The Redivivus Trilogy (Book 3): Miasma Page 2
Her idea consisted of two parts: removing all the rev’s teeth and eliminating the flow of its highly infectious saliva. Although she wasn’t a medical doctor, she’d performed many surgical procedures on laboratory animals throughout her career. Between that and the textbooks she found at the CDC facility, she felt confident she could perform the procedures—especially given that she didn’t have to worry about any complications aside from being bitten. She’d been hopeful that injecting a paralytic agent would render the revs temporarily immobile, and thus incapable of biting. Unfortunately, the medication had no discernable effect. Bite blocks and puncture resistant gloves were all that diminished her chances of ending up like Dr. Banks. Although the gloves were somewhat bulky, the work wasn’t exactly delicate, and she wasn’t about to put her fingers near a rev’s mouth without wearing them.
“I understand the rationale behind both the dental extractions and the salivary procedures, but don’t you think pulling the teeth would be sufficient?” Maria asked, not wanting to be so close to the business end of a rev for any longer than absolutely necessary.
“I agree it’s a bit redundant, but as the infected don’t appear to possess any appreciable capacity to heal themselves, my concern is that pulling the teeth might leave exposed bone that could prove to be just as dangerous as teeth,” Dr. San replied.
To prove her point, Dr. San placed one of the puncture resistant gloves in the snapping maw of the rev after they completed its dental extractions. Maria’s face went pale when she inspected the glove and found a small hole where a tooth socket’s bony edge had pierced the fabric. From that moment on, they never discussed the necessity of removing the salivary tissue. The procedure’s risk was further justified when LNV was undetectable after the salivary tissue had been removed and the rev’s mouth had been copiously irrigated.
Dr. San clamped the salivary duct before cutting it and removing the lump of gray tissue. She ligated the duct before placing several large sutures in the mottled skin.
“Okay, that’s the last of the major salivary glands. Let’s have a look at the next one’s teeth, shall we?”
* * *
From the moment Dr. San arrived at the CDC, she’d worked tirelessly toward the goal of finding an effective treatment for LNV. She’d been shocked to learn that of the original scientific team, all that remained were Dr. Louis Sodecci and Maria Abrams. While Dr. Sodecci meant well, he was an epidemiologist and not a bench scientist. As such, he’d made virtually no progress toward advancing the work of Dr. Jim Banks, one of the CDC’s leading emerging infectious disease scientists. Maria Abrams was a smart and capable woman and had been Dr. Banks’s primary research assistant; in Lin’s mind, Maria was easily the more skilled of the remaining personnel.
Maria and Dr. Sodecci informed Dr. San of the great strides that Dr. Banks’s team had made toward understanding LNV. He and his associates had sequenced a significant portion of LNV’s genome and found significant similarities to both the rabies virus and HIV. Although they’d never found a cure for the disease, their failed attempts provided Dr. San with valuable information about the pathogen and its host interactions. They also highlighted just how difficult the job of defeating the virus was going to be. Knowing that one of the foremost infectious disease scientists had failed to unravel LNV’s puzzle left Lin feeling woefully inadequate to complete the task. She had to continually remind herself that she might be the only one left with any chance of stopping mankind’s extinction. Fortunately, she had something that the previous scientists hadn’t possessed: the flash drive containing the virus creator’s files. She prayed the information would be enough.
Dr. San knew that the effective treatment of any infectious disease often depended on the stage of its life cycle and the timing of the therapy relative to the host’s infection. A medication that killed a pathogen when it was outside the host wouldn’t necessarily be effective once that pathogen made its way inside a person’s cells. Similarly, a vaccine designed to prepare the host’s immune system was useless if administered after infection had already occurred.
While a vaccine would be ideal for those lucky few who remained uninfected, Lin worried that LNV’s design would make the development of such a treatment virtually impossible. The virus’s creators had engineered it in such a way that its appearance changed almost daily, leaving the host’s immune system chasing its tail. Were she to succeed in creating a potential vaccine, testing it in humans would require the inoculation of healthy individuals followed by exposure to LNV; volunteers weren’t likely to line up for such a trial. Given what Dr. San knew about the virus and the dismal results of Dr. Banks’s attempts to create a vaccine, she decided to focus her efforts on other treatment approaches.
The concept of post-exposure prophylaxis—taken right out of the rabies’ treatment playbook—proved more straightforward. The idea was to administer therapy during the brief window of time after someone was bitten and before the onset of full-blown symptoms. As LNV infection represented a death sentence, there was little to lose by trying any potential therapy the scientific team came up with. The goal was to hold LNV at bay long enough to allow the host’s immune system to get a handle on it. Unfortunately, even after adding several HIV medications to the treatment regimen used in cases of rabies exposure, they only managed to slow the onset of clinical symptoms. Dr. San believed that the same challenges facing the host’s immune system in vaccination were largely to blame for this therapeutic method’s failure.
