the argument over which organization will coordinate which part of the operation. Joe McCormick and C.J. Peters are both anxious to coordinate the full operation, but not because they are concerned about the potential scope of the virus. Instead, their decision is based on mutual dislike and professional rivalry. The final decision for the operation to be split is not necessarily made for the sake of how to best contain the virus, but instead, to keep the peace between organizations. Preston points out that the leadership at USAMRIID is still unable to access the Reston facility without Dalgard’s permission. Because the facility is privately-owned, they have no legal authority, despite having confirmed the presence of a filovirus. Given these bureaucratic delays, the reader cannot help but wonder what would happen if the facility is actually infected with Ebola Zaire or a virus with a similar human kill rate.
Preston draws another parallel between the Reston operation and Ebola Zaire through Jahrling and Geisbert’s refusal to admit their exposure. Both men inhaled from a flask containing a potentially airborne filovirus, yet they choose to ignore the possibility that they could be vectors for the virus. Instead of checking themselves into the Slammer for the remaining eight days of the incubation period, they decide to take a chance that they won’t develop symptoms. This choice has echoes of Nurse Mayinga’s decision to spend two days in Kinshasa in the hope that she had not actually been exposed and could still travel abroad for her studies. Although Jahrling and Geisbert are much less likely to develop symptoms than Mayinga, their decision is still undeniably selfish and potentially disastrous to their loved ones and colleagues.
Even after Peters informs Dalgard of the possibility of an Ebola outbreak at the facility, Dalgard is somewhat casual in his reaction. It is only after he is informed of Jarvis Purdy’s heart attack that he decides to cease all nonessential operations in the facility. However, even then, Dalgard still requires the animal caretakers to enter the monkey rooms in order to feed the animals and clean the cages. Given his guilt after killing the healthy monkeys in Room F, it is possible that Dalgard is trying to keep as many healthy monkeys alive as possible until the virus can be contained. However, another possibility is the threat of punishment from his employer, Hazelton Research Products, which stands to lose a great deal of money if the entire population of monkeys die from a lack of feeding.
At this point in the book, Preston reintroduces Nancy Jaax as a main protagonist. After her early struggles with discrimination, Nancy has clearly proven herself at the Institute, even to the point that she is Colonel Peters’ first call after Jahrling identifies the virus. Unlike Dalgard, who is ignorant of the danger posed by Ebola, Nancy has first-hand experience with the virus, and her presence in the narrative suddenly raises the stakes for the Reston operation. However, even Nancy is unable to conclusively identify the Ebola virus in the sample from Dalgard. Just as Gene Johnson has no proof that Kitum Cave is host to the Marburg virus, Nancy has no proof that the monkeys are not just suffering from simian fever. This section reinforces the engima-like qualities of Ebola, and the quagmire of human reaction to a potentially catastrophic outbreak.
