The Fatal Strain (48 page)

Maybe so. But yet another source of vital intelligence had been choked off. Indonesia had severed the supply of virus samples to the world’s labs. It had shut down the one lab inside the country capable of fully analyzing specimens. And now the government had deprived flu hunters, and Indonesians themselves, of information needed to confront a budding epidemic. Supari promised that all details would be released in time. But time is the most precious commodity when it comes to flu.

The fracture between haves and have-nots now yawned wide. Even as the novel strain increasingly marked its territory in Indonesia, the world became ever less able to chart its progress.

CHAPTER TWELVE

Peril on the Floodplain

T
he figures first appeared on the ridgeline. They emerged one after another from behind a bluff in the middle distance, more than a dozen of them. Then, like ants, they started down a dirt track hewn from the lush, sculpted mountains separating Vietnam from China. The descent was steep, the footing treacherous. The slopes above were densely forested. But the trail itself was broad and exposed, the deep brown earth well trampled. As the smugglers drew closer, their stooped forms became visible in the afternoon light. Their backs heaved under the weight of their freight. Soon the cargo came into view. They were hauling bamboo cages crammed with live, bootleg chickens.

On the paved road below, two young men waited, mounted on a pair of red dirt bikes. They were lookouts. My Vietnamese driver had pulled our car to the side so I could check out the foot traffic coming over the border. Now, as I stood beside the guardrail, staring past a cornfield up into the craggy cliffs, I was the one being checked out. The two sentinels revved their engines and brazenly approached, slowing briefly as they buzzed by. Several dozen yards away, they stopped their bikes. One man produced a two-way radio and barked into it. Though his words were inaudible to my translator and me, within moments the figures on the slopes above began to shift to the edge of the track and melt into the surrounding brush. Yet almost instantly, more traffickers appeared over the ridge from China. Even more were bounding down a second path about a hundred yards to the left. This
trail was narrower, largely concealed by banana palms and other trees. These smugglers apparently figured I couldn’t see them and continued their progress undeterred by the alarm.

I had come to the village of Dong Dang escorted by two provincial officials. Now, with some urgency, they were inviting me to get back in the car. The smugglers were a violent lot, known to set upon outsiders with stones, even guns. In recent weeks, the traffickers had bat tled soldiers dispatched to intercept them. In one case, five troops had been injured and their car destroyed. I quickly understood who had the upper hand. “You can put helicopters up there, really mobilize the army and put all kinds of resources in, and it would still go on,” Jeffrey Gilbert of the UN Food and Agriculture Organization told me after I returned to Hanoi. “It’s like the Ho Chi Minh trail.”

Every day, despite an import ban, the smugglers were hauling more than a thousand contraband chickens into Lang Son, one of six Vietnamese provinces along the untamed Chinese frontier. In Lang Son alone, the jagged border runs for 150 miles through angular, misty mountains that seem drawn from a stylized Oriental painting. The highest peak, Mau Son, rises nearly 4,500 feet. It also lends its name to the local rice wine, widely sold in unmarked, five-hundred-milliliter plastic bottles for about sixty cents each. My government escorts had knocked back enough shots over lunch that it had taken some of the edge off their anxiety.

For centuries, extended tribal families straddling the border have navigated highland footpaths to run goods from one side to the other. In recent years these had come to include electronics, DVDs, exotic wildlife, and all sorts of clothes and shoes. The illicit poultry business had turned lucrative in 2004 after Vietnam began slaughtering about 50 million chickens to contain its bird flu epidemic. The resulting shortage of chicken meat, a favorite protein source for the Vietnamese, sent prices soaring on their side of the border. But with the increase in the illegal poultry trade, the traffickers had also unknowingly—and repeatedly—smuggled the virus from its source in southern China into Vietnam, at times introducing altered strains that bedeviled efforts to contain the outbreaks.

Two months before my visit to Lang Son in July 2006, Vietnamese
veterinary officials had disclosed they’d identified the virus in a sample taken there from smuggled chickens during a bust on the border. Two years later, provincial health authorities reported they were discovering H5N1 in nearly a quarter of all the illegally trafficked chickens they were confiscating. Researchers had already uncovered lab evidence implicating cross-border commerce in spreading the disease. In mid-2005 they had isolated a strain of the H5N1 virus in Vietnam that was entirely new to the country—different from the subtype that had burned through farms starting in 2003 and killed dozens of people—but similar to one found months earlier in China’s Guangxi region, just over the mountains from Lang Son. Another study published in 2008 found genetic evidence that the virus may have been introduced from Guangxi to northern Vietnam on “multiple occasions,” most likely by poultry trade.

