The top floor room in the Municipo, or City Hall, is brightly lit by the midday sunshine streaming through the windows that frame the famed Via Garibaldi below. Alana paused on her way in to admire the iconic building with its vaulted ceiling and tiered balconies. It reminded her of how little she had seen of Genoa in her two and a half days here. Normally, visiting a city so rich in history for the first time, she would’ve found time to soak in the local ambience and culture through morning jogs and evening strolls. But there’s nothing normal about this visit. Not only is her mission unsanctioned, but she feels an urgency she hasn’t experienced since she joined NATO.

Aside from Byron, four other members of the WHO task force are squeezed around the table among the Italian officials. The highest-ranking is the country’s deputy minister of health, a doughy-faced man who has thus far remained silent.

The table is so crowded that Alana’s knee keeps brushing against Nico’s. His cologne is a constant distraction. She hasn’t shared this kind of proximity with him since that last morning in Palermo when they lay naked and winded in the four-poster bed, plotting out future reunions that were never to materialize.

It’s been over eight years, Alana reminds herself. There have been other relationships since, two of which lasted longer. She came close to marrying the last man, a gentle but, as it turned out, insufferably idealistic water engineer whom she had met in Geneva. But Nico was different. He was her first love after her shoulder injury, and their romance hadn’t sputtered out like most of the others had. They had chosen their careers, which kept them constantly separated in different hot spots across the globe, over their relationship.

Byron’s voice pulls her back to the meeting. “Just to review: the plague is spread by the rat flea, or Xenopsylla cheopis, which transmits bacterium through its bite.” He clicks the remote in his hand and the screen above him fills with the image of a golden translucent creature that resembles a lobster without claws. “These fleas require an animal vector, or carrier, to ‘host’ them. That can be almost any mammal, especially rodents like rats, mice, squirrels, or even prairie dogs. But in most cities the plague is usually spread by the black rat.” The slide above him dissolves and re-forms as a photo of a mischief of rats, clumped together and crawling over one another. The image, although static, gives Alana a queasy sense of movement.

“As most of you know, there are three clinical variants of the plague,” Byron continues. He speaks in English, not allowing time for translation, even though this meeting is in Genoa to discuss an Italian outbreak. “All are caused by the same bacterium: Yersinia pestis. The most common form is the bubonic plague, which presents with classic skin buboes, or swollen lymph nodes, that are discolored from internal bleeding.” The next slide is that of a wide-eyed young boy whose neck is distended on both sides by darkish lumps. “But there are two other, even deadlier forms. The rarest is a type of blood poisoning known as the septic plague.” The body of a pale, thin woman, with a bar drawn across her eyes to hide her identity, fills the screen. Her skin is riddled with small purplish red spots, known as purpura. Both her legs are blackened from the knees down with the patches of dead skin or necrosis, and it’s obvious to Alana the photo was taken postmortem. “And, of course, the other form is known as the pneumonic plague, which attacks the victims’ lungs . . .” The screen comes to life with a grainy video clip. A middle-aged man writhes on a hospital bed. His cough is so harsh it almost made Alana hack. Even though he covers his mouth with a hand, bloody sputum sprays between his fingers with each violent hack. “Both the septic and pneumonic plagues are uniformly fatal without early and aggressive antibiotic treatment.”