“What killed her?” Gil Jacoby asked. Elsie Hughes’s death, although not a homicide, had been assigned to his department and he’d drawn the short straw. No one in homicide wanted to deal with any infectious-disease death, let alone one this ugly.
Katie Wood, the chief medical examiner for Austin, Texas, snapped off her protective gloves and deposited them in the biohazard trash just outside the autopsy room. She shook her head as she removed her plastic hair net. “I’m not sure, but I know what it looks like and I hope I’m wrong.”
Jacoby was suddenly awake. The tone of the ME’s voice was not good. “What?” he asked.
“You’ll have to wait a few minutes,” she said. “I’ve got to shower.” She left the detective standing in the anteroom, wondering what had just happened. He was even more concerned when another employee showed up a few minutes later in full protective gear and removed the trash can that contained the gloves and hair net. Another person, dressed from head to toe in rubber and plastic, placed a strip of yellow tape across the door to the autopsy room. Neither spoke to him.
“What’s going on?” he asked when Wood returned. Her short dark hair was still wet.
She pointed to another room abutting the examining room and they entered, shutting the door behind them. “This is serious,” she said, pouring two coffees and offering one to the homicide detective. “Right from the start I suspected this was something different, dangerous. The symptoms the victim exhibited were synonymous with some sort of hemorrhagic fever. Pharyngitis, conjunctivitis, and bleeding from openings in her body.”
“Whoa, talk English, Doc. What did you just say?”
“Her throat was inflamed, as were the mucous membranes in and about her eyes. That’s what forced her eyeball out of its socket.”
“Okay, but what makes this so dangerous?”
“Ever heard of Ebola?” she asked, sipping her coffee.
Jacoby instantly went white. “Of course. But that only happens in Africa. And it’s spread by animals.”
Wood raised an eyebrow. “Very good, Detective. Ebola’s not the only virus that causes hemorrhagic fever. There’s one more: Marburg. They’re both filoviruses, and they’re both very dangerous and very communicable. Once I suspected I may have a filovirus, I stopped normal autopsy procedure, cut out a slice of infected tissue, and magnified the sample on our electron microscope. The viral particles are about fourteen thousand nanometers long and encased in lipids. The only reason I know it’s not Ebola is that the particles are over a hundred and sixty nanometers in diameter, twice that of the Ebola virus. And I’m pretty sure they’re not Marburg, either.”
“Then if the virus isn’t Ebola or Marburg, it isn’t a filovirus,” Jacoby said hopefully.
“I can’t say for sure that it is or it isn’t,” she said. “But we’ll know soon enough. Can you find out for me if the victim has been in Africa recently?”
“Of course. I’ll call her husband.” He started to stand up, but the ME put her hand on his arm.
“Use your cell phone, Detective, because neither you nor I are going anywhere until we find out if we’ve been infected.”
Jacoby slowly sat down. “How does that happen?” he asked after a few seconds.
“An hour from now, this place is going to look like something from one of those plague movies. Everyone in protective suits, washing every square millimeter of this place down with the strongest industrial cleaners on the market. They’ll bring the necessary equipment with them to run an immunohistochemical procedure once they’ve fixed a skin biopsy with formalin. It’s a pretty definitive test. And if whatever killed her turns out to be a filovirus, we’ve got a real problem.”
“What’s that?”
“This facility is rated Biosafety Level Two. Somehow they’ll have to get her body to the U.S. Army Medical Research Institute of Infectious Diseases in Fort Detrick, Maryland. It’s the only Biosafety Level Four facility in the country.”
“Holy shit,” Jacoby said. “What about us?”
The ME looked grim. “That’s a good question, Detective. A very good question indeed.”