The Fatal Strain (24 page)

 

 

Prathum sat cross-legged on his back porch, surveying all that he and his chickens had built. His eyes panned past across the barn and the sheds, where his amply nourished hens were settling in for the afternoon, past the fish ponds, where a fleeting fin glinted amid the vines of morning glory, toward a line of trees casting long shadows at the edge of his property.

His thoughts returned to those new, modern chicken shelters that farmers were chattering more about. They were called evap houses, short for evaporative cooling houses. They had automatic ventilation and used large fans and water to maintain mild temperatures even during intense tropical heat. Because they were enclosed, they could keep out most contagion. “Even insects can’t get in,” he noted, impressed. But the cost was tremendous. He would need a loan and have to quadruple the size of his flock to make the numbers work. He would need at least five years to break even. No need to be hasty, he reasoned.

“I’m not worried right now,” he put it to me. “We haven’t heard anything lately about the epidemic. Maybe the disease left with our last lot of chickens. The new ones all look healthy.”

His wife appeared in the doorway with a watermelon. She wasn’t buying his cool assurance. “I’m definitely afraid the disease will come back to this area,” she offered. “Some people say the disease came with the wind. Some say it came with birds. We have no clear idea. And deep down, he’s still worried about it, too.” She glared at Prathum, then laughed.

“Yes, I’m still scared,” he confessed. “But I try not to show it. What can I do? We’d never had bird flu before. It just came. I’m hoping it won’t come again.”

Prathum took the watermelon from his wife. He grabbed a knife from the bench and started carving the fruit.

His sons were urging him to invest in an evap house, he told me without looking up. It was all that fancy university education. His
older son, the one studying veterinary science, he’d even visited several evap houses to check them out. But Prathum had seen enough change in his life.

“I may not be able to learn as fast as young people,” Prathum said. “I’ll retire after a while and pass the farm on to my son. Then, he can do what he wants.”

CHAPTER SIX

From a Single Spark

P
rofessor Yi Guan gingerly placed the small cooler box with its mysterious contents into his black canvas satchel. He covered the box with a towel, then a newspaper, to conceal it from prying eyes. He wasn’t quite sure what he had. Whatever it was, it had already proven to be a ruthless killer. The cooler box contained about two dozen vials, and lurking inside each one, Guan feared, was enough biohazardous material to start a global epidemic. But the specimens could also be the world’s salvation—if only he could get them back to his laboratory in Hong Kong.

Guan slung the strap of the satchel over the shoulder of his gray suit jacket and headed for the door of the hospital. The medical staff at the Guangzhou Institute of Respiratory Diseases had nervously collected the mucus specimens from the noses and throats of patients stricken by the strange plague now burning through China’s Guangdong province. The institute director, an esteemed scientist named Dr. Nanshan Zhong, had agreed that Guan could take the samples back to Hong Kong University for identification. But Guan had no such permission from the Chinese government. If he was stopped, he had no papers to show. If the vials were discovered, they could be confiscated and Guan detained. He could be held until his Beijing contacts vouched for him, if he was fortunate. If not, he could be accused of stealing state secrets or espionage and sentenced to life in a labor camp.

Chinese officials were determined to keep the severity of the epidemic under wraps. That very morning, February 11, 2003, Guangzhou’s vice mayor had announced that the city was facing an outbreak of unusual pneumonia but it was under control and no extraordinary measures were required. But WHO was already picking up rumors of a far more serious outbreak involving a “strange contagious disease” that “left more than 100 people dead in Guangdong Province in the space of one week.”

Guan suspected avian flu. Three months earlier, in November 2002, the wild birds of Hong Kong had started to die, first in the New Territories bordering Guangdong Province, then at a park in the teeming downtown of Kowloon. Samples from the outbreaks tested positive for the virus. Guan’s suspicions hardened in February when bird flu was detected in a Hong Kong family. They had been traveling in China’s Fujian province for the Chinese New Year when a young daughter came down with a severe respiratory illness. She had perished before the family returned home and was never tested for the virus. Soon her father and brother also fell sick and were hospitalized in Hong Kong. The father died. Both tested positive. It was the same H5N1 subtype that had first struck Hong Kong in 1997. They were the first confirmed cases anywhere since then.

