The Neah Virus, previously unknown to science, has arisen in the dense rainforests surrounding Neah Bay, the Makah Tribe's home village. Its victims develop a zombie-like raving mania, then succumb to high fevers and convulsions. Incomprehensibly, the virus strikes only non-Makahs, leaving tribal members untouched while people of other races are stricken down.

McKean traces one possible origin to the recently-opened grave of a Spanish colonist of the 1700s. Exploring the tomb, he encounters an old Makah shaman, Gordon Steel. Steeped in native lore, Steel claims this is the legendary Lost Souls Disease, created by Raven to punish the Spaniards, now unleashed on the modern world to avenge the destruction of the tribe's traditional ways. McKean asks Steel to make his traditional medicines available, but the bitter old man refuses to cooperate. McKean is certain he knows more about the virus than he is telling.

As the death toll mounts, the virus spreads to Seattle, where both McKean and his young son begin showing signs of the disease. With time running out, Steel's daughter Tleena arrives to lead McKean on a desperate quest from Seattle to her father's traditional longhouse near Neah Bay. On the way, they travel through the chaos of a crumbling society and streets rife with raving victims and grisly death. But the old shaman is by no means certain to help.

This taut medical thriller is a page-turner start to finish.