Loads of medical stuff that'll need researching and checking here – essentially just assume that the whole section has QQ throughout it. It's also where I explain that the normal isolation procedures wouldn't work with CLBD-7.
After all the packing and the promise of travel I’m somewhat disappointed that my first appointment is at Cambridge.
I’m here to speak to Dr. Robert Aldbridge, I’ve already done an online search for him and it appears that he has the most peer reviewed articles published on CLBD-7 in the world. He’s an epidemiologist who works for the World Health Organisation and he’s married with two kids.
I pull up some of his papers from BMJ.com onto my phone while I’m on the train to Cambridge, it’s all above my head so I skim read the abstracts and ignore the numbers. It’s the science nerds at Finsbury who suggested Aldbridge as the go to guy on CLBD-7 infection and I suspect that I’m just going to have to trust them.
The rocking of the train and my inability to understand half of what this guy has written threaten to lull me to sleep, so I spend my time looking out of the window watching the world go by. The other people in the carriage all seem tied up working on laptops, bent over their keyboards pecking away at whatever is important in their world.
Their working makes me feel guilty so I peck out a few lines of questions for the good doctor, unfortunately I haven’t really got my head around the way I’m going to write this thing, what shape it’s going to take so my questions are generic in the extreme. It’s good news that he is so close to home, perhaps when I’ve finished the globe-trotting part of this job I can head back to him and fill in any gaps.
When the train pulls up at Cambridge station only a few other people disembark with me, mostly men in suits, not that I was expecting many students at this time of the year, but it would have been nice perhaps to see some college scarfs on the platform. Thankfully there are plenty of taxis parked at the rank and I soon find myself on the outskirts of the city standing in front of an anonymous looking industrial building made of metal and green glass.
I notice the barbed wire on the fence.
I find myself once more sitting in reception wondering where to stick my printed out ID card. Bored I read the warning on the back ‘This ID car must be worn visibly at all times. For your own safety this card will track your movements while within the grounds of the building. If an alarm sounds and the card flashes red please remain where you are so that security may assist you’.
Box analyses the RFID in the card and reports that it is encrypted to international standards and that to attempt to break the encryption would break several laws and put me in prison for not more than ten years.
I pin it to my jacket.
Dr Aldbridge meets me in the reception and begins the tour. He looks to be in his fifties and is greying around the temples, somewhat podgy his skin has the remnants of a tan.
“While we are mostly concerned with statistics in this laboratory”, he tells me, “we still do a bit of bio-science work – mostly though it’s outsourced to other, better equipped labs”.
I don’t know why I expected him to wear a lab coat instead of a suit, I guess I’ve been watching too many films.
“Of course, our work here isn’t widely known to the world, most people would think that we are working on a cure for CLBD-7 here. You may have noticed the barbed wire on the fence? We had to put it there after a rumour spread that we held a cure. We were attacked by a mob of people convinced we could save them, or their children. Nonsense of course”.
Leading me into an undecorated office we sat down and I pulled out box to begin recording.
“Still, I don’t need to remind you of how things were in the early days. Us scientists were alternatively the destroyers of humanity, or it’s saviours. Some people thought that we were working just to save ourselves and the politicans. Nonsense of course, but the fear was huge in those days, before we knew what we were facing”.
“Of course, if we knew then what we know now, things may well have been much, much worse.”
I tapped Box and it projected what few notes I’d made onto my eyeglasses.
“Doctor Aldbridge, if we can make a start, what can you tell me about CLBD-7?”
“From the beginning? Simply?”, he took a deep breath, “Please stop me if I’m telling you things that you already know, or find too complicated.”
I nodded and double checked that Box was recording this, I popped out the support legs and started a video record as well, I never knew If Steve wanted this bit to be video as well as text on the site.
Aldbridge straightened his tie and cleared his throat, I love it how people who never grew up with ubiquitous recording devices behave when they realise that they are being watched.
He started speaking as if he were lecturing a class, clean and clear received pronunciation, “CLBD-7 stands for Contagious Lewy Body Dementia, and it was the Seventh strain that we discovered. That’s what the seven is for.”, He swallowed again.
“It was first discovered in 2009, well, the this strain was at least. Epidemiologists from several countries were seeing reports of sudden onset dementia in atypical populations. Initially it was thought that it had some sort of environmental source, it was only eighteen months later that we discovered that the vector was a retrovirus. Of course, from then it was only a short matter of time before we could sequence it properly.”
He paused, “Would you like a cup of tea?”, nodding my agreement he tapped some commands into his phone.
“So, we realised that this was something contagious, and that it was causing a rapid onset of dementia. Sadly our diagnostic criteria in those days were to rule out everything else, like lead poisoning, and if we were left with no apparent cause we’d diagnose it as CLBD-7”.
“Tell me about the ‘Seven’”, I asked.
“Hmmm, well we’d known that there were small groups of people who would get Lewy body dementia outside of the statistical grouping of the disease. Young people, or a small cluster within a community. We assumed that these were outliers, statistical groups. Ne never thought that it could be contagious.”
“You’ve got to understand that around one in five cases of dementia are thought to be because of the ‘normal’ Lewy body disease, but most of the research was going into Alzheimers. Sadly dementia wasn’t a ‘sexy’ disease that needed curing, after all most of the people who got it were near, or beyond retirement age. Money doesn’t get spent on that sort of thing much”.
He knitted his fingers together in front of him and continued, “So, with little research, we thought that the outliers were just that. It was only after we discovered CLBD, the contagious form, that we started to look at the older cases, and we discovered six other variation of CLBD. They weren’t as contagious, or as virulent as the CLBD-7 strain.”
The door opened and a tray of tea was brought in, the Doctor paused while we made tea for ourselves.
Holding the hot drink as if his hands were cold he kept his lecture up, “Where was I?, ah, yes. We had discovered that CLBD had existed for some time, latest thoughts are that it was around in the 1800’s although the evidence for that is sketchy to say the least.”, A small smirk crossed his face, “however it does seem that CLBD has been present for at least two generations although obviously not in the form we have now.”
I sipped the tea, I’d always drunk the tea hot out of the pot – a cast iron belly my family had joked, “If it’s been around for so long, why did we get Clubbed?”
“Clubbed… A reasonable slang I suppose. The problem is that retroviruses can easily mutate, and that was what happened here, CLBD-6 got struck by a bit of cosmic radiation or underwent a transcription error and turned into CLBD-7, a much nastier bug. Once it had that increased contagiousness it spread around the world via boat and airplane. It was helped that it takes such a long time from infection to expression of symptoms – a long time figuratively speaking”.
He blew on his tea and took a sip, “You’ve got to remember the flu pandemics, pigs and birds, yes? In that case the virus responsible infects the subject, and symptoms start to show up within a few days, fever, muscle pain, respiratory symptoms, you know – flu. With CLBD-7 the disease alters some of the cells in your body, it re-writes your genome which takes time. It alters the PARK11 sequence which then starts creating the Lewy bodies that reside in the brain causing the symptoms. This all takes time. I’d say that the time from exposure to initial symptoms is probably no less than a month, maybe two.”
“With that sort of progression there was no way that quarantine would work, to do that you would have to isolate everyone from everyone else – after all you don’t know who is sick until two months after they have been spreading the illness around themselves. It’s not as simple as sitting at an airport reading passenger’s temperatures with a thermal camera and locking up those who read hot”.
“So the disease was all across the world before anyone knew about it?”
“Exactly, it took us time to realise that there even was a disease, by then quarantine and travel restrictions were pointless, there would be infections everywhere across the globe.”
He took another sip, “By then all we could do was sit and wait.”