“Then vivax is not what we’re facing now,” I said.
“Correct.”
“What are we dealing with?” Captain Santo asked.
I liked Gaines. He couldn’t be ruffled. When he gave a briefing, he included all elements, even ones that might at first seem unconnected. He knew that something peripheral at the beginning of an investigation could be crucial later. He knew that the wrong kind of speed, impatience, could kill thousands. Eddie’s knee was pumping with frustration. I listened hard. Gaines would get to things his own way.
Gaines said, “Plasmodium falciparum is what we face. It is the most deadly form of malaria, and the youngest. Evolutionary biologists believe falciparum has only affected humans for about one hundred thousand years. A drop in the bucket, evolution wise. The theory is, falciparum originated in apes and jumped to humans. Our DNA is similar enough for that to happen. But the parasite has not decreased its virulence over time. On the contrary, Plasmodium New York is killing faster than the usual falciparum, and at a greater rate. It is even younger, definitely deadlier.”
“So there are two kinds of malaria,” Izabel prompted.
“Actually there are many kinds. But the others affect animals. Apes. Birds. Even snakes and rodents. Dr. Umar sought the most virulent human forms.”
I asked Gaines, “You’re saying that this new falciparum has evolved, become even more deadly?”
“Not exactly.”
“Mutation, then?”
“Not necessarily.”
On-screen now, two mosquitoes, side by side. One labeled NORMAL and the other ACCELERATED.
They looked the same.
I was getting impatient. “Then you’re saying that the malaria DNA was altered in that laboratory?”
Gaines shrugged, meaning maybe, and Eddie snapped, “Then what’s left to explain it?”
Gaines gazed out his window, at the CDC complex, containing his own labs where I knew the blood of tristate victims had been under analysis for days. Then he sighed.
“All the sick have algid malaria, the worst kind of falciparum. Algid multiplies like wildfire. It infects up to ninety-nine percent of victims’ red blood cells. Adult sufferers in New York are dying of kidney failure and respiratory distress. Children…” He trailed off. He was trying not to show emotion. It didn’t work. Gaines had three young children.
“Children are dying from the cerebral form. Their brains are more susceptible.”
“What is different about the new strain?” I asked.
“The speed. Normally algid takes a minimum of seven to eight days between infection and onset. We’re seeing something faster, since we’ve traced many victims to infection point. A concert. A cookout. We know when these people were bitten, and where.”
“You’re not making sense,” I said. “First you tell us that the parasite is the same as always. Then you tell us that it’s acting differently. But you shoot down every suggestion of how the parasite changed.”
But suddenly I saw the answer to my own question, and it chilled me.
“No,” I said, reasoning out loud, “you’re telling us that a malaria attack requires two distinct elements: the parasite and the mosquito.”
Gaines nodded as if a student had given a proper answer. “Yes. Malaria is species specific. Parasite without carrier doesn’t work.”
“The mosquito is different!” I saw. “Umar changed the delivery system! He didn’t need to change the parasite. He just collected the flukes, the worst ones. He spread the net in the biggest malaria field on earth, for victims who would have died so fast they never had the opportunity to spread infection. He harvested the top killers. Then he altered the carrier!”
Eddie nodded. “And when I beat it, Umar wanted to know how.” He brightened. “Does that mean my blood has an antidote?”
Gaines sighed heavily. “It’s more likely that you’re just stronger than most people. We’ll test your blood for antibodies, but don’t count on it. If there was some magical cure in you, Umar would have drained you dry.”
Now I saw what looked like ancient hieroglyphics on-screen, rows of symbols that represented mosquito DNA. But there were gaps between some of the symbols. “Normal anopheles,” Gaines said. “And new ones, collected in Central Park.”
I looked down from the window at Florida’s Everglades, the U.S. version of an enormous mosquito breeding ground. Farther north would be Okefenokee Swamp, 300,000 acres in Georgia, and the inland waterway, the Cape Fear River in Norh Carolina, a cornucopia of Virginia, Maryland, and Delaware rivers, harbors, and ponds, mosquito-friendly waters all the way up the East Coast.
But it was worse. Eddie and I had just spent weeks advising impoverished Amazon slum dwellers on tactics to defeat malaria, and what needed to be done here was no different. New York contained a million bodies of standing water in which insects could breed. Water in flowerpots. Water in stagnant swimming pools and old sewage drains and clogged roof gutters.
Gaines waited like a teacher eyeing a favorite student.
“But how did Umar change the mosquito?” I asked.
“He sped up the metabolism, Joe.”
Izabel asked, “How does that make the illness worse?”
“Malaria 101, Captain. The only way to get the parasite into a mosquito is through a blood meal. The parasite enters while a mosquito feeds on an infected person, through the proboscis, the needlelike probe it uses to suck up blood. But the only way to transmit the parasite out of the mosquito is through its salivary glands. And to reach those glands, the parasite migrates through the mosquito, into its stomach, then back up to the glands. Only after that, when the mosquito bites a new person, and injects saliva, does the parasite ride in.”
“And this takes time?” asked Izabel.
“Normally two weeks. Hot weather, it’s quicker. Cold, it’s so slow that the mosquito dies of old age before the parasite ever reaches the salivary glands. That’s why people don’t catch malaria in cold countries, or in winter. The process is too slow. Usually.”
“But now?”
A head shake. “The transition seems to be taking as little as two days. Not eight.”
Horrified, I saw the implications. “So if our terrorists in the U.S. have a supply of altered mosquitoes…”
“And if they feed them blood meals infected with parasites,” Eddie continued.
“And if the supply of altered insects is big enough, or they get new shipments…” added Izabel Santo.
Gaines looked miserable. “Then you’re looking at the biggest mass murderer in history, because he can release a new batch every few days,” he said.
I was thinking, There’s something I may have missed here. Something that Eddie told me. Something on the island. What am I missing?
“It gets worse,” Gaines said, which pulled my attention back to him.
“Christ, what’s left?” Eddie asked.
“All the attacked cities sprayed pesticides after the initial outbreak, but still, we found some infected mosquitoes afterward, alive. They’re resisting chemicals. Just like in Africa and South America. It’s harder to kill them. Pesticide resistance has been growing for years.”