“It bothers me because of a pattern,” Jack said. “It presented as a fulminant form of a pneumonia just like the other, rarer diseases. The difference is that with influenza the infectivity is higher. It doesn’t need a vector. It spreads person to person.”
“I understand that,” Kathy said. “But as I’ve pointed out we’ve been seeing influenza all winter long.”
“Primary influenza pneumonia?” Jack questioned.
“Well, no,” Kathy admitted.
“This morning I had someone check to see if there were any other similar cases currently in the hospital,” Jack said. “There weren’t. Do you know if there are now?”
“Not that I am aware of,” Kathy said.
“Could you check?” Jack asked.
Kathy turned to her terminal and punched in a query. The answer flashed back in an instant. There were no cases of influenza pneumonia.
“All right,” Jack said. “Let’s try something else. The patient’s name was Kevin Carpenter. Where was his room in the hospital?”
“He was on the orthopedic floor,” Kathy said.
“His symptoms started at six P.M.,” Jack said. “Let’s see if any of the orthopedic nurses on the evening shift are sick.”
Kathy hesitated for a moment, then turned back to her computer terminal. It took her several minutes to get the list and the phone numbers.
“You want me to call them now?” Kathy asked. “They’re due in for their shift in just a couple of hours.”
“If you don’t mind,” Jack said.
Kathy started making the calls. On her second call, to a Ms. Kim Spensor, she discovered that the woman was ill. In fact, she’d just been preparing to call in sick. She admitted to severe flu symptoms with a temperature of almost 104°.
“Would you mind if I talked with her?” Jack asked.
Kathy asked Kim if she’d be willing to speak to a doctor who was in her office. Kim apparently agreed, because Kathy handed the phone to Jack.
Jack introduced himself, but not as a medical examiner. He commiserated with her about her illness, and then inquired about her symptoms.
“It started abruptly,” Kim said. “One minute I was fine; the next minute I had a terrible headache and a shaking chill. Also, my muscles are aching, particularly my lower back. I’ve had the flu before, but this is the worst I’ve ever felt.”
“Any cough?” Jack asked.
“A little,” Kim said. “And it’s been getting worse.”
“How about substernal pain?” Jack asked. “Behind your breastbone when you breathe in?”
“Yes,” Kim said. “Does that mean anything in particular?”
“Did you have much contact with a patient by the name of Carpenter?” Jack asked.
“I did,” Kim said. “And so did the LPN, George Haselton. Mr. Carpenter was a demanding patient once he started complaining of headache and chills. You don’t think my contact with him could be the cause of my symptoms, do you? I mean, the incubation period for the flu is more than twenty-four hours.”
“I’m not an infectious disease specialist,” Jack said. “I truly don’t know. But I’d recommend you take some rimantadine.”
“How is Mr. Carpenter?” Kim asked.
“If you give me the name of your local pharmacy I’ll call you in a prescription,” Jack said, purposefully ignoring Kim’s question. Obviously his fulminant course started after Kim’s shift had departed.
As soon as he could, Jack terminated the conversation. He handed the phone back to Kathy. “I don’t like this,” Jack said. “It’s just what I was afraid of.”
“Aren’t you being an alarmist?” Kathy questioned. “I’d guess two to three percent of the hospital personnel are out with the flu currently.”
“Let’s call George Haselton,” Jack said.
George Haselton turned out to be even sicker than Kim; he’d already called in sick to the floor supervisor. Jack didn’t talk to him. He simply listened to Kathy’s side of the conversation.
Kathy hung up slowly. “Now you’re starting to get me worried,” she admitted.
They called the rest of the evening shift for the orthopedic floor, including the ward secretary. No one else was ill.
“Let’s try another department,” Jack said. “Someone from the lab must have been in to see Carpenter. How can we check?”
“I’ll call Ginny Whalen in personnel,” Kathy said, picking up the phone again.