Alex Lettau’s YELLOW DEATH Reviewed
Yellow Death, the debut novel from Alex Lettau, a prominent infectious diseases physician in Charleston, South Carolina, is a complex whodunit medical thriller.
The heroine of the story is Kris Jensen, a physician in the medical detective corps of the CDC known as the Epidemic Intelligence Service (EIS). The famed EIS officers are front line epidemiologists who confront outbreaks of infectious diseases across the globe. Dr. Lettau uses the EIS construct to tell a story that moves from the rural South of the U.S. to its large cities and deep into the South American jungle.
Kris is called to investigate a small cluster of fatal hepatitis cases among intravenous drug abusers in northern Mississippi, and her investigation quickly takes a horrifying personal turn when she is accidentally stuck with a needle used to draw heart blood from one of the dead drug users.
She knows as she starts her probe that hepatitis has profound historical and clinical roots. Many infectious and chemical agents can cause acute hepatitis, although few cases are rapidly fatal. Best known are the hepatitis viruses, types A, B, C, D, E and G, sometimes referred to as the alphabet soup of viral hepatitis.
With the aid of her lab colleagues at CDC, Kris quickly rules out the alphabet soup hepatitis viruses as the cause of death in the Mississippi drug users. Within two days, Kris realizes she herself is now infected with this unknown virus that causes liver failure and death within a week. Knowing that there is no cure and confident that she will not infect others, she tells no one of her infection and vows to continue her investigation in the few days she has left to live.
The trail of the Yellow Death virus transmission leads to New Orleans, where more drug users are dying of fulminate hepatitis. There, she teams up with Dr. Ed Beaufain, an Orleans Parish epidemiologist. In the New Orleans investigation, we meet one of the most interesting characters in the book, King Dewey Duarte, who looms like Jabba the Hutt over a tattoo parlor and an illicit drug ring. King Dewey becomes a key person of interest for Kris and Ed. In New Orleans, their medical sleuthing leads to a series of discoveries that indicate the virus may be of Venezuelan origin and may have been transmitted, possibly with criminal intent, to drug users deliberately via contaminated heroin. Shadowy government agents try to thwart the investigation and become increasingly desperate to keep Kris from learning the truth.
As the story unfolds, Dr. Jensen has anything but a facile course to the epidemic’s origin. As she becomes increasingly ill from the virus, there are fast car pursuits, gun battles, harrowing plane rides over dense jungle, a bombing, terrorist overtones, and—well, you’ll see as the quest continues. Things go from bad to worse with many obstacles to overcome before the final battle between good and evil.
Could Kris Jensen be dealing with a world-threatening infectious agent – a.k.a. the “next big one” – or is it a sinister bioterrorist plot? YELLOW DEATH tells an exciting story of her investigation that illustrates these problems with chilling effect.
Dr. Joe John practices infectious diseases in Charleston and is Editor-in-Chief, The Journal of the South Carolina Medical Association.