Hard Science: Patient Zero
In all plagues there has to be a first case. Whether this is the person who contracted the disease from eating the wrong thing, getting stung by the wrong mosquito, cavorting with the wrong livestock, or being in the wrong place at the wrong time…someone has to be first.
This deeply unlucky individual is called “patient zero” or the “index patient.” The importance of patient zero can hardly be underestimated because how an epidemic begins often provides clues to its origin, which in turn may lead to the best possible chance of either a cure or of some kind of prophylactic measure.
Identifying the patient zero also helps scientists in their attempts to track the spread of the disease.
Why is this person not referred to as patient 1? Well, it’s because someone read it wrong back in the 1980s. When Dr. William Darrow and his colleagues at the Centers for Disease Control were studying the earliest instances of HIV, they believed they had identified the first (or at least first known) infected person. Since this person had come from California his confidential case record was designated as Patient (Out of California), or Patient O for short, O’s and 0’s look pretty close, and someone else read it as the number. And so patient zero came into the worldwide lingo of epidemiology.
Dr. Andrea White, a colleague of Dobson’s who worked with him in South America to study smallpox, adds, “Just because an infection exists it does not mean we have an infectious disease. An infection may remain within a host, with or without clinical symptoms or impairment to the host, and it may not spread. Sometimes a disease can be contained within a host so that the infected person does not become an active carrier.”
“There are a number of ways in which the transmission of a disease can occur,” Dobson says. “In general transmission refers to the process by which a disease is passed from an infected host to another person or to a group of people. This can happen through airborne transmission (if the pathogen remains in the air for extended periods of time); through direct contact between infected and uninfected, and this includes everything from kissing to sexual contact to biting; through droplet contact (from coughing, sneezing, etc.); through fecal-oral transmission (which happens often with contaminated water or food sources—you see that a lot in the Third World); through indirect contact, meaning contact with some substance that carries the contaminate; and, of course, through vector borne transmission, which means that it is carried by an animal or insect. Or, in this case, by a zombie.”
“We would have to do studies,” adds Dr. White, “to determine if the contaminate is something that can exist outside of the host. If this plague is strong enough to exist without the support of a living organism, which you see with some kinds of bacteria, parasites and so on, then everything the infected zombie touches is a potential source of infection.”
“And,” Dobson says, “you have to wonder if we have a nidus, or natural reservoir, in play. A nidus is a host who carries the pathogen but does not contract the actual disease. For example shellfish can carry cholera but don’t become infected by it, just as black rats and prairie dogs carry bubonic plague and mosquitoes carry malaria. If that’s the case, then you may have disease vectors other than zombies carrying the zombie infection. That would be very, very bad.”
The Zombie Factor
As with all outbreaks, a zombie plague would need to be placed in its correct historical context, which means that a search would have to be done to see if a similar outbreak has occurred before. If so, the way in which it progressed, the rate at which infection spread, the methods used to identify it and then combat it are all relevant because any steps taken—successes or failures—will refine and inform the steps that doctors take to combat the current outbreak.
It’s equally important to make sure we know exactly what type of outbreak is being faced, especially when faced with something new and potentially radical. Few diseases present with absolutely no historical reference, which is why keeping—and checking—exact medical records is so crucial. If a zombie plague existed, there may be some reference to it, possibly under some other name, in the world’s many shared medical databases. And even if no zombie plague has previously existed, diseases with similar symptomology may serve as guideposts toward treatment, prevention, or even a cure.
Dr. Michael Augenbraun of Brooklyn University Hospital advises us to, “Compare current and historical rates of zombieism to make sure this is real and not someone’s
impression
. Develop a case control study of cases versus matched controls to determine associations and possible causes. Assuming you have no preconceived notion of how one acquires this illness, this is the only way you can really impose any sort of control program.”
Plagues have been used in a large number of zombie stories, and these are largely responsible for the resurrection of zombie pop culture and which stand as being among the most significant in the recent resurrection of the genre. Certainly
Shaun of the Dead
, Romero’s
Land of the Dead
, and the Zack Snyder remake of
Dawn of the Dead
are all key players in the return of the dead to top pop culture status, but along with
Resident Evil
one other movie, also released in 2002, stands a little apart as an impetus behind the genre:
28 Days Later
.
Zombie Bugs from Outer Space
At one point during preproduction, the story of
Night of the Living Dead
dealt with humans infected by an alien pathogen brought to earth in the ill-fated Venus probe, but this was later scrapped. The working title
Night of the Flesh Eaters
was attached to the film at this point, but Romero and his writing partner, John Russo, decided to take the story in another and far less specific direction.
This landmark flick, written by novelist Alex Garland (author of
The Beach
) and directed by Danny Boyle (who directed the 1998 film version of
The Beach
as well as the marvelous comedy
Trainspotting
), took the supernatural out of the zombie genre and infused it with new “life.” The threat in this film is not a reanimated corpse but rather a human being infected with a virus that hyperactivates the rage impulse in the brain. The virus was being tested on lab monkeys, but a well-intentioned but misguided group of animal rights activists breaks in to a research center and liberates the chimps. It all goes to hell from there as the infection immediately spreads to humans, and once infected a person immediately succumbs to total and uncontrollable murderous rage. The infection spreads so quickly that England is virtually destroyed in four weeks; and there it is suggested that much of the rest of the world may have likewise been affected.
