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No, Doctor, the admissions clerk replied.

Cold packs, the head nurse said, handing over an armload of them. These went under the armpits, under the neck, and elsewhere to bleed off the body's potentially lethal heat.

Dilantin? Quinn wondered.

She's not convulsing yet. Hell. The chief resident took out his surgical scissors and cut off the patient's bra. There were more petechiae forming on her torso. We have a very sick lady here. Nurse, call Dr. Klein in infectious disease. He'll be at home now. Tell him we need him here at once. We have to get her temp down, wake her up, and find out where the hell she's been.

* * *

47 - INDEX CASE

MARK KLEIN WAS A FULL professor at the medical school, and therefore a man accustomed to regular working hours. Getting called in at almost nine in the evening wasn't the usual thing for him, but he was a physician, and when called, he went. It was a twenty-minute drive on this Monday night to his reserved parking space. He walked through the security staff with a nod, changed into scrubs, came into the emergency room from the back, and asked the charge nurse where Quinn was.

Isolation Two, Doctor.

He was there in twenty seconds, and stopped cold when he saw the warning signs posted on the door. Okay, he thought, donning a mask and gloves, then walking in.

Hi, Joe.

I don't want to make this call without you, Professor, Quinn said quietly, handing the chart over.

Klein scanned it, then his brain stopped cold, and he started from the beginning, looking up to compare the patient with the data. Female Caucasian, yes, age forty-one, about right, divorced, that was her business, apartment about two miles away, fine, temperature on admission 104.4, pretty damn high, BP, that was awfully low. Petechiae?

Let me take a look here, Klein said. The patient was coming around. The head was moving a little, and she was making some noise. What's her temp now?

One-oh-two-two, coming down nicely, the admitting resident replied, as Klein pulled the green sheet back. The patient was nude now, and the marks could hardly have been more plain on her otherwise very fair skin. Klein looked at the other doctors.

Where's she been?

We don't know, Quinn admitted. We looked through her purse. It seems she's an executive with Sears, office over in the tower.

Have you examined her?

Yes, Doctor, Quinn and the younger resident said together.

Animal bites? Klein asked.

None. No evidence of needles, nothing unusual at all. She's clean.

I'm calling it possible hemorrhagic fever, method of transmission unknown for now. I want her upstairs, total isolation, full precautions. I want this room scrubbed-everything she touched.

I thought these viruses only passed-

Nobody knows, Doctor, and things I can't explain scare me. I've been to Africa. I've seen Lassa and Q fever. Haven't seen Ebola. But what she has looks a hell of a lot like one of those, Klein said, speaking those awful names for the first time.

But how-

When you don't know, it means you don't know, Professor Klein said to the resident. For infectious diseases, if you do not know the means of transmission, you assume the worst. The worst case is aerosol, and that's how this patient will be handled. Let's get her moved up to my unit. Everybody who's been in contact with her, I want you to scrub down. Like AIDS or hepatitis. Full precautions, he emphasized again. Where's the blood you drew?

Right there. The admitting physician pointed to a red plastic container.

What's next? Quinn asked.

We get a sample off to Atlanta, but I think I'm going to take a look myself. Klein had a superb laboratory in which he worked every day, mainly on AIDS, which was his passion.

Can I come with you? Quinn asked. I go off duty in a few minutes anyway. Monday was usually a quiet day for emergency rooms. Their hectic time was generally weekends.

Sure.

I KNEW HOLTZMAN would come through for me, Arnie said. He was having a drink to celebrate, as the 747 began its descent into Sacramento.

What? the President asked.