Justine shrugs. “Bugs mutate. Shit happens.”

“There hasn’t been a case of bubonic plague reported in Ethiopia—in man or animal—in over twenty years. Besides, the two cases in Genoa have behaved far more aggressively than any of the ones seen in Africa recently.”

“See my earlier point about mutation . . . and also . . . shit happening.”

The deputy minister raises his hand. “Dr. Menke, a question, if you will allow me?”

“Of course.”

“Are you saying that this outbreak did not originate in Africa?”

“No. Not yet, at least. As Dr. Williams points out, there are all kinds of mammals living in that ecosystem, including black rats. We also know that the rat flea is endemic to the same park. We’ve got a WHO team on the ground in Ethiopia collecting samples at the national park, and we should know better in the coming days. Meantime, all I’m saying is that we have no confirmed source and we shouldn’t presume anything.”

“But if the so-called Patient Zero was not infected on her trip to Africa, then she could only have acquired it here in Genoa.”

“It is too early to know.”

“Where else could it possibly come from?” the deputy minister persists. “There have been no such infected animals in Italy for hundreds of years!”

“Underestimate the ingenuity of rats at your own peril,” Justine says. “To them, intercontinental travel is little more than a jaunt in the park.”

Alana can’t hold her tongue any longer. “How do we know the first victim became infected through a rat or any other animal vector?”

All eyes turn to her. “Would our NATO colleague care to elaborate?” Byron asks.

Alana introduced herself only as an infectious diseases colleague of Nico’s, but she realizes it’s not the time or place to confront Byron for calling her out. “As you said yourself, Dr. Menke, we can’t presume anything about the source,” she says calmly. “Including that there ever was a zoological source. Or, for that matter, that the person whom you’re calling ‘Patient Zero’ is in fact the index case.”

Byron holds her gaze for a moment, and then looks around the table. “I think we can all agree that, whatever the source, containment is now the top priority.” Heads nod and there are murmurs of concurrence. “To that end, we need to start every casual contact of both known victims on antibiotics.”

“We have already done so at the hospital,” says Dr. Sansa, a distinguished-looking older man who was introduced as the city’s chief Public Health officer. “Everyone who had direct contact with the victims has been started on doxycycline and ciprofloxacin, or some alternative if allergic.”

“What about immunization?” Nico asks.

Byron motions across the table to a man with reddish blond hair and a boyish face, whose bushy beard makes him somehow look even younger. “For that I will defer to our immunization expert, Dr. Larsen.”

Larsen removes his glasses. “The World Health Organization does not, as of yet, have ready access to mass quantities of Yersinia vaccine.”