As a fledgling researcher, Guan had helped investigate the 1997 outbreak. He had been part of the team that uncovered the widespread infection among Hong Kong’s poultry, crucial information that helped energize the city’s decisive response. He believed a pandemic had been averted. Now he was trying to repeat the feat.

As he left the Guangzhou institute, an aging seven-story gray cement edifice along the Pearl River, and set out to catch his Hong Kong-bound train, Guan felt time was running out. He feared that the next time the virus departed the province, it wouldn’t be in securely sealed vials nestled inside a carefully prepared cooler box but unknowingly in the lungs of a victim. Once it escaped southern China, he was afraid, moreover, that the pathogen would spread to dozens of countries. Finally, he was sure it would then take only days to reach the far side of the planet.

Guan was tragically prescient on all three counts. The transformation
of Asia over the previous generation had not only been internal, amplifying the hazards of an animal-born epidemic; but it had also redefined the region’s ties with the rest of a globalized world. And in this age, the magnitude of a pandemic threat was growing as the distance between its origin and the rest of the world was shrinking.

Guan, however, was wrong about one thing.

 

 

 

When Yi Guan was six years old, growing up in the impoverished Chinese province of Jiangxi, his sister changed his name. He had been born Qiu Ping Guan. Qiu meant “autumn,” the season of his birth. Ping meant “peaceful.” Guan was the family name.

He was the youngest of three boys and two girls raised in the remote countryside about 180 miles from the provincial capital. In 1966, when Guan was four, Chairman Mao Zedong launched China’s Cultural Revolution, a decade of violent upheaval targeting those considered as capitalists, intellectuals, or vestiges of the former ruling class. Guan’s mother was descended from property. Though spared the worst excesses, his family was forced to subdivide its six-room house to make space for others. His father, an engineer, was sentenced to reeducation and put to work threshing flax plants to extract an ingredient for wine.

One day, as Guan was preparing to enroll in first grade, his adult sister called him aside.

“Come on, brother. I need to talk to you about something,” she said. She seemed unusually earnest.

“What do you want to talk to me about?” the young Guan asked.

“I want to give you a new name,” she responded. “You are the only boy in our whole family who has the hope to become successful. So I’m changing your name. It’s becoming Yi.”

She wrote the name on a piece of paper. Guan couldn’t understand the significance. His sister said one of its meanings was “extraordinary.”

“I picked this meaning to make you remember you must become outstanding, extraordinary,” she told him. “That is your duty.” She took
him to school and registered him under his new name. It was a heavy burden, Guan later recalled. But he took his charge seriously.

As part of his radical remaking of Chinese society, Mao had shuttered the colleges. But just as Guan was preparing to graduate from high school, China announced they would reopen. For nine months he crammed for the entrance exam. Less than 1 percent of high school students would make the cut, Guan recounted. He would be among them.

Guan went on to study medicine and specialize in pediatrics, winning a place at an elite Beijing institute where he hooked up with a senior scientist specializing in infectious diseases of the respiratory system. He was later offered a slot in the PhD program at Hong Kong University and, after that, a chance to go overseas. He continued his research with one of the world’s top flu scholars, Dr. Robert Webster, at St. Jude Children’s Research Hospital in Memphis, Tennessee.

Several years had passed when, on a Saturday morning in late November 1997, Webster called him. Guan had returned to Memphis hours earlier after defending his doctoral thesis in Hong Kong and visiting his aging mother for the first time in two years. “Don’t open your baggage,” Webster ordered him. Guan was to turn around and go back.

“What happened?” Guan asked.

“While you were in the sky crossing the Pacific,” Webster said, “they had three cases of H5N1.”

“Really?” Guan was shouting excitedly over the telephone. “Really?”

Webster instructed him to get his travel documents ready and prepare the biological materials he would need to transport to Hong Kong. They were going to join the virus hunt.

