Marilee Peters - Patient Zero (Revised Edition): Solving the Mysteries of Deadly Epidemics

To Tom, Olivia, Jackson, and Frania a great bunch of people to spend a pandemic with.

Disease Detectives on the Case

A Deadly Year: The Great Plague of London, 1665

Plotting a Mystery: The Soho Cholera Outbreak, 1854

Did the Mosquito Do It? Yellow Fever in Cuba, 1900

Cooking Up Trouble: Typhoid in New York, 1906

World vs. Virus: Spanish Influenza Pandemic, 191819

Mystery in the Jungle: Ebola in Zaire, 1976

The New Plague: AIDS Pandemic., 1980

A Wakeup Call to the World: COVID-19 Pandemic, 202021

Pandemics and the Future of Disease Detection

Thanks to Rick Wilks, Kaela Cadieux, and the team at Annick for making this update of Patient Zero possible, and in record time.

The updates to this book, including a brand-new chapter on the worlds latest pandemic, were written in the spring of 2020 as the news media exploded daily with stories about the spread of COVID-19. While public health organizations, scientists, and government agencies around the world moved quickly to offer scientific information about this new virus and how to respond to it, its also true that misinformation, myths, and plain old lies were spread as well, in both mainstream and social media.

Efforts to get reliable, helpful information to the public have been complicated by the fact that we are all still learning about COVID-19. As more information emerges, responsible scientists and public health officials have in some cases had to change their advice, and as a result some have been criticized for being wrong. Like those scientists, I want to add a word of caution for readers: the information about COVID-19 that you will read in these pages is what was known by January 2021. In the months ahead, we will undoubtedly learn more, and some of what we think now about the virus may change. To some extent, thats true of all the diseases in this bookscience never stands still, and there are always new discoveries to be made.

In some places, I have quoted directly from letters, reports, and journals of the people involved in treating or investigating the epidemics covered in this book. While their spelling has been modernized, their thoughts and ways of expressing them have not. In other cases, I have created dialogue to bring characters and stories to life, but always closely following the historical record.

So, tell me, where were you on the night of the murder?

In movies or TV, when a detective asks this question, they narrow their eyes and lean in close to the suspect, to see how theyll respond. The audience pays attention too. We know that question is a sign that the detective is close to cracking the case.

Sure enough, the suspect starts squirming. Sweat breaks out on their forehead. Their eyes dart around in panic as they search their memoryor try to come up with a good excuse. Unless the suspect has an air-tight alibi, the detective announces, Case closed! A few scenes later, we watch as a cell door slams shut, putting the criminal behind bars. As the credits roll, the detective heads off into the night, to solve the next case and keep the public safe.

Now, take that detective out of their trench coat and fedora and put them in a lab coat. Instead of a gun, give them a microscope and a computer. This time, the assignment isnt to track down an escaped convict with a grudge, or a deranged psychopath masquerading as a friendly neighbor, or any of the usual suspects. The murderer theyre trying to identify isa microbe.

This is a disease detective. Otherwise known as epidemiologists, these scientists are trained to solve medical mysteries and find the evidence needed to prevent the spread of disease and improve the publics health. Like police detectives, epidemiologists make a beeline for the scene of the crime when a disease first strikes, to search for clues that reveal how the outbreak started, how it is transmitted, what puts people at risk of getting sick, and how to stop or slow its spread.

Just like the hardboiled detectives in old movies, they talk to the victims, track down witnesses, ask lots of questions, sniff out facts that may have been overlooked, and then assemble their case. In addition to these tried-and-true detective techniques, they also take advantage of the latest technologies and use their scientific skills and know-how to understand how diseases spread and to protect our health.

The investigation into an outbreak starts with the first patient who shows up at their doctors office or local hospital with an illness. While epidemiologists call this first patient the index case, in the media and popular culture this person is often referred to as patient zero. (Spoiler alert: to find out how patient zero became a popular term for the first known case in an outbreak, flip to chapter 7.) Starting from this first case, epidemiologists trace the infections spread. They look for clues that help them understand the factors that contribute to the transmission of the disease.