Rainforest

guest post by Elena, 2-17-2013

Job Title: Hemorrhagic Fever Specialist

Job Location: Fort Detrick MD

Task #: 13

The scenario:

                The sounds there were eerie in their novelty. There was an absence of loud mufflers, sirens, and far away roars of planes and helicopters. The tempo of the modern world had drifted away and Katy had found a new and vibrant cacophony of the wild earth. The strange conversations of the howler monkeys, the urgent chirrups of strange new insects, and the symphony of birds played out for her entertainment. The stars had never seemed so bright, and the smells of the native’s land permeated her senses.

                Katy heard the bored bleating of goats and the patient moans of the cattle as she sat in her thatched bed, waiting for the sun to grace the rainforest once again.

                This was her first trip south of the equator and only her second voyage outside of the United States. She had just finished her graduate research in infectious disease, and she had decided on a vacation to the world she would soon be researching:  the mysterious depths of the Yamari forests in Africa.

                She moved on her bed, not quite satisfied with her simple abode, yet grateful for the village for allowing her to rest. This had been her last day in Africa before she would travel home again to her small apartment outside of Fort Detrick. Katy did not relish the thought of hours on a plane and sighed into the warm air inside the Yamari hut.

                Finally, the grey that had obscured the features of the small structure began to lift and she once again gazed upward at the straw roof and mud-composed walls of the hut. There were sparse decorations around the hut, only a few small vases of grain and rainwater rested on the dirt floor. Katy took one of the small containers and took a sip of the fresh water. The villagers assured her of its cleanliness, though it still tasted faintly of clay and dirt. She usually would have abstained from drinking the native water, but her stores had run out, and she had been told hydration was of upmost importance in the warm environment.

                And warm it was. The day before, Katy had taken a day expedition to the top of Kali hill, located a few miles away from the camp. She had gone in search of the rare Tenga bat that was rumored to live there.

                The long trek through the forest, harder than she had ever imagined, had, however, been fruitless. After pushing and cutting through the thick foliage of the forest, Katy had emerged, drenched in perspiration and dew to find nothing but a series of empty caves near the peak of the large hill. For several minutes, Katy had stood, crestfallen, at the mouth of one of the largest caves. Her feet were slowly sinking into the strangely prolific moss that carpeted the cave entrance while the invasive ferns and vines brushed her skin.

                She marched to a large rock and sat down, disappointed that the most promising expedition of her trip had not surfaced anything of interest. She sat facing the forest, listening to the melody of sounds in a haze of exhaustion. It felt to Katy like she had been drained of her energy, like the hot and humid air coursed through her veins and took a toll on every one of her tried muscles.

                She pushed around the moss at her feet, trying to plan out her next steps. She was leaving in two days; back home to her new job at the CDC and the host of research projects assigned to her. She sighed with the weight of long hours ahead of her, and decided to make it back to the airport a few hours early. She needed a shower and some non-dried food before she headed back to the States.

                Katy heaved another sigh and pulled a battered knapsack from her aching back. She unzipped the first zipper and removed a piece of wrapped fruit. It was her last morsel of fresh fruit, and now seemed the most peaceful spot for her to eat it. She unwrapped the fruit and ate it slowly, savoring the small sugary rush to her stomach. She turned to find her water canteen in a side pouch of her bag.

                When rummaging for the canteen, she nicked herself on a small blade. She inhaled sharply from the suprising prick of pain and jerked her hand away from the bag. She examined the damage and realized the cut was beginning to bleed profusely. She did not have any spare cloth, so she ripped a piece of moss from the ground and laid it on her cut.

                She cursed her lapse in caution and mopped up the area around her cut. She did not want any predators or bugs to find their way to her. As she cleaned, Katy took a closer look at the moss. It seemed there was a fine, rich soil on its underside, perfect for the moss. The compost explained the verdant and abundant growth of the moss. She studied it as the fauna chirruped around her and eventually she deemed her hand well enough to withstand another forest trek back to camp.

