The Fatal Strain (56 page)

188 about 7,500 years:
Barbara West and Ben-Xiong Zhou, “Did Chickens Go North? New Evidence for Domestication,”
Journal of Archaeological Science
15 (1988): 515-33.

188 most likely in Thailand itself:
Akishinonomiya Fumihito et al., “One Subspecies of the Red Junglefowl (
Gallus gallus gallus
) Suffices as the Matriarchic Ancestor of All Domestic Breeds,”
PNAS
91 (Dec. 1994), 12505-9.

188 red jungle fowl:
Ibid.

189 “fight for kingdoms”:
“Commemoration of King Naresuan: The Nation’s Great King 400 Years Ago,” Welcome to Chiangmai and Chiangrai, n.d.,
www.chiangmai-chiangrai.com/king_n.html
(accessed Feb. 16, 2009).

190 Yuenyong included the song:
Charles Piller, “Squawking at Bird Flu Warning,”
Los Angeles Times,
Sept. 1, 2005.

196 clear their throats:
For the various details of this case, see Vijay Joshi, “Thai Man Dies of Bird Flu, Asian Toll Rises to 28,” Associated Press, Sept. 9, 2004; “Bird Flu Kills 18-Year-Old Man in Thailand,” Kyodo News Service, Sept. 9,
2004; and “Thai Man Dies of Bird Flu: Health Ministry,” Agence France Presse, Sept. 9, 2004.

197 had died in previous weeks:
“Breeder Dies from Bird Flu,”
Nation
(Thailand), Sept. 10, 2004.

197 “The victim failed to report”:
Anusak Konglang, “Thailand Reports First Bird Flu Death in Over Seven Months,” Agence France Presse, July 26, 2006.

197 villagers had declined to notify officials:
“Thailand Tries to Improve Bird Flu Monitoring,” Reuters, June 27, 2006.

198 The state’s chief minister:
“Repent, Nik Aziz Tells Cockfighting Buffs,”
Bernama,
Sept. 23, 2004.

198 Thailand shipped nearly six thousand:
Kasikorn Research Center, Feb. 10, 2004, cited in “Raising Domestic Chicken Breeds: Interesting,” Thai Press Reports, Feb. 11, 2004.

198 illegal cockfighting tours:
“Cock-fighting Birds Likely Culprit in Mukdahan H5N1 Outbreak,”
Nation
(Thailand), Mar. 21, 2007.

200 30 million households:
“Govt Defends Its Bird Flu Measures,”
Jakarta Post,
Aug. 10, 2006.

200 “greatest single challenge”:
Comments from the U.S. Agency for International Development in appendix 2 of
Influenza Pandemic: Efforts to Forestall Onset Are Underway; Identifying Countries at Greatest Risk Entails Challenges
, Government Accountability Office, June 2007, GAO-07-604.

201 force poultry farming underground:
Juan Lubroth at an FAO press conference in Bangkok, quoted in FAO news release, “New Bird Flu Outbreaks Require Strong Vigilance,” Jan. 23, 2007.

202 continue to take risks:
Sowath Ly et al., “Interaction Between Humans and Poultry, Rural Cambodia,”
Emerging Infectious Diseases
13, no. 1 (Jan. 2007): 130-32; and H. M. Barennes et al., “Avian Influenza Risk Perceptions, Laos,”
Emerging Infectious Diseases
13, no. 7 (July 2007): 1126-28.

203 thirteen thousand live poultry markets:
Joseph Domenech et al., “Trends and Dynamics of HPAI—Epidemiological and Animal Health Risks,” Background Paper at the Technical Meeting on Highly Pathogenic Avian Influenza and Human H5N1 Infection, Rome, June 27-29, 2007.

203 a perilous nexus:
Robert G. Webster, “Wet Markets—a Continuing Source of Severe Acute Respiratory Syndrome and Influenza?”
Lancet
363, no. 9404 (Jan. 17, 2004): 234-36. See also Writing Committee of the Second World Health Organization Consultation on Clinical Aspects of Human Infection with Avian Influenza A (H5N1) Virus, “Update on Avian Influenza A (H5N1) Virus Infection in Humans,”
NEJM
358, no. 3 (Jan. 17, 2008): 261-73; and L. D. Sims, “Lessons Learned from Asian H5N1 Outbreak Control,”
Avian Diseases
51 (2007): 182-88 (2007).