An average of 1,500 birds came over the mountains into Long San each day, provincial officials reported. Along the entire Vietnam-China border, the total could run well into the thousands. The syndicates running the smuggling rings were paying local villagers about thirty cents a bird to haul the contraband along mountain trails that could snake for more than ten miles. Some smugglers, especially women and children, could carry only a few birds. But hardy highland men lugged as many as twenty at a time. Their earnings could far outstrip the salaries of animal-health officers, inspectors, and others charged with stemming the commerce.

Once the smugglers came down from the slopes, they often transferred their haul to motorbikes, which ferried it to local farms serving as transit depots. From there, the chickens were loaded onto trucks for transport, in many cases to the markets of Hanoi, five hours away, and points even farther south. The smugglers were repeatedly seeding new outbreaks, and each outbreak was affording the virus a new chance to ensnare human victims and, even more ominously, mutate. This was how the novel strain continued to press its offensive.

Do Van Duoc was the director of animal health in Lang Son, a friendly man with full cheeks and silver hair that sat atop his head like a mushroom cap. He explained it would be nearly impossible to stem the smuggling as long as prices on either side of the border were so
different. On average, chicken that sold for thirty cents a pound in China was fetching a dollar or more in his country. But that wasn’t the whole explanation. He accused Chinese farmers of unloading chickens from areas struck by bird flu at bargain-basement prices.

China’s agriculture ministry confirmed for me that poultry was being illegally transported into Vietnam. An investigation by Guangxi animal-health investigators had discovered three clandestine routes originating in different areas adjacent to Lang Son. But Chinese officials, true to form, denied that any birds coming from their side of the border were infected. Duoc wasn’t buying that. “We have evidence,” he told me. “We’ve tested and we can prove there’s H5N1.”

 

 

The farther influenza goes, the closer it comes to hitting the microbial jackpot. Extent means opportunity, more chances to mutate or swap genes. By 2009 the virus had stricken birds in at least sixty countries and spread to people in fifteen of them.

The strain made its debut in Europe in October 2004 when customs officers at Brussels airport discovered two infected eagles in a passenger’s hand luggage. A Thai traveler had smuggled them from Bangkok, wrapping the creatures in cotton cloth and shoving them headfirst into a pair of two-foot-long woven bamboo tubes. Then he had tucked these into an athletic bag, left unzipped slightly so the birds could breathe. His delivery had been destined for a Belgian falconer who had paid nearly $1,900 for the pair. They would have arrived unnoticed but for the passenger’s bad luck. He was stopped and searched as part of a random drug check. “We were very, very lucky,” Rene Snacken, the flu chief at Belgium’s Scientific Institute of Public Health, said at the time. “It could have been a bomb for Europe.”

But before long the virus indeed exploded out of East Asia. The startling outbreak among migratory birds at China’s Qinghai Lake in April 2005 had left Hong Kong’s Yi Guan and other scientists wondering where the virus might next wing. Over the following year, the disease struck birds in more than forty countries in Europe, Africa, South Asia, and the Middle East, and each time researchers checked,
they found the distinctive genetic signature of the Qinghai subtype. By that winter, a dozen people had fallen sick in Turkey, four fatally, bringing human casualties to Europe’s doorstep for the first time. Wild birds and domestic poultry were succumbing in more than two dozen European countries. Panic spread. In Paris, the famed bird market on the Île de la Cité removed all live fowl, and France’s annual livestock festival took the unprecedented step of banning poultry. In Britain, where legend claims that the monarchy will survive only as long as the ravens at the Tower of London, these celebrated birds were locked up for their own protection for the first time in history.

The virus struck in the Middle East amid the conflicts in Iraq and the Palestinian territories, where health officials were hard-pressed to respond. The disease also turned its wrath on Egypt, where denizens of Cairo, terrified to learn that chicken carcasses were being dumped in the Nile River, initially stopped drinking tap water. Soon Egypt would record more human cases and deaths than anywhere but Indonesia and Vietnam.