Guan never gave up the chase. He soon moved back to Hong Kong to become a researcher in microbiology at the university and quickly went to work sampling the city’s birds. Before long, he would emerge as one of the world’s great collectors of flu viruses. Even as memories of the 1997 outbreak were fading, he was compiling data on myriad strains and amassing thousands of samples from birds in Hong Kong
and southern China. In the summer of 2000, he had extended the net to Guangdong, establishing a virology lab at Shantou University Medical College. The facilities there had been idle for a decade. Guan spent a week cleaning the lab. He scrubbed the floor and washed the research bench and its protective hood. Only then did he set off to collect specimens from nearby poultry markets. Within two years, he had set up a network of field researchers that was gathering samples from birds in four provinces of southern China.

Webster, his mentor, had helped recruit Guan to the post at Hong Kong University. Webster was convinced that the novel flu strain simmering in southern China posed a grave danger to the world and wanted someone, preferably a Chinese virologist with Western training, who’d be nothing less than bullheaded in tracking the evolving threat. “Yi doesn’t know the word
no
. He doesn’t take
no
from anyone,” Webster put it to me. “He believes in what he’s doing and he’s intellectually driven to do these things. He talks a million miles an hour, and a lot of it is not totally focused, but his overall mission is focused. You’ve got to have someone who is hard-driving to get out there and be able to interact with the people and understand the region, and he was the perfect person to do the surveillance.”

 

 

Rumors of a bird flu epidemic among the Chinese of Guangdong first surfaced in November 2002. WHO’s influenza chief, Klaus Stohr, who would later mobilize the agency’s flu hunters after bird flu exploded in Vietnam in early 2004, was at a medical conference in Beijing when a health official from Guangdong stood up and described an especially nasty outbreak of respiratory disease among people of his province. “He talked about deaths, very severe disease and deaths,” Stohr recounted. Chinese doctors had been unable to identify the precise cause, but they said it looked a lot like flu. Stohr was inclined to agree. “I just put two and two together, and it added up,” he recalled. “I thought this must be H5N1 coming back in precisely the way we had feared. It was our worst nightmare, and the world’s.”

But when WHO subsequently pressed Chinese officials for more
details, they offered a terse, dismissive reply. It was indeed flu, they reported, but just routine flu and everything was under control. In essence, “Now buzz off.”

By the waning days of 2002, with wildfowl in Hong Kong starting to drop, Guan and his fellow researchers suspected that whatever was killing the birds was also afflicting the patients in Guangdong’s hospitals. So on Christmas morning he came to Kowloon Park, an exquisitely maintained expanse of manicured greenery, flower beds, and faux waterfalls at the heart of central Kowloon, just off a stretch of Nathan Road known as the Golden Mile for the bountiful commerce of its shops and boutiques. Toward the center of the park, fringed by palms and shade trees, was the man-made lake where several dozen species, including flamingos, ducks, geese, and teal, frolicked in the water and sunbathed on the banks. Guan laid out his gear. Meticulously, he clasped a small vial in his curled pinky, leaving the rest of his fingers free. As a colleague restrained the first bird, Guan slowly inserted a Q-tip-like swab into its cloaca and withdrew a specimen. Guan sampled at least a dozen birds this way. Most later tested positive in the lab for avian flu.

He and fellow researcher Malik Peiris also continued to stalk the strain into the Mai Po Marshes of the New Territories. There the mudflats and mangroves offered a refuge unique in Hong Kong for hundreds of species of wild birds. The scientists drove up before dawn. It was a cold, damp morning. Though they were wrapped in heavy coats, the chill penetrated Guan’s bones. He pushed a small boat into the dark water, mud soaking his sneakers, and then rowed across the narrow inlet. He came ashore on Duck Island, a sliver of land that fittingly boasted more than twenty species of ducks. It was too hard to catch these birds. So for an hour and a half, Guan scoured the ground for their droppings. Live virus would be lurking inside.

The specimens collected from scores of birds in Hong Kong suggested that the mystery outbreak in Guangong’s hospitals was H5N1. But by February 2004, Guan and his fellow microbiologists realized there was no substitute for actual human samples. Someone would have to go to Guangzhou to get them.