203 “missing link”:
D. A. Senne, J. E. Pearson, and B. Panigrahy, “Live Poultry Markets: A Missing Link in the Epidemiology of Avian Influenza,” in B. C. East erday, ed.,
Proceedings of the Third Annual Symposium on Avian Influenza, Madison, Wisconsin
(Richmond, VA: U.S. Animal Health Association, 1992).

203 1997 human outbreak in Hong Kong:
J. C. de Jong et al., “A Pandemic Warning?”
Nature
389, no. 6651 (Oct. 9, 1997): 554; Eric C. J. Claas et al., “Human Influenza A H5N1 Virus Related to a Highly Pathogenic Avian Influenza Virus,”
Lancet
351, no. 9101 (Feb. 14, 1998): 472-77; and Anthony W. Mounts et al., “Case-Control Study of Risk Factors for Avian Influenza A (H5N1) Disease, Hong Kong, 1997,”
Journal of Infectious Diseases
180 (1999): 505-8.

203 returned to Hong Kong’s markets:
L. D. Sims et al., “Avian Influenza in Hong Kong 1997-2002,”
Avian Diseases
47 (2003), no. s3: 832-38.

203 On the mainland:
Ming Liu et al., “The Influenza Virus Gene Pool in a Poultry Market in South Central China,”
Virology
305, no. 2 (Jan. 20, 2003): 267-75.

203 six city dwellers:
Hongjie Yu et al., “Human Influenza A (H5N1) Cases, Urban Areas of the People’s Republic of China, 2005-2006,”
Emerging Infectious Diseases
13, no. 7 (July 2007): 1061-64.

207 a rapid-response unit:
Interview with Nick Marx, WildAid.

207 imported by the tens of thousands:
Hong Kong government press release, Jan. 6, 2007.

207 principal threat of reinfection:
Mary Ann Benitez, “Ban Wild Bird Imports, Experts Say,”
South China Morning Post,
Jan. 20, 2007.

213 related to the Guangdong goose isolate:
Xiyan Xu et al., “Genetic Characterization of the Pathogenic Influenza A/Goose/Guangdong/1/96 (H5N1) Virus: Similarity of Its Hemagglutinin Gene to Those of H5N1 Viruses from the 1997 Outbreaks in Hong Kong,”
Virology
261, no. 1 (Aug. 15, 1999): 15-19.

213 At least three other academic papers:
H. Chen K. Yu, and Z. Bu, “Molecular Analysis of Hemagglutinin Gene of Goose Origin Highly Pathogenic Avian Influenza Virus,”
Agricultural Sciences in China
32 (1999): 87-92; X. Tang et al., “Isolation and Characterization of Prevalent Strains of Avian Influenza Viruses in China,”
Chinese Journal of Animal and Poultry Infectious Diseases
20 (1998): 1-5; and Y. Guo, X. Xu, and X. Wen, “Genetic Characterization of an Avian Influenza A (H5N1) Virus Isolated from a Sick Goose in China,”
Chinese Journal of Experimental and Clinical Virology
12, no. 4 (Dec. 1998): 322-25.

213 continued to deny publicly:
See, for example, “Authorities Deny Claim on Disease,”
Chinadaily.com
, Mar. 7, 2007.

213 spawned the wider epidemic:
On Guangdong as the continuing source of H5N1 virus strains that spread internationally, see, for example, Robert G. Wal lace et al., “A Statistical Phylogeography of Influenza A H5N1,”
PNAS
104, no. 11 (Mar. 13, 2007): 4473-78. For a discussion of the precursor flu viruses that gave birth to H5N1, see, for example, L. Duan et al., “Characterization of Low-Pathogenic H5 Subtype Influenza Viruses from Eurasia: Implications for the Origin of Highly Pathogenic H5N1 Viruses,”
Journal of Virology
81, no. 14 (July 2007): 7529-39; and Zi-Ming Zhao et al., “Genotypic Diversity of H5N1 Highly Pathogenic Avian Influenza Viruses,”
Journal of General Virology
89 (2008): 2182-93.

213 just months before the Hong Kong cases:
See, for example, Rone Tempest, “Hong Kong to Extend Poultry Ban to Ensure Avian Virus Is Eradicated,”
Los Angeles Times,
Dec. 31, 1997. Chinese authorities may also have covered up poultry outbreaks in Guangdong in Oct. 2003. See Dennis Chong, “Guangdong Hid Deaths,”
Standard
(Hong Kong), Feb. 4, 2004.