                She knew she would need some sort of ointment or disinfectant for the cut, but she decided it was more prudent to find camp before the sun went down. Her trek took longer than expected. She exhausted her water supply as she went, and after wiping sweat from her eyes and face for the millionth time, Katy saw a small settlement ahead of her. She made a decision to stay the night there and worry about finding the base camp in the morning.

                And so, Katy lay in the hut, thinking about her previous hike through the woods and the next things she needed to do to prepare for departure. She packed her bags, took another swig of the suspiciously earthy water and left her hut. The few locals who had welcomed her into the camp were sad to see her go so soon, but were understanding in her need to move on.

                Katy left down the winding, crude path that would take her to the base camp, and eventually, back to Fort Detrick.

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                The last few days had been like a typhoon of fast-dry cement washing over Kay’s life. The world of research had swept her up and she was barely staying on her feet as she went in for orientation. She was working in the BSL4 lab at Fort Detrick and all the material she had read beforehand did not prepare her for the ensuing whirlwind. There was so much to learn.

                To come into the lab, there were stages and infinite layers of security and decontamination procedures. She needed to change from her street clothes into scrubs and move slowly into increasingly sterile labs. When she got to her lab, Lab 4A, she had to clear security, strip down, change clothes, and then change into a sterile "space suit". She went through even more contamination procedures like the chemical bath and the UV irradiation chambers as she moved closer to the actual lab. Her suit was equipped with its own respirators and she used multiple pairs of gloves to prevent any kind of exposure. The apparatus was positively pressured, ensuring any breach in the suit would cause air to rush out of her suit instead of in. In short, she was a walking, terrestrial astronaut, constrained to short movements within a layer of protective fabric and air.

                She never liked the procedure, and was distinctly frustrated with using small implements in her bulky gloves. Her coworker, Dale, said she would get used to it. He was a quite helpful man with two years experience working with hemorrhagic fever. If Katy was ever nervous, he would assure her of the integrity of the suits. He made jokes about the severity of the pathogens and was always willing to double check the respirators and pressure gauges on his coworkers’ suits. He was forgiving of mistakes, and was fairly calm under the enormous strain of repetitive work.

                Katy did not fare as well as him, and on top of it, she was feeling ill. Her schedule did not leave her much time to catch up on the research she would soon be starting nor time to go over every page of the bulky safety manual. In fact, the past few days, Katy went go to bed soon after reading the bare minimum she could. She assured herself it was merely the long hours and deluge of information that was making her tired. Every now and then, she entertained the idea that the earthy water she had sipped in the Yamari hut had been rife with some unknown biological agent. She usually pushed away these thoughts after a moment’s consideration. If there had been anything in that water, she would have been violently ill, not just rundown. If anything, she had a mild case of the flu picked up from some sick passenger at the airport. She slowly forgot about the more dire premonitions of her health.

                One morning, a Friday, Katy woke up with a running nose and itchy eyes. She was a bit nauseous and disoriented, but she chalked it up to a rough week and decided to finish out the work day. As soon as she moved about, Katy grew more confident and even read some of the assigned readings during her morning bus commute.

                Once at the lab, Katy went through the tedious decontamination and suiting up procedure. She went into her lab and set to work on one of her first projects – she was studying the effects of a new treatment for the Marburg virus on the liver of a monkey. She moved around the lab, picking up the thoroughly autoclaved, sterile equipment. She listened to the thrum of HEPA filters in the sealed room, every once in a while admiring the shiny surfaces of the steel furnishings. She had just cleaned them and was particularly proud of their sheen.

                She began to hum to herself, barely noticing the light headache and soreness in her muscles.  She picked up a tray of sterile scalpels and carried them over to her work station. She retrieved the samples – they had been sent in through the double sealed delivery chamber, and set to work cutting up the livers. She found a good pace and was making good time when a wave of dizziness overcame her.