The last approach, and the one with the potential to treat the greatest number of individuals, was eradicating the virus from someone already manifesting the clinical signs of LNV infection—that is, a full-blown rev. They had tested every known antiviral medication with virtually no benefit. Considering the damage typically incurred by a person as a result of LNV infection, Dr. San still wasn’t sure what would happen to an individual if they found a medicine capable of destroying the virus. Would the human body be able to survive after such an infection? She didn’t know, but it seemed plausible that LNV was the only thing keeping most, if not all, of the infected alive. She couldn’t even say if “infected” was the correct word. The whole idea called to mind a question that had been a mystery to Lin since the beginning of the outbreak: were the revs dead, alive, or stuck in some Hell in between?
The complexity of the virus and the lack of any promising results left Dr. San feeling as though finding a cure was a lost cause. She’d tried everything she could think of and had very little to show for it. After delivering a particularly gloomy progress report to the other survivors at the CDC, she felt overwhelmed by a crushing sense of defeat. As somber as a funeral procession, the scientific team trudged to the research area in silence. Sensing Lin’s despair, John accompanied her back to the lab in hopes of cheering her up. As if thinking out loud rather than speaking to anyone in particular, John said, “If LNV has no consistent target we can exploit, it’d be nice if we had some sort of broad-spectrum antiviral drug.”
The comment stopped Maria dead in her tracks. Her mind flashed to a forgotten conversation she’d had with Dr. Gerald Graham several days prior to the outbreak’s start. Dr. Graham was a world-renowned virologist whose state of the art lab was also located in Building 18. Knowing the awkward man had a crush on her, Maria had generally tried to avoid him. When she’d failed to do so that day, she’d politely feigned interest in the conversation as she’d waited for the barista to prepare her coffee. She recalled how he’d flapped his hands excitedly as he’d rambled about his new research project involving a novel “broad-spectrum” antiviral therapy. Thinking back, she wanted to kick herself for not paying closer attention to what he’d said.
2
Cold hands reached for her, like tentacles emerging from the darkness all around her. She wanted to scream, but she knew that was what they wanted. Were she to give in to that urge, it would be the last sound she ever made. Staying quiet and running held her only chance of survival, so run she did.
Panting hard, she put one leg in front of the other even as her lungs begged her to stop. In stark contrast, the terrifying moans coming from behind her urged her forward. She felt as though she were in a tunnel that grew more confined with every step. Jagged fingernails—once just out of reach—now scraped lightly across her burning hot skin. It was only a matter of time before they found better purchase and locked her in their deadly embrace. Were it not for the faint spot of white light at the tunnel’s end, she would’ve given up right then. The dark figure silhouetted against the bright light motioned frantically, and there she found the strength she needed to press onward.
The world had become such an unfair place, and she was tired of the monsters dictating the course of her life. In her heart, she knew the shadow ahead represented the person she’d been searching for all along. Despite her considerable effort, however, she never seemed to get any closer to him. She began to wonder if the shadow might be an illusion caused by a lack of oxygen constricting her visual field. Finally, when she thought she couldn’t take another stride, the tiny orb of light began to grow larger before her. It became so bright that she felt as though she were on a collision course with the sun. The dark figure waved at her with increasing urgency, and she put on a final burst of speed. She was rewarded for her exertion when the hungry moans faded behind her. Unfortunately, her relief proved painfully short-lived as the space in front of her filled with a singular groan that was more terrifying than that of the entire infected horde she’d been fleeing.
The shadowy figure lurched forward to meet her in the darkness, but she was moving too fast to stop. She caught a glimpse of its deathly face just before colliding with its outstretched arms. Were her lungs not already struggling to keep her alive, the malevolent look in her father’s vacant eyes would’ve made her gasp. The gore hanging from his open maw left no doubt about his intentions. At the moment his bloodstained teeth bit deeply into the soft flesh of her neck, she wasn’t sure she would’ve stopped running had it been possible. Despite the immense pain, she found comfort in knowing that it was all over. She’d finally found her father.
A piercing scream shattered the silence as Ava Wild sat bolt upright in bed. Her sheets were soaked with perspiration, and she breathed so hard it seemed more likely that she’d just finished running a marathon. The wide-eyed look of sheer terror on her face was something that everyone still alive had grown all too familiar with.
“Ava, honey, it’s your Dad. You’re safe. Everything’s okay.”
If Ava was comforted by John’s words, she gave no indication. If anything, she recoiled slightly at the sight of his silhouette in the moonlight. Only after the fog of slumber slowly dissipated did she finally begin to calm.
“You all right, Ava?” he asked with concern evident in his voice.
Nightmares were the norm among survivors of the LNV plague. The virus had forced them to endure things so far beyond what any person should ever have to experience; the psychological toll was immeasurable. Given that Ava had spent nearly a month alone at the start of the plague, John was surprised that Ava wasn’t troubled by such nightmares more frequently.
“I’m fine, daddy. It was just a bad dream, that’s all,” she replied. Her voice was strong and steadfast, and John couldn’t help noticing how much she sounded like her mother, Rebecca.
* * *
Although sunrise was still several hours away, John knew he would get no more sleep that night. As expected, he lay awake with only his thoughts to keep him company long after Ava had dozed off in his arms. Nighttime was always the hardest. It was the time when dark thoughts chose to emerge from the brain’s shadowy recesses. When dawn finally came, he was thankful for the escape that it brought.
