A modern day horror tale that could be set in any medical facility in the world; and may have already occurred but the death of a small tribe or village is only news for those who work at the C.D.C.
Our tale begins as Mary a twenty something homeless woman is brought into the emergency room of a major medical center in a large city.
One of the night residents who happened to have just come on shift and not been up thirty hours; immediately recognized the signs of TSE (transmissible spongiform encephalopathy). Death was imminent.
He ordered her set up in an isolation room and basically covered head to toe he and his assistant turned her and he used a eight inch needle to draw yellow spinal fluid with blood streaks into the syringe. As he lay the syringe on the metal tray Mary seized and the syringe took a small bounce and a single drop of fluid dropped down onto the leg of the gurney.
Mary did not survive the seizure. The young resident from Zimbabwe, Africa understood the dangers of this horrible disease and gave strict instructions first to the Carepartners who prepared her for the morgue, double bagging her; then to the housecleaning crew to take special care to clean the front legs of the gurney. He also spoke with the Metro Police Department to search for her place and with anyone she had contact. The disease was highly contagious.
Marty and Carol geared up and prepared to sanitize the room. Marty had gotten served just that afternoon with papers. His wife had found out about his affair with Molly and filed for divorce throwing all his stuff in the yard, which was now packed in his car. She wouldn’t be reasonable and listen.
Carol rubbed her back, she should not have hung those new drapes today in the den--but damn they looked good. Now her back was giving her fits.
Both worked automatically; scrubbing and wiping all surfaces using the special wipes that killed everything microscopic...fungi, bacteria, viruses.
Carol bent to clean the front legs of the gurney and gave one a cursory swipe with the twinge of pain in her back. Marty cleaned the other, his cloth got the leg but neither cleaned the wheels. Both had their mind ion their problems.
On the wheel nut the bacteria died without its host, the prion--softer than a whisper but more than total silence, remained. It was classified as a protein, only having hooked up with a certain bacteria it had folded into an aberrant form--a harmless protein turned into a rogue agent.
The little prion rode up to surgery and waited patiently until a woman was moved onto the gurney. It held on as the gurney rolled onto the surgical floor, the gurney paused before the secretary's desk. Given a room number the gurney pushed off bumping into the desk and jostling the prion down to the floor.
Here it lay all day, people walked by, stood at the secretary’s desk. Gurneys rolled by ...wheelchairs were pushed, walkers shuffled but each one missed the prion. Day turned to night and still the prion waited supposedly not alive for it had no DNA of its own, though it was contaminated with the TSE. New people walked and were wheeled by and still it waited.
Meanwhile, housekeeping came to the floor and started with the hallway in front of room 901 began the long trek around the square the floor using the giant floor scrubbing machine, armed with chemicals to kill all living microscopic and scrubbing up all nonliving agents. If the prion could feel emotion it would have known fear at the sound of the machine drawing near. If it had had nerve endings it would have felt the vibrations drawing nearer yet and its fear would have mounted. But it was just a prion--softer than a whisper but louder than silence and so it waited. It was an opportunistic little rogue.
Terri G., R.N., M.S.N. finished reading the chart on the patient in room 906. He had an open wound they were debriding from an ulcer on his foot, a result of his diabetes. The dressing was to be changed q4h (Every 4 hours) but the day nurse had only had time to change it once that morning. She entered the room and checked the dressing. Of course, since it had been over eight hours since it was changed it was saturated in serous fluid (yellowish fluids drained from the tissues of the body). Her first thought was to report it to the charge nurse but then she remembered she had to get him up to walk in thirty minutes. If she changed it now, the charge nurse would make her change it again. She just didn’t have the time. Better to let the day nurse escape the wrath.
She got Mr. T. up on crutches and walked with him down the hallway toward the charge desk. Mr. T. did well until he reached the desk where he ran out of gas and breath. A Carepartner ran for a wheelchair, Mr. T stood his wounded foot bent off the floor behind him. As the chair approached he settled it to the floor directly on the prion.
The prion being an opportunist little protein begin making its way up through the bandage through the serous fluid, through the serosanguineous fluid(bloody and tissue fluid) toward the wound. As it traveled it coopted the normal prions into rogue prions which began seeking bacteria to corrupt. Just as the prion reached the edge of the wound Mr. T. reached beneath the bandage and scratched.
“What are you doing?” screeched Mrs. T.
“It itches, anyway I don’t feel anything in in my feet anymore, you know that.”
The prion now mixed with microscopic bits of blood and tissue fluids lay beneath his nail and waited.
The Carepartner entered and Mr. T. rubbed his finger on the bed to remove the blood. He was to have a shower. Without thought he scratched an itch on his bicep leaving behind microscopic bits including the rogue prion. The nurse came in and removed the bandage now filled with rogue prions folded it and removed her gloves round it, sealing it before disposing of it.
As Mr. T. got ready to get up for his shower the lab tech entered to draw blood.
“It’s the vampire.”
She rolled her eyes and tied her tourniquet around his bicep entered the vein, removed the tourniquet and stuffed it in her pocket. The opportunistic prion hitched a ride coopting millions of prions already on the tourniquet into rogues.