213 continuing to circulate:
Angela N. Cauthen et al., “Continued Circulation in China of Highly Pathogenic Avian Influenza Viruses Encoding the Hemagglutinin Gene Associated with the 1997 H5N1 Outbreak in Poultry and Humans,”
Journal of Virology
74, no. 14 (July 2000): 6592-99; and Robert G. Webster et al., “Characterization of H5N1 Influenza Viruses That Continue to Circulate in Geese in Southeastern China,”
Journal of Virology
76, no. 1 (Jan. 2002): 118-26.

213 geese and ducks exported from Guangdong:
Yi Guan et al., “H5N1 Influenza Viruses Isolated from Geese in Southeastern China: Evidence for Genetic Reassortment and Interspecies Transmission to Ducks,”
Virology
292, no. 1 (Jan. 5, 2002): 16-23.

213 duck meat exported from Shanghai:
Terrence M. Tumpey et al., “Characterization of Highly Pathogenic H5N1 Avian Influenza A Virus Isolated from Duck Meat,”
Journal of Virology
76, no. 12 (June 2002): 6344-55; and X. H. Lu et al., “Pathogenesis of and Immunity to a New Influenza A (H5N1) Virus Isolated from Duck Meat,”
Avian Diseases
47 (2003): 1135-40.

213 had repeatedly come back positive:
H. Chen et al., “The Evolution of H5N1 Influenza Viruses in Ducks in Southern China,”
PNAS
101, no. 28 (July 13, 2004): 10452-57. For more discussion of the virus in Chinese ducks, see L. D. Sims et al., “Origin and Evolution of Highly Pathogenic H5N1 Avian Influenza in Asia,”
Veterinary Record
157, no. 6 (Aug. 6, 2005): 159-64.

213 China as the wellspring:
H. Chen et al., “Establishment of Multiple Sublineages of H5N1 Influenza Virus in Asia: Implications for Pandemic Control,”
PNAS
103, no. 8 (Feb. 21, 2006): 2845-50. China’s health ministry dismissed this study, saying it jumped to conclusions. See Mary Ann Benitez and Joseph Ma, “H5N1 Kills 8th Person on Mainland,”
South China Morning Post,
Feb. 11, 2006.

214 vaccinating their flocks against it:
Debora MacKenzie, “Bird Flu Outbreak Started a Year Ago,”
New Scientist,
Jan. 31, 2004.

214 an even riskier strategy:
The account of amantadine use in Chinese poultry flocks is based on extensive interviews with animal-health experts and executives of pharmaceutical companies.

214 had become resistant to the drug:
On amantadine resistance among some H5N1 variants, see K. S. Li et al., “Genesis of Highly Pathogenic and Potentially Pandemic H5N1 Influenza Virus in Eastern Asia,”
Nature
430 (July 8, 2004): 209-13; T. T. Hien et al., “Avian Influenza A (H5N1) in 10 Patients in Vietnam,”
NEJM
350 (2004): 1179-88; Natalia A. Ilyushina, Elena A. Govorkova, and Robert G. Webster, “Detection of Amantadine Resistant Variants Among Avian Influenza Viruses Isolated in North America and Asia,”
Virology
341, no. 1 (Oct. 10, 2005), 102-6; and Chung-Lam Cheung et al., “Distribution of Amantadine-Resistant H5N1 Avian Influenza Variants in Asia,”
Journal of Infectious Diseases
193 (June 15, 2006): 1626-29.

215 used the drug in poultry:
Fu Jing, “Misuse of Antiviral on Poultry Must Stop,”
China Daily,
June 21, 2005.

216 in a pair of Hanoi markets:
Doan C. Nguyen et al., “Isolation and Characterization of Avian Influenza Viruses, Including Highly Pathogenic H5N1, from Poultry in Live Bird Markets in Hanoi, Vietnam, in 2001,”
Journal of Virology
79, no. 7 (Apr. 2005): 4201-14.

216 a new variant of the H5N1 virus:
J. Wang et al., “Identification of the Progenitors of Indonesian and Vietnamese Avian Influenza A (H5N1) Viruses from Southern China,”
Journal of Virology
82, no. 7 (Apr. 2008): 3405-14.

