Alan E. Nourse - The Fourth Horseman Page 7

  Whatever the exact numbers—they varied with the source, Ted knew—The Pestilence had vanished as suddenly as it had come, and remained quiescent for centuries. It was next recorded in Rome in a.d. 103. It was Rome at the height of its glory, a city of 1.5 million people, largest of all cities of the ancient world. The Rome of those days was remembered down through history for its excellent supply of pure water, and its fine sewers for the disposal of human waste. But for garbage disposal and other matters of everyday hygiene, Ted reflected, not so much could be said. The common man of Rome in those days lived in filth, along with the rats. Even the kitchens of the nobles were filthy and rat-ridden.

  When the disease struck Rome, perhaps the same disease of Athens; perhaps something slightly different, it stmck with ferocious violence, devouring five thousand human lives a day. The sheer logistics of disposing of all those corpses in that huge city must have been staggering in itself. And the death toll went on for months, perhaps years, no two accounts agreed. Then, once again, it stopped for a while—but by that time another name had been coined for the murderer. A name that said it all: The Plague.

  It recurred repeatedly in parts of Italy in succeeding centuries. With the fall of Rome, records became obscure. In the tenth and eleventh centuries Italian coastal cities recognized that the dread death-dealer often arrived by ship. Boats were required to hold offshore for a quarantine—a period of forty days—before anybody or anything was allowed to come ashore; as a result, some of those cities escaped The Death.

  Despite all this, in the 1300s, The Plague struck hard and fast in Mediterranean regions and began moving inexorably north and west in a long, slow, murderous sweep across Europe and Asia. In those days, in the very depths of the Dark Ages, there, were few cities large enough to speak of. Most people lived in villages and hamlets clustered around the manor houses or castles of local lords for protection. Nobody had the slightest concept of personal cleanliness or public hygiene. "Lest one think it a romantic time to have lived," Ted had once told a lecture audience, "bear in mind that everyone had lice and everyone had fleas—rats, dogs, cats and humans. The average life expectancy for a new baby in those days was about thirty years." As The Plague struck these villages, one by one, the widely rumored symptoms began appearing: fever, shock, huge black draining sores in the neck and groin, followed by convulsions and death, or—in some cases—a long, painful convalescence leading to recovery. No patterns of spread were recognized; people accused the physicians of the day of spreading the disease in order to fatten their purses, despite the fact that they were dying faster than the patients they tended. And in that great epidemic, a new twist seemed to appear: some victims, after a few days of illness, suddenly began burning up with fever, coughing fiercely and hemorrhaging from the lung. This so-called "pneumonic" form of The Plague terminated in death within two or three days and killed as many as eighty-five percent of its victims—and, for the first time, direct spread of infection from one person to another was clearly recognized.

  Of course The Plague spread panic wherever it struck. People boarded themselves up in their houses to keep it out—and died inside. Bodies of the dead were stacked like cordwood at the crossroads to be bumed or just left to fester and decompose. The stench of rotting bodies clung over whole villages. Dwellers in castles and fortresses pulled up their drawbridges to protect themselves from the horror outside, only to be found, sometimes years later, all dead inside the walls, mostly from Plague, but many from starvation or thirst because people were too terrified to come out. Certainly in those superstitious days The Death was considered the work of Satan, but the spread of the disease was slow and sporadic. Nobody traveled very far or fast in those days, and the march of The Pestilence was measured in years as first one village was hit, then another. Some were missed altogether by some stroke of fantastic good luck; others were wiped out almost totally. The slow march of Plague across the continent took 150 years or more that time, and when it was all over, it had proved to be the most vicious Pestilence in all human history, leaving some twenty-four million people dead in its wake—one-quarter of the entire population of Europe.

  Slow as it was, that great Plague had been more virulent, more deadly, than any that had preceded it. All the accounts and records Ted had ever read confirmed that. But why? Had there been some tiny, seemingly insignificant genetic change then, too? Some rearrangement of atoms on a strand of DNA? No way to tell, of course, but earlier plagues, horrible as they were, had been a laugh compared to what that one had been.

