Can I use gender (she) to refer to a disease

I'm translating a novel from Spanish to English, and in the very first chapter there's a sentence that roughly translates as "we followed a strict diet, especially after She appeared". In this case, she refers to leukemia, which is a feminine noun in Spanish.

Logically, in English I should use it, but there's a caveat: the disease isn't disclosed in the book until much, much later, and the use of she is intentional to avoid mentioning the disease, so it would likely give away too much and spoil the intended effect.

So the use of a personal pronoun (he/she) seems preferable in this case, but I'm unsure how to proceed, as using the feminine pronoun she works best in the context but I don't want any gender-based discord.

Any suggestions would be much appreciated. Thanks!

I would stick with she. The reason because that is how the author perceives it. Even more with how this writing is a novel and not an academic writing. in this book with the disease; who is the person that has this disease and what is their gender?

I recommend using a gender-neutral phrase like "the thing" or "it" to refer to the disease.

I'm fluent in both Spanish and English and understand why 'she' was used in the original text (la enfermedad, or illness, is feminine). However, as a native English speaker, it sounds unnatural to refer to diseases as 'she'. For example, news broadcasts do not refer to Covid-19 as 'she' or 'he'.

Using 'she' inevitably leads a reader to form certain impressions of this unknown 'thing'. Using 'she' gives the impression that the thing is a living creature (a human or animal) or a certain prized possession (like a valued car or yacht). This would create certain connotations that don't seem to align with the idea you want to convey.

This can be avoided using a neutral yet still generic term like "the thing" or "it".