24.The Solution

Sue arrived early enough so that they had time to have lunch together. About half way through lunch, Sue looked quizzically at Sam: "Is something wrong?" she asked.

"What makes you think so?" Sam asked

"You seem a bit anxious."

"Maybe it's just the impending meeting," Sam said, hoping that she would leave it at that. She didn't pursue it.

The meeting seemed like a social gathering. It was held in Mike Levering's suite. A rolling cart with coffee and hors d'oeuvres stood in the corner and everyone was seated in comfortable chairs arranged in a circle.

"I understand that the group has collected an amazing amount of information, considering the short time that it has been in existence," said Levering. "I would like to review what you have discovered to date. Sam, what does our epidemiology section have?"

Sam deferred to Eric, who discussed the Buffalo findings. "We have about forty cases of EE that are traceable to the administration of R7001 to the children of the Cheektowaga School. All of these have been traced to only four of the 400 children who were given the vaccine. Most of the victims, if you can call them that, were exposed to the children in the first two weeks after they were given the vaccine. We have one new case that was exposed at three weeks, but that seems unusual. We can say with reasonable certainty, that about one percent of the children given the vaccine develop into transmitters of Epidemic E and that they remain infectious to adults, between the ages of thirty five and fifty five, for about two weeks."

Sam stated that his study of the Ogden group appeared to confirm Eric's findings.

Nick Tarkas passed a folder with six pages of data to each participant. "The data, for those of you who are interested, are in the sheets that I've given you. Briefly summarized, we found polio antibody in all of the children who had been given the vaccine. We also found antibodies to coxsackie type A in about half of the children who were given the vaccine, but the titers didn't go up, which indicates that they had the virus before the vaccination. The kids who turned out to be carriers of EE all had no antibodies immediately after vaccination, but the antibody levels to both Coxsackie and Polio increased afterwards indicating that they had an active infection with both viruses."

While Tarkas was talking, Zabalka sat back with a broad grin on his face, and tapped his fingers together slowly. Nick kept glancing at him and it was obvious that Zabalka's attitude was disturbing Nick. Tarkas continued; "Antibody levels to both polio and coxsackie A went up in all of the adults who contracted EE. We have tested both the polio antibodies and the coxsackie and find that the polio antibodies are compatible with the strain of virus present in the vaccine and the coxsackie A appears to be in the A7 subgroup. Now, Arthur, tell us what the hell you have up your sleeve before it chokes you!" he said, a touch of anger in his voice. Nick had just presented the best that he had and Zabalka looked at it as if it were of no consequence whatever compared to what he was about to offer. That Zabalka can sure be a prick when he wants to be, thought Tarkas.

Zabalka looked like the proverbial cat that had just swallowed the canary. He dragged out his presentation like someone who had a surprise and wants to get the most mileage out of it. " As you all know, we have been trying to isolate virus from both the R7001 polio vaccine and the people in the Buffalo epidemic. Our results are as follows: The polio vaccine yielded only polio virus. There was no coxsackie present so far as we could determine, nor any other contaminating virus. Our cultures of the secretions and feces of the children who were not carriers yielded only polio virus. Cultures of nasal secretions and feces taken from adults with active Epidemic E yielded nothing, no polio and no coxsackie." A grin wreathed Zabalka's face, "In contrast," he drawled slowly, " The children who were carriers of Epidemic E yielded virus plaques that had the morphology of coxsackie. Cultures taken from the brain tissue of the man who died yielded a virus which produced similar plaques. We performed complement fixation tests on this virus and tested positive to coxsackie antiserum as well as polio antiserum." Zabalka had a smile that went from ear to ear.

"Holy cow!" Tarkas exclaimed, "a hybrid virus! Are you sure, Arthur?"

"Not one hundred percent, but almost. We'll be absolutely sure in a couple of weeks after we do inactivation studies." He passed two sheets of data to Tarkas for his scrutiny.