                The lights above her dimmed for a moment and the steel table before her swayed before her eyes. Her headache seemed to get worse, and she instinctively lifted a gloved hand to her facemask to steady her pulsating brain. As she did this, she realized that there was a small leak in her suit. When she had clenched the scalpel in the wave of dizziness, she had cut through her suit. There was a small hole right below her right wrist. The hole looked small enough that she was not worried, but Katy nonetheless started to clean up her work.

                She did not want another episode to happen and her headache did not seem to be getting any better. Right as she was opening one end of the autoclave, which would sterilize the equipment and even send its steam to a specialized disposal area, Dale entered the lab. Katy waved from a distance, finished loading the autoclave, and went to meet him.

                There was a system inside the suit where the wearer could wirelessly communicate with a coworker, even above the sound of the respirators. As Katy moved closer to Dale, she noticed that the scalpel she had cut herself on was still lying on the table. Dale only noticed a panicked and pained look on Katy’s face as she drew near.

                Katy moved for the scalpel just as Dale started to move towards her. Seeing Katy move, Dale drew back – right into the path of Katy’s hand. As she watched in disbelief, Katy saw the scalpel cut through Dale’s thick suit, all the way through his thin scrubs. There was a whoosh of air as the scalpel cut, immediately stopping both workers in their tracks.

                Their eyes met. Katy wore a look of horror and Dale a look of incredulity. They stood still for a few seconds, looking at one another. Slowly Dale’s eyes shifted to his torn suit. His intercom system came on and his normally calm voice held an undertone of panic. He quickly said to Katy that it was an accident, “Not to worry about it.” Katy knew there was reason to worry. Procedures of accidents in a lab, especially such a clear one as this, meant extensive decontamination, tests, and quarantine. Her eyes teared up.

                Dale reassured her it was not a problem as he moved towards the decontamination station. Katy was beginning to sob as she dialed the required numbers to report the incident.

       

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                The two would spent three weeks in a quarantined room. Their lab would be cleaned for contaminants and essentially fumigated with toxic chemicals. Katy and Dale were given attentive treatment and packets of anti-virals. Katy’s condition deteriorated. Her skin broke out in rash and her skin swelled. Her muscles ached and her vital signs dropped. Dale too, after two weeks, began showing signs of illness. Through extensive testing, it was found that there had indeed been a breach in the suits of both workers and that both workers had been exposed to an unobserved strain of Ebola.

                The odd part was, the monkey liver Katy had been prepping was not the culprit. All workers in nearby labs did multiple and exhaustive testing of the liver and other tissues from the monkey. None showed any sign of infection by Ebola – the monkey had been one of the control receivers of medication.

                The virus had an external source. Katy. During her excursion to the strange land of the Yamari forests, Katy had made an egregious mistake. When she cut herself outside the cave of the Tenga bats, Katy used moss to clean her wound. This moss, with the fertile organic mass beneath it, was a surviving link to the bats that had once lived in the nearby caves. The moss had been growing in bat guano. Katy’s heedless use of the moss had allowed some of the guano to seep into her exposed skin.

                Once near her body, an inactive cluster of viruses made their way through Katy’s system. She cultured them for days, and was only beginning to feel the effects of the virus on the day of the incident. Nevertheless, her body was becoming a factory for the lysosomal powers of the exponentially increasing virus particles.

                When she had pricked her suit, she had drawn the ever-slightest amount of epithelial cells from her hand. The thorough scrubbing Katy had performed had made her skin raw, and the raw skin, infected by the virus, was shedding  pathogen profusely. This was how the scalpel became “hot.” When she swung around and sliced through Dale’s suit, she spread her cells to his arm, ensuring the virus had a new host to burn through.

                Katy had been careless one too many times. Her body could not withstand the fever, and the virus overtook her. Dale’s condition worsened, nosebleeds and other symptoms popped up with textbook regularity. In the end, however, he did not succumb. As it turned out, the chemical bath rid Dale of the worst virus clusters, and the few that survived and multiplied were not as dangerous as the viruses that had taken Katy. Dale lived on to tell the tale of caution, and of the young woman who had not taken seriously the dangers and precautions of the lab.