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Still using the subway because he hadn't bought a bike Saturday, in Chapter 23 Jack enters The Medical Examiners Building to see a full ID (body identification) waiting room. Vinnie tells him that eight cases of "meningococcal deaths" had come in over night.
Jack, Laurie and Chet discuss the irregular outbreak pattern of cases followed by an abrupt ending of cases. In other words, once an infectious disease occurs, there should be further cases that can be tracked as being related in some way to the original "index" case. Jack uses this unusual occurrence to suggest that there is some sort of intention, by some sort of person, behind the outbreaks; he also suggests there is a connection to chronic illness in the index cases.
"All the index case from these recent outbreaks have had some sort of chronic illness," Jack said.
"A lot of people who are hospitalized have chronic illnesses," Laurie said. "In fact, most of them. What does that have to do with anything?"
After Jack, Chet and Laurie complete the eight autopsies, Jack further notices another emerging pattern. The last case in all four disease outbreaks--plague, tularemia, Rocky Mountain spotted fever and now meningococcus--was a woman from central hospital supply. Jack makes a prediction about the next outbreak they will see: diphtheria, pertussis, or influenza.
"I'd use drug-resistant diphtheria, or maybe even drug-resistant pertussis. Those old standbys are making some devastating comebacks. Or you know what else would be perfect? Influenza! A pathological strain of influenza."
Terese calls Jack for emergency help over coffee where she tells him that she had had the foresight to meet with a friend from college who works at National Health hospital before her presentation and learned that mention in an advertisement of nosocomial infections (hospital originated infections) would never meet with National's approval.
She relies upon Jack to help find a new angle. In the conversation, Jack mentions the new outbreaks at Manhattan General and just before dashing off, Terese insists that there be no secrecy like National's secrecy over their nosocomial infection outbreaks (though theirs were of milder diseases that nonetheless led to deaths).
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