Tarkas scrutinized the papers and said "It looks pretty good to me. Still, it's so incredible, that you'll have to really do everything that you can to confirm it." He looked at Levering, "If this is true, Mike, we can't keep it a secret -it's too important."

" Goddamn! Arthur," Levering said in admiration," its amazing. What you say is true, Nick; We can't keep it a secret. But how can it be released without screwing up the whole polio vaccination program?"

" An important question now," Sam said, "is whether all polio vaccine will hybridize with coxsackie or just the R7001. If it's just the R7001 then we've stopped it already. If it's all polio vaccines, we're in deep trouble."

"Where did this hybrid virus come from?" Sue asked.

"I think that we can assume," said Nick, " that the coxsackie virus was just going around the school population at the same time that the kids were given the vaccine. If both the coxsackie and the polio viruses entered cells at the same time, we might get a hybrid virus. The reason that it was so uncommon was that the timing had to be just right. You need a coxsackie epidemic occurring at the same time the polio vaccine is given, and presumably it has to be the right type of coxsackie and the right type of polio."

"I thought that that wasn't supposed to happen because of interferon," said Sam.

"Maybe this R7001 virus is defective and doesn't stimulate interferon production," Zabalka said.

"If that is true, then the likelihood of having another outbreak of Epidemic E is very small." said Sam.

"That's a pretty big IF, Sam," said Nick. "What Arthur said is just a guess. We really don't know how it could have happened. All that we do know is that it did happen."

There was deep silence which lasted for several minutes. Finally Levering said " Let's adjourn until ten tomorrow morning."

The adjournment didn't stop the meeting. The whole group proceeded to the dining room where they obtained a large table and ordered cocktails.

"Does this mean," asked Jack Monser, "that you now have the EE virus?"

"It's a pretty good bet," answered Zabalka.

"Then you could give it to someone of the appropriate age and that person would develop EE?"

"We won't know that for sure until we try it." said Zabalka, "but we may not try it because of the risk of fatal encephalitis."

"Only one of the many people who got the virus died," said Monser.

"That's true," said Zabalka," but the cultured virus may be much more potent. Besides, we know nothing about what dose of virus is necessary to produce infection. If we give too little we may get nothing and too much may be fatal."

"I would like to volunteer for your test," Monser said.

There was a sudden silence -all of the chatter stopped and everyone, except Sam and Eric, looked at Monser as if he had suddenly gone mad.

"Why the hell would you want to do that?" Nick asked.

Monser looked at Ellen who nodded in assent to him. She knew exactly what was on his mind and with the nod gave him permission to reveal her secret, "Ellen," he said, "do you want to tell them?"

"Yes," she said " the rest of the group might as well know what Sam and Eric already know. I've contracted EE."

Nick grasped the situation immediately, "So now you, Jack, want to join her."


"No!" said Zabalka, shaking his head, "It's much too risky."

"I want to take the risk," said Monser.

"I agree with Arthur," said Levering, "It's too risky. We'll have to test it out on volunteers: maybe prisoners."

" I doubt that we would want to do that," said Monser. It's one thing to subject a prisoner to death or paralysis. But to give him an uncontrollable sexual libido and keep him in prison would be truly inhumane."

"We could test it on chimpanzees," said Tarkas.

"I was planning to do that when I returned to the lab," said Zabalka." At least that would give us some idea of dose and whether it had a similar effect on other primates. I certainly wouldn't even consider a human test without first giving it to a whole range of animals."

"How long will that take?" asked Monser.

"A couple of months; maybe more, maybe less," Zabalka answered.

"I guess a couple of months wouldn't make any difference," Jack said sadly.

"We could give it to Harvey Schneider," said Sam, trying to rescue the group from the grim situation.

Nick picked up on it immediately, "He's a susceptible primate."

"Since he has already taken the polio vaccine, he is probably immune," said Zabalka seriously, having missed the point of the joke.

The waiter came to the table to take orders for dinner. He started with Sue who looked as if her thoughts, which were elsewhere, had suddenly been interrupted. "I haven't looked at the menu yet. Please start with someone else."