216 how it decimated poultry:
Interviews with animal health officials in Ha Tay and Vinh Phuc provinces.

216 Japfa’s annual corporate filings:
PT Japfa Comfeed Indonesia Tbk, Annual Report 2003; PT Multibreeder Adirama Indonesia Tbk, Annual Report 2003; and PT Japfa Comfeed Indonesia Tbk, Annual Report 2004.

216 hushed up their findings:
Karl Taro Greenfeld, “On High Alert,”
Time Asia,
Jan. 26, 2005.

217 “the first signs of an epidemic”:
Ibid.

217 first outbreak eventually confirmed:
T. Delquigny et al., “Evolution and Impact of Avian Influenza Epidemic and Description of the Avian Production in Vietnam,” final report for FAO’s TCP/RAS/3010, Emergency Regional Support for Post Avian Influenza Rehabilitation (Rome: UN Food and Agriculture Organization, 2004).

218 at least three separate occasions:
H. Chen et al., “Establishment of Multiple Sublineages of H5N1 Influenza Virus in Asia: Implications for Pandemic Control,”
PNAS
103, no. 8 (Feb. 21, 2006): 2845-50.

218 the government had not responded:
Ben Rowse, “Hospitalized Woman in Vietnam Tests Positive for Bird Flu,” Agence France Presse, Aug. 16, 2004.

218 were going unanswered:
E-mail, Aug. 13, 2004.

218 “So basically, bugger all”:
E-mail, Aug. 17, 2004.

218 “grave concerns”:
Avian influenza update, WHO, Report from Hanoi office, Mar. 16, 2005.

218 they were flying blind:
E-mail exchange between senior WHO officials in Geneva, Mar. 13, 2005.

220 widely praised by UN agencies:
See, for example, FAO news release, “Once Hard Hit by Bird Flu, Vietnam Consolidates Progress,” Dec. 6, 2006; and WHO, “Successful Strategies in Controlling Avian Influenza,” INFOSAN Information Note no. 4/2006, Aug. 14, 2006.

220 called its performance “remarkable”:
Comments from the U.S. Agency for International Development in appendix 2 of
Influenza Pandemic: Efforts to Forestall Onset Are Underway; Identifying Countries at Greatest Risk Entails Challenges,
Government Accountability Office, June 2007, GAO-07-604. The term
remarkable
was applied to both Vietnam and Thailand.

220 “The situation is alarming”:
“Vietnam Battles Three Bird Flu Outbreaks,” DPA (German Press Agency) article published in the
Bangkok Post,
Dec. 22, 2006.

222 Their revelations hit the streets:
Duc Trung and Hoai Nam, “Chances of Bird Flu to Break Out, Quarantine Papers Are Sold like Vegetables,”
Thanh Nieh,
Aug. 16, 2005.

222 spread to nearly one-third of Indonesia’s provinces:
Remarks of Agriculture Minister Bungaran Saragih in Material of Consultative Meeting Between Minister of Agriculture and Commission III DPR on Avian Influenza, Jan. 29, 2004.

222 provenance of the Indonesian strain:
J. Wang et al., “Identification of the Progenitors of Indonesian and Vietnamese Avian Influenza A (H5N1) Viruses from Southern China,”
Journal of Virology
82, no. 7 (Apr. 2008): 3405-14.

223 separate findings of a pathologist:
Walujo Budi Priyono of the Disease Investigation Centre in Yogyakarta, quoted in FAO news release, “Virus Detective Work in Indonesia: The Case of the Mysterious Livestock Disease,” 2005.

223 “As of now, there are no findings”:
Sofyan Sudrajat in
Republika,
Jan. 25, 2004.

224 10 million chickens:
“Death of 10 Million Laying Hens in Indonesia from Bird Flu,”
Kompas,
Jan. 25, 2004.

224 trade in poultry and poultry products:
G. J. D. Smith et al., “Evolution and Adaptation of H5N1 Influenza Virus in Avian and Human Hosts in Indonesia and Vietnam,”
Virology
350 (2006): 258-68.

224 “Indonesia is a time-bomb”:
“Indonesia Is a Bird-Flu Time-Bomb, Animal Health Chief,” Agence France Presse, Apr. 14, 2006.

