Little Shop of Horrors --- a three-part series on emerging biological threats…

Stealthy, resilient and fickle, they play hide-and-seek and multiply. They are the agents of mass death and they are poised to strike.

At first, he thought it was the flu. A couple of days later, doubled over with severe abdominal cramps, feverish, suspecting little more than a bad case of dysentery, a 36-year-old lab technician named Kinfumu checked into the general hospital in Kikwit, Zaire. Doctors and nurses soon realized this was no ordinary case of dysentery. In fact, this was not dysentery at all but some gruesome, if invisible, miscreation feasting on their patient from the inside. Within hours, Kinfumu's capillaries became clogged with dead blood cells, causing the skin to swell, blister and eventually dissolve like soap flakes. Blood bubbled and seeped out freely from his eyes, ears and nostrils, then from every orifice in his body in rank, foamy rivulets. An overpowering spasm then seized and shook Kinfumu's nearly lifeless frame, causing him to vomit a black slime --- his liquefied internal organs. He died the next day. That was just the beginning. The disease spread like wildfire among the hospital staff, killing two nurses, and spilled into the teeming streets of Kikwit. Terrified, people fled into the countryside, many carrying the monstrous illness with them and infecting scores in their paths.

No, this is not Stephen King or Clive Barker at their horrific best. This is Ebola, a nightmare virus discovered about 20 years ago when a similar outbreak killed over 400 people in Zaire and Sudan. So far, no one can tell where the vampire virus dwells, how it occurs in nature and why it attacks with such unpredictable and sporadic frequency. What is known is that humans are not its natural host, that it spreads rapidly, that body secretions act as vectors, and that it kills up to 90% of its victims in a week or less after reducing them to pulp.

If Ebola is a hideous reminder of a microbial world gone amok, it is but one in a vast and growing army of merciless pathogens capable of wiping out millions in their wake. Some have plied the Earth for millennia and continue to flare up wherever poverty, illiteracy, inadequate sanitation and overcrowding persist --- among them bubonic plague, cholera, smallpox and typhus. Others have mutated and gained formidable strength with each succeeding epidemic.

Many, secretive, not well understood, lurk in their tropical abodes, awaiting a fitting host. Most are yet unknown and, like AIDS, which has claimed 40 million victims, most will be lethal.

Over a dozen deadly viruses have surfaced in the past decades. Genetically programmed to interact with specific body cells, their aim is not to cause illness but to replicate and multiply. Once confined to narrow regions of the globe, they now jet toward random destinations, stowaways on an unwitting mission of death. These agents of mass destruction include:

o Dengue. Lethal strains (hemorrhagic fever) of this mosquito-borne tropical virus now plague parts of Asia and Latin America. Over 120,000 infections were recorded in Latin America in 1996. First identified in the South Pacific during World War II, it is thought to have evolved through complex cross-breeding between different viral strains and various types of mosquitoes. Dengue, which peaks during the rainy season, continues to thrive in Central America and the Caribbean. Cases have been reported in Florida.

- Hanta. A new form of this East Asian, rodent-borne flu-like virus struck the southwestern US in 1993, killing 12. Over 100 cases --- 50 of them fatal --- have since been reported in 23 states.

- HLTV. Transmitted in the same manner as HIV but less deadly, it causes fatal T-cell leukemia in about one percent of its victims. The virus is pandemic.

- Junin. Isolated in 1953 on the banks of the Junin river in Argentina, the virus is spread by field mice and kills 20% of its victims. The incidence of Junín, according to the Centers for Disease Control in Atlanta, is increasing.

- Lassa fever. When the deadly Lassa virus was first identified in Nigeria in 1969, it swept through a missionary hospital with terrifying speed, killing nurses, doctors and patients in the open wards. Other outbreaks followed in West Africa, each claiming huge victims, particularly among hospital staff.

Causing hemorrhagic fever, Lassa infects nearly half a million people and kills about 5,000 annually.

- Marburg. A cousin-in-crime of Ebola, this virus was identified in 1967 when 31 people were infected in Germany and Yugoslavia --- seven fatally --- by Ugandan green monkeys.

- Mapucho. The rodent-borne virus made a recent comeback in Bolivia. Six of seven affected family members died.

