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might not be the virus's indispensable intermediaries after all. A pandemic of frightening lethality there-
fore might be imminent, and it was desperately important for the team of international flu experts in Hong
Kong to uncover the exact circumstances of the child's infection.
The most obvious hypothesis—that he had encountered sick chickens at one of the New Territory
farms or in a local live-poultry market—turned out to be unlikely. Indeed, the only plausible avian contact
that researchers could establish were some chicks and ducklings that had been pets at his preschool; the
baby birds had died mysteriously, but when researchers painstakingly tested dust in the playroom they
could find no sign of the virus. On the other hand, extensive blood testing revealed that a handful of the
child's contacts, including a playmate, a nurse, and a few others (but not his immediate family), had an-
tibodies to H5N1. Five poultry workers also displayed immunological evidence of contact with the vir-
us, but none had become sick. Meanwhile, the trail grew cold, and no more cases appeared: perhaps the
child's death had been a fluke. The international experts returned home.
Virologists remained unsettled by the fierce behavior of H5N1/97 in the laboratory. “It reproduced
much faster than ordinary flu strains, and in cells that ordinary flu strains couldn't live in, and if you grew
it in eggs, it killed them. This virus, said Lim [a Hong Kong scientist], was like an alien.” Indeed, when
veterinary researchers in Athens, Georgia, infected a poultry flock with the recently isolated human strain,
the entire flock died within a day. Horrified scientists, who had never seen such a rapid killer, immediately
donned biohazard containment suits and dosed themselves with antivirals; this ignited a controversy about
the safety protocols necessary for work with the Hong Kong virus. Influenza diagnostic labs, at least in
the United States, were not equipped with the elaborate containment systems required for working with
such a potent virus: federal biosafety guidelines had not anticipated an influenza that acted like the night-
mare protagonist of a sci-fi thriller. (Nor did they foresee the possibility that by 2004 scientists would use
reverse genetic engineering to re-create the 1918 monster in their labs.) A majority of the research com-
munity now decided that H5N1 research should be confined to a small number of Biosafety Level 3-plus
or Level 4 labs, but a few scientists chafed under the restrictions (and were later accused of cutting corners
on safety). Lurking in the background was the memory of the unexpected resurrection of the H1N1 virus
in 1977, an outbreak that almost certainly resulted from the inadvertent escape of the strain from a Russi-
an, or possibly Chinese, laboratory. H5N1, however, might be incomparably more dangerous. 80
None of the journalistic accounts of the 1997 outbreak mention the extreme weather, but it was the
wettest year in Hong Kong's meteorological record—a massive Pacific El Niño event brought typhoons
and torrential rain to southern China throughout the summer. (Did the deluges wash away the poultry ex-
crement that spread the infection?) The city was still soaked when the pandemic threat suddenly returned
at the beginning of winter. A six-year-old with heart problems was hospitalized on 6 November with or-
dinary flu symptoms; he recovered quickly, but the lab assay confirmed he had H5N1. Two weeks later, a
teenager and two adults—all unrelated—were hospitalized with the virus. State-of-the-art intensive care
failed to prevent the onset of viral pneumonia or other macabre complications like those that had killed
the toddler in May; two of the patients died in December. Meanwhile, flu experts from Atlanta, Memphis,
and Tokyo were flying back to Hong Kong. The WHO set up a special Pandemic Task Force and expected
the worse.
The city was on the edge of panic. Although Hong Kong had just been returned to Chinese sov-
ereignty, the local press was unfettered in its coverage of the new outbreak. Opposition politicians
hammered the administration of Tung Chee-hwa for any perceived hesitancy in its response to the
threat. 81 Throughout December public anxiety was reinforced by the seemingly random fashion in which
new human cases were appearing across the territory. In addition, the regular flu season had started early,
thus increasing the chance of co-infection and reassortment between H5N1 and the prevailing H3N2 hu-
man virus. CDC's top scientist on the scene, Dr. Keiji Fukuda, later reminisced to the New York Times :
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