  Finally it had seemed to burn itself out, reappearing only sporadically, here and there, over the next two hundred years. Then, abruptly, London was struck in 1665—that crowded, huddled, jam-packed, filthy city of 500,000, built on the banks of the oily Thames with its piers and docks and warehouses and rats and fleas. Plague swept the city then like a giant scythe— sixty-eight thousand dead in a single year. The following year a sort of Providence intervened: the Great London Fire gutted four-fifths of the city, burning out millions of rats and their breeding places at the same time. It was an awful remedy—but never again was there a major outbreak of plague in that city.

  Just over two hundred years later, in 1894, Hong Kong was struck with epidemic Plague. Things had changed during those two hundred years, Ted reflected. The concept of scientific observation had emerged, and now it was known that rats and Plague were inextricably interrelated. Get rid of the rats and The Plague slowed and stopped. Bacteria had been discovered, and were known to cause infectious diseases of all kinds. Though the organism that caused Plague had not yet been isolated or observed, it was assumed to exist, and was given a name: Pasteurella pestis after the great French pioneer of microbiology, Louis Pasteur. Then in 1894 two different men—a Japanese named Shibasaburo Kitazato, and a Swiss, Alexandre Emile Yersin, separately isolated a slender, poorly staining rodlike bacillus from blood and tissue of Plague victims— the organism causing The Plague. Ultimately its name was changed to Yersinia pestis.

  Identifying the ancient killer did not stop it, however. In the late 1890s it swept from Hong Kong to the cities and opium dens and brothels of the South China Coast—Canton, Foo-chow, Shanghai—killing fifteen million people. It moved south across tropical Asia—Singapore, Bangkok, Rangoon—and plunged into India, where ten million people died in a single year. And in Bombay, amid festering heaps of dead bodies, another obscure scientist finally closed the link of causation. Yersinia pestis was primarily a disease of rats, afflicting the ubiquitous black Norway rat in particular, but other rodents as well. Fleas living on an infected rat drank its infected blood; when the rat died, the fleas abandoned the corpse, found another rat and injected their bacteria-laden vomit into the new victim when they bit. And when rats weren't handy as a new host, those infected fleas found humans instead, and the humans grew feverish and shocky, with huge festering buboes developing in their armpits and neck and groin, and developed massive purple skin hemorrhages as the infection progressed to septicemia, or coughed blood as it reached the lung. And when they died, their infected fleas went on to bite other humans.

  Fortunately, there were no airplanes in 1894, Ted Betten-dorf thought. If there had been, that vast pandemic of Plague might never have been stopped. Ships were far slower, with far fewer ports of call. Ships from Hong Kong brought The Plague from the Far East to Philadelphia, New York and San Francisco, especially San Francisco. Public health measures stopped it at the docks in each of those places, but plague-bearing rats abandoned ship all the same. Some of those rats, unwelcome in the city, made their way into the hills and forests surrounding San Francisco, and then to the Sierra Nevada, their fleas infecting forest rodents as they went—chipmunks, ground squirrels, marmots. A reservoir of plague-in-waiting built up in those creatures, far from human habitation, a reservoir of "sylvan plague" which slowly, slowly spread north to the Cascades and east to the Rockies, and south through the Sangre de Cristos.

  From then on, a few cases of human pl
ague had begun to appear in the western United States each year. Isolated cases, a dozen or so one year, three or four the next. Year by year, Ted Bettendorfs section on Uncommon Diseases at the Centers for Disease Control, a branch of the United States Public Health Service, monitored those cases, kept a watchful eye on them, ever alert to the subsurface danger that existed. A child playing with a sick chipmunk on a California camping trip. A Mexican woman near Nogales living in a house infested with rats. Two boys in New Mexico cutting off the flea-ridden pelt of a dead coyote they found in the hills. The cases were sporadic, individual, almost always related to rats, rodents or fleas. Often diagnosed far too late, and veiy deadly—three-quarters of those victims died. But slow-moving, never really catching fire. Over the years, Ted thought, we've been lucky. That Horseman, called Death, has been in no hurry.

