Lost Immunity by Daniel Kalla (best free ebook reader txt) 📗

short notice,” Lisa says. “We are now at day three of a meningococcal eruption that has already met the CDC criteria to be classified as an organizational outbreak. Due to the lethality of the pathogen involved, we’ve decided to convene an Outbreak Control Team and create this subcommittee to share information and coordinate responses among all involved agencies. If it’s all right with everyone, for the time being we’ll aim to meet daily, if not in person then at least via videoconference.”

There are nods and murmurs of agreement around the table.

Lisa taps a button on her desk and a map of greater Seattle appears on the screens along with an animated red circle made of dots that revolve around the location of Camp Green, just south of the city. She talks through a few more slides with tables and graphs that highlight a basic epidemiological survey of the outbreak—including the dates of onset for the eleven known cases and, in the case of the five fatalities, the times of death.

Next, Lisa turns to the source of the infection. An electron microscope image of the offending bacterium fills the screens. It resembles two side-by-side, fuzzy red Ping-Pong balls. “Harborview’s microbiology lab has confirmed the pathogen is a particular strain of Neisseria meningitis, serotype B. The evidence suggests it’s the same strain of meningococcus that was responsible for the outbreak in Reykjavík last winter. Like most type B strains, for reasons that aren’t fully understood, this pathogen strongly targets teenagers and children. In Iceland, more than ninety-five percent of the victims were between the ages of five and twenty-five.” She motions to the woman halfway down the table who wears gold-framed glasses and has her gray hair tied tightly on top of her head. “I will defer to our expert microbiologist, Dr. Klausner, from the state lab for further characterization.”

“What’s left to say?” Angela pipes up. “It’s the same bug that did Iceland’s kids in.”

Klausner emits a quiet chortle and then clears her throat. “Well, yes, it does appear that way.”

“And you’ve confirmed this how?” Moyes asks.

“The PCR tests are unequivocal for that specific strain,” Klausner says. “The blood and spinal-fluid cultures have already grown meningococcus.” She stops frequently to clear her throat in what Lisa recognizes as a vocal tic. “We hope to get the WGS—whole genome sequencing or its molecular fingerprint—results soon. Then we’ll know for certain.”

Angela looks over to Moyes. “The WGS isn’t going to change diddly, Alistair. This is the Icelandic pathogen. There’s zero doubt.”

Moyes only smiles at her. “It’s good to see you back, Angela. Feisty as ever.” He turns to Lisa. “Does this mean you’ve linked one of the cases back to Reykjavík?”

“Not yet, no,” Lisa says.

“They don’t have any active disease in Iceland,” Angela says, tugging at her scarf. “We’re working under the assumption that it must’ve been brought back to Seattle by someone who is asymptomatic. In other words, a healthy carrier.”

Moyes raises an eyebrow. “Has one of the campers recently returned from Iceland?”

“We haven’t identified one so far,” Lisa admits. “But we haven’t reached everyone yet.”

“Point is, Alistair, one way or the other, the very same killer bug has reached Seattle.” Something in Angela’s tone suggests that she has more than just a collegial history with the CDC doctor. “And we better stop it from detonating like it did in Reykjavík.”

“You don’t find it the least bit… odd… that the same deadly bacteria show up here in the Pacific Northwest without an easily traceable connection back to Iceland?” Moyes asks.

“It’s an emerging pathogen, Alistair. A brand-new bug. Everything about it is odd.”

“How often do emerging pathogens cross the planet without leaving a trace?”

“We’re still actively looking for the link,” Lisa intervenes, feeling the need to wrest control of the meeting back, although Moyes’s point resonates. “Meantime, we’ve reached out to Public Health over there. A Dr. Haarde. He was extremely helpful. In Iceland, they ended up with three clusters of infection once it spread into the community. Thirty-five victims died, all of them young.” She pauses to let the stark statistic sink in. “Reykjavík has a population of two hundred thousand, give or take. And metro Seattle is nearly twenty times that size.”

One of the two state officials grimaces and pushes his chair away from the table. “So we’re talking seven hundred dead, potentially?”

“Nah,” Angela grunts. “Reykjavík is relatively remote. Nowhere for the bacteria to spread. If we were to be hit as hard as they were, it would be way worse than that.”

The official clutches his head in his hands and turns to Moyes for reassurance. “That can’t be true, can it?”

Moyes only shrugs.

“We’re nowhere near that point,” Lisa says. “Right now we have to focus on expanded chemoprophylaxis. Getting every potentially exposed person on antibiotic treatment. These first three days represent the prime—maybe the only—window of opportunity to catch everyone. To stop it from spreading beyond the campers themselves.”

She goes on to summarize her department’s round-the-clock contact-tracing strategy and distribution of antibiotics to the “usual suspects,” which means people living in the same household as victims, family members, or anyone who had direct contact with the saliva of patients, including all sexual partners, along with all fellow campers, and the medical staff who treated the patients.

“What about a vaccine?” asks the other official from the state department of health, Corrine Benning, whose small features give her face a mouselike quality.

Lisa shares a quick glance with Angela, which is enough for them to wordlessly agree to not tip their hand about Neissovax. “Neither of the two available vaccines for type B meningococcus has worked against the Icelandic strain.”

“Why not?” Benning asks.

“It’s somewhat complicated.” Klausner answers for her. “For the other serotypes of meningococcus—types A, C, W, and Y—the vaccines target the antigens—a type of protein—on their thick cell walls. But the antigens on the walls of the type B strain are too similar to human proteins for our immune systems to differentiate them as invaders.”

“So our immune system won’t produce antibodies against