Tampered
Page 21
“What mustard?”
“Didn’t you say you have to slather mustard all over the sandwiches because the bread is so stale?”
It looked like Natasha was on to something. “Art,” Zol said, “is the mustard in a jar?”
“Oh, yes.”
“And is it always the same jar that’s set out with the sandwiches?”
Art turned to Phyllis and raised an eyebrow. He was hoping two memories were better than one.
“Don’t even think about asking me,” she insisted, her arms still crossed.
“Yes,” Art decided. “I think it’s the same jar.”
“Does Gus serve any other condiments?” Natasha asked. “Mayo? Ketchup? Relish, maybe?”
“Just a single jar of that French stuff,” Art said. “You know what I mean . . . begins with a D.”
“Dijon?” Zol suggested.
Art flashed a tentative smile. “That’s it.”
Zol pictured a simple kitchen table knife spreading Dijon onto contaminated cold cuts, returning to the jar, then spreading mustard — and bacteria — over the next sandwich, and the next, and the next. A jar of mustard could last for weeks. Was this Natasha’s point source, a single strain of listeria doled out over a couple of months?
But could listeria survive in Dijon? Perhaps its white wine and vinegar were too acidic for bacteria to survive in it.
Hamish was staring out of the window as if the conversation were suddenly irrelevant. Was he worrying about his Saab, imagining it in a shed somewhere, dismantled into parts? He finally stood up and tugged at his sleeves. “I’m not sure how much I care about the mustard,” he said, “but we can easily check it out. Listen, I’ve saved the best for last.” His eyes twinkled as he ran his hand across his flat-top. But then he paused, suddenly uncertain.
“Go on, Dr. Wakefield,” Art said. “What is it?”
“Art and Phyllis,” Hamish continued, his voice cloaked with caution, “this is strictly confidential. And I mean strictly. I shouldn’t be sharing this information with anyone outside the health unit.” He looked at Zol, then took a deep breath. “Viktor Horvat — everyone’s favourite pharmacist — was a patient in our ICU at New Year’s. I looked after him. He had listeria meningitis. And completely recovered.”
“Yes,” Natasha said. “We investigated, but couldn’t find a local source. We decided he’d picked up his infection in Mexico. He’d been there quite often. You know, the business about his son.”
“Well, listen to this,” Hamish said. “Ellen told me that Horvat’s listeria is identical to every isolate from Camelot, down to the very last detail on the MLVA fingerprinting.”
Natasha dropped her pen. It rolled off her lap and clattered onto the floor. “Oh my God. His case was reported on New Year’s Day.” She tugged at the curls at the nape of her neck. “That . . . that makes him case number one. The index.”
“Sacrum excrementum,” said Art. “You mean he brought it from Mexico and gave it to us?”
“Wherever he brought it from,” said Hamish, “he’s been shoving his stubby, unwashed fingers into something you’ve been eating.”
Zol had a feeling that something wasn’t as simple as a jar of Dijon, but the kitchen in Gus and Gloria’s apartment was about to get a surprise inspection.
CHAPTER 30
At eight-thirty that evening, Natasha pulled her Honda into the lot behind Caledonian Medical Centre. She took her ticket from the dispenser and the gate opened. The pavement ended in the tangled shadows of the Mountain brow. She quickly rolled up her window. In the daytime, the Escarpment’s woodland cliff soared above the lake, offering views of two skylines, Hamilton’s rising immediately below and Toronto’s shimmering in the hazy distance, like an echo. But at this time of night, the black mass of trees and shrubs threatened with the rawness of a jungle.
She checked over both shoulders before turning off the ignition. No lurkers. She opened the door a crack to turn on the light, then checked her teeth and lipstick in the rear-view mirror. She’d flossed away the remains of her mother’s curried veggies. Filling up on plain chapattis, she’d only taken a few bites of the spicy dishes, but still those damn okra seeds got stuck between her front teeth. She dug into her purse for two sprays of mouth freshener to cover the garlic, if only for a few minutes while she broke the ice with Ellen. It was a continual struggle to get her mother to tone down her spices, especially the cumin. Natasha had loathed the smell of cumin since grade nine, when she’d overheard two freckled girls complaining that curry stank like sweaty armpits. They were right: too much cumin reeked through your pores. But so did cabbage and red meat.
