The Virus has taken over the entire world/country/town. Almost always, there is a patient zero. This is the person that started it all, the very first person to be infected. Perhaps s/he carried the virus for a while without realizing she was a Zombie Infectee. Perhaps s/he was the one who created the virus. Sometimes, you have to kill patient zero to stop the virus before it spreads to anyone else. Other times, Patient Zero carries the original, unmutated virus, which the heroes need to Find the Cure. If the Patient Zero is asymptomatic and/or doesn't know what they're carrying they may be a Typhoid Mary.
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- In The Smurfs, Grouchy Smurf was the original carrier of the Black Smurf virus that very nearly wiped out the Smurfs (old enough to be an Ur-Example of Zombie Apocalypse), and it was given as an explanation for why he is so grouchy (he was the first to catch the virus and the last to be cured). In the TV adaptation, it was Lazy Smurf that was Patient Zero of the Purple Smurf virus.
- The Patient Zero in Afterlife with Archie is technically Jughead's dog Hot Dog after he is brought back to life by magic, but the first human zombie is Jughead after Hot Dog bites him.
- In the film Zombieland, Patient Zero is said to have been a person who ate a bad hamburger
- In Contagion, Patient Zero is Beth Emhoff although technically the true Patient Zero is the chef that handled the infected pig as shown in a flashback at the end of the movie.
- In Outbreak, Patient Zero is a monkey.
- In Rise of the Planet of the Apes, Franklin is Patient Zero for what will become known as Simian Flu (according to the Viral Marketing website for the sequel). Unfortunately for all, it's an airborne virus, and he managed to infect a pilot before he died. Dawn of the Planet of the Apes reveals that only 1/10th of the population survives, most with a natural immunity to the virus.
- In the film of World War Z, Patient Zero is what the main characters are searching for. They never find it.
- In Pro Wrestlers vs. Zombies, killing the two zombies raised by ritual seemingly causes all of the other zombies to vanish.
- In the Sanctuary episode "Pavor Nocturnus", Magnus is the first carrier of the virus that turned almost everyone into cannabalistic monsters.
Helen: I was patient zero.
- In Star Trek: Deep Space Nine, Section 31 creates a devastating virus that afflicts Changelings, hoping to bring about a Changeling genocide. The group infects Odo without his knowledge. The virus is spread by linking, so Odo unwittingly passes the pathogen to other Changelings while in the Great Link.
- In Community's "Epidemiology", Patient Zero is Pierce, being the first person to eat the tainted "taco meat".
- In the Sliders episode "Fever", Quinn's double is Patient Zero for the "Q", with a million-dollar bounty on his head. Turns out the plague is nothing more than a hard-hitting bacterial infection, which is lethal here because this alternate Earth never developed penicillin.
- In Helix The CDC rapid response team's best guess is that research scientist Peter Farragut is the first human infectee of NARVIK-B, The Virus and Synthetic Plague that turns its victims into super-strong Vectors compelled to infect others. However, the staff at Arctic Biosystems, the remote research base where the outbreak is occurring, refuse to tell the whole story, and from the rantings of Vectors, other scientists likely went before him.
- In Person of Interest, Finch refers to himself as this in regards to knowledge of the Machine, as he built it. This isn't an actual disease, but since the government tends to arrange for fatal accidents to happen to anyone they think is even considering leaking information about the Machine's existence to the public, it's no less deadly.
- Jamie from Doctor Who is Patient Zero of the "Empty Child" gas-mask zombie plague.
- World War Z plays with the trope a bit. "Patient Zero" is apparently a young boy in China, who was diving for salvage in the reservoir where his family's home village used to be and came up bleeding heavily and missing a toe. If we take everything in prequel-of-sorts The Zombie Survival Guide to be canon for World War Z, the only possible source of the infection is another zombie, possibly from a former Chinese military biological warfare programme. But The Zombie Survival Guide seems to exist in a universe where the zombie virus is a known, scientifically-documented phenomenon with a long history of outbreaks stretching back at least to Ancient Egypt, yet in World War Z humanity is almost entirely blindsided. The precise origin of the outbreak is therefore unclear, with "Patient Zero" merely being the first known Zombie Infectee.
- Patient Zero of the Blue Pox in Circle of Magic: Briar's Book was a stupid mage who became infected after improperly disposing of a failed weight loss potion. She was discovered dead in her study.
- Vergil Ulam is patient zero of the noocyte outbreak in Blood Music, being both the first infectee and the creator of the noocytes. He is killed in an attempt to prevent the outbreak.
- In The Stand, Charles Campion can be considered Patient Zero, in that he's the one who gets out of the base and spreads the superflu virus along his path from California to Texas.
- In John Ringo's The Last Centurion, an illegal Chinese immigrant provides the vector that gave the H5N1 virus a path from China (the source of the virus) to the US.
