Wildcard

THREE

Steven arrived for the 7.30 p.m. briefing at the Foreign Office at 7.20 and found more than fifty people already there. Some he knew, many he didn’t. One of those he did was Fred Cummings; a consultant microbiologist attached to the London Public Health Service. Fred tended to stand out in a crowd because of his sparse but bright-red hair and a liking for loud sports jackets.

‘Big turn-out,’ said Steven, coming up at his elbow.

‘Porton wanted to speak to everyone concerned at the same time, rather than have a series of meetings with health chiefs and local authorities,’ said Cummings.

‘So they’ve identified it?’

‘Let’s hope so,’ said Cummings. ‘They’ve taken long enough about it. A fiver says it’s Ebola.’

‘Ebola fever in the Old Kent Road — now there’s a thought to conjure with,’ said Steven, ignoring the bet.

‘Tell me about it.’ Cummings smiled. ‘I haven’t needed All Bran since that bloody plane landed.’

A distinguished-looking man, whom Steven took to be a Foreign Office official, appealed for quiet and the hubbub died down. Four people mounted the platform and were introduced jointly as the investigating team from Porton Down. Their leader, Dr Clive Phelps, a tall, gangly man with bushy grey hair and a straggly beard, took the Foreign Office man’s place at the microphone and tapped it twice unnecessarily before speaking. Steven wondered idly how he would get his beard inside a surgical mask.

‘Good evening,’ said Phelps. ‘I understand that everyone here — apart from Foreign Office personnel, who have their own reasons for requiring information — is a health professional so I won’t beat about the bush. It’s a filovirus.’

‘Surprise, surprise,’muttered Cummings. ‘The Daily Mail ’s been telling us that for weeks.’

‘But, contrary to popular reports and rumour, it isn’t Ebola,’ continued Phelps.

‘So it has to be Marburg,’ whispered Cummings. ‘There only are two filoviruses.’

‘And it isn’t Marburg disease either.’

‘Bloody hell,’ breathed Cummings. He felt like the straight man in a comedy double act. ‘Then how can you call it a filovirus?’ he asked out loud, as hubbub again filled the room.

‘Under the electron microscope the virus appears filamentous, forming branched filaments of up to fourteen thousand nanometres in length. In other words, it looks like a filovirus and, of course, it causes a haemorrhagic fever very similar to Ebola, if not identical. The victims suffer high temperature, stomach cramps and nausea, and bleed profusely from just about everywhere.’

‘So why do you say it isn’t Ebola?’

‘The four subtypes of Ebola that we know about and have characterised in the past all have a uniform diameter of eighty nanometres. This virus has a diameter of a hundred and twenty nanometres.’

‘It could be a new subtype,’ suggested Cummings.

‘That’s possible,’ conceded Phelps with an uncomfortable shrug, ‘but we think not. We’ve carried out an investigation of the nucleic acid content of the virus — that’s what’s been taking the time — and there are significant differences. That’s why we think it’s a new virus.’

‘All we need,’ whispered Cummings to Steven. ‘Another bloody African virus.’

‘Any ideas about source?’ asked someone else.

‘None at all,’ replied Phelps. ‘But if the truth be told, we still have no idea about the source of Ebola either, and we’ve known about that disease for over thirty years. Ebola’s natural reservoir is as much a mystery today as it was when the disease was first reported.’

‘Would it be fair to say that this new virus is not as potent as Ebola, in view of the way it was so easily contained? I seem to remember people dropping like flies during the Ebola outbreaks in Zaire a few years back.’

‘No, that’s an entirely false impression,’ replied Phelps. ‘And I can’t stress that enough. The Heathrow incident was contained with apparent ease because of the expertise of the people involved. The African outbreak you’re thinking of was made to appear worse than it actually was by the poor practice in the local hospitals and a lack of knowledge among the staff about how the disease was spread. Using the same syringe needle for several patients was common practice at that time, and still is in many African hospitals. You can work out for yourselves what happens when you get a case of Ebola among them: the disease spreads faster than bad news. Another factor in the Zaire outbreak was nursing care. In African hospitals, basic nursing care tends to be carried out by the patients’ families. They, of course, cannot be expected to have any notion of aseptic technique, so they come into contact with contaminated body fluids and then go down with the disease themselves. That’s why the African outbreaks appeared to suggest that the virus was airborne and could spread like wildfire.’

