Jakes turned to her. “But that doesn’t make sense,” he said in a bewildered voice, almost as if he spoke to himself. “We both know woolsorter’s disease, respiratory or inhalation anthrax, has never been shown to be transmissible from person to person. It is inconceivable that so many people could have independently contracted respiratory anthrax in such a short time short of some sort of terrorist attack with powdered anthrax, such as we saw in the postal service back in the early 2000s.”
“A terrorist attack out here in bug-fuck Mexico, that’s your explanation?” Shirley asked incredulously.
Jakes shook his head, distractedly. “No, of course not, but besides that, the typical mortality rate of untreated anthrax pneumonia is only seventy to eighty percent, not one hundred percent like it appears to have been here.”
Shirley shrugged, the shoulders of her Racal bunching with her movements. “I know you’re right. But if tissues from the others show this pattern, I don’t know what else it could be.”
“What else do we need to do to be sure this bug is anthrax and that it did indeed cause the disease we see here?” Mason asked Shirley.
“Well, it’s kinda hard to explain…”
“Trust us, Shirley,” Jakes said sarcastically, “we’re doctors too.”
She shrugged within her Racal, “Okay, then, to be one hundred percent certain, we’ll need to do pleural biopsies and subject them to immunohistochemical staining or IHC. Then we’ll need to get some tissue samples from the bodies and check the levels of serum antibody or IgG to protective antigen or PA component of Bacillus anthracis using enzyme-linked immunosorbent assay or ELISA.”
In spite of the seriousness of the situation, Mason had to smile. “Oh, is that all?”
Shirley smiled back. “Actually, no. To be absolutely certain, I’d also like to do a polymerase chain reaction or PCR on some tissue samples from different bodies, and we’ll need to do specific staining for anthrax to make sure, but that’ll only take a couple of hours. The rest of the tests, however, could take days to complete with the equipment I have here.”
“Shirley,” Jakes asked, his voice more reasonable now, “in light of what I said earlier about anthrax not being passed person to person, do you think it could be some mutant form of anthrax, one that jumped species or something, one we’ve never seen before?”
She hesitated. “Well, that would almost have to be the case if this is anthrax, since like you say, modern anthrax has never been shown to be transmissible from person to person or to be this aggressive or to have such a high mortality rate.”
“Moreover,” she continued, her forehead wrinkled in thought, “this bacterium is almost certainly four hundred or more years old, and has been isolated in an airtight, sealed burial chamber and has had to form spores and encapsulate itself in order to survive for so long without living tissue to replicate in, sort of like suspended animation. Anything’s possible, I guess. The way bacteria mutate with exposure to antibiotics, viruses, and bacteriophages, it’s certainly not outside the realm of possibility the strains we have today are totally different from those present in the early 1500s.”
“I guess so,” Jakes agreed, although he sounded doubtful.
“Don’t you gentlemen remember your Bible?” Shirley asked, warming to her subject and looking back and forth between the two men.
“The Bible? What the hell’s the Bible got to do with this bug, or anything else?” Jakes demanded, his irritation at having been proven wrong showing now.
Shirley grinned, her teeth flashing in the light from the monitor screen. “The book of Genesis talks about the fifth plague of Egypt in which hundreds of thousands of animals and people died over the course of a few years, and Moses mentions a disease with symptoms remarkably similar to anthrax in Exodus 9:9.
“It has always been suspected by biblical scholars that the hot-bug that caused the fifth Egyptian plague was anthrax, but the mortality rate and number of deaths was thought to be too high for anthrax as we know it today. Maybe an older species, or perhaps subspecies would be a better term for it, was this super virulent type that could be spread person to person.”
“You’re really reaching now, Shirley, quoting an obscure plague, described by people ignorant of the basic rudiments of environmental theory,” Jakes replied, his tone thick with sarcasm.
Mason tried to end their argument. “Okay, people, let’s calm down.”
Shirley wasn’t so easily stopped. She continued. “In the eighteenth and nineteenth centuries, a plague of anthrax swept over the southern part of Europe, taking a heavy toll in both human and animal life.” She paused to remember details of the epidemic. “Make no mistake about it, gentlemen, and you too, Sam, we’re dealing with a heavy hitter here. This bug is a real bad actor, and if you’d look at the evidence of history, it may have been around for a very long time.” She glared at Dr. Jakes defiantly.
“Bullshit,” Jakes snapped, making Mason wish he could turn down the volume of his earpiece. “I think it’s good news, if it does turn out to be anthrax.”
“How so?” Mason asked, curious how bacteria that had just wiped out an entire archaeological expedition could be classified as good news.
“It’s simple,” Jakes said, spreading his arms. “Anthrax is treatable by penicillin and ciprofloxacin, if my memory serves me, and we have a vaccine against it. In fact, it was the first infectious disease in which a vaccine was found to be effective. We can thank Louis Pasteur for that.”
A quiet chuckle, clearly one of derision from Shirley came through Mason’s headset. “Au contraire, my dear friend. You’ve been working with viruses so long you’ve forgotten your microbiology and your medical history, if you ever knew any to begin with.”
“Oh?” Jakes sounded sure of himself. “And just where am I going wrong, Dr. Cole?”
“Almost everywhere, Sam. In the first place, the anthrax vaccine is ineffective against inhaled forms of anthrax, and in the second place, the treatment protocols for anthrax have undergone lots of changes since penicillin was used back in the dark ages when you were in medical school.”
“What are the new treatment protocols, Shirley?” Mason asked.
“Antibiotics known to be effective in varying degrees are ciprofloxacin, amoxicillin/clavulanate or Augmentin, doxycycline or tetracycline, clindamycin, rifampin, vancomycin, and chloramphenicol.”
“So what’s our problem?” Jakes asked, smiling. “We just pump anyone who comes down with this bug full of antibiotics and go on our merry way.”
“I have a feeling from the expression on Shirley’s face that it’s not going to be that simple, Sam,” Mason said.
“You’re right, Mason. In the first place, we’ve only had less than a hundred cases of anthrax in the antibiotic era, so only a handful of cases have actually been treated with these antibiotics, so the possible combinations and dosages haven’t been fully worked out yet, and to make matters worse, Bacillus anthracis makes beta-lactamases, which often makes the bacteria resistant to antibiotics even while under treatment.”
She hesitated, and then she continued in a grave voice, “Believe me, if this mutant form of anthrax gets out of the Mexican jungle we’ll be looking at a plague that could make the influenza pendemic of 1918, which, by the way, killed fifty thousand people in the United States alone, look like the common cold.”
Everyone remained silent while Mason and Jakes absorbed this latest news. Finally, Mason said, “Okay. Then it’s our job to make certain this mutant strain, or subspecies, or whatever the hell it is, stops here and to make absolutely sure it is anthrax we’re dealing with. I want those special stains done now, and I want some cultures set up to see if it’ll grow on the normal anthrax medium, which it may not since it’s either a mutated form or even a completely different subspecies.