- The pimp in the Illuminatus! trilogy, who is unaware he carries the deadly virus and who sparks a panicked manhunt. fortunately he has gone to ground, terrified of arrest after the death of a working girl and after having acquired top-level secrets. He is found dead in a cave.
- Subverted in the Newsflesh universe, in which there is no known Patient Zero for Kellis-Amberlee. There were not quite 100 living Marburg Amberlee patients when the Kellis virus was released and combined with MA, which had recently started spreading to those close to the original patients. Factoring in incubation periods, the combination had plenty of time to spread before the Rising began in multiple places almost simultaneously.
- In the Fablehaven series, Ephira the tree spirit was the first victim of the demon Kurisock's corrupting power, the Shadow Plague. She'd been corrupted for a while before finding an Amplifier Artifact that allowed her to spread The Corruption to others.
- The reanimated corpse of Doctor Alex Mercer, a.k.a. Blacklight, protagonist of Prototype. Elizabeth Greene is also one, carrying her own Redlight virus.
- Melissa Pearce in Parasite Eve. Late in the normal game you find out that Aya's dead sister was actually the original, true Eve. The original appears in the optional dungeon as the True Final Boss.
- The appropriately named Zero of Mega Man X was designed by Dr. Wily to be the original carrier of the Maverick virus, the very virus makes Reploids go berserk in the first place. As such, not only is he himself immune to the virus, he also gains benefits from said virus whenever it enters his system.
- The final chapter in Trauma Team. It's even called Patient Zero. It involves finding the girl whose blood originally carried both Rosalia and its antibody.
- In the Old World Blues DLC of Fallout: New Vegas, Patient Zero of the spore virus found in Vault 22 is a miniboss that can be encountered. There's also the Lobotomite Test Subject 1.
- Infinity Wars has a card named Patient Zero. Sure enough he's the origin of the zombie nanovirus on his world.
- Infected: The Twin Vaccine is all about locating a six-year-old who's the only known survivor of a virus which first hit her and her twin sister so that the title vaccine can be produced.
- Rika Furude of Higurashi: When They Cry.
- Dutifully parodied by xkcd in the strip Outbreak.
- In Manly Guys Doing Manly Things, Patient Zero for The Nomura Virus was Nier.note
- In Stand Still, Stay Silent the apparent Patient Zeroes of the Rash Illness that caused The End of the World as We Know It were a group of eleven illegal refugees arriving in Spain. Where they contracted the disease (and where they even came from) remained unknown, and by the ninth day after their arrival only four were still alive.
- In the South Park episode "Pink Eye", Kenny becomes a zombie and causes an undead outbreak. He gets killed, and the originally undead return to life.
- The boys are actually told to kill the original zombie, and not just kill random zombies. This news comes a little too late, as they had already killed half the town by this point.
- An episode of Codename: Kids Next Door had a little girl named "Patient C" play this. She was apparently supposed to be infected with cooties, with the (entirely male) science staff using Numbah Four as justification for her being infected. Numbah Four had extremely large, swollen lips after eating coconut logs even though he was violently allergic.
- Cinnamon Bun of Adventure Time becomes Patient Zero during the Episode "From Bad to Worse". Why? Because he ate a piece of zombie flesh. Did we mention Cinnamon Bun is a complete moron?
- In The Smurfs, Lazy Smurf was the original carrier of the Purple Smurf virus that very nearly wiped out the Smurfs. In the comic it was based on (itself old enough to be an Ur-Example of Zombie Apocalypse), it was Grouchy Smurf that was Patient Zero of the Black Smurf virus, and it was given as an explanation for why he is so grouchy (he was the first to catch the virus and the last to be cured).
- Typhoid Mary, who caused many outbreaks of Typhoid Fever.
- Although there is plenty of evidence that he wasn't technically Patient Zero, Gaetan Dugas is traditionally known as the "Patient Zero" of the HIV/AIDS epidemic, at least in the western world.
- The True Patient Zero, whose identity remains unknown (and will likely remain so) originated from Africa, where a mutation of a Simian Immunodeficiency Virus (SIV) from the White-collared monkey jumped the species barrier when the monkey's meat was consumed by a human.
- Back in 1976 when the Ebola virus was first identified and named it was traced to Yambuku, a small village in Mongala District in Equateur Province in northern Democratic Republic of the Congo (previously Zaire). The virus was first identified in a blood sample from a Flemish nun. After the fact through testing it was discovered that an outbreak in Sudan several months previously could be traced to a storekeeper known as YG in a cotton factory in Nzara, so he is considered the Patient Zero of the virus.
- Thomas Eric Duncan is considered the USA's patient zero for the 2014 USA Ebola outbreak.
- Teresa Romero, a Spanish nurse, contracted Ebola from a priest who was sent home from Liberia. That technically makes her "patient one" for Spain. Brother Miguel Pajares and Brother Manuel García Viejo were both technically patient zero for Spainnote .