  He got up, walked to the window and stared out at the flowering Atlanta trees, fresh and green in the morning sun. Yes, on balance, we've been lucky. But now, something alarmingly new. A brush fire of cases from the mountains of Washington. Maybe more than one brush fire, in more than one place. Too many cases, too fast and too deadly—and the connection with rats and rodents and fleas seemed terribly tenuous. Was it just the sylvan plague they knew? Or something slightly—and murderously—different? This was the question he had sent Dr. Carlos Quintana west to answer, winging his way from Atlanta to the western mountains for the second time in six months. The right man for the job, Carlos Quintana—an odd, uneasy, little man, the perfect plague hunter, his mind stirring with an ancient, irrational cultural awareness of the imminent presence of Death—

  A buzzer on his desk sounded. He took the phone, heard Mandy's voice. "Ted, are you operational?"

  "Right. Bring 'em on."

  "The President caught an item about that Seattle thing on the morning newscast. He wants to talk to you. Can you stand by at ten-oh-three?"

  "Sure. Break in on anybody but Carlos."

  "And the Secretary wants a briefing too. He'll be on-line in four minutes."

  Ted Bettendorf sighed, loosened his necktie and settled down to the phone.

  "La Muerte," the dark-haired man muttered, twisting in the cramped airplane seat and pushing the maps aside.

  The woman beside him blinked awake. "Hm?"

  "The Death," Carlos Quintana translated. "The word is . feminine in Spanish—isn't that interesting? There are some weird cultural reasons for that, but I won't bore you. Well, she may be female, but she isn't any lady. A lady at least would wear a deceptive fragrance, and this particular sweetheart can't be bothered. She stinks from here to Chihuahua and back."

  Monique gave him a level look. "Honey, you're dog tired. Why don't you just lean back and sleep till we get to Denver?"

  "Look, I was tired before we started, and I'm going to be a lot more tired before we finish. And how am I supposed to sleep? I keep looking at these maps and the more I look at them, the more this whole business stinks. There's a great big gap in the picture somewhere. We just aren't getting the whole story."

  "So what do you think is missing?" Monique said.

  The engines rumbled and the plane lurched in some choppy-air as it approached the escarpment of the Rockies. Carlos, who hated flying, clutched his seatbelt and hoped he wouldn't be violently ill right in front of this beautiful, talented woman. When the flight settled down again, he looked at her. "You mean you can't see the gap?"

  "Not really. We're certainly dealing with plague, that's clear enough from those first cultures we've run in the Atlanta lab. They just confirm what Seattle and Fort Collins have reported. It's plague all right. A lot more plague than there ought to be."

  Quintana snorted. "You might say so," he said. "But where are the rats? Where are the fleas? Doesn't that strike you odd? All this data piling in about a sudden, plaguelike illness, but not one word about rats or fleas."

  "We'll find the rats and fleas," Monique said firmly. "They'll be there, don't worry. They always are."

  "Maybe so," Carlos said uneasily, "but the pattern's all wrong. Look here." He flattened the maps out on their laps. "We've got the index case way up here in the Northwest, the girl died in the wilderness. Not down in a hospital, mind you. Out in the woods somewhere. She's got to be the index case, because everybody who came close to her has also died. We've got eleven cases so far in the Northwest alone, confirmed or suspicious, nine of them dead, and the Shoeleather Boys up there, along with the State Health Department, have pinned every one of them down to her. God knows what the count's going to be by the time we get to Denver. But no rats, and no fleas. Okay, now look here." The dark-haired doctor shuffled maps again. "We've also got this disaster at this little hospital in Rampart Valley, Colorado. That place was apparently contaminated from top to bottom in about three hours. A very sharp doc there pinned it down, thank God, and got everybody in sight taking prophylactic antibiotics, and even at that we already have five dead out of there by last count, according to our people in Fort Collins, and still no rats, no fleas. ..."