225 She repeated her allegations:
Agnes Aristiarini, “Fighting Against Bird Flu,”
Kompas,
Sept. 20, 2005.

225 because of party politics:
“Avian Flu Expert Speaks Out,”
Van Zorge Report
, Apr. 12, 2006.

226 “the lack of a national strategy”:
Katia Dolmadjian, “Animal Health Experts Discuss Merits of Vaccination Against Bird Flu,” Agence France Presse, Mar. 22, 2007. On how the poultry epidemic in Indonesia continued to pose a threat to
human health, see Endang R. Sedyaningsih et al., “Epidemiology of Cases of H5N1 Virus Infection in Indonesia, July 2005-July 2006,”
Journal of Infectious Diseases
196 (Aug. 15, 2007): 522-27.

226 the commission formally acknowledged:
The commission wrote, “Indonesia reported its first case of H5N1 infection in poultry in Pekalongan and [the Jakarta suburb of] Tangerang Regencies in August 2003.” Media release, “Indonesia after 2 years, 99 cases,” KOMNAS FBPI, June 6, 2007.

226 “I will remember the support”:
Josephine Ma and Mary Ann Benitez, “Beijing Agrees to Share Bird Flu Samples Sooner,”
South China Morning Post,
Dec. 2, 2006.

227 “my nationality on my sleeve”:
Mary Ann Benitez, “A Giant Responsibility,”
South China Morning Post,
Nov. 12, 2006.

228 “We will have to look”:
Ma and Benitez, “Beijing Agrees.”

228 “No nation has the right”:
“Health Diplomacy in the 21st Century,” address to Directorate for Health and Social Affairs, Norway, Oslo, Feb. 13, 2007.

228 a cause for concern:
Doubts about China’s openness in dealing with bird flu escalated in June 2006, when Chinese researchers disclosed that mainland China had had its first human case in November 2003, two years earlier than authorities had previously reported. See Qing-Yu Zhu et al., “Fatal Infection with Influenza A (H5N1) Virus in China,”
NEJM
354, no. 25 (June 22, 2006): 2731-32.

228 “What on earth is going on?”:
E-mail, Apr. 19, 2006.

228 a related outbreak in poultry:
WHO’s chief representative in China, Hank Bekedam, expressed public frustration, saying, “That is not a good record.” Audra Ang, “WHO: Bird Flu Continues to Be Public Health Threat in China as New Case Reported in Military,” Associated Press, May 28, 2007.

228 without fully disarming the virus:
A general warning about the difficulty of monitoring for bird flu in areas where poultry immunization is widely but imperfectly practiced can be found in Influenza Team, European Centre for Disease Surveillance and Control, “World Avian Influenza Update,”
Eurosurveillance
11, no. 6 (2006): 060622.

228 exposure to this second strain, H9N2:
For a fuller discussion of the dangers posed by cocirculation of H9N2 and H5N1, see Alexey Khalenkov et al., “Modulation of the Severity of Highly Pathogenic H5N1 Influenza in Chickens Previously Inoculated with Israeli H9N2 Influenza Viruses,”
Virology
383 (2009): 32-38.

229 the politics of China’s public health system:
Huang’s exploration of infectious-disease policy in China can be found in his writings, including “China’s Response to Avian Flu,” paper delivered at SAIS China Forum, Mar. 18, 2006, Washington; “The Political Challenges of Health Crises in China,” speech at the Conference on Asia and the Science and Politics of Pandemics, CNA Corp., Feb. 3, 2005; and “The Politics of China’s SARS Crisis,”
Harvard Asia Quarterly,
Fall 2003.

229 transformed the country’s health sector:
See also Nan-Shan Zhong and Guang-Qiao Zeng, “Pandemic Planning in China: Applying Lessons from Severe Acute Respiratory Syndrome,”
Respirology
13, suppl. 1 (2008): S33-S35.

229 did not extend to the agriculture ministry:
See, for example, “Sanitising the Record; Infectious Diseases in China,”
Economist,
July 1, 2006.

229 the central government wasn’t sure:
Notes of WHO meeting with Hui Liangyu in e-mail, Feb. 6, 2004. Two years later, the Chinese health ministry was still complaining that local authorities were failing to report possible cases of bird flu in a timely fashion. See, for example, Nicholas Zamiska, “China Bird-Flu Data in Doubt,”
Wall Street Journal,
Apr. 27, 2006.