The waiter moved to Levering as Sue started scrutinizing the menu. Sam wondered what she was thinking about. He felt as if he knew the look and the attitude from his experience with his wife. With Janet, it was the calm before the storm. He could expect all hell to break loose at any time thereafter. The fact that Sam felt guilty increased his apprehension. He had a feeling of impending doom.

With the arrival of the food, the conversation became more intimate, with people talking to their neighbors rather than the group. Sue remained silent until about the middle of the entree. It was as if she had resolved whatever had been going on in her mind. She smiled at Sam. "How does the idea of a movie appeal to you, love," she whispered.

"I'd like that," Sam said; relieved that her silence had finally been broken. She didn't seem angry. Maybe her intense concentration had nothing to do with what he felt guilty about. She could have been empathizing with the Monsers or thinking about some problem with her children.

Tarkas, Zabalka and Levering were engaged in a lively conversation about what animals were going to be used and what precautions would have to be taken to prevent the infection of the animal handlers. They decided that it would be prudent to immunize the animal handlers with killed vaccine against both the Coxsackie virus and the polio virus; besides taking the precaution of sterilizing anything that came from the infected animals. Sam turned to Ellen, "Are you sure that you want Jack to risk encephalitis?"

"What makes you think that I want it? It's all his idea! I wouldn't want to lose him and end up like poor Mrs. Grossbeck."

"Who is Mrs. Grossbeck?"

"She's the wife of the man who died. Poor woman! I've never seen anyone quite as confused as she was. On the one hand, her husband of over 20 years had just died. She was totally desolate with grief, and on the other hand she had E.E. and needed sex. She had no trouble finding men to help her out (her intonation of that phrase had an icy sound to it), but she had no one to whom she could express her grief. She'd no sooner start to talk to a man than she'd want to screw him. Fortunately, whatever E.E. does, it also attacks whatever cells are concerned with sexual guilt so she didn't have that to contend with."

"Did you try to help her?"

"Of course, it's the least that we could do considering that we hadn't been able to stop it from happening."

"What did you do?"

"We put our best female psychiatric social worker on her case. She could vent her grief to her. She also persuaded her to be very discreet about her sexual affairs because other people might not understand it the way that she did."

"Did it work?"

"It looks like it. She's now going steady with an old friend. Hers may be one of the shortest widowhood in history.

"It sounds almost as pathetic as the macaques," said Sue.

"What macaques?" Sam asked.

"I mentioned it at our first meeting; the monkeys that had had their temporal lobes removed. I went back and looked up the paper to refresh my memory." She reached into a large envelope that she was carrying. "You might want to read it." She put it on the table, "The salient paragraphs are marked."

Jack Monser picked it up and started reading. He chuckled as he read.

"Come on, Jack, let us in on it!" Sam said.

"O.K., listen to this: When the monkey is confined alone to a cage, the following states and activities can be observed: frequent erection of the penis, often without previous manipulation....... long continued licking and sucking of the penis, the animal at times apparently falling asleep with the penis in the mouth -Nice trick. The monkeys may, for instance, copulate almost continuously for half an hour. It may leave the female only to mount again almost immediately......Although they frequently bite each other's legs, arms or tail, fights never develop, the injuries are merely the by-product of heightened sexual activity. (Kluver, H. and Bucy,P.C., Arch. Neur. and Psychiat.42:879-1000, 1939). Unfortunately, their observations were chiefly with male monkeys."

"I'm glad that our E.E. victims aren't monkeys," Ellen said.

"There haven't been any fights with our EE people either -no apparent jealousy either." said Sam.

Sam and Sue lingered over a brandy until everyone else had left. They decided that it was too late for a movie and that they would go to one at some other time. As they started to leave, Sue looked at Sam and with a mischievous smile and a raised left eyebrow, said, "How come, Sam, you didn't tell me this morning that Ellen Bast had contracted EE?"

Sam knew better than to even try to answer.

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