Jon Doneson started feeling ill on a Friday morning in June, after he arrived home in New York on a red-eye flight from the West Coast. He’d traveled to China, then to California, as part of his job managing the back office of his wife Susan’s apparel company. He hoped to re-acclimate to Eastern time, so rather than resting he went to the gym. But he became ill after his workout, vomiting violently and sweating heavily.

Doneson, 52, wrote it off to fatigue. In subsequent weeks Susan pointed out that he had a strange cough. But to Doneson it wasn’t particularly bothersome.

Then, on August 12, he woke up around 5:30 a.m. feeling something different.

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