‘Can we be perfectly sure there’s no danger of a general outbreak arising from the Heathrow incident?’ asked a female voice.

‘Absolutely. The patient, Barclay, was the source of the outbreak, if you want to call it that. The others contracted the disease by coming into contact with his body fluids. Barclay and all the others who died were cremated, so we are confident that the virus died with them.’

‘What about the other passengers?’ asked a man who identified himself as Chisholm, a professor of virology at the London School of Hygiene and Tropical Medicine.

‘What about them?’

‘Isn’t there a chance that they might still be incubating the disease?’

‘No. We’re talking about an incubation time of four to ten days. That time has passed and everyone is still okay.’

‘It’s four to ten days for Ebola,’ the professor reminded him.

‘A fair point,’ agreed Phelps. ‘I suppose it is conceivable that this virus might have a longer incubation period than Ebola, but not judging by the rapidity with which the stewardess and the others went down with it after coming into contact with Barclay.’

‘But they had direct contact with Barclay,’ said the professor, clearly unwilling to let the matter drop.

‘What is the point you are making, Professor?’ asked Phelps, his voice betraying slight impatience.

‘Merely that some of the other passengers might have received smaller initial doses of the virus and therefore might conceivably take longer to go down with the disease.’

‘What did you have in mind?’

‘A cough or a sneeze from Barclay would have given rise to small fluid droplet particles, which could for all intents and purposes be deemed to be body fluids.’

‘I take your point, Professor, and we did consider that aspect, but the surviving stewardess was able to tell us that Barclay did not have any coughing or sneezing fits while he was on board the aircraft, although he did vomit once.’

The professor’s silence emphasised his point.

Phelps appeared to develop a slight tic below his left eye. ‘Well, as of this morning, all the other passengers are absolutely fine,’ he said, hoping to put an end to speculation.

‘Am I right in thinking that this new virus appears to have a hundred-per-cent mortality rate?’ asked Heathrow’s chief medical officer. ‘There were no survivors, were there?’

‘You’re quite right,’ said Phelps, ‘but thankfully there were only a small number of patients and therefore that is perhaps not significant in a statistical sense. It is true, however, that they all died.’

‘So in that respect the disease could be said to be even worse than Ebola?’

‘Yes, on the basis of just five cases,’ agreed Phelps. ‘Ebola itself has a seventy- to eighty-per-cent mortality rate. It would be quite unusual to find anything more deadly than that. Let’s hope we’ve seen the last of this particular bug so we won’t get the chance to compare it.’

‘And so say all of us,’ muttered the man behind Steven and Cummings.

‘I take it you have no idea how Barclay himself caught the disease?’ asked Fred Cummings.

‘None at all, I’m afraid. I understand there is no current outbreak of haemorrhagic fever in Ndanga or its immediate neighbours, so it’s all a bit of a mystery.’

Steven left the meeting with Fred Cummings and they went for a drink. ‘So what’s your interest in all of this?’ asked Cummings as they sat down with their beer.

‘The foreign secretary’s due to visit Ndanga in the next couple of weeks. His people want to be sure there’s no outbreak of Ebola or anything like it in the country, so they asked Sci-Med if we could sniff around, see what we could come up with on the unofficial grapevine.’

‘And?’

‘It seems to be clear from all accounts but, like the man said, it’s a bit of a mystery how Barclay went down with it in the first place.’

‘Happily, it’s not my mystery,’ said Cummings. ‘Salmonella from dodgy restaurants I can cope with, the occasional pocket of TB, seasonal blips of meningitis, yes, but the thought of something like one of these African viruses on the streets of London makes my blood run cold.’

‘Or just run,’ said Steven. ‘From every orifice, I understand.’

‘The trouble is, it is going to happen one day. I’ve never been more sure of anything.’

‘You don’t think we’re prepared?’

