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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 she carried the virus for awhile without realizing she was a Zombie Infectee. Perhaps she 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 a cure.
Examples:
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Film
- 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 shown as shown in a flashback at the end of the movie.
- In Outbreak, Patient Zero is a monkey.
Television
Literature
- 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.
Video Games
- The reanimated corpse of Doctor Alex Mercer, a.k.a. Blacklight, protagonist of Prototype. Elizabeth Greene is also one, carrying her own Redlight virus.
- Rika Furude of Higurashi no Naku Koro ni.
- 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.
- 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.
Webcomics
Western Animation
- In an episode of South Park, called "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?
Other
- Quite a few stories in which someone is turned into a vampire involve killing the vampire that bit them, or in some rare cases, the head vampire.
- In the Zombies, Run! app, Patient Zero is Patient 29 of 50 patients who received an injection that was supposed to make cells regenerate faster.
Real Life
- Typhoid Mary, who caused many outbreaks of Typhoid.
- 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 originated from Africa which was a mutation of a Simian Immunodeficiency Virus (SIV) from the White-collared monkey. Consumption of meat from that breed of monkey who is infected is most likely what caused the mutation.
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