She showed her health-unit badge to the security man at the front door. He didn’t bother to check her tote bag, so he didn’t notice the hunk of chouriço sausage and the half-full jar of Dijon mustard.
She and Dr. Zol had visited the Oliveiras’ apartment immediately after the powwow in the library. Gloria had been resting in bed, but Gus Oliveira’s face was full of smiles and crooked yellow teeth as he answered the door. You’d never know from his demeanour that he’d just buried his mother-in-law. But when Dr. Zol asked to inspect the kitchen, Natasha saw apprehension flash into Gus’s eyes. He led the way without protest and didn’t fuss about handing over the jar of mustard Natasha found in the refrigerator.
“Nice-looking chouriço sausage in there,” Dr. Zol said, as Mr. Oliveira closed the fridge door. “You make it yourselves?”
“Oh, no,” Gus said. The trepidation in his face showed he was aware that deli meats and old people’s homes weren’t supposed to mix. “A Christmas present. From my cousin in Stoney Creek.”
“Must be from that Portuguese butcher. The guy from San Miguel?”
Gus beamed utter surprise and delight at Dr. Zol’s knowledge of Azores culture. “You like chouriço, Doctor?” His shoulders relaxed and he pulled open the cutlery drawer. “I cut you a piece.”
Dr. Zol took a step back and put up his hands. “No thanks, Gus.” He glanced knowingly at Natasha and added, “I prefer salami.”
“Salami?” Gus shook his head in disgust. “Not salami. Taste like old shoe.”
“Only when it gets sliced ahead of time and dries out.”
“I stick with chouriço.”
“And let the English have the salami, eh?” Dr. Zol said with a chuckle.
“They don’t know no difference.”
“Like my granddad, eh? He’s happy with his salami.”
Gus nodded. “Always asking for more. But they don’t always have it.”
“Yeah, I know. The Royal Hamilton is more famous for its chipotle egg salad and Thai veggie wraps.”
Gus started to nod again, then caught himself. “Um . . . Royal Hamilton? You mean the hotel?” He shook his head, but his deception was obvious.
“It’s okay, Gus. I know all about your charity work. Driving for Waste Not. Feeding the poor.”
“But?”
“You’ve got to stop bringing the salami back here. No matter how much a treat it is for the residents. You know the ministry’s guidelines.”
“How . . . ?” Gus seemed to shrink in size as his face went pale. “You going to report me?”
“That depends on our investigation. If the residents have been getting sick from the salami and bologna you’ve been skimming from your Waste Not deliveries, then the ministry is going to find out. If not . . . well, we’ll see.”
Gus scratched an itch under his singlet and said nothing.
“For now, no more trips for Waste Not. My office will call them on Monday, let them know you’re unavailable until further notice.”
Again, the man said nothing. Just stared at his slippers.
Natasha opened the fridge again. She couldn’t take her eyes off the chouriço.
“You’re right, Natasha,” Dr. Zol said, reading her mind. “We better test that sausage. Exclude it as our point source.” He turned to Oliveira. “Okay, Gus, I’ll take that piece of chouriço you offe
red me.”
Natasha tossed her ID badge into her tote bag as the hospital’s security guard picked up his phone and punched in Ellen’s extension. He stumbled over Natasha’s name, then nodded, grunted, and hung up. He pointed down the hall and waved his arm, left-right-left-left, mumbling the directions. She already knew the micro- biology laboratory was on the sixth floor.
Ellen was waiting as the elevator opened. Her fine blond hair was cut in a pageboy style for easy care. She wore a lab coat that was no longer crisp, designer jeans over slim hips, and an Anne Fontaine blouse. Clearly, she was a savvy shopper. Probably made Saturday trips battling the traffic to Buffalo or Toronto. Or did she know a gem of a place hidden somewhere in Hamilton? Natasha hoped so. She’d have to find out.
They introduced themselves with a handshake and agreed it was a pleasure to finally meet face to face after speaking about so many cases over the phone. Ellen led the way down the deserted, dimly lit corridor toward the laboratory. A broad smile crossed Ellen’s face as she opened the door into the clear light and soothing hum of her domain.
