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

boss—technically, former boss, since Angela left on an indefinite medical leave three months ago—waves off the approach with a flick of her bony wrist. “No hugs. I got brittle bones. Besides, this place is supposed to be all about infection control, right?”

Lisa’s grin masks how alarmed she is at Angela’s appearance. Along with most of her hair, Angela has lost significant weight. Weight she didn’t have to lose. And the scarf tied around her scalp only accentuates the deep hollows of her sallow cheeks.

“What are you doing here?” Lisa asks.

“Taking a break from my daily poisoning session,” Angela says of her chemotherapy. “Truth is, Lisa, I’m bored as fuck.”

“Sounds about right,” Lisa says as she sits down on the other side of the desk.

“Also, I needed to get away from Howard. He’s driving me nuts with all the coddling. And I’d feel bad about putting a bullet between the eyes of a living saint.”

“Poor Howard is a saint to put up with you.” Lisa chuckles. “Seriously, Angela, how’s the treatment going?”

“Treatment? Yeah. Up and down. The nausea is better for sure. Anyway, forget all that. I’m here to talk business.”

“You heard?”

“Course I heard. First the new school HPV vaccine program and now this meningitis scare.” She rolls her eyes. “You steal my job and in no time at all you score the public-health equivalent of the moon landing and 9/11 in the same week.”

Lisa laughs. Clearly, Angela’s metastatic ovarian cancer hasn’t dulled her penchant for hyperbole. “All you ever dealt with was COVID.”

“Yeah, that was a time to forget.” Angela had led the city’s public-health response to the novel coronavirus outbreak. Even after she fell ill with it herself, she worked twenty-hour days from home, videoconferencing and answering emails, brilliantly managing the response while calming the city. She never got the credit she deserved, mainly because she didn’t want the recognition.

“It’s been quite the morning.” Lisa sighs.

“Tell me.”

Lisa doesn’t even bother describing the backlash she faced at the HPV vaccine forum, aware that her ailing friend has no patience for the anti-vax movement. Angela’s remark to one anti-vaxxer at a public health forum—“Let’s see how you feel about vaccines after you get bitten by a rabid bat”—is still legendary in the office.

Instead, Lisa updates Angela on what she knows about the meningitis outbreak, its origins in Iceland, and her initial thoughts on containment strategies.

Angela leans back, absorbing the news. “All the victims come from the same camp?” she asks.

“So far. We’re heading out there this afternoon. We have to launch our contact tracing immediately if expanded antibiotic prophylaxis is going to be effective.”

“And you’ve got no idea how our outbreak traces back to Iceland?”

Our, Lisa thinks with a smile. She’d long suspected that, regardless of her deteriorating health, Angela wouldn’t be able to keep away from the job for long. “No. I only just heard. But Iceland is one of the world’s most popular tourist destinations, especially in the summer. I’m assuming one of the campers’ families must’ve visited recently.”

“But Reykjavík hasn’t reported any new cases of meningitis since the winter, have they?”

“Not that I am aware of. But you know how it is with meningococcus. Especially type B. You can’t declare an outbreak over until you go a year without a single new case. After all, healthy people can be colonized with the bacteria growing in their noses or throats without causing any infection.”

“Or them having any idea they’re even carrying the murderous little bastards. Have you spoken to anyone over there?”

“I just found out.” Lisa checks her watch. “Besides, it’s got to be pretty late in Iceland right now.”

Angela pushes the desk phone toward Lisa. “Trust me when I tell you, there’s no time like the present.”

“If you were on call, would you pick up an overseas call at almost midnight?” Lisa asks.

“Hell no! But Europeans are weird.”

Lisa digs her mobile out of her purse. She Googles the number for Reykjavík’s public-health officer, spots the twenty-four-hour emergency contact number, dials it on her speakerphone, and is surprised to hear a male voice answer on the second ring in a staccato of Icelandic.

Assuming that, like most Scandinavians, he must also speak English, Lisa says, “Hello, this is Dr. Lisa Dyer and Dr. Angela Chow from Seattle Public Health.”

“Yes, hello, this is Dr. Haarde from Icelandic Health speaking,” he says, his accent giving his words a lovely lilt. “How can I be of assistance?”

“Sorry to disturb you so late, Dr. Haarde, but we have a bit of a situation here in Seattle. A new outbreak.”

“Related to our meningitis, yes?” he suggests, astutely making the connection.

“Exactly.” Lisa glances over to Angela, who taps her temple, impressed. “We have a local outbreak of what appears to be the same strain of meningococcus as the one that hit Reykjavík last winter.”

After Lisa summarizes the cases, Haarde says, “It does indeed sound very similar to our epidemic, yes.”

His use of the term epidemic heightens Lisa’s unease. “When was your last reported case?” she asks.

“Late February,” he says. “To be accurate, the poor girl died in early March.”

“Can you remind us how many victims in total you saw in Reykjavík?”

“There were seventy-six infected patients that we know of.” He pauses. “And thirty-five deaths.”

“So the mortality rate was almost fifty percent.”

“Forty-six percent, yes.”

“And the outbreak began at one of the high schools?”

“It did.”

“But spread beyond the school? Into the community?”

“Yes. At its worst, we had three distinct geographical clusters of infection around the city. All of them traceable to the index cases from the high school. Most of the victims were teenagers.”

“So how did you contain it, Dr. Haarde?” Angela pipes up.

“We implemented very comprehensive contact prophylaxis,” he says. “We started anyone who might have had exposure—even the most casual of interactions—on antibiotics. We even closed our schools for six weeks.”

“Quarantines?”

“It wasn’t necessary, really. People were frightened enough. Very few people gathered in public.”

“And you had no luck with vaccines?”

“None at all. We tried both commercially available products. Neither was effective.” He exhales so heavily that