The Fatal Strain (21 page)

“I never imagined the changes when I started out,” he told me, chuckling softly, creases deepening at the corners of his eyes. He spoke with the exaggerated inflection of a Suphan Buri native. Even today, this distinct accent marks people from the province as something of country bumpkins, at least in the reckoning of their cosmopolitan Bangkok cousins. But they’re hardly poor yokels. Prathum eventually bought twenty acres of land, more than tripling the size of his holdings, and erected seven open-sided sheds, each stretching about forty yards under pitched metal roofs. His flock reached fifteen thousand birds. And with average Thai consumption of eggs doubling in just a decade, Prathum’s hens were indeed laying gold. “We got a better income so we could do whatever we wanted,” he continued, gently shaking his head with wonder and then bowing it slightly to acknowledge the good fortune. “I feel grateful to the chickens. Chickens are like human beings. You take care of them and they’ll take care of you.”

Three years after he started chicken farming, this broad-shouldered peasant who had once been unable to afford even a motorbike bought a used Ford pickup. A few years later, after the increasingly prosperous village put in paved roads, he added a second, a new one. He knocked down his old shack, replacing it with an airy wood-frame dwelling three times as large. He furnished it with a refrigerator, color television, and air-conditioning. To give his teenage daughter privacy, he later built her a separate room, her territory marked by a Britney Spears poster on the outside of the door. He then went on to construct a second house, a retreat on the edge of some neighboring paddies, and started taking vacations with his family, renting a van twice a year and driving to the mountains of northwestern Thailand. For each of his three children, he bought a new computer. One son went on
to study veterinary science at the university in Bangkok; the other, computer engineering.

But then, a dozen years after he answered their calling, chickens changed his life again. On a warm December morning in 2003, truck-loads of livestock officers swept into Banglane. It was no surprise. Prathum knew that flu had broken out in a neighbor’s poultry shed just beyond a nearby canal.

In less than a generation, a livestock revolution had brought unthinkable wealth to dirt-poor peasants, not just in Thailand but across much of East Asia, and dramatically enhanced the diets of tens of millions of people. But now this fundamental transformation of Asian farming was posing a threat unprecedented in the history of human economy. By packing together so many birds, often in close quarters with people, pigs, and other livestock, farmers like Prathum have created ideal conditions for a flu pandemic. The sheer number of birds has opened the door for the disease to take hold. The proximity of other creatures heightens the chance it will jump species, swap genes, and mutate. Cramped together, these flocks are dry tinder awaiting a conflagration that could race across farms, provinces, and national borders, burning through the unrivaled concentrations of humanity in their midst.

This far-reaching economic change is but one of the factors making East Asia so treacherous for those struggling to avert a pandemic. The same forces of globalization that birthed the Asian tiger economies can now speed the flu virus around the globe within a day. Traditional Asian practices, from cockfighting to live poultry markets, have acquired a sinister cast, defying efforts by WHO and its allies to reform them before they seed a pandemic. Confronted with these hostile realities on the Asian terrain, the world would hope for a demonstration of political will equal to the threat. Instead Asian governments have repeatedly hushed up their outbreaks until death’s reach caught them in the lie.

When the livestock officers descended on Prathum’s farm, he tried to turn them back. He vowed his hens were healthy. But he realized the battle was lost.

“Everyone has to abide by the government’s decision,” a senior officer urged him. “Go with the flow.”

Prathum shuffled through the sheds, counting his birds so he could apply for compensation.

“Where do you want us to dig the hole?” the officer asked.

Prathum motioned to the edge of his property and left. He couldn’t watch.

 

 

 

Since animals were first domesticated ten thousand years ago, they have promised humans a richer, fuller life but all too often delivered death. As scientist Jared Diamond notes, the peoples who first drew animals into their daily lives were the first to fall sick, infected by germs descended from those afflicting their livestock. Though these pioneers later developed a measure of immunity, mankind has continued to be ravaged by such offspring diseases. Many of the most prodigious killers of the modern era, including measles, tuberculosis, smallpox, and, of course, flu, have evolved from animal pathogens.

