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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and Indonesia outbreak

and mutation of virus

SARS

and Thailand outbreak

and Vietnam outbreaks

Hygeia

immune response

to H5N1

to Spanish flu strains

Indonesia

chickens, significance to people

cockfighting

economic boom

flu victims, symptoms

Ginting family outbreak

H5N1, spread from China

home-raised poultry, dangers of

human fatalities, first

human-to-human transmission

locals, tests/treatment, refusal of

locals’ denial of flu

magic

and pandemic risk

poultry, devastation of

poultry infection, first report

prevention, neglect of

secrecy about outbreaks

tests/treatment, refusal of

transmission, points of origin

Uyeki investigation

WHO, lack of cooperation with

WHO actions

witch doctors

influenza pandemics

Asian flu (1957)

China as epicenter

computer simulations of

conditions for

economic costs

globalization, impact on

H5N1 risk

H9N2 risk

halting, ingredients for

Hong Kong flu (1968)

and Indonesia

inevitability of

mild, impact on population

pandemic risk (2005), investigation of

pandemic risk (2005), Vietnam

Spanish flu (1918)

swine flu as unpredictable

U.S emergency preparedness, lack of

victims, age of

influenza virus

and acute respiratory distress syndrome (ARDS)

A and B types

cellular attack, mechanisms of

first recorded outbreak

flu test inaccuracy

genetic factors. See genetics, bird flu virus; mutation of virus

seasonal. See seasonal flu

spread, factors in

International Emerging Infections Program, of CDC,

International Health Regulations

Japfa Comfeed

Jatinegara Market

Jennings, Dr. Lance

Jeremijenko, Andrew

Jia Youling

Karo, Manajus Boru

Komsan Fakhorm

Kramat Jati Market

Krisana Hoonsin

Kumnuan Ungchusak, Dr.

Ky, Van Dang

Lam Hoi-ka

H5N1 infection

transmission of flu to

Laos, poultry infection, first report

Legionnaires’ disease

Liem, Nguyen Thanh

Lim, Dr. Wilina

Liu Jianlun

live poultry markets, as infection source

livestock revolution, economic impact of

Longini, Ira M., Jr.

Lubis, Dr. Nur Rasyid

lungs, viral attack of

Madagascar, flu outbreak

magic

Begu Ganjang, conjuring of

and medicine. See witch doctors

Mai, Dr. Le Thi Quynh

Malaysia

economic boom

spread of disease to

Manh Thang

Marburg hemorrhagic fever

Marek’s disease

Mariner, Jeffrey

Marriott, Edward

medicine men. See witch doctors

merit birds

mutation of virus

and agricultural practices

antigenic drift/antigenic shift

and drug-resistance

genetic reassortment

and human-to-human transmission

influenza virus

and livestock revolution

Vietnam outbreak (2005), novel strain

virus, strengthening of

See also genetics, bird flu virus

Nabarro, David

Naipospos, Tri Satya Putri

Nam, Hoai

Nanshan Zhong, Dr.

Naresuan, king of Thailand

Narti, Made

National Pediatric Hospital (Vietnam)

Naval Medical Research Unit 2 (NAMRU-2)

neuraminidase

Newin Chidchob

New Territories

Ngoan, Nguyen Thi

Nicoll, Dr. Angus

Nidom, Chairul A.

Nigeria, bird flu outbreak

Nik Aziz Nik Mat

Nikon Inmaee

Nirundorn Aungtragoolsuk

Nirun Phitakwatchara

Omi, Shigeru

Orussey Market

Oseltamivir. See Tamiflu

Oshitani, Dr. Hitoshi

Osterhaus, Dr. Albert

Osterholm, Dr. Michael T.

on emergency preparedness

Oxford, John S.

Palese, Dr. Peter

pandemics

conditions for

HIV-AIDS

influenza virus. See influenza pandemics

preparedness for. See emergency preparedness

Peiris, Malik

Pennsylvania Hospital

Perdue, Dr. Michael

Phalla, Kong

Phapart Thieuviharn

Philadelphia, Spanish flu (1918)

Philadelphia General Hospital

pigs

as intermediate hosts

See also swine flu

plague, origin and spread of

Plant, Dr. Aileen

Plummer, Dr. Frank

politics, interference with prevention efforts

Polo, Marco

polymerase chain reaction (PCR)

Potter, Dr. Ellen C.

poultry

agricultural practices, risky

Asia, significance to people

devastation by influenza

disease transmission by. See bird flu transmission

slaughter of. See culling

symptoms/death

See also chicken farming; cockfighting; ducks

Pranee Thongchan

Prasert Thongcharoen, Dr.

professional credentials

Thailand investigation

Prasetyaningsih, Rini Dina

Prathum Buaklee

chicken business, development of

culling

rebuilds chicken business

prevention

amantadine, illegal use, China

disinfection procedure

donations needed for

drug-resistance issue

failure and politics

flu testing problem

poultry, slaughter of. See culling

and poultry farming practices

scientific constraints to

Thailand campaign

vaccination

Prince of Wales Hospital (Hong Kong)

Purba, Agenda

Qiao Songju

Qinghai Lake/Bird Island

quarantine, noncompliance

Queen Elizabeth Hospital (Hong Kong)

Queen Mary Hospital (Hong Kong)

Rafei, Iwan Siswara

Ram Khamheng, king of Thailand

researchers. See epidemiologists; World Health Organization (WHO)

Reye’s syndrome

rice farming, Thailand

RNA viruses, flu as

Rodier, Guenael

Rohland, Klaus

Roongroje Thanawongnuwech

RT-polymerase chain reaction

Russian flu

Ryan, Dr. Michael

as Alert and Response Operations director

epidemiology investigations

SARS containment

Ryan, Jordan

Sakuntala Premphasri

Samaan, Gina, Indonesia investigation

Samida, Ibu

Samrouy Buaklee

San Francisco, plague (1894)

Sangwan Klinhom

SARS. See severe acute respiratory syndrome (SARS)

Scotland, H5N1 detected

seasonal flu

fatalities from

flu outbreak (2003) in U.S.

origin of

progression of

secrecy

China

Indonesia

Sembiring, Tempu

Senne, Dennis

severe acute respiratory syndrome (SARS)

Canada, misdiagnosis

China outbreak (1997)

civets as carrier

civets, culling

epidemic, end of

compared to flu

government inquiry into investigation

human-to-human transmission

identification of

transmission/speed of infection

WHO response to

wild-game markets, testing animals

Yi Guan investigation

Shantou University Medical College (China)

Shortridge, Kennedy

Sims, Dr. Les

Siriraj Hospital (Thailand)

Sitthidej Sanrin

Slingenbergh, Jan

smallpox

Soendoro, Dr. Triono

Soeroso, Dr. Luhur

Soeroso, Dr. Santoso

Sompao Hoonsin

Somporn Panyastianpong

Southeast Asia. See specific countries

Sovann, Ly, Cambodia investigation

Sovanratana, Khy

Spanish flu (1918)

dead, burial of

fatalities of

global reach of

origin and spread of

Philadelphia, devastation of

public chaos

similarity to bird flu

symptoms of

victims, age of

speed of infection

and emergency preparedness

and globalization

Starr, Isaac

Stohr, Dr. Klaus

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