This idea is turned around with the 2007 sequel
28 Weeks Later
, in which NATO troops move in to England several months after the plague. All the infected are believed to have died from starvation and exposure, and the world governments (led, apparently by the United States) are attempting to repopulate London. Of course things go to hell and the infection starts again, this time definitely spreading to Europe, where it is presumed there will be no English channel to act as a barrier for a pandemic. At this writing a third film,
28 Months Later
is in preproduction.
Though, as mentioned elsewhere in this book, this theme is not original and doesn’t even supplant Romero (because he thought of it first in 1973 for his film
The Crazies
), it does bring the concept to a new generation where the idea benefits from higher production values and better special effects.
The nonzombie virus is, to many, more frightening than the undead ghoul idea mainly because it’s so much more scientifically plausible. Viruses are real. Out of control rage states are possible, as we learned from forensic toxicologist Dr. Raymond Singer in Chapter 2.
The rage infection in the
28
series is not specifically spread through a bite, though it can be passed along that way just as it can through serum transfer, meaning any transfer of body fluids. Primarily rage is transmitted when one of the infected vomits blood at its victim. The diseased blood is absorbed through mucous membranes and open wounds. It is not, it appears, transmitted through skin absorption.
Codename: Trixie
In his follow-up to
Night of the Living Dead
, George A. Romero went deeper into speculative fiction with
The Crazies
, in which a weaponized virus, called Trixie, is accidentally released following a the crash of a military plane. The virus gets into the water supply of a small Pennsylvania town and anyone who drinks it either dies or becomes a homicidal maniac.
The soldiers sent in to clean up the mess are almost always seen as faceless killers in white Hazmat suits; and the threat of these dehumanized, white-faced killers echoes similar themes from
Night
.
Though well-made and a cult favorite,
The Crazies
never quite found the audience it deserved, and Romero eventually returned to flesh-eating ghouls to serve as the voice of his social commentary.
Though terrifying in concept, the rate of transmission of the rage virus isn’t logical. Like the zombie virus in the Zack Snyder remake of
Dawn of the Dead
, the rage virus in the
28
movies spreads too fast. Not too fast within the population, but too quickly within the human body. Our expert witnesses have all confirmed this. The stories, as told, just don’t provide enough time for the entire blood supply and all of the mucous membranes, including the mouth, to become totally infected and therefore capable of transmitting the disease.
The speed with which these hyperactive plagues spread through the host-victims is crucial to the believability of the stories, and because they are in some ways less possible than a mutation of the central nervous system resulting in the slower Romero zombies, the threat becomes one of purely fictional supposition. The logic of this has created a significant division between the view of how we would react and respond to a plague that created the slow, shuffling zombies and one that created very fast human infected. If a disease could spread that fast through the host so that it is immediately transmissible, and if the infected host could move like a marathon sprinter, then it would be game over unless natural barriers such as wide rivers or, indeed, oceans, separated the lands of the infected from those of the uninfected.
Mad Monkey Kung-Fu
In
Shaun of the Dead
, made two years after
28 Days Later
, a quickie gag involves a newscaster commenting on the zombie plague in London and denying reports that it was caused by rage-infected monkeys.
J
UST THE
F
ACTS
Forensic Psychology
Forensic psychology has gotten a lot of play on TV and in movies. Often the Hollywood view of what one of these professionals does is wildly inaccurate or clinically incorrect.
Zombies are not known to be “thinking creatures,” but perhaps there are some elements of psychology that can help us predict how they’ll act, which could aid in finding them, understanding how to oppose them, or even (gasp) understanding them.
Expert Witness
To understand the nature of this branch of science, I spoke with Katherine Ramsland, Ph.D., who teaches forensic psychology at DeSales University in Pennsylvania, and is the author of 31 books, including
Beating the Devil’s Game: A History of Forensic Science and Criminal Investigation
(Berkley, 2007),
The Human Predator: A Historical Chronicle of Serial Murder and Forensic Investigation
(Berkley, 2006), and
The Science of Vampires
(Berkley, 2002). She writes features about forensics for Court TV’s crime library and has also cowritten books and articles with former FBI profilers.
Zombie Novels
Bookstore owner and genre expert Greg Schauer shares his picks for the must-have zombie novels:
- Among Madmen
by Jim Starlin and Daina Graziunas (Roc, 1990)- Berserk
by Tim Lebbon (Leisure, 2006)- Dead City
by Joe McKinney (Pinnacle Books, 2006)- Dead in the West
by Joe R. Lansdale and Colleen Doran (Night Shade Books, 2005)- Deadlands
by Scott A. Johnson (Harbor House, 2005)- Deathbringer
by Bryan Smith (Leisure, 2006)- Dying 2 Live
by Kim Paffenroth (Permuted Press, 2007)- Plague of the Dead (The Morningstar Strain)
by Z. A. Recht (Permuted Press, 2006)- Roses of Blood on Barbwire Vines
by D. L. Snell (Permuted Press, 2007)- The Dead
by Mark E. Rogers (Infinity Publishing 2001)- The Night Boat
by Robert R. McCammon (Avon, 1980)- Twilight of the Dead
by Travis Adkins (Permuted Press, 2006)- Xombies
by Walter Greatshell (Berkley, 2004)