Cummings took a sip of his beer and thought for a moment. ‘There’s a real danger of complacency,’ he said. ‘The Heathrow people did a good job, but the fact is that their problem was confined to the inside of an aircraft. They had all the time in the world to surround the problem and contain it, and they did. All credit to them, but there’s a danger of people in my line of work thinking that it’s always going to be that easy, or that the virus really isn’t that dangerous when it is. The real lesson to be learned from this incident is the fact that a highly trained nurse, equipped with all the protective gear available, still managed to contaminate herself. Despite what Phelps said, it’s surprisingly difficult to avoid contact with body fluids, especially in a domestic situation where people tend not to have Racal suits with self-contained air supplies hanging in their wardrobes or boxes of surgical gloves sitting by the kitchen sink. Frankly, it’s damned nearly impossible. I think we’d see a very different picture if Ebola or Marburg broke out on a large housing estate instead of in an airliner at thirty-five thousand feet.’

‘Put that way, it doesn’t bear thinking about,’ said Steven.

‘And d’you know the worst thing? If it did, the whole medical profession put together couldn’t do a blind thing about it. We’d be completely powerless. It would be like the great plagues of the Middle Ages all over again. We’d have to resort to nosegays and prayer books.’

‘Then the solution must be to tackle the problem at source,’ said Steven. ‘Seek out the natural reservoirs of these viruses and destroy them before they spread into the community.’

‘Unfortunately their source, whatever it is, lies in Africa and nothing is ever easy in Africa. CDC Atlanta has been trying to establish the natural source of Ebola for decades without success. The Pasteur Institute in Paris is trying to get a handle on it by examining all the data ever logged about the disease, but records are less than scrupulous.’

‘I can imagine.’

When he got home, Steven poured himself a gin and tonic and put a CD on the stereo to fill the room with the soulful tenor sax of Stan Getz. He found two fax messages lying in the tray of the machine and sat down in his favourite chair by the window to read them. They were from two of his contacts in the medical charities, one working with the Red Cross and the other with a voluntary organisation called Medic Outreach. Both stated that, as far as they could ascertain, Ndanga was free of haemorrhagic fever and had been for some time. He faxed back his thanks.

Steven switched out the lights and rested his head on the chair back for a moment to look up at the sky. It was a clear night and he could see the stars — that was why he liked sitting in this chair. He reflected that finding out what he wanted to know had all been surprisingly easy. No one had reported that they didn’t know or that they weren’t sure. Everyone had said that there was no haemorrhagic fever in Ndanga. Barclay’s misfortune in contracting the disease had just been one of these things — whatever that meant, he mused; it tended to be a generally accepted explanation anywhere outside academia. Just one of these things… just one of those ‘crazy’ things, as the song said, or one of those ‘unexplained’ things that spawned late-night television programmes that invariably never came to any conclusions. To the list he added one of those ‘foolish’ things, when he realised with a wry smile that this was the title of the current Getz track. But whatever the reason for Barclay’s bad luck, he felt confident that he could tell Macmillan in the morning that there was no good reason for the foreign secretary’s visit not to go ahead. With a bit of luck, he himself should be able to catch an afternoon flight up to Scotland and be in Dumfriesshire with his daughter by early evening.

Steven’s five-year-old daughter, Jenny, lived with his sister-in-law, Sue, and her solicitor husband, Richard, in the Dumfriesshire village of Glenvane where she was being brought up with their own children, Mary, aged eight, and Robin, six. This had been the case since Steven’s wife, Lisa — Sue’s sister — had died of a brain tumour some two years ago. It had become his practice to visit Scotland every second or third week and stay the weekend, so that Jenny would not forget who her real father was and he could enjoy watching her grow. Despite her tender years, there was a lot about Jenny that reminded him of Lisa and he took pleasure from that — especially the look in her eyes when she thought that he might be keeping something from her. That was Lisa to a tee and he just melted inside when she did it.

To say that Steven had taken Lisa’s death badly would be a gross understatement. Although there had been seven months to prepare for the inevitable after the initial diagnosis, her death had hit him hard, and after the funeral he had given up on just about everything. He hadn’t worked at all for over nine months afterwards, preferring instead to seek solace in booze and trying desperately to live in the past by shutting out the present and ignoring the very possibility of a future. But, like most people going through the hell of bereavement, he survived and came out the other side — perhaps not better for the experience, but knowing a great deal more about himself than he had before. He could now look back on his painfully short time with Lisa — a little over four years in all — with great fondness. He still missed her but it was no longer that awful knife-in-the-guts feeling.

