Alan Sipress - The Fatal Strain

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Outbreaks of avian and swine flu have reawakened fears that had lain dormant for nearly a century, ever since the influenza pandemic of 1918 that killed at least 50 million people worldwide. When a highly lethal strain of avian flu broke out in Asia in recent years and raced westward, the
’s Alan Sipress chased the emerging threat as it infiltrated remote jungle villages, mountain redoubts, and teeming cities. He tracked the virus across nine countries, watching its secrets repeatedly elude the world’s brightest scientists and most intrepid disease hunters. Savage and mercurial, this novel influenza strain—H5N1—has been called the kissing cousin of the Spanish flu and, with just a few genetic tweaks, could kill millions of people. None of us is immune.
The Fatal Strain The ease of international travel and the delicate balance of today’s global economy have left the world vulnerable to pandemic in a way the victims of 1918 could never imagine. But it is human failings that may pose the greatest peril. Political bosses in country after country have covered up outbreaks. Ancient customs, like trading in live poultry and the ritual release of birds to earn religious merit, have failed to adapt to the microbial threat. The world’s wealthy countries have left poorer, frontline countries without affordable vaccines or other weapons for confronting the disease, fostering a sense of grievance that endangers us all.
The chilling truth is that we don’t have command over the H5N1 virus. It continues to spread, thwarting efforts to uproot it. And as it does, the viral dice continue to roll, threatening to produce a pandemic strain that is both deadly and can spread as easily as the common cold. Swine flu has reminded us that flu epidemics happen. Sipress reminds us something far worse could be brewing.

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Azerbaijan outbreak

Bach Mai Hospital (Vietnam)

backyard birds, infection to

Bang-on Benphat

Bangun, Heni Boru

Bangun, Suherman

bataks

Baxter International

Begu Ganjang (spirit)

bird flu

Asian outbreaks. See Cambodia; China; H5N1; Hong Kong; Indonesia; Thailand; Vietnam

fatalities, prediction of

H5N1

H7s

origin and spread of. See bird flu transmission

pandemic risk. See influenza pandemics

preventing epidemic. See epidemiologists; prevention

compared to SARS

signs of. See diagnosis; symptoms

compared to Spanish flu

timeline

victims, age of

viral features. See genetics, bird flu virus; mutation of virus

bird flu transmission

and agricultural practices

from China

and cockfighting

and droppings

and ducks

and family clusters

and globalization

home-raised poultry risk

human-to-human. See human-to-human transmission

live poultry markets

merit birds risk

out of Asia

preventing. See prevention

and smuggled birds

species barrier broken

and swans

See also specific countries

birds, wild, and flu viruses

Black Death. See bubonic plague

brain, viral attack of

Brown, Dr. Caroline

Brudon, Pascale

bubonic plague

origin and spread of

Buddhist custom, merit birds

Byrne, David

Cambodia

bird flu outbreak

merit birds, dangers of

poultry infection, first report

rapid-response system

Sovann, work of

Tonle Sap

Canada, SARS misdiagnosis

Cantlie, James

Captan Boonmanut

Centers for Disease Control (CDC). See specific persons by name

Fukuda at

H5N1 investigation

International Emerging Infections Program

Uyeki at

Vietnam investigation

Chan, Anson

Chan, Dr. Margaret

culling ordered by

H5N1 investigation

and Indonesia sample sharing conflict

as SARS inquiry victim

at WHO

Chan Man-kei

Charoen Pokphand

Cheng, Maria

Cheung Sha Wan

chicken farming

agricultural practices, risky

chicken hotels

preventing epidemic. See prevention

Thailand, growth of

U.S., disease prevention

See also poultry

China

amantadine, illegal use of

bird flu outbreak (2004)

and bubonic plague

H5N1 outbreak (1997)