- Oropouche. Transmitted by sand flies, this virus causes severe flu-like symptoms. It was identified in 1961 after infecting 11,000 people in Belém, Brazil.

- Rift Valley Fever. Transmitted by mosquitoes, the virus caused an epidemic in Egypt's Nile River delta in the late 70s, infecting more than 10,000 people and killing several hundred.

- Sabía. This new virus was identified in 1990 in São Paulo, Brazil. Last year, a Yale University scientist accidentally infected himself but survived.

While new diseases are straining the world's health resources, old ones --- some presumed vanquished --- are returning, fortified by multiple mutations and a pugnacious fancy for the best anti-viral agents and antibiotics money can buy. Among them:

o Cholera. A water- and food-borne disease capable of killing a healthy person in six hours, this acute enterotoxin-caused scourge has brought death to nearly two million Latin American and West Indian children aged under five since 1990. Dubbed the "misery thermometer," cholera serves as a reminder that Latin America, like the rest of the developing world, remains overwhelmed by physical and social conditions that make largely preventable and easily treatable diseases the hemisphere's biggest killers.

o Diphtheria. While a United Nations advisory issued two years ago said that the world supply of diphtheria vaccine is perilously low, 40,000 people contracted the highly contagious disease in Russia and two former Soviet Republics in the first three months of 2000. The epidemic rages on, sustained by the waning immunity of primary vaccinations.

o Malaria. In 1994, five people in the northeast US contracted malaria. They hadn't traveled anywhere. Native US mosquitoes had picked up the Plasmodium parasites by feeding on travelers and transmitting them at random. Over 270 million people have been infected. Drug-resistant, incurable forms now ravage parts of Southeast Asia.

o Polio. The Atlanta-based Center for Disease Control recently warned that the US was running out of polio vaccines. Although the US is relatively polio-free, epidemics linger in parts of the world, notably India.

o STDs. Seeking --- and finding --- new permissive environments, sexually transmitted diseases are out of control worldwide with frightening scales of infection. According to Laurie Garret, author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance, syphilis, gonorrhea, hepatitis B, chlamydia, chancroid and HIV continue to foil medicine's best and newest weapons.

"There are strains of streptococcus and staphylococcus that are resistant to heavy detergents and chlorine. Some can even grow on a bar of soap. E coli, one of the most common bacterial species, has evolved new, ultra-poisonous capabilities," she warns.

o Tuberculosis. The virus that causes AIDS has infected 16 million people around the world since the epidemic began. As the incidence of HIV infections rises in areas where tuberculosis is common, the highly contagious lung disease is taking an even greater toll on people whose protective immune systems are compromised by HIV Better than one-third of all deaths among HIV-infected people will result from TB. Tuberculosis is the major cause of death in Africa, where it kills over 40% of HIV patients. TB is also on the rise in the US among the HIV-positive. Resistant to treatment, the mysterious W strain that struck New York in 1990 is still out of control. The city has since spent upwards of $1 billion to eradicate the disease.

One way to stir up trouble, according to a growing body of evidence, is to encroach on a microbe's habitat. Destruction of primary forests and other fragile environments has not only precipitated the extinction of countless aboriginal societies, it has also forever imperiled a delicate and finely tuned ecosystem by compromising biotic harmony. This intrusion, scientists agree, has triggered unforeseen mutations and hastened the propagation of dormant organisms out of their original habitat. The Ebola outbreak is widely believed to be the result of such meddling.

Air travel also continues to aid and abet the microbes' uninhibited marathon for self-perpetuation. In 1950, fewer than three million people had traveled by plane to foreign countries. By 2000, 400 million passengers had crisscrossed the globe. Unlike people or dangerous contraband, diseases cannot be intercepted at customs checkpoints. Nor can they be identified during sometimes-prolonged incubation periods. As people continue to move about the planet, so will viruses and bacteria hitch rides on unsuspecting hosts. From the seeds they sow in the fertile ground of unpreparedness will be reaped some very bitter fruits.

Programmed to replicate --- like its genetic kin, the microbes --- the human race is pushing the planet too far. Perverse disregard for nature's unfathomable plan could bring the family of Man to the brink of catastrophe. So could the ghoulish manipulation of nature by nations seeking military superiority in the name of national security. The work of these latter-day alchemists of death will be explored in the next issue.

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