Alan Sipress - The Fatal Strain

“I picked this meaning to make you remember you must become outstanding, extraordinary,” she told him. “That is your duty.” She took him to school and registered him under his new name. It was a heavy burden, Guan later recalled. But he took his charge seriously.

As part of his radical remaking of Chinese society, Mao had shuttered the colleges. But just as Guan was preparing to graduate from high school, China announced they would reopen. For nine months he crammed for the entrance exam. Less than 1 percent of high school students would make the cut, Guan recounted. He would be among them.

Guan went on to study medicine and specialize in pediatrics, winning a place at an elite Beijing institute where he hooked up with a senior scientist specializing in infectious diseases of the respiratory system. He was later offered a slot in the PhD program at Hong Kong University and, after that, a chance to go overseas. He continued his research with one of the world’s top flu scholars, Dr. Robert Webster, at St. Jude Children’s Research Hospital in Memphis, Tennessee.

Several years had passed when, on a Saturday morning in late November 1997, Webster called him. Guan had returned to Memphis hours earlier after defending his doctoral thesis in Hong Kong and visiting his aging mother for the first time in two years. “Don’t open your baggage,” Webster ordered him. Guan was to turn around and go back.

“What happened?” Guan asked.

“While you were in the sky crossing the Pacific,” Webster said, “they had three cases of H5N1.”

“Really?” Guan was shouting excitedly over the telephone. “Really?”

Webster instructed him to get his travel documents ready and prepare the biological materials he would need to transport to Hong Kong. They were going to join the virus hunt.

Guan never gave up the chase. He soon moved back to Hong Kong to become a researcher in microbiology at the university and quickly went to work sampling the city’s birds. Before long, he would emerge as one of the world’s great collectors of flu viruses. Even as memories of the 1997 outbreak were fading, he was compiling data on myriad strains and amassing thousands of samples from birds in Hong Kong and southern China. In the summer of 2000, he had extended the net to Guangdong, establishing a virology lab at Shantou University Medical College. The facilities there had been idle for a decade. Guan spent a week cleaning the lab. He scrubbed the floor and washed the research bench and its protective hood. Only then did he set off to collect specimens from nearby poultry markets. Within two years, he had set up a network of field researchers that was gathering samples from birds in four provinces of southern China.

Webster, his mentor, had helped recruit Guan to the post at Hong Kong University. Webster was convinced that the novel flu strain simmering in southern China posed a grave danger to the world and wanted someone, preferably a Chinese virologist with Western training, who’d be nothing less than bullheaded in tracking the evolving threat. “Yi doesn’t know the word no . He doesn’t take no from anyone,” Webster put it to me. “He believes in what he’s doing and he’s intellectually driven to do these things. He talks a million miles an hour, and a lot of it is not totally focused, but his overall mission is focused. You’ve got to have someone who is hard-driving to get out there and be able to interact with the people and understand the region, and he was the perfect person to do the surveillance.”

Rumors of a bird flu epidemic among the Chinese of Guangdong first surfaced in November 2002. WHO’s influenza chief, Klaus Stohr, who would later mobilize the agency’s flu hunters after bird flu exploded in Vietnam in early 2004, was at a medical conference in Beijing when a health official from Guangdong stood up and described an especially nasty outbreak of respiratory disease among people of his province. “He talked about deaths, very severe disease and deaths,” Stohr recounted. Chinese doctors had been unable to identify the precise cause, but they said it looked a lot like flu. Stohr was inclined to agree. “I just put two and two together, and it added up,” he recalled. “I thought this must be H5N1 coming back in precisely the way we had feared. It was our worst nightmare, and the world’s.”

But when WHO subsequently pressed Chinese officials for more details, they offered a terse, dismissive reply. It was indeed flu, they reported, but just routine flu and everything was under control. In essence, “Now buzz off.”

By the waning days of 2002, with wildfowl in Hong Kong starting to drop, Guan and his fellow researchers suspected that whatever was killing the birds was also afflicting the patients in Guangdong’s hospitals. So on Christmas morning he came to Kowloon Park, an exquisitely maintained expanse of manicured greenery, flower beds, and faux waterfalls at the heart of central Kowloon, just off a stretch of Nathan Road known as the Golden Mile for the bountiful commerce of its shops and boutiques. Toward the center of the park, fringed by palms and shade trees, was the man-made lake where several dozen species, including flamingos, ducks, geese, and teal, frolicked in the water and sunbathed on the banks. Guan laid out his gear. Meticulously, he clasped a small vial in his curled pinky, leaving the rest of his fingers free. As a colleague restrained the first bird, Guan slowly inserted a Q-tip-like swab into its cloaca and withdrew a specimen. Guan sampled at least a dozen birds this way. Most later tested positive in the lab for avian flu.

He and fellow researcher Malik Peiris also continued to stalk the strain into the Mai Po Marshes of the New Territories. There the mudflats and mangroves offered a refuge unique in Hong Kong for hundreds of species of wild birds. The scientists drove up before dawn. It was a cold, damp morning. Though they were wrapped in heavy coats, the chill penetrated Guan’s bones. He pushed a small boat into the dark water, mud soaking his sneakers, and then rowed across the narrow inlet. He came ashore on Duck Island, a sliver of land that fittingly boasted more than twenty species of ducks. It was too hard to catch these birds. So for an hour and a half, Guan scoured the ground for their droppings. Live virus would be lurking inside.

The specimens collected from scores of birds in Hong Kong suggested that the mystery outbreak in Guangong’s hospitals was H5N1. But by February 2004, Guan and his fellow microbiologists realized there was no substitute for actual human samples. Someone would have to go to Guangzhou to get them.

“Why not Yi?” Webster asked. “It’s not everyone who’s going to want to go into that room and risk his life.” Guan was impetuous and courageous, and it was obvious to him that this was his moment.

When Guan arrived at the Guangzhou Institute of Respiratory Diseases, he told the director, Nanshan Zhong, that the pathogen was most probably influenza. “It is possible this is the early stage of a pandemic. If we don’t deal with it carefully, this will be a disaster,” Guan warned.

To contain it, medical experts had to determine precisely what it was. Guangzhou didn’t have the necessary lab facilities, Guan concluded, but Hong Kong did. Zhong concurred.

With the vials stashed in his satchel, Guan hailed a taxi outside the institute gate on the afternoon of February 11 and set off into rush-hour traffic. He wanted to make the 6:30 P.M. express train to Hong Kong. If he did, he could turn over the cache of vials to his lab staff in time for them to begin the process of culturing the virus samples that very night. Guangzhou East Railway Station was teeming with travelers. The cavernous hall echoed with the announcement of trains departing for destinations in the Chinese hinterland. Guan headed toward the terminal for the Kowloon-Canton Railway, which would whisk him to Hong Kong. Police officers, some alone, some in pairs, meandered through the crowd. Guan avoided eye contact.