he might be chasing rainbows. He collected the file from Jean and went to the unit library to read it, collecting a cup of coffee from the machine in the corridor on the way.
Steven learned that fourteen of the children who’d been present at Pinetops camp when Mubarak had been diagnosed with TB had subsequently sought treatment from their GPs. He read with some alarm that one had actually died. Keith Taylor, a thirteen-year-old boy, had succumbed to the ravages of necrotising fasciitis after having been admitted to hospital in Carlisle. Steven screwed up his face as he read the report, thinking how cruel fate could be and what his parents must have gone through, watching their son die a terrible death.
Patricia Lyons was on the list too, reported as suffering from vitiligo and currently recovering from a scalding accident. Two more children had been treated in hospital for burns. Three had been treated for broken bones — two with arm fractures, one with compound leg fractures after falling off his bike. Four of the children were being treated for impetigo…
Impetigo was a skin complaint. Steven had been looking for any early warning signs of TB among the green sticker children but now the four cases of impetigo leapt out at him. Trish Lyons had been suffering from vitiligo, another skin condition. That made five reports of skin complaints out of one hundred and eight children, six if the boy who’d died of necrotising fasciitis was included. Maybe not significant but… Steven read on and alarm bells started to ring when he read that three more children had been referred to their GPs suffering from unspecified ‘loss of pigment’ in their skin. Nine.
What the hell was going on? There was no sign of TB in the children but the incidence of skin complaints must be well above what could be expected in previously healthy twelve-to thirteen-year-old children. Four with impetigo, three with unspecified ‘loss of pigment’, Patricia Lyons with vitiligo and a boy who’d died of necrotising fasciitis — the flesh-eating disease… Surely this couldn’t be coincidence but if not, what was he suggesting? That there was some common cause of their ailments? That they had all contracted a skin condition through being at Pinetops camp?
Steven rubbed his forehead nervously as he tried to decide what to do next. The only thing the children had in common, apart from their age, was that fact that they had attended Pinetops camp at the same time and had been given BCG vaccine after a TB scare. BCG vaccine was something that had been used for fifty years so it was hardly likely to be that causing the trouble. According to Jim Brewer, it wasn’t the most effective vaccine in the world but it was certainly safe. This left the possibility that something the kids had been exposed to at Pinetops had been the cause of the problem although, he reminded himself, it did not seem to be a single problem. Vitiligo, impetigo, loss of pigment were all vague terms. Even necrotising fasciitis could have a number of causes. Maybe he had been precipitate in lumping them all together as ‘skin problems’ but he would certainly investigate further and he would start with the one that had caused Keith Taylor’s death.
The pathology report wasn’t included in the file Jean had given him — the cause of death had simply been put down as necrotising fasciitis. He needed to know more about the bacterium that had caused it. He wanted to know the exact cause of death.
Two days later, Steven finally got access to the PM report on Keith Taylor. His physician had made the original diagnosis of necrotising fasciitis after flesh ‘instability’ had been noted in several areas of Keith’s body. The Carlisle hospital pathologist had confirmed the diagnosis at post mortem but no cause had been given. The lab reports had all been negative.
Negative? Steven shook his head in frustration. The boy had an infection that was eating him alive and the lab had come up with nothing? What the hell did they imagine caused it, pixie dust? This was beyond… He stopped himself in mid-thought and cautioned himself to calm down. There had to be a rational explanation some where. It was just a question of finding it. He phoned the hospital in Carlisle and asked to speak to the consultant microbiologist. He turned out to be an Irishman by the name of O’Connor.
‘It was most unusual,’ conceded O’Connor. ‘We simply failed to grow any bacterium or virus from the boy’s tissues.’
‘But according to the medical report, his flesh was so infected it was falling off him,’ said Steven.
‘I know,’ said O’Connor. ‘But the fact remains, the cultures were all negative and so was the serology.’
‘What did you test for?’
‘Just about everything we could think of.’
Steven put the phone down, feeling far from happy but not quite sure what to do about it… or rather, he was sure but was unwilling to contemplate it unless he could convince himself and John Macmillan that it was absolutely necessary. It would involve the exhumation of Keith Taylor’s body.
Steven made his request to Macmillan the following morning having agonised about it long and hard and Macmillan had reluctantly agreed after unsuccessfully reminding Steven, unnecessarily, just how much upset and stress this was going to cause to the boy’s parents.
‘I know,’ agreed Steven. ‘But there’s something very wrong here. I have to find out why Keith Taylor died. I want a Home Office pathologist to carry out a second post mortem and a top lab to analyse the samples.’
Keith Taylor had been buried in a cemetery about half a mile from his home. A new granite headstone recorded his untimely death and the undying love of his parents. Bunches of fresh flowers marked the grave and cards spoke of his youth and all too premature demise. They appeared unreal under the lights from the rig set up by the police to illuminate the scene, an operation which started at midnight behind a canvas awning to avoid prying eyes.
‘I hope you’ve got a damned good reason for this,’ said the police superintendent who was overseeing the operation. The disapproval was plain in his voice. ‘As if losing their son wasn’t enough…’
Steven resisted the temptation to snap back: Of course I’ve got a good reason. Do you think I do this as a bloody hobby? Instead he remained silent, eyes fixed on the digging, aware of the patter of rain on the shoulders of his waxed cotton jacket. He saw the coffin hoisted from the ground and loaded into the back of an unlettered black van for transport to the city mortuary where the second post mortem was to be carried out. He left the scene and returned to his hotel to grab a few hours’ sleep before joining the Home Office pathologist who was due at nine.
The post mortem was carried out with full bio-precautions being observed. The danger associated with bugs causing necrotising fasciitis was not to be underestimated and the pathologist, Steven and two assistants were fully gowned and masked with full-face visors being employed.
‘All right?’ asked Mark Porter, the pathologist detailed by the Home Office to carry out the examination. Steven nodded.
‘Bloody hell,’ were Porter’s first words as he began his work. ‘I’ve seen a few cases of Nec Fash in my time but never one as bad as this… he’s absolutely riddled… the flesh is like… Jesus, what a mess…’
‘You’re absolutely sure about it being necrotising fasciitis?’ asked Steven.
‘What else could it be?’
‘But the hospital lab couldn’t grow anything.’
‘Crazy,’ said Porter. ‘His flesh must be hoaching with bacteria.’
‘Can you take lots of samples, please? It’s important we find out exactly what caused this. I don’t suppose you’d care to hazard a guess about the bug’s identity?’
Porter gazed down at the corpse. ‘I’d rather not. Like I say, I’ve never come across anything as bad as this although…’
‘Yes?’
‘It might be a one-off. I mean, the boy might have been ultra-susceptible to the bug. It happens. I’ve seen AIDS victims succumb to infections that rip through them like a tsunami hitting a beach simply because they have no body defences left when the HIV virus is finished with them. On the other hand of course, it could be the bacterium itself that’s ultra-virulent; in which case, we could all be up a certain creek without a paddle.’
Porter turned to the two assistants who were waiting to clean up. ‘Be very careful.’
Three days passed without any word from the London lab dealing with the Taylor boy’s samples. Steven was collating paperwork he had obtained from various sources over the past couple of weeks when he suddenly saw something that made his blood run cold. It was the entry in Keith Taylor’s medical notes that recorded his receipt of a bone marrow transplant and that he was receiving immuno-suppressive treatment. He snatched up his phone and called Jim Brewer at Great Ormond Street.
‘Is BCG a live virus vaccine?’ he asked.
‘It certainly is,’ replied Brewer, a reply that made Steven close his eyes. ‘It’s an attenuated form of TB