The CDC compound was buzzing with activity when John entered the lab and found Lin already hard at work.
“Good morning, John. How’s Ava? I heard her screaming last night. Everything all right?”
John sighed as he rubbed his neck and looked toward the floor. “She’s okay—just another nightmare.”
Being no stranger to bad dreams, Lin replied, “That’s about all that’s left these days. Sometimes I think it’d be better not to dream at all.” After a pause, she added, “Ava is a strong girl. She’ll get through this, John.”
Although he appreciated the sentiment, he knew Lin had no way of knowing if any of them would actually survive the plague. Still, he marveled at how well adjusted Ava was despite the horrors she’d faced. If he ever felt like giving up, all he had to do was look at her for the inspiration needed to persevere.
Partly out of curiosity and partly to change the subject, John asked, “How’s the research coming? Did you find what Maria was hoping for in that guy’s lab?”
Lin’s tone of voice became noticeably more animated. “Yes—I think so. It looks promising, anyway. Fortunately, Dr. Graham’s lab is located in a section of the building that is still accessible. Mother and some of the soldiers put down a couple of infected in the hall, but none were in the lab. We found a great deal of information and equipment. We’re still sorting through all of it.”
“That’s great,” John replied.
With excitement coursing through her words, Lin provided John with the details of what they’d discovered. Dr. Graham’s lab had started researching a technology called DRACO, or double-stranded RNA activated caspase oligomerizer. Although it was in its infancy at the start of the LNV outbreak, it had already shown promise against many different types of viruses. DRACO was considered to be a potential broad-spectrum antiviral treatment because it didn’t rely on a specific viral marker such as a protein or a receptor in order to identify its target. Instead, it capitalized on the fact that virus-infected cells produced unusually long segments of genetic material compared to their healthy counterparts. Once an infected cell was identified, rapid self-destruction occurred through of the activation of programmed cell death—the normal pathway by which an organism rids itself of damaged cells. Uninfected cells—those without the virus’s genetic marker—were left untouched when DRACO passed by them. The scientists responsible for DRACO’s development hypothesized that it would be effective against a wide range of viruses while simultaneously having minimal negative impact on the host.
Dr. San saw DRACO’s theoretical promise, but her experience to date made her wary of becoming overly optimistic. Many questions remained, and extensive testing still needed to be done. It occurred to her that there had to be a critical threshold with respect to the ratio of infected to uninfected cells, beyond which a person couldn’t survive due to the number of cells DRACO would kill. If that were true, she had no idea exactly what that critical threshold might be. Even so, she was more encouraged by DRACO than any other treatment they’d investigated to date, and in the end, she decided it was worth the risk to further study its potential.
Although much of what they needed to study DRACO was found in Dr. Graham’s lab, they were getting dangerously low on some supplies required for their experiments. As much as Lin hated it, that meant the scavenging team—and Garza—would have to go on another supply run soon. In the short time since she’d met him, her feelings for him had grown considerably.
3
Ava yawned and rubbed her red-rimmed eyes as she walked into the old cafeteria. She’d slept for nearly six hours, but it had been fitful, and she felt as though she’d been awake the entire night. That was usually the case whenever the nightmares found her. Her stomach grumbled at the thought of breakfast. Although the provisions were never extravagant, she hadn’t gone hungry since her arrival at the CDC. She was happy to see Annalee already there, enjoying a bowl of cereal drowned in reconstituted powdered milk. The two girls had become as close as sisters in the short time since they’d met.
Annalee knitted her brows together when she took in the dark circles under Ava’s eyes. “Rough night?” she asked.
She did not press her friend when Ava didn’t reply; the answer was plain to see.
Anthony had turned fourteen shortly after arriving at the CDC with Dr. San’s group. They’d had a little party complete with the worst cake any of them had ever tasted. Charon hadn’t seemed to notice and had eaten the majority of it. While Anthony’s insight and maturity made him seem much older, the usual acne and awkward voice changes of adolescence belied his true age. He’d quickly become smitten with Annalee, who at age thirteen was looking more like a young lady every day.
“Good morning, Sunshine!” Anthony said in an overly cheery voice.
His attempt to brighten her mood had the desired effect, as Ava’s smile noticeably relaxed. He pushed his chair back and stood.
“I’m sorry to have to leave so soon, but I’m supposed to meet Sgt. Garza for training this morning. Get some rest today, Ava. Annalee—I’ll catch up with you later.”
Annalee’s eyes tracked the tall boy as he left the room with Charon on his heels. Ava considered making a snarky comment about Annalee and Anthony kissing in a tree, but she was too tired. While she knew Annalee had a crush on him, it wasn’t something she completely understood. Ava no longer thought boys had the cooties or anything; she just wasn’t overly interested in them yet.
Annalee turned her gaze back to Ava and asked, “Do you want to talk about it?”
Ava shook her head from side to side, and again, Annalee did not press.
“What are we going to do today? I wish we could go to training with Sgt. Garza,” Annalee said, knowing that wasn’t an option.