1634: THE BAVARIAN CRISIS – snippet 47:



            Mary Simpson made the diagnosis first, long before Bill Hudson had finished leafing through his manuals. Through the admiral’s old friendships in the Netherlands, she knew people at the World Health Organization who had worked for the international center for vaccination when the disease made its way through the former Soviet republics in the early 1990s.




            The down-time physicians concurred. It was the “strangling angel of children.” They had, all of them, seen it before. All too often.




            “It’s a kid’s disease,” Toby said, when Bill told him. “You get your DPT shots and that’s that.”


            “They don’t have DPT shots here,” Bill pointed out. “And we don’t have any magic bullet to cure it. Oh, yes, it’s bacterial rather than viral. My little pamphlet says that it can be treated with penicillin. Or with erythromycin. Neither of which I happen to have available.”




            “Try to get through to Grantville tonight, will you, Toby? I know that reception in these hills has been driving you guys, crazy, but please try. If not tonight, then tomorrow morning. Keep trying. Get me one of the doctors. What I have is chloramphenicol, and not much of that. Ask them if it works on diphtheria. If it doesn’t, there’s no point in wasting what we have; I’ll save it for something it does work on. If it does work, well . . . ask them if they can send some more. Please.”


            “People don’t really die of it, do they?”


            “According to what I have here, it was a major killer, right up through the end of the nineteenth century. There aren’t going to be DPT shots for a long, long, time. I’ve put your tech into quarantine. Let’s hope that it doesn’t spread too fast. What about you. Are your shots up to date? When did you get your last DT shot?”


            Toby didn’t have the slightest idea. “Last time that I had to get one, I suppose. That would have been, uh, when I started high school, maybe?”


            “And you’re twenty-five now? So, about ten years. Well, let’s hope that you still have antibodies.” Bill stomped off, looking glum.


            He was feeling frightened. That’s about how old his shots were, too. He was just a year younger than Toby. Of all the up-timers in Amberg, only two had their immunizations up to date when the Ring of Fire hit. Keith Pilcher was one of them, because of the nature of his job He had to have tetanus shots, being a machinist, and diphtheria vaccine came with it. Mrs. Simpson was the other one, partly because she traveled so much; and partly because she was just naturally one of those super-picky people who kept everything up to date. Jake’s last shot was before his and Toby’s.


            And there were a lot of down-timers who had never had diphtheria. Including, he found out, Mrs. Dreeson. She’d had a lot of stuff, but no diphtheria. Duke Ernst, yes; Böcler, no; Zincgref, yes; Hand, no; Brechbuhl, yes; Leopold Cavriani, no; Lambert Felser, no; Marc Cavriani, no. The “no” list went on and on. Not a virgin field, but bad enough.


            Like the out-of-date immunizations, he hoped that the immunity gained from childhood exposure would last for the ones who had already had it. Diphtheria was one of those things you could get again, once the antibodies wore off. Strangling on the swollen membranes in your own throat wasn’t a pretty way to die. Not that there were very many pretty ways. It hit children hardest, mainly because their windpipes were smaller, more quickly closed off by the membranes.


            The pamphlet talked about complications, too. Severe heart and nervous system complications which develop after two to six weeks and can lead to collapse, paralysis, coma and death in about five percent of the cases. He guessed that real doctors found that sort of information fascinating. And stuff about possible long-term complications for people who survived. He’d worry about those later.


            And how was he supposed to identify carriers? Not! At least, he could tell the down-timers that there were carriers and ask them to look for patterns. If person X’s visit to a household is regularly followed by an outbreak, quarantine him, too. And tell them what the incubation period was. If he could convince them that it was contagious and that’s how it was spread.


             Oh, damn.


            If he ever got out of the army, he was going back to Grantville. And going to work for Tom Stone. Let the other guys go to med school. He was going to make the medicines. Somebody else could deliver the doses.




            Caspar Hell’s voice was steady. “I have closed the school because of the epidemic. Too many children are quarantined, or their parents are afraid to let them come, for us even to try to hold classes.”


            None of the other Jesuits disputed that.


            “We will offer the collegium to the city as a quarantine hospital. It is the largest suitable building. Those diagnosed can be brought here and we will nurse them. That may offer some hope, at least, that uninfected members of their families will escape exposure. Otherwise, the young medic, as they call him, tells us that whole families will die, one after another.”


            None of the other Jesuits disputed that, either. Most of them had seen it happen, when families, the sick and the well alike, were quarantined together in their own houses.


            Duke Ernst accepted the offer of a lazarette with gratitude.


            Hand crossed “espionage centered at the collegium” off his list of things to worry about for the time being.




            Bill Hudson’s hopes sank. He had kept wishing for a magic bullet. That someone could dispatch a 4×4 from Grantville with a batch of a lifesaving drug. Instead…as best the medical personnel in Grantville knew, chloramphenicol would not work on diphtheria. They didn’t know just why. Diphtheria was a gram positive bacilli, which chloramphenicol was effective against as a class. In short, it did work on the class of bacteria but they couldn’t find anything in their searching that specifically said that it would work on C. diphtheria—on this specific organism. It probably wouldn’t hurt someone, if he tried it on them as an experiment, Doc Adams had radioed. But they didn’t have any evidence that it would help.




            Jakob Balde found it odd, having so many strangers inside the private portions of the collegium. There were usually students, of course. The few boarding students, however, had now been confined to their own quarters on the other side of the building, where the infection had not entered yet, and to the care of one of the cooks.


            The Jesuits were not the only ones who volunteered to nurse. The older up-time man had been here, almost from the start. He wasn’t squeamish, either. An up-time woman had volunteered to come, but Father Hell had drawn the line at having that. So she worked in the city, with the young medic, who insisted that he was not a full-fledged physician. Doing something that she called triage. The arriving patients were marked: those who, God willing, would benefit from nursing; those who, barring a miracle of God, probably would not.