The majority of illnesses that now strike humans are cross-species zoonotic diseases. Of the 1,415 human pathogens that have been catalogued, about 60 percent also cause disease in animals. These microbes can hopscotch among species and mutate along the way, acquiring new, more lethal characteristics. An even higher proportion of previously unknown human diseases, about three-quarters, originate in animals. These maladies include recent arrivals like SARS, which passed from infected civets in China to humans before spreading to thirty countries in 2003, and West Nile Virus, which first appeared in the Western Hemisphere in 1999, before going on within a decade to sicken people across much of the United States and become endemic in the country’s wild birds. Indeed, the emergence of new, zoonotic diseases has ominously accelerated since the 1970s. “Similar to the time of animal domestication, which triggered the first zoonoses era a number of millennia ago, a group of factors and driving forces have created a special environment responsible for the dramatic upsurge of zoonoses today,” writes the National Academy of Science.

Chief among these causes is development, which is extending human settlement into new habitats and bringing people into contact with animals as never before. In late 1998 a mystery illness erupted in
the Malaysian district of Nipah, infecting 265 people and killing more than 100. While local health officials initially identified the disease as encephalitis because it often caused inflammation of the brain, investigators later concluded it was an entirely new pathogen. They discovered that the virus was carried by fruit bats, which gathered in trees on newly developed pig farms. The bats infected the pigs and the pigs infected the farmers. To break this chain, 1.2 million pigs were ultimately slaughtered.

But the classic example of the unintended consequences of progress is not a new one: bubonic plague. Some scholars have posited that the opening of trade routes between China and Europe in the Middle Ages was responsible for conveying the Black Death from its source in Asia’s Gobi Desert to its killing fields in the West. The plague bacterium had found itself a permanent home in the burrowing rodents of the Asian steppe. Marco Polo himself had remarked on the great number of what he called “Pharoah’s rats” that he encountered in the Gobi Desert. Caravans of the mid-fourteenth century snaked through their habitat, steadily carrying infected rats and fleas onward toward the Crimea and Europe’s doorstep.

Some researchers have contested this account, saying evidence of plague in China centuries ago is thin. But another recent pandemic makes an even more convincing case for the fateful relationship between progress and plague and for East Asia’s starring role in this drama. In the late eighteenth century, plague erupted in southern China, not far from the Burmese border. During the preceding decades, hundreds of thousands of migrants had streamed into a largely undeveloped corner of Yunnan province, lured by a boom in copper mining. This explosive growth transformed the area from a rural hinterland into an increasingly urban outpost and exposed the miners, merchants, transporters, and various other fortune hunters, laborers, and camp followers to plague bacteria long harbored by local mice and voles. Caravan trade in copper, as well as other minerals, salt, cotton, tea, and grain, dispersed the disease around the province. With the acceleration of long-distance trade in opium grown in Yunnan, plague spilled beyond the provincial borders. This lucrative commerce carried the epidemic inexorably eastward, by land, river, and sea, past the
border regions north of Vietnam until the Pearl River delta and Hong Kong fell prey in the last decade of the nineteenth century.

When the epidemic came ashore in the spring of 1894, it ravaged Hong Kong. Corpses were left abandoned in the streets of the British colony. Stores and houses were shuttered, draining the once teeming quarters of life but for the English infantry. The soldiers went from home to Chinese home in search of the sick and dead, forcibly disinfecting furniture, sheets, and kitchenware and carrying off the ailing to a great ghostly ship, the
Hygeia
, moored three hundred yards off the waterfront. “Little wonder, then, that this malevolent-looking hulk, pressed into service at the start of May 1894 as a floating plague hospital, should have become an object of terror,” recounts author Edward Marriott. Local Chinese resisted the raids, and some doctors took to carrying revolvers for protection. It was whispered that the
Hygeia
was no hospital but a sinister laboratory where the English were concocting a cure from the livers and other organs of patients. Fearing the abduction of their children, mothers pulled them from classes, and by the middle of May, half of Hong Kong’s schools had closed. About eighty thousand Chinese fled the colony altogether. And though international shipping companies urgently rerouted their vessels to bypass what had been the world’s fourth-busiest port, the plague would not be denied, eventually spreading as far as San Francisco.

