Alan Sipress - The Fatal Strain

“How many were dead?” Samaan asked, confirming the number.

“There were two,” the second man repeated.

Then a third man, with a bushy mustache, stepped forward, weighing in, “Yes, there were two dead chickens a month ago.”

Samaan listened intently, producing a large, spiral notebook from her handbag and jotting down the details. “What were the symptoms?”

“It was all of a sudden. We didn’t see any symptoms,” answered the mustachioed neighbor.

“What made you think the birds were sick?” she pressed.

“My wife found them,” he answered. “My mother-in-law poured kerosene on them and burned them. I just cleaned up the remains.”

The three men started buzzing among themselves. The translator fell silent, trying to follow the conversation. Samaan waited. Perhaps the neighbors were trying to recall the details. Or perhaps, like many other Indonesians, they were reluctant to disclose them, fearing that local veterinary officers would raid the kampung and cull the remainder of their birds.

“How’s it going?” Samaan prodded after a few minutes.

“We didn’t see any chickens with symptoms,” insisted the man with the mustache. “They were just kind of dead. We still don’t know whose chickens they were.”

Samaan rolled his remarks over in her mind, examining them for any elusive clue. Two dead birds, no symptoms, no samples. It was hard to conclude they were responsible for the death. She excused herself. Then she went to locate the victim’s relatives in the crowd.

The victim’s mother was a handsome woman in a coarse, orange dress with thick brown hair pulled back in a bun. Samaan ushered her to the shade of a stately jackfruit tree in a corner of the yard. The great green fruit dangled from the canopy. Another neighbor dragged over two folding chairs so the pair could sit down.

“When did your daughter become sick?” Samaan asked, this time pulling a large calendar out of her handbag.

“Nine days ago.” That made it the first week of January. The timing could eventually prove crucial to cracking the case.

“Did she have a temperature?”

The mother furrowed her brow trying to summon the specifics. “She was very hot. She had a terrible cough. She had a bad infection in the lungs.”

Samaan inquired about the rest of the family, where they lived, and whether the other members were healthy. Everyone else was fine. She asked about the family’s recent travels. She asked who did the shopping and the cooking in the family.

“Do you own chickens?”

“No, but sometimes the neighbors’ chickens come around,” the mother responded, squinting as she thought about the answer.

“Did any of those chickens die?”

“We didn’t see any sick chickens. But most of the time we weren’t home. We’re a working family,” she said, lines deepening across her dark brow. Then she added, “My daughter’s a nurse at a hospital.”

This last disclosure landed like a bombshell. Though Samaan’s expression remained placid, her heart fell. If the victim had been a nurse, she might have been infected by another flu patient, signaling that the novel strain had mastered the ability to jump from person to person. Or she might have passed the disease to one of the many people whom she treated on the wards. Was the hospital itself breeding an epidemic? Had it already burst beyond the walls into the teeming quarters of Jakarta? The possibilities were frightening. The prospect of pandemic instantly seemed closer. But Samaan refused to let her anxieties betray her. She pressed on.

“Which hospital did she work in? Where is it located?” Samaan probed.

“West Java.”

“Which department did she work in? ICU? Pediatrics?”

“I don’t know,” the mother said. “She’s a regular nurse.”

As Samaan wandered down the narrow concrete alley to the victim’s home, her mind was humming with questions. First, what was the culprit? She wanted to uncover the precise source of her victim’s infection to determine how the sickness spread and whether others were at risk. Had the mercurial virus changed its modus operandi? If so, this might reflect a fateful mutation, and the world would want to know. Samaan also needed to find anyone who’d been in contact with the deceased to see if they required medical care. Most urgent of all, was this extraordinarily lethal disease now being relayed from person to person? Was it time to sound the alarm?

The answers lay in the quotidian details of kampung life. Samaan intended to sift through the family’s habits, peering under their prosaic routines for the tracks of a killer.

That meant delving into the family’s medical history, whom they worked with and lived with, how they prepared their meals, and where they slept. She would need to know if they raised animals and how they kept them. She would learn where the family shopped and who butchered the poultry, whether they took traditional medicine or had a taste for liver, eggs, or raw meat, whether they were hunters, farmers, or regulars at the city zoo. To solve this whodunit, Samaan would also reconstruct the victim’s final weeks and days. She would weave together the account in the hospital records with the recollections of relatives and coworkers whose memories were now buffeted by fear, confusion, and grief.

Epidemiology is often likened to detective work. But the metaphor is misleading. In reality, disease investigators all too rarely enjoy the satisfaction of collaring their suspect. Clues are few and easily overlooked: a smudge of bird feces on an eggshell, mucus on a feather. Trails go cold quickly. Infected birds may have flown away; victims may have been diagnosed too late and died before investigators could question them. Witnesses forget innocuous but crucial details: a friend’s songbird, fertilizer in the garden, or a quick stop at the market. Even when a death coincides with an obvious outbreak in a neighbor’s flock, the evidence of infection is often circumstantial. When several family members contract the virus, it’s often impossible to conclude whether they all got it from the same sick chicken or shared it among themselves.

If a nascent pandemic strain were circulating in an Indonesian hospital, Samaan would find this out. If it wasn’t, she would offer the world a measure of reassurance. But she also realized she might never be able to stamp “Case Solved” on her file. A study of Indonesia’s first 127 confirmed cases found that that investigators had failed to come up with any possible explanation for one-fifth of them. At best, Samaan might only be able to suggest a plausible hypothesis for her victim’s death. Yet this would leave much of the flu’s mystery unrevealed and possible strategies for defeating it obscured.

“Sometimes you can only go so far and stop,” she told me. “Sometimes you have to draw the line.”

The victim’s neighborhood was not as poor as Samaan had expected. Small, tidy dwellings lined the alley with laundry hanging limply out front. Sewage trickled down a ditch beside the alley.

After two minutes, Samaan reached the family home, a simple, middle-class house at the top of the alley. The victim had lived there with her parents, husband, and four-year-old son. Samaan crossed the porch and removed her shoes at the doorway. She joined half a dozen Indonesian officials inside. The air was close, tangy with sweat. They sat cross-legged on a woven mat in the front room, unfurnished except for a large wooden cabinet with glass doors, the walls unadorned but for family portraits. The mother reached up, took down a photograph in a carved wood frame, and passed it around. It was a formal portrait of the deceased and her young boy. The woman was fleshy but attractive with wavy brown hair and thick red lipstick. For the photograph, she had donned a green tunic over a red batik sarong. She was standing with her hands folded before her. At her side was the boy, smart in a traditional Javanese sarong and black pece cap.