H5N1 spread from

as influenza epicenter

market reforms, impact of

meat output

poultry infections, reports of

Qinghai Lake/Bird Island outbreak

research, attack on

SARS

SARS containment

secrecy about outbreaks

whistleblowers, punishment of

WHO, lack of cooperation with

See also Hong Kong

Chinese flu (1888)

cholera

Chulalongkorn University

civets, and SARS

cockfighting

and disease transmission

historical view

Indonesia

restriction, difficulty of

roosters, culling

roosters, devastation by flu

Thailand

Vietnam

computer simulations, of flu pandemic

Corlett, Richard

Cornaro, Markus

Coronavirus

Cox, Dr. Nancy

cruise ships, outbreaks on

CSL Limited

culling

cullers, lack of infection to

Hong Kong

Thailand

Vietnam

Cultural Revolution

cytokine storm

Dakun (witch doctor)

Death Railway

De Jong, Jan

Delgado, Christopher

dengue fever

Dharma, Dr. Surya

diagnosis

antibody tests

flu test inaccuracy

Western blot

Diamond, Jared

disinfection procedure

Domenech, Joseph

Dongmen Market

drug-resistance

humans

and mutation

and vaccination programs

drugs

overseas manufacture of

See also drug-resistance; Tamiflu; vaccination

ducks

agricultural practices, risky

and bird flu transmission

duck blood, recipe with

East Asia

chicken farming, rise of

economic boom

Ebola virus

economic costs, of influenza pandemic

Egypt, bird flu outbreak

emergency preparedness

globalization, impact on

rapid-response system, Cambodia

and speed of infection

Tamiflu, use of

U.S., limitations of

U.S., system for

ventilators, requirements

WHO guidelines

epidemiologists

dangers of infection to

field versus lab

information gathering methods

protective garments

puzzling scenarios

small animals, testing of

See also specific persons by name

Europe, transmission to

false negatives

false positives

family clusters

Ferguson, Neil M.

flu and flu pandemic. See entries under influenza and bird flu

Franklin, Benjamin

Fukuda, Dr. Keiji

CDC, role at

H5N1 investigation

personal characteristics of

professional credentials

on rapid response

SARS investigation

on U.S. health care system

Vietnam investigations

as WHO influenza chief

GenBank

Gendreau, Mark A.

genetics, bird flu virus

and family clusters

intermediate hosts

PCR testing

pedigree of virus, tracing

RNA viruses, flu as

species barrier, breaking

swine flu, development of

See also mutation of virus

Ginting, Dowes

bird flu tracked to

transmission, source of

witch doctor, interventions

Ginting, Dr. Diana E.

Ginting, Jones

Ginting, Rintang Boru

Ginting, Sanita

Global Influenza Surveillance Network

globalization

and agricultural practices, risky

emergency preparedness, impact on

and spread/speed of transmission

Govorkova, Elena A.

Greenfield, Karl Taro

Grein, Dr. Tom

epidemiology investigations

Guangzhou Institute of Respiratory Diseases (China)

H1N1. See also swine flu

H5N1

China, origin and spread from

China outbreak (1997)

culturing

Fujian-like subtype

Hong Kong outbreak

human-to-human transmission

immune response to

initial identification of

mammals, transmission to

mortality predictions

mortality rate

pandemic risk

progression of infection

resurgence patterns

species barrier broken

swine flu, relationship to

Thailand outbreak

victims, age of

Vietnam outbreak

virulence of

H7s

H9N2

global spread of

pandemic risk

protective to poultry

Hall, Dr. Julie

hemagglutinin

Heymann, Dr. David

Hien, Dr. Nguyen Tran

HIV-AIDS, as pandemic

Hong Kong

Ap Lei Chau cases

bird flu strain. See H5N1

Chan investigation of

Chinese flu (1888)

culling

first report of illness

flu victims, symptoms

Fukuda investigation of

as global city

impact of flu on

Lam Hoi-ka, infection of

medical tests/treatment, refusal of

merit birds, dangers of

pandemic, aversion of

plague (1894)

poultry, devestation of

SARS outbreak/spread

second case

transmission, points of origin

wet markets, perils of

Hong Kong flu (1968)

victims, age of

Horby, Dr. Peter

Thailand investigation

Vietnam investigation

Horvath, Dr. John

hospitals, emergency preparedness, lack of

humans, signs and symptoms. See diagnosis; symptoms

human-to-human transmission

contagion and stage of illness

dangers of

first case

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