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 isolated by two French scientists in the Fifties — Calmette and Guerin, hence the name. BCG. Bacille Calmette-Guerin. What’s the problem?’
‘One of the kids I told you about, the ones who were given BCG vaccine at the school camp, was on immuno-suppressive drugs when he was vaccinated.’
‘Jesus,’ said Brewer. ‘I take it they didn’t know?’
‘The kid’s dead,’ said Steven. ‘Necrotising fasciitis — it swept through him like a runaway train.’
‘Jesus Christ, what a fuck-up.’
‘Looks like the medics who gave him the BCG didn’t know about the kid’s background and the medics who treated him in hospital didn’t know he’d been given the vaccine.’
‘I take it the lab grew the BCG bug?’
‘They didn’t grow anything. There are secondary tests being carried out by another lab at the moment.’
‘They might not look for TB,’ said Brewer. ‘It’s a lung disease, not exactly the thing you’d expect to cause a rip-roaring flesh infection.’
‘The first lab said they’d checked for everything,’ said Steven.
‘It might be as well to check with them again. TB grows very slowly in the lab compared to other bugs and it needs a special culture medium. It can take six to eight weeks to grow up while something like a streptococcus grows up overnight.’
‘I’ll do that,’ said Steven. ‘Thanks again.’
Steven felt sick inside. It looked very much as if a mix-up in paperwork had led to Keith Taylor’s death, a mix-up which had also led to his requesting an exhumation and causing the boy’s parents a great deal of stress on top of everything else. It had all the elements of a Bungling Docs story in the tabloids. He called the lab dealing with the Taylor specimens.
‘Nothing yet, I’m afraid.’
‘Have you set up cultures for TB?’
‘Just a moment…’
Steven drummed his fingers on the desk while he waited.
‘We wouldn’t normally,’ came the reply. ‘But in this case, because it doesn’t seem to be one of the usual suspects, we’ve set up cultures on every bacterial growth medium we have, including those for TB. If this bug grows in the lab, we’ll find it.’
Steven hung up before he was asked about his interest in TB. He wanted to talk things over with John Macmillan first. Knowing now that it would take the lab the best part of six to eight weeks to grow up the BCG bacillus, he decided to check with O’Connor, the microbiologist at the children’s hospital in Carlisle. It was he who had told him they’d looked for ‘everything we could think of’ in the Taylor boy’s specimens.
‘We got such a surprise when nothing grew up overnight that I told the staff to inoculate his specimens on every other culture medium we use,’ said O’Connor.
‘Would that include media capable of supporting TB?’ asked Steven.
‘It would.’
‘And?’
‘And nothing. No growth on anything.’
‘Would you just check again for me please?’
O’Connor put down the phone with a clatter. He returned after two minutes. Steven had followed the second hand sweep of his watch.
‘The cultures were discarded as being completely negative after fourteen weeks.’
‘Thank you,’ said Steven without further comment.
He decided not to talk it over with Macmillan until the following morning. He needed time to get things clear in his head. He had been concentrating so much on Keith Taylor’s death that he had lost sight of the connection he was looking for with the other vaccinated children who had developed skin complaints.
He decided to phone the children’s hospital in Edinburgh to ask about the condition of Patricia Lyons.
‘She’s very ill.’
This was not what he wanted to hear.
‘She has some kind of an infection in the flesh of her burned arm and it’s not responding to treatment.’
‘Some kind of an infection?’ said Steven. ‘What does that mean?’
‘It’s hard to say. The lab hasn’t found anything.’
NINE
The words hit Steven like a body blow. He mumbled a request to be kept informed if and when the lab came up with anything and hung up. He uttered a series of expletives as he thought things through. Surely Trish Lyons’ infection could not possibly be the same as Keith Taylor’s. If it was, it meant that his logical supposition that the BCG bacillus had somehow rampaged through the boy’s body because his immune system had been compromised was wrong. As far as he knew, there was nothing wrong with Trish Lyons’ immune system and for two children to have reacted the way they had to a vaccine that had been safely in use for fifty years seemed highly unlikely. Some other factor was involved, possibly something that Scott Haldane had recognised… and had been murdered to keep him quiet?
Steven spoke to John Macmillan first thing next morning. ‘I’m sorry, there’s much more to it than we first thought.’ He told Macmillan about Keith Taylor being given BCG vaccine when his immune system had been suppressed, something that brought a frown to his face which was quickly followed by a droop to his shoulders when Steven mentioned that Trish Lyons might also be suffering from the same infection.
‘Bad to worse,’ complained Macmillan.