A sadistic serial killer, his weapon a deadly virus. Dublin, Ireland, and Richmond, Virginia: separated by miles - connected by murders. For Dr. Kay Scarpetta, a lecture in Ireland offers the perfect opportunity to discover whether the murders on both sides of the Atlantic are indeed connected. Five decapitated bodies were found in Ireland five years ago - now four have been discovered in the USA. But the tenth body in Virginia is different. There are vital differences and an indication that the elderly victim was already seriously ill. A deadly replica. Chilling, perhaps, but not unusual. And then, absolute terror grips Scarpetta and her associates when the next body is found. The circumstances of the death convey a clear and terrifying message: the killer is armed with the most deadly weapon in the world - smallpox.