“I don’t remember this problem as a child,” Kim said. “I used to eat raw hamburger all the time.”
“It’s a relatively new situation,” Kathleen said. “It’s thought to have originated in the late seventies, perhaps in Argentina. The belief is that a shigella bacterium gave an E. coli bacterium the DNA necessary to make a shigella-like toxin.”
“By bacterial conjugation,” Kim suggested.
“Precisely,” Kathleen said. “Conjugation is bacteria’s answer to sexual reproduction, a method of genetic shuffling. But if conjugation was involved, it’s curious since conjugation usually only happens within a species. But the truly surprising aspect is that once this new strain of E. coli was formed, it spread extraordinarily rapidly around the globe. Today it exists in about three percent of bovine intestines.”
“Are the infected cows sick?” Kim questioned.
“Not necessarily,” Kathleen said. “Although it can cause a bovine diarrheal disease, cows seem to be generally immune to the toxin, at least systemically.”
“Strange!” Kim commented. “And ironic! Back when molecular biology was in its infancy, a doomsday scenario was envisioned that scared everybody: a researcher would give an E. coli bacterium the ability to manufacture the botulism toxin, and then bacteria would inadvertently get released into nature.”
“It’s a good analogy,” Kathleen said. “Especially considering that with the emergence of E. coli 0157:H7 nature probably didn’t do it on its own. Man helped.”
“How so?” Kim asked.
“I believe E. coli 0157:H7 has come from the intense farming techniques that are in use today,” Kathleen said. “The need for cheap protein to feed the animals has resulted in creative but disgusting solutions. Cows are fed rendered animals, including themselves. Even chicken manure is being widely used.”
“You’re joking!” Kim said.
“I wish,” Kathleen said. “And on top of that, the animals are given antibiotics. It creates a soup within the animals intestines that fosters new strains. In fact the E. coli 0157:H7 was created when the shigella toxin DNA was transferred along with the DNA necessary for a particular antibiotic resistance.”
Kim shook his head in disbelief. He was hearing about an issue of considerable interest, but then, all of a sudden, he remembered the case in point: Becky’s situation. The realization was instantly sobering.
“The bottom line of all this is bovine fecal material particularly in ground beef,” Kim said. His voice returned to its previous anxious intensity.
“I think that’s fair to say,” Kathleen said.
“Then I know how Becky got it,” Kim said angrily. “She had a rare hamburger at the Onion Ring restaurant Friday night.”
“That would be consistent,” Kathleen said. “Although the incubation period for E. coli 0157:H7 is usually longer, sometimes as much as a week.”
The door to the chart room banged open, causing both Kim and Kathleen to start. One of the nurses leaned in. She was flushed.
“Dr. Morgan!” she said urgently. “There’s an emergency with your consult Rebecca Reggis!”
Kim and Kathleen raced out of the room and ran headlong down the corridor toward Becky’s room.
NINE
Wednesday afternoon, January 21st
Kim came through Becky’s door, he saw a nurse on either side of his daughter’s bed. One was taking her blood pressure, the other her temperature. Becky was writhing in pain and whimpering. She appeared as pale as a ghost. Tracy was standing off to the side, with her back against the wall and a hand pressed to her mouth. She was almost as pale as Becky.
“What happened?” Kim demanded.
Kathleen came into the room behind Kim.
“I don’t know,” Tracy wailed. “Becky and I were just talking when suddenly she cried out. She said she had a terrible pain in her stomach and her left shoulder. Then she had a shaking chill.”
The nurse taking the blood pressure called out that it was ninety-five over sixty.
Kathleen went around the left side of the bed and felt Becky’s pulse. “Has Dr. Stevens been called?” she asked.
“Yes, immediately,” one of the nurses said.
“Her temperature is one hundred and five,” the other nurse said with dismay. Her name was Lorraine Phillips. Her colleague was called Stephanie Gragoudos.
Kim nudged Lorraine away from the right side of Becky’s bed. Kim was frantic. It was like being stabbed in the heart to see his daughter suffering.