A half hour later they had the full picture. Four people had symptoms of a bad case of the flu. Besides the two nurses, one of the evening microbiology techs had abruptly experienced sore throat, headache, shaking chill, muscle pain, cough, and substernal discomfort. His contact with Kevin Carpenter had occurred about ten o’clock in the evening, when he’d visited the patient to obtain a sputum culture.
The final person from the evening shift who was similarly ill was Gloria Hernandez. To Kathy’s surprise but not Jack’s, she worked in central supply and had had no contact with Kevin Carpenter. “She can’t be related to the others,” Kathy said.
“I wouldn’t be too sure,” Jack said. He then reminded her that someone from central supply had perished with each of the other recent infectious cases. “I’m surprised this hasn’t been a topic of debate with the Infection Control Committee. I know for a fact that both Dr. Zimmerman and Dr. Abelard are aware of the connection, because they have been to central supply to talk to the supervisor, Mrs. Zarelli.”
“We haven’t had a formal committee meeting since all this started,” Kathy said. “We meet on the first Monday of each month.”
“Then Dr. Zimmerman is not keeping you informed,” Jack said.
“It wouldn’t be the first time,” Kathy said. “We’ve never been on the best of terms.”
“Speaking of Mrs. Zarelli,” Jack said. “She’d promised me printouts of everything central supply had sent to each of the index cases. Could we see if she has them and, if so, have her bring them down?”
Having absorbed some of Jack’s anxiety about the influenza, Kathy was eager to help. After talking briefly to Mrs. Zarelli and ascertaining that the printouts were available, Kathy had one of the administrative secretaries run up to get them.
“Let me have Gloria Hernandez’s phone number,” Jack said. “In fact, give me her address as well. This central supply connection is a mystery that for the life of me, I can’t understand. It can’t be coincidence and could be key to understanding what is going on.”
Kathy got the information from the computer, wrote it down, and handed it to Jack.
“What do you think we should do here at the hospital?” she asked.
Jack sighed. “I don’t know,” he admitted. “I guess you’ll have to discuss that with friendly Dr. Zimmerman. She’s the local expert. In general, quarantine is not very effective for influenza since it spreads so quickly. But if this is some special strain, perhaps it would be worth a try.
I think I’d get those hospital personnel who are sick in here and isolate them: worst case, it’s an inconvenience; best case, it could help avert a disaster.
“What about rimantadine?” Kathy asked.
“I’m all for it,” Jack said. “I’ll probably get some myself. It has been used to control some nosocomial influenza in the past. But again that should be up to Dr. Zimmerman.”
“I think I’1l give her a call,” Kathy said.
Jack waited while Kathy spoke to Dr. Zimmerman. Kathy was deferential but firm in explaining the apparent connection between the sick personnel and the deceased, Kevin Carpenter. Once she had spoken, she was reduced to silence punctuated only by repetitions of “yes” at certain intervals.
Eventually, Kathy hung up. She rolled her eyes. “That woman is impossible,” she said. “At any rate, she’s reluctant to do anything extraordinary, as she puts it, with just one confirmed case. She’s afraid Mr. Kelley and the AmeriCare executives would be against it for PR reasons until it was undeniably indicated.”
“What about the rimantadine?” Jack asked.
“On that she was a little more receptive,” Kathy said. “She said she’d authorize the pharmacy to order in enough for the staff, but she wasn’t going to prescribe it just yet. At any rate, I got her attention.”
“At least that’s something,” Jack agreed.
The secretary knocked and came in with the printouts Jack had wanted from central supply. He thanked the woman, and immediately began scanning them. He was impressed; it was rather extraordinary what each patient utilized. The lists were long and included everything short of medications, food, and linen.
“Anything interesting?” Kathy asked.