The story continues right where it left off; led by an ancient Master who controls them, the new breed of vampires (virus and parasite) have a long sucker that springs out of the mouth to acquire sustenance, and once drained of blood, the humans are turned. These zombie-like creatures roam the streets and subterranean tunnels of New York, the changed ones tending to return home to their loved ones to infect them as well. Fighting this epidemic is an unlikely vampire hunting and killing team, intent on saving the human race, composed of a CDC doctor named Eph and his associate, Nora, a Holocaust survivor and professor turned pawnshop owner -- Setrakian is the one who has the most knowledge about these creatures and a plan for how to stop them, and a city rat exterminator, Fet, who has key knowledge of the underground sewers. These folks are intent on saving New York, and the world, from extinction. Now the Ancients have joined the hunt to seek out and destroy the Master -- because he is evil and is not following the rules and plan that have been laid out since their origination or becoming.
The narrative is mostly non-stop action and the reader is treated to all manner of violent vampire killing methods with lots of gory details, vivid descriptions of the changed ones young and old, and the hunt continues to find and stop the Master before he can take over the world with his dastardly plan. Meanwhile, Eldritch Palmer, a very wealthy but physically sick human is trying to buy immortality by enticing the rogue vampire to the "New World" and acquiring whatever means will allow that to happen. In addition, Eph's ex-wife and his son Zach's mother (who became a vampire in the fist book) is searching to find her boy.
This second book in the series ends on an ambiguous note, another cliffhanger, and we will have to wait to find out what happens to all the remaining humans in the final thriller in this trilogy.