  Monique pulled on her lower lip, frowning. "What did that doctor use there? Tetracycline?"

  "For the antibiotic? No. Streptomycin and chloramphenicol, together. Full therapeutic doses."

  "Both? And five people still died? But Carlos, that's weird. Those drugs stop Yersinia. Unless he started the drugs so late—"

  "He started them within an hour after he identified the bug under the microscope, you can't get much faster than that, and the people still died. So maybe you see what I mean about somehow not having the whole story?"

  "I'm beginning to see."

  "Well, I'm not quite clear yet just where that Rampart Valley case came from, but if a bunch of people have brought some plague down from the Northwest to central Colorado, and it's acting like this, we may just have a mess on our hands. Ted said the state of Colorado is already frantic about a publicity leak. This is the peak of their tourist season and one little news story could kill them." Carlos pushed the maps aside with a sigh. "I just hope Ted has gotten things organized out here by the time we arrive. Who are we supposed to meet in Denver? You have that list?"

  Monique unfolded a memo sheet. "First there's Roger Salmon from our CDC base in Fort Collins. He's supposed to meet us at the airport in Denver. He's coordinating things, Ted said, already has a crew of Epidemic Intelligence Service people gathered in from Seattle, San Francisco and Mullin, Idaho—"

  "Experienced people, I hope," Carlos said.

  "Ted said they may be pretty green, but they've got good shoes. Then there'll also be a man up from Albuquerque, name of Bob Romano."

  "Right, I've worked with him. Knows what he's doing in a field investigation." Carlos scratched his head. "There was somebody else Ted mentioned just as we left, a funny one, but he thought it might be important. Something about some other town. Somebody named Barringer . . . Farringer . . . ?"

  "Barrington," Monique said. "He's a forester."

  "A what?"

  "He takes care of trees. In the wilderness. He works for the Forest Service."

  "So what are we going to learn from him?"

  "I don't know," Monique said. "Maybe something about rats and fleas." Carlos glanced at her sharply, and she shrugged. "One thing, though—Ted said he was living with the first girl before she died."

  "Ah, so." Carlos nodded. "In that case, I certainly will want to see him, and early on, too. I think maybe you'd better stick around for some of these first meetings, my dear. You're going to need the background as much as we are. And then I think you're going to have your work cut out for you when you get to Fort Collins."

  "So do I," Monique said soberly. "If these little bugs they've been collecting for me are as nasty as they sound, we're going to need a full-scale hot microbiology lab to play with them. We are, that is, if we want to find out how these Yersinia are different from ordinary plague bugs—and how to stop them. . . ."

  Like ships passing in the night, the Boeing 747 carrying Chet Benoiiel south f
rom Denver to Atlanta whispered past the Eastern DC-10 carrying Carlos Quintana north from Atlanta to Denver a little bit before midnight. Neither man had ever met the other. Neither one would have wanted to.

  Chet squirmed in his seat in the almost empty first-class cabin, trying somehow to get comfortable. A large-boned, beefy man of thirty-five, he was not built for air travel, and this trip had been a disaster from beginning to end. First that godawful bush flight by Lear Jet across the north slope into Kotzebue; the ten hours' wait there, in the heat and mosquitoes and the stink of rotting fish, for the Wienie-Bird flight down to Anchorage and on to Seattle; and the fast briefing meeting with Carey at Sea-Tac before he ran to catch the Continental flight to Denver, rush-rush all the way. And then, to top it off, that goddamned kid they'd planted right beside him in the first class Denver flight, because they'd overbooked the coach section and the kid said he was sick—acted it, too, for God's sake, coughing in his face all the way to Denver and gasping like a fish out of water—he should sue that goddamned airline for dumping that kind of company in his lap, practically. Then fourteen hours' bloody delay in Denver getting aboard this crate—fourteen hours—just because some crazies had called the airport and said a bomb was on board, and the airline didn't have another seat unbooked for the next two days. He'd almost called for a company plane, but decided he'd better not. There wasn't any emergency, after all; the meeting in Savannah