Her office, tinier than Natasha’s at the health unit, was at the back of a large laboratory. They settled themselves in front of Ellen’s computer. A department-store photo of a family of four was sitting on a shelf: Ellen with a handsome man and two school-age kids against a pseudo-Hawaiian backdrop. Beside it was a four-photo collage of a huge black dog lounging in various rooms of a house.
“That’s Alfie,” Ellen said, pointing to the dog. “A great big suck. A Newfoundland. I need to teach him to vacuum his own hair. He’s a mess but we love him.” She swept her dark jeans with her palms, then gestured at the family photo. “Thank heavens for movies-on-demand. They’re watching Mrs. Doubtfire at the moment. Won’t notice I’m not there until they get a craving for popcorn.”
“But you’ve been here all day doing the genetic fingerprinting.”
Ellen rubbed the back of her neck and looked suddenly tired. “Not all day. We have a fantastic machine that does much of the work with minimal supervision. It can run a hundred samples at a time, once you get them set up. But I did have to get them done today while the machine was free. It’s booked for tomorrow.”
“I’m sorry to take you away from your family on a Saturday, but you have no idea what a help it is to know for sure we’re looking for a point source.” Natasha pulled the sausage and mustard from her bag and held them up, not sure she should put them down on Ellen’s spotless desk.
Ellen eyed them skeptically. “What have you got there?”
“We’re hoping they’re the cause of our listeria. One or the other.” After Natasha and Dr. Zol had left the Oliveiras’ apartment, Dr. Zol had speculated that either Gus had been secretly sharing his chouriço with the residents, or he’d contaminated the mustard weeks ago when making a sandwich. That didn’t explain Viktor Horvat getting infected with the same listeria strain as the Camelot residents, unless he had a passion for chouriço too. Colleen had traced Horvat’s home address to a Croatian neighbourhood in Stoney Creek. Horvat could easily be a customer of Gus Oliveira’s Portuguese butcher, whose shop was in the same part of Greater Hamilton.
Ellen slipped on a pair of vinyl gloves and took the sausage and Dijon from Natasha. “Follow me,” Ellen said, “we’ll take these into the lab.” In the lab, she set the sausage on the counter and read the list of ingredients printed on the mustard jar. “I don’t know, Natasha. I’m sorry to disappoint you, but there’s vinegar in here. You know, acetic acid. The Americans are using an acetic acid derivative to kill any residual listeria in their packaged deli meats. We should be doing the same to our packaged cold cuts, but the government doesn’t require it.”
“So the listeria can’t be living in the mustard?”
“Sorry, but I doubt it. Never mind, we’ll culture it and see what we get.” Ellen put down the jar and picked up the hunk of sausage Gus had sealed in a clear sandwich bag. “Now this could be your culprit.” She sniffed the chouriço and made a face. “Do they actually eat this at Camelot? I thought it was a pretty white-bread kind of place.”
“We don’t know. Mr. Greenwood, Dr. Zol’s grandfather, didn’t recognize it when we showed it to him. But the time frame is perfect. Gus says he got the sausage at Christmas, and the listeria started showing up at Camelot on January eleventh.”
“Well, you’ve got to cover all the bases, eh?”
“Right now, I need to follow any lead I can find. I’m thinking, if there is listeria in the chouriço, it may have contaminated the kitchen in Gus’s apartment and somehow made its way into Camelot’s food chain.”
“We’ll set up cultures tonight. Of both the mustard and the sausage.” She pulled off her gloves and began washing her hands in the sink. “Viktor Horvat is your index case, right?”
“He got sick first, yes.”
“Doesn’t it make sense that he is the source of the epidemic, not Gus and his sandwiches?” Ellen dried her hands and tossed the paper towel in the waste bin. “Pharmacists don’t mess about in kitchens. But they do count pills. Could Horvat be accidentally contaminating the residents’ medications when he’s preparing their prescriptions?”
“We thought about that,” Natasha said. “Did you know I went to his dispensary undercover?”
“Undercover?”
Natasha explained about the wig, the sari, and the fake Punjabi accent.
Ellen laughed. “You’ve got guts, girl. Didn’t know public health required training in drama school.”