She made twenty blood draws all using the same tourniquet and leaving behind a few hundred prions on the arms of each victim. The next room she had to gown and double glove because the patient had VRE (vancomycin-resistant enterococci) Vanc. being the drug used to kill MRSA (methicillin-resistant staphylococcus aureus) A highly contagious patient, the tech only carried her syringes and a needle. She got beside the very ill patient and dug under her gown and in her pocket for the tourniquet.
Here, while the lab tech stood outside the door filling her test tubes, did the prion--soft as a whisper--find a home inside the patient. It moved into the blood already filled with bacteria, a war zone as T-cells, Europhiles, basophiles and other white blood cells fought valiantly against the invader but were losing the war and since the prion was just a protein even a rogue one they ignored it for the larger bacteria. Once in the lungs the prion and its million of rogue prions entered the bacteria cells folded them, mutated them into something like the world had never seen.
Each day the lab tech came and carried away the prion's protégé to other victims and each day more isolation carts appeared. One day it was a sixty-five year old woman who had gotten pneumonia after surgery on her gall bladder. The prions infiltrated and created super bacteria that began to slowly kill their host. Another day a forty year old woman with bowel surgery received a couple of hundred thousand prions that moved into her gut and began folding, folding the natural bacteria of the gut into a new super bacteria.
On day ten the Infection Control nurse came to the floor that morning, it was her job to find the primary infection host and the carrier.
They lost the initial VRE patient that afternoon.
The day charge nurse assured her that none of her nurses nor Carepartners had violated health procedures. It must have been the night shift Carepartners.
The night charge took that bit of news with dollop of let me figure out your job for you and not play the blame game. No one nurse or tech had been in all the infected rooms. They had varied doctors including residents and radiology did not take portables into all the rooms. That left the lab tech. The Infection Control Nurse verified this herself as she followed the tech that morning.
As for the patients--the sixty-five year old with pneumonia? Even though there ARE super-antibiotics most insurance companies including Medi-Care consider them experimental and therefore do not pay, I’m certain the $42,000 price for a full treatment does not figure into their decision. Her husband did not have the money for the treatment, could not get a loan on his free and clear home because his income was less than payments would be...and his son had just lost his job and was moving in with them with his family. He did not have enough time to sell the home; so he sat alone after sending his family home to rest and watched as the prion infected bacteria captured the last breath of his wife.
The husband of the forty year old woman overheard the Infection Control Nurse speaking with the Floor Manager, and the next day brought an attorney to the hospital administration office...they agreed to foot the cost of his wife’s treatment, with the agreement he not say anything about the arrangement. His wife lived but she lost the use of her kidneys so went on dialysis and is waiting for a kidney transplant.
A twenty year old young woman came in for a fractured humerus (upper arm bone) that had broken through the skin. Once infected the rogue prion traveled through the blood stream through the veins into the heart bypassing any and all bacteria because the army of white blood cells were strong warriors inside this young woman. So the prion moved steadily through the heart and lungs out the aorta and up the carotids where it reached and penetrated the blood brain barrier and moved into the rich glucose which bathes the brain, the brain stem and the spinal cord.
Finding no bacteria it moved down into the spinal cord pausing and coopting the prions around the Herpes labialis hidden in the spinal cord. The young woman would wake with a giant blisters from a cold sore in the morning. The prion moved along initializing the varicella zoster virus
(Chicken Pox) but before it could gain a stronghold the antibodies made during a childhood outbreak were standing by and annihilated them.
But there at the base of the spine being contained but not eradicated lurked the bacteria the prion loved to mutate. It slipped inside after coopting the thousands of proteins around it and began folding...folding and mutating becoming stronger and stronger carrying new DNA from the VRE into this bacteria. The guards were slain with a single rush and within hours she was infected from the base of her spinal cord throughout her brain. Her hands and feet blackened first the next morning. Doctors scrambled, isolation was installed. By noon she was seizing. By dinner she as dead...a healthy twenty year old woman.
Her cord had been tapped and an unidentified bacteria found. The C.D.C. quietly came and collected the vials of her fluids and blood and the body. The floor was locked down and sanitized.
Twenty dead...one survivor.
A prion softer than a whisper...goes rogue and becomes a killer, a maimer. A prion which is so small it can only be imagined not even the strongest electron microscope can capture it. A prion capable of mass murder of the likes not even Europe’s Black Plague imagine.
Prion--softer than a whisper---humanity killer if not contained. There will be no zombie brain-eaters like the movies...just the end of man.
Prion---think of it the next time a friend, a loved one or you go into the hospital and pick up the remote control for the TV or push the button to raise the head of your bed or call your nurse. Think of it when you grab your IV pole to go to the bathroom and flush the handle, turn on the faucet to wash your hands. Think of it the next time the ‘vampire’ draws your blood.
Prion softer than a whisper but it can make you SCREAM.
**VRE can live up to six days on the railing of a bed, IV pole or anything solid. A rogue prion is a protein and therefore is there until its cleaned away or finds a home.
We don’t have to Make viruses and bacteria for warfare that could out of control and kill and kill and kill. We just have to get careless. See the news--an outbreak of a super bug in California? Maybe my tale of horror is not a tale at all. All prion diseases are 100% FATAL.
Any similarities to any prion, bacteria, or virus living or dead is purely coincidental. This is a work of fiction...maybe...or maybe not. Only the C.D.C. knows for sure.