Alan Sipress - The Fatal Strain

Captan fell ill within days. A nearby clinic diagnosed the illness as a common cold. When it got worse, his father brought him to the local hospital, where he was given injections of antibiotics. Then, as his fever climbed and his breathing began to race, he was rushed by ambulance to Siriraj Hospital, eventually admitted into the pediatric intensive care unit. His white-blood-cell count was plummeting. So was the level of platelets in his bloodstream. Doctors prescribed broad-spectrum antibiotics on the assumption that his pneumonia was caused by a bacterial infection—but to no effect. The disease was unrelenting. So the doctors shifted their diagnosis to a possible viral infection and began treating Captan with antiviral drugs. They notified Prasert, the hospital’s most respected virologist.

The doctors had learned from Captan’s parents about his history of close contact with poultry. His father had related the tale of the rooster. Family members further reported that all three hundred chickens on the uncle’s farm had eventually died or been culled and that all but one of the chickens at Captan’s home had also succumbed.

Prasert was afraid he knew what this meant, that he was seeing his worst fears materialize in his own hospital. But without definitive test results, he was reluctant to go public. “We had suspicions already but couldn’t say anything. At that time, nobody could reveal information to anyone. The information the government was releasing was that we didn’t have any avian flu,” he said with narrowing eyes and an ironic smile. For all his credentials and earlier bluster, Prasert was wary of tangling with Thaksin and his ministers, at least for now. That very week, the agriculture ministry had threatened to sue another research institute and the media for allegedly damaging Thai national interests by exaggerating the number of chickens that had died nationwide. “What could I do?” Prasert asked. “I’m only a small, old man. Who would believe me?”

Subsequent study would reveal the viciousness with which the virus was assaulting the little boy’s body. The disease was decimating his respiratory system, destroying the air sacs and capillaries in his lungs and inundating them with blood. The virus also invaded his intestines, where it established a beachhead and began to reproduce further. The pressure on the ventilator helping him breathe had to be turned up so high that even this was starting to take a toll.

Shortly after he arrived at Siriraj Hospital, initial tests confirmed that Captan had influenza A. A week later, on Thursday, January 22, another set of results came back and showed conclusively that it was the novel strain. Prasert now had proof that the second condition for a pandemic had been met. The virus was again infecting people.

Time was up. Prasert placed three calls in the following hours to officials at the public health ministry, including the minister and the director general of the Thai center for disease control. He rebuked them: “Bird flu has reached humans already.” He also went public with his laboratory evidence of a flu outbreak in chickens, telling reporters that the H5N1 strain was widespread and the “cover-up” had to stop. His efforts were seconded by a top Thai lawmaker, a physician-turned-politician named Nirun Phitakwatchara. Nirun, a member of the Thai Senate, announced he’d learned from health officials about a second boy, this one from Suphan Buri province, who had also tested positive for bird flu. He accused the government of hushing up the outbreak for the sake of poultry exports. “I think it’s very late but very late is better than not telling the truth,” Nirun told me at the time.

The next morning, Thailand’s Public Health Minister, Sudarat Keyuraphun, hastily summoned the Bangkok press corps. “There are two cases of bird flu, in a seven-year-old boy from Suphan Buri and a six-year-old boy from Kanchanaburi,” she announced, adding that they were in stable condition. She said that everyone who had contact with the boys would be quarantined for ten days. She blamed the delay in disclosing the cases on the time required to finish testing samples.

The agriculture ministry followed right behind by issuing a statement confirming that chickens on a farm in Suphan Buri province had tested positive for the H5N1 strain. Samples from elsewhere in the country were still being analyzed. Newin, the deputy agriculture minister, announced that a mass slaughter of birds in central Thailand was already under way and that Thailand’s poultry exports were to be suspended.

“It’s not a big deal,” Thaksin reassured the Thai public. “If it’s bird flu, it’s bird flu. We can handle it.”

Tamiflu was urgently flown into the country and immediately administered to the sick boys.

Three days later, Thailand confirmed its first fatality from bird flu. In the early hours of Sunday, January 26, after taking an abrupt turn for the worse, Captan died.

Krisana Hoonsin could not sleep the night he paid eight laborers to slaughter all his chickens. He took a pill to help. When he awoke, he discovered that the silence blanketing the flat, lush province of Suphan Buri had enveloped his farm. Morning broke without the cackling and cooing he had known since he was a teenager. “It reminds me I’m not a chicken farmer anymore,” he told me plaintively. “In a week, all the chickens in our district will be gone.”

One day after Thai officials publicly confessed that bird flu had struck, Krisana sat heartbroken in a small, clapboard kiosk erected inches above a fishpond in front of his farmhouse. He wore a loose, black-checked work shirt and had a slight scar on his left cheek. His eyes were bloodshot, his dark brow deeply furrowed, like some of the nearby plots. Between the fingers of his rough right hand, the thirty-eight-year-old farmer clutched a lit cigarette, but he barely puffed. It would burn to a stub. Then, noticing just in time, he would rub it out and light another. This was still January, one of the coolest months in Thailand, but the midday sun was intense, so Krisana had taken refuge beneath the pitched, corrugated metal roof of the simple shelter. It was here that he had often come at dusk, when his chores were finished, and fondly gaze at one of his poultry sheds on the other side of the narrow country road. “My chickens would recognize me,” he recounted. “They would stick their heads up and see me. Now it’s empty.” His voice cracked. “I still think of all my chickens.”

His birds started getting sick two weeks earlier. He reported it to local livestock officers. Though they assured him it was only a minor case of fowl cholera, he was ordered to take draconian measures and put all seven thousand to death. Too upset to execute the sentence himself, Krisana hired a few locals. They marched down the tight aisles of the poultry sheds, wrestled the birds from the raised metal cages, and stuffed them alive into plastic feed and fertilizer sacks. The chickens were left to suffocate, then buried in a pit coated with lime at the edge of his property. “How can I express the feeling to see all our chickens die that way?” he asked. He let his sandals slip from his feet and rubbed his soles against the rough wood planks. “When you do chicken farming, it’s like you’re taking care of your own children. You love them. They love you back.”

I had come to Suphan Buri early that morning with an energetic Thai journalist, Somporn Panyastianpong, who often worked as my translator. Before we left Bangkok, she had stopped to buy us surgical masks and rubber gloves, though the two health officials I had consulted were unsure whether these would adequately protect us. The disease was still so new, its precise lines of attack still uncharted. We drove north along the modern divided highway that connects the sprawling suburbs of the capital with Thailand’s central wetlands. After an hour, shimmering green rice paddies opened up before us, many fringed with coconut palms. Storks, herons, egrets, and cormorants swooped and scavenged amid the neon fields. Peasants in straw hats meandered along the earthen dikes, hoes slung over their shoulders. A few ragged duck herders, barely teenagers, squatted at the edge of flooded paddies while their flocks waded into the murky waters, shaking their dark brown tail feathers and rooting around in the muck, hunting snails.