The situation with Jenny was not ideal but his job was such that it ruled out arrangements involving day help or nanny care. He had toyed with the idea of finding a more ordinary job so that he would be home every night and could therefore have Jenny living with him, but, if he was absolutely honest with himself, it hadn’t gone much further than that and it wouldn’t. It might be selfish — in fact, it almost certainly was, he admitted — but he liked working for Sci-Med too much to give it up. Any feelings of guilt he might harbour were comfortably offset by the fact that Jenny seemed very happy living with Sue and Richard and their kids, and they saw and treated her as one of their own.

The Getz track changed to something soulful and almost subconsciously he started to look round the room in the dim light coming from outside. There was a photograph of Lisa in her nurse’s uniform — she had been a nurse in Glasgow, where he had met her while on an assignment — and a photograph of the pair of them together when they went on holiday to Skye. He remembered that it had rained solidly for seven days before the weather had afforded them one beautiful day to walk in the Cuillins and appreciate just how lovely the island was. There was a picture of Jenny with Sue’s children at the beach in Dumfriesshire, holding hands as they paddled together, their eyes bright with childish joy. There was a picture of himself in uniform and one in civilian clothes with his friend Mick Fielding when they had served in Special Forces together. Mick now ran a pub down in Kent; at least, that’s what he’d been doing the last time Steven had heard about him — Mick tended not to keep up with old friends. God help the troublemakers down there, he thought with a smile.

There were a few bits and pieces he had rescued from the family home after his parents died, mainly books, but also a Spanish guitar he had bought when he was seventeen and still played when the notion took him. Not much to show in the way of possessions for a man on the wrong side of thirty-five, he concluded. The music stopped and he got up to pour himself another drink. He turned on the TV to hunt for news.

‘The virus that has recently claimed the lives of three airline passengers, a stewardess and a nurse at the hospital where they were treated is thought to be a new one, previously unknown to medical science,’ announced the newscaster.

‘How the hell did they get hold of that so quickly?’ exclaimed Steven.

‘This was the conclusion of medical scientists who examined specimens taken from the victims of the Heathrow incident in a maximum-security lab at Britain’s biological defence establishment at Porton Down. The source of the virus remains unknown. Health officials when contacted by Sky News in the last hour, however, have stressed that the outbreak posed no threat to the general public.’

Bloody hell, thought Steven. Does everything leak these days?

The report was accurate and had obviously been leaked to the media by someone present at the briefing. Accurate or not, any government assurance that things posed ‘no threat’ still smacked of the false assurances given during the time of BSE, he thought.

The news editor had decided to pad out the story and had found a microbiologist to interview.

‘Dr Marie Rosen is a medical microbiologist at a leading London hospital. Where do you think this virus emanated from, Doctor?’ asked the interviewer.

‘Well, I haven’t seen the report yet,’ replied the woman. She was dressed in ‘sensible’ clothes and rimless glasses that sat well down her nose. Her skin looked as if it desperately needed moisturising and her plentiful mop of grey hair suggested she had recently been standing out in a gale. ‘But I understand that the aircraft at the centre of this incident had just arrived from Africa. That would seem to be the likely source of the virus. It wouldn’t be the first to come

… “ out of Africa ”.’ She seemed pleased with her allusion.

‘Why do you think this is, Doctor?’ continued the interviewer, not bothering to smile. ‘Why should new viruses appear all the time in Africa when this doesn’t happen anywhere else in the world?’

‘I would question whether or not they really are new viruses,’ replied Rosen. ‘I think it highly likely that they’ve been there all along, but with so much of the African interior being opened up these days, and people moving around much more than they used to, we’re seeing what happens when a vulnerable population are suddenly exposed to agents they have not come into contact with before.’

‘A bit like the situation when Native Americans were exposed to measles when the Pilgrim Fathers landed?’ suggested the interviewer.

‘Quite so.’

‘But surely it can only be a matter of time until one of these viruses slips through the net and threatens us all?’

‘I think the way the authorities dealt with the problem at Heathrow demonstrates that we can have confidence in the defences currently in place,’ said Rosen.

‘Maybe you should talk to Fred Cummings,’ said Steven under his breath. He watched the rest of the news, then switched off the set. He decided to pack his bag for his trip up to Scotland tomorrow. He made a mental note to buy presents for Jenny and Sue’s children after he’d talked with Macmillan in the morning.