Then the disease crossed the desert to sub-Saharan Africa, infecting commercial farms in Nigeria and stoking fears that this indigent, ill-governed continent could become an entirely new breeding ground for a pandemic strain. Nigeria’s information minister told reporters, “While it was originally suspected that migratory birds may have been the purveyor of this disease, preliminary reports recently obtained from relevant security agencies indicate that there is a strong basis to believe that avian flu may have been introduced into Nigeria through illegally imported day-old chicks.” Scientists who later decoded the genetics of Nigerian samples concluded the virus had been introduced to the country three separate times along routes coinciding with the flight paths of wild birds. But the study also said imports could not be ruled out as the cause.

Once the virus was established in Nigeria, the epidemic spread, most likely along internal trade routes, and put neighboring countries in jeopardy because of widespread cross-border commerce. By the close of 2007, eleven African governments had reported outbreaks in birds, some in countries no better able than the poorest in Asia to confront the disease.

A rancorous debate has erupted over exactly how avian flu spreads.

Are wild birds the culprit, conveying the virus on their seasonal migrations? Or is it trade in poultry, legal or not, that inadvertently extends the global reach? Some wildlife conservation groups have said that migratory patterns aren’t a good match for the distribution of outbreaks, suggesting instead that the virus spread from Asia to Europe by commerce along the route of the Trans-Siberian Railroad. But other researchers have noted outbreaks near wintering sites for migratory birds and far from any farms or markets that could account for contamination. After more than a decade, there is now enough evidence to conclude that the novel strain has taken ample advantage of both these opportunities to advance across the Eastern Hemisphere.

 

 

 

Some countries have been able at times to roll back the tide of infection, notably those in Europe and more developed Asian states like Japan and South Korea. But elsewhere, the disease refused to surrender its foothold.

No one is better positioned to evaluate the viral storm gathering in the animal kingdom than Joseph Domenech, chief veterinarian of the UN Food and Agriculture Organization. In a series of public warnings starting in the fall of 2007 and running into 2008, Domenech offered a disturbing, though not universally bleak prognosis. “Surveillance and early detection and immediate response have improved and many newly infected countries have managed to eliminate the virus from poultry,” he reported. “But,” he continued, “the H5N1 avian influenza crisis is far from over.”

He singled out Indonesia as the place where bird flu had become most stubbornly entrenched. “I am deeply concerned that the high level of virus circulation in birds in the country could create conditions for the virus to mutate and to finally cause a human influenza pandemic,” Domenech said in another assessment in March 2008. “The avian influenza situation in Indonesia is grave—all international partners and national authorities need to step up their efforts for halting the spread of the disease in animals and making the fight against the virus a top priority.” He faulted a lack of money, poor coordination
among different levels of government in Indonesia’s decentralized political system, and insufficient commitment. With the strain in Indonesia actively undergoing genetic changes, Domenech warned that the virus was spinning off new subtypes that could elude the poultry vaccines meant to contain it.

Even when outbreaks ebb, it doesn’t mean flu has been beaten. It goes to ground, smolders, waits for an opening. Vietnam adopted a raft of eradication measures in late 2005, including a drive to vaccinate tens of millions of chickens and ducks. Officials also imposed a ban on live markets and poultry farming in cities, tightened regulations on transporting birds, and restricted the raising of ducks and quail, which were thought to be spreading the disease without getting sick themselves. The virus went silent for a time. Vietnam boasted it had cornered the virus. But then it resurfaced, establishing a new beachhead in ducks that had not been properly vaccinated. In 2008 and then again in 2009, poultry outbreaks were reported from the north of the country to the south. After more than two dozen provinces were struck in 2008, Vietnam’s agriculture minister acknowledged that only a few localities were completely capable of controlling the disease and blamed their slow response for the recurring epidemic. His deputy said the country’s poultry vaccination program was flagging. While both poultry outbreaks and human cases were still few relative to 2004 and 2005, FAO officials cautioned that the Vietnamese government would be unable to keep paying for the vaccination drive. Researchers, meantime, noted the separate strains circulating in northern and southern Vietnam were both becoming more lethal.