 

 

Six years earlier, in 1888, another epidemic had struck Hong Kong. Its stay was less tumultuous but its symptoms nonetheless severe. James Cantlie, a fellow of the Royal College of Surgeons posted in the colony at the time, reported that patients suffered from headaches, backaches, and sore eye sockets and limbs. At times the pain was agonizing. Nearly all had runny noses, and many suffered from coughs, diarrhea, and vomiting. Some complained of jaundice, profuse rash, and mottled skin. Their fever would usually spike by the third day, approaching 104 degrees. When the disease first broke out, Cantlie misdiagnosed it as a form of “tropical measles.” Others called it dengue fever. But by the time Cantlie reported his findings in 1891, he knew what it was. In the intervening years, an influenza epidemic had
sprinted around the world. The Europeans dubbed it the Russian flu, because it came from the east. The Russians in turn called it the Chinese flu. Cantlie told readers of the
British Medical Journal
that the Hong Kong outbreak had in fact been the first recorded appearance of this flu pandemic and its original source. Moreover, after conducting research among the Chinese, he concluded that flu was endemic in China.

Writing a century later, another Westerner who devoted his career to medical inquiry in Hong Kong determined that China was the “epicenter” of all influenza viruses. Kennedy Shortridge has been one of the world’s premier scholars of flu, a lanky Australian with thick, graying eyebrows and a deep melodious voice. He spent three decades as a microbiologist in Hong Kong before retiring to New Zealand. His research pinpoints southern China, and in particular the Pearl River delta of Guangdong province, adjacent to Hong Kong, as the cradle of the world’s flu. He noted that the natural hosts for flu viruses are aquatic birds, harboring the microbes in their guts, with ducks playing a unique and leading role. Before the rise of China’s Qing dynasty in the mid-seventeenth century, duck herders grazed their flocks along riverbanks and in canals and other waterways. But that changed in response to a mounting problem with pests in the rice paddies of southern China. Ducks were introduced into the paddies and fed on the insects and snails. When rice plants started to sprout, the flocks were temporarily rotated elsewhere. This elegantly balanced agrarian system made ducks far more profitable, and their population soared. With as many as five rice harvests annually in Guangdong, ducks became a year-round presence in the densely populated villages of the delta, and duck droppings, often larded with virus, became ubiquitous. Pigs snuffed up the fecal matter, offering themselves as a natural laboratory for gene swapping, because they can contract both bird and human flu viruses at the same time. Contagion was everywhere, Shortridge observed. It was a recipe for repeated epidemic.

The flu pandemic of 1957 is known as the Asian flu. Western countries learned of it after it was identified in Singapore. But Shortridge told me the strain had actually been isolated earlier in China’s southern Guizhou province. The 1968 pandemic was dubbed the
Hong Kong flu. Yet Shortridge asserts that this, too, arose first on the mainland, specifically Guangdong, but the mainland Chinese were too preoccupied with the Cultural Revolution to take note. Hong Kong was just about the only conduit out at the time. It caught the bug and lent its name.

The origin of the 1918 Spanish flu is a matter of greater dispute. All agree the epidemic did not start in Spain. It only took this name because the Spanish were willing to report it. Unlike the United States and the European powers embroiled at the time in World War I, Spain was neutral and did not censor news deemed to undercut morale. Spain broke with their policy of censoring news about the outbreak. The flu made headlines in Spain, and eventually the press in other countries picked up reports of this “Spanish” flu.

American author John Barry has made a strong case for Haskell County, Kansas, as the origin of the pandemic. He cites medical reports as evidence of an extraordinary flu outbreak there in early 1918 and describes how the county’s young men would have reported to an army camp three hundred miles to the east before being deployed with their germs to the European front. British virologist John S. Oxford, by contrast, has postulated that the scourge first arose at a mammoth British army camp in northern France, where many soldiers had been treated in 1916 for what was then diagnosed as acute purulent bronchitis. Oxford’s review of those clinical findings concluded that the outbreak was actually pandemic flu.