IN a small town in the American Midwest, teenage girls are beginning to fall strangely ill. It all starts with one girl at the high school, pretty Lise, who has just recently come into her own and blossomed over the summer. There’s something very macabre about the seizure Lise has in class, her body wracked with spasms and mutated by something grotesque. Lise slams into the ground as the other students watch, “her bright red face turned up, mouth teeming with froth,” her best friend Deenie frozen in horror as a “low snarl” comes from Lise’s “delicate pink mouth.”

No one can understand what is happening to Lise just as no one can diagnose what is wrong with the girls who fall sick following her. In a lean, incredibly controlled narrative Megan Abbott tells the story of the fears and paranoias of teenage female sexual awakening, of fraught relationships that set something loose, the demons that claw the world around into a strange, altered landscape. The Fever is a story about teen girls in a small town and while that may be a common enough premise, there aren’t many people who can tell it with the sensitivity and appropriate darkness that Abbott has. “You spend a long time waiting for life to start,” writes Abbott. The “past year or two filled with all these firsts, everything new and terrifying and significant — and then it does start and you realise it isn’t what you’d expected, or asked for.”

The first scene in The Fever shows a group of teenage girls in a town called Dryden, waiting for something, nervous and afraid. “The first time, you can’t believe how much it hurts,” one tells Deenie, who is afraid though “she tries to hide it, pushing her knees together, her hands hot on her thighs” as she awaits her turn. “It just kind of burns,” says a girl, “you’re sore for a few days. They say by the third time, you don’t even feel it.”

What starts off sounding like a potential sexual encounter is actually one with a nurse and the first in a set of HPV vaccines, declared mandatory for young women who have not yet been ex-posed to this primarily sexually transmitted disease. This set up of a group of teen girls anxious but insisting on bravado before each other, says it all. This is a book about fear, sudden adulthood and the bonds between young women who are experiencing something that is recognising them as sexual beings, whether they are ready to be thought of as such or not.

But what is causing the girls’ sudden illness? The parents of the victims each begin to consider alternate possibilities — can it be a side effect of the mandatory HPV vaccine? An STD? The pollutants in the local lake that cause it to glow in the nights, or something worse, something darker and more ominous? Do the girls share psychological demons of some sort? No one can work out what ties them together and when Deenie’s two closest friends are the first to suffer and be hospitalised, she is left wondering: “if it happens to both your best friends, the next one must be you. If it happens to both your best friends, it must be you.”

The town itself, Dryden, comes across as slightly threatening too. Deenie’s father recalls how he felt when his wife left him: “Demons had come in the dark, come with the famous Dryden fog that rolled through the town, and taken possession of his lovely, smart, kindhearted wife.” As he tries to raise a teenage daughter as best he can alone, faced with a terrifying condition ruining the lives of the town’s girls, he is constantly afraid that “next they’d come for his daughter too.”

There is a dead lake which the occupants of Dryden avoid, an “alien, an otherworldly lagoon,” where “blue-green algal blooms effloresced at night.” It is suggested that perhaps the lake and its strange, polluted water may have poisoned the girls in some way. Deenie, who knows more about this connection to the lake than she lets on (both to her father and to the reader), remembers stories about a “teenage couple [who] had gone skinny-dipping and drowned, their mouths clogged with loam, bodies seen glowing on the shoreline from miles away.” She remembers hearing that “swimming in it gave you miscarriages, or took away your ovaries and you’d be barren for life.”

The mention of sexual reproduction and health of course leads back to HPV inoculations. The possibilities of the HPV vaccine affecting the girls negatively is something that many of the parents are concerned with, reflecting the controversy that rose around the vaccine some years ago in the US, with parents questioning why girls as young as 11 were being exposed to a strong drug that may have caused rare neurological disorders in some children. In The Fever, Lise’s mother is broken and desperate to understand what has happened to her child, insisting “they want us to believe they’re helping our girls. They’re killing our girls. It’s a kind of murder. A careless murder.”

Abbott tells her story not just from the perspective of Deenie, but also that of her father Tom and her brother Eli, both of whom have their own crosses to bear. Eli fears for his sister as much as his father does, but in his own complex way. Popular with girls his age, Eli has frequent sexual encounters at home that leave him feeling emotionally bereft and afraid for the young women he’s been with. And often afterwards, he can only “ever think about his sister, one wall away. And how he hoped Deenie never did things like this. With guys like him.” Sometimes, “he wished he didn’t have a sister.” Eli’s vulnerability, even as the popular jock at school, is something Abbott doesn’t ignore, acknowledging that transitioning from teen to adulthood is just as hard on boys as it is on girls.

At times Abbott’s writing is a complex, devious mixture — clever and lean and extremely effective for a writer with the ability to write absolutely ferocious prose. Her treatment of the relationships between teenage girls is nothing short of riveting, as is her understanding of what it means to be the parent or sibling of one. How much can you or should you protect them from the darkness that will inevitably seep into their lives? Even puberty, Abbott seems to indicate, is a sort of “witchcraft.”

The Fever is one of those books that makes you want to go and read everything else by the writer. I feel I’ve missed out by not having read Abbott’s work before. Sure, The Fever is about a set of middle class, (presumably) white teenagers in a small town in America — very far from my reality, but aren’t teenage girls all the same, the world over, in great many ways? Abbott’s understanding of what it means to balance on that threshold between childhood and adulthood is just so deft. And when you finally tip over into the great big world, it’s “a thing you didn’t know you were waiting for. Like something inside opening, and then opening something else.”

The Fever

(NOVEL)

By Megan Abbott

Little, Brown and Company, US

ISBN 978-0316231053

320pp.