“There are twenty-one new cases of plague in Genoa since yesterday, and it’s barely breakfast time. And eight more deaths, bringing the total to thirty.” Byron clears his throat. “Including Angelo, the eight-year-old with the antibiotic-resistant infection.”

The unwanted image of the critically ill boy—his mother stroking his hair while the father paced frantically at the bedside—pops to mind. She also thinks of Rosa, the little girl with the colorful ribbons in her hair. But there’s no time for pity or grief. She shakes off the memories and instead asks, “Still just the one case in Rome, right?”

“So far. I connected with the head of Public Health there. They’re tracing all passengers who were on his flight and placing them on home quarantine and antibiotic prophylaxis.”

“Good. And what’s the status of the ring prophylaxis campaign here in Genoa?”

“On schedule. Over a hundred local public health workers are fanning out this morning across the neighborhoods identified as hot spots. We have enough antibiotics to start ten thousand people on prophylaxis, if necessary.”

“It’s going to be necessary, Byron.”

Their eyes meet. “We could end up breeding a lot more antibiotic resistance,” he warns. “Especially if people don’t bother to finish their whole course of antibiotics.”

“You’re preaching to the choir.” Alana knows that doctors bear much of the blame for causing worldwide antibiotic resistance through overprescribing, but in mass prophylaxis campaigns like this one, it’s inevitable that some patients will fail to complete courses of prescription and thereby spare enough bacteria that could “learn” to acquire resistance.

Her eyes are drawn again to the patient whose arm is casted. “This guy doesn’t look like he’s suffering from the plague.”

“Apparently he was one of the kids who was beaten so badly yesterday.”

“Which kids?”

“You didn’t hear? Two Turkish teens were attacked outside their dad’s convenience store. This one got clubbed in the head with a brick.”

“Are they saying the attack was racially motivated?”

“A bunch of local thugs got all fired up after some anti-Muslim rally. He and his brother were just in the wrong place at the wrong time.”

“Jesus,” Alana mutters, but she stops herself before adding, it’s my fault.

Chapter

Thirty-Nine

Letizia Profumo sits beside her husband, Francesco, at the very same table where he proposed to her almost three years earlier. On that memorable day, the quaint family-run restaurant was packed, whereas tonight only one other table is occupied. Though it’s the night of their second anniversary, Letizia would still rather be at home. She’s exhausted. And her nausea is intractable.

Letizia pushes the cima ripiena, the restaurant’s signature dish, around on her plate. She has no appetite for the veal specialty that’s normally her favorite. The thought of another bite turns her stomach. She never expected to feel this sick or overheated so early in her pregnancy.

Francesco is too busy sopping up the white sauce from his penne dish to notice right away. But as soon as he does, he grips her wrist in his meaty hand. “What is it, Leti?”