“Mr. Horvat is a meticulous hand washer. I saw that for myself. And he doesn’t touch the pills when he counts them. Uses a stick thingy, then slides them off a tray into the bottle. The assistant puts in the cotton batten.”
“And besides,” Ellen added, “he must be dispensing meds for clients all over the region. We recovered listeria with his MLVA pattern only from Camelot Lodge.”
“Which means there’s a unique link between Viktor Horvat and Camelot.”
Ellen paused for a moment, then her eyes widened. She went to the computer, clicked the mouse, then began typing on the keyboard. “Let’s see what MLVA matches we can find between the Camelot strain and anything else out there on the Internet.”
She clicked again, tapped at the keyboard, and pressed Enter. Up came the website of the CDC, the U.S. Centers for Disease Control and Prevention — the granddaddy of epidemiology, central command for outbreaks around the world. After a few false leads she came to the MMWR, the CDC’s weekly publication documenting outbreaks and other infectious “fascinomas,” as Dr. Wakefield called them.
Ellen typed “Listeria” into the search box. In less than a second, the first of fifty-two citations appeared on the screen, with a clarification: the results were only those items found within MMWR; for a wider search of the CDC website, select “All CDC documents” and search again. Ellen clicked the All Documents button, and up came a list of 1,540 citations.
“Listeria’s a popular pathogen,” Natasha said, scanning the first twenty citations on the screen. “Look how often it gets into raw milk.” There were outbreaks from all over the U.S., and reports involving American tourists who’d visited places like Azerbaijan, Syria, and Sarajevo. “At least we don’t have to worry about the milk at the Lodge. I’ve never seen suspicious-looking dairy products in their fridges.”
Ellen clicked in the search box and added “MLVA” to “Listeria.” The list narrowed to twenty-five. “That’s better. We can handle that.” She clicked on the citations one by one. Not all of them involved listeria. A few concerned the MLVA fingerprinting of other bacteria, such as E. coli and staphylococci. When she’d finished making selections, they had four relevant papers. She clicked Print.
She handed two of the printed articles to Natasha. The first one described an outbreak in Wisconsin, a listeria strain 1/2. It was the wrong strain; they were only interested in strain 4b, the one found at Camelot. Natasha tossed the paper aside.
The second paper described
a listeria 4b outbreak traced to un-pasteurized goat cheese in Michigan. Her pulse quickened. Michigan was only three hours away by car. A good start, but it didn’t prove anything. It was the genetic fingerprint that counted, and the researchers had used two fingerprinting methods, the standard pulse-field gel and the new MLVA. The pulse-field gel looked like a bunch of fuzzy white bars on a black background. How anyone could make sense of such nebulous output, Natasha had no idea.
She turned the page and studied Michigan’s MLVA. Now that looked like a proper high-tech test: a printout of crisp lines and numbers. You didn’t have to be a techno wizard to see how easy it was to compare the MLVA printouts from different laboratories. MLVA’s numbers and lines let you compare the fingerprints of a listeria from Hamilton with another down the road or across the world.
“This one looks promising,” Natasha said, waving the Michigan paper. “A 4b from Detroit. It’s got a nice clear MLVA profile.”
“Mine are both 4b,” Ellen said. “An outbreak linked to sausages in Brandon, Manitoba, and another involving dairy products in Sarajevo.” She opened a drawer of hanging files, walked her fingers along the tabs, and pulled out half a dozen sheets of paper stapled together. “Here are the printouts of my MLVAs.” She pointed to rows of lines and numbers. “This is what I’m calling the Camelot strain. You can see that Viktor Horvat’s isolate is identical to all the samples from Camelot. And these over here, my controls from anywhere but Camelot, are all very different.”
“Check out my Michigan one. Do we have a match?”
Ellen put the papers side by side on her desk and compared them. “Not even close.”
“How about Brandon?” Manitoba was a long way away, but maybe Viktor Horvat had connections there.
“No,” Ellen said. She picked up the paper detailing the outbreak in Yugoslavia.
It didn’t match, either. Of course not. Listeria isolated from a commercial dairy in Sarajevo could have nothing to do with Hamilton, Ontario. Linking Mr. Horvat with Mexico would be a much better bet, but no one had published any MLVA results from Mexico.