Birds of Hong Kong - The Monster at Our Door: The Global Threat of Avian Flu - page 21

“None of us was sleeping much. The adrenaline was really flowing at this point. A pandemic was sud-
denly not a misty historical possibility. It seemed very current.” 82
Parallels with 1918 were becoming obvious. Like its ancestor, H5N1 was now focusing its virulence
on healthy adults. Of the seventeen new cases diagnosed between early November and the end of Decem-
ber, eight children, happily, all recovered, with few complications; five of the nine teenage and adult vic-
tims, however, were destroyed by viral pneumonia and ARDS. The silver lining (and scientific paradox)
was that the virus's success in replicating so efficiently inside humans was not yet matched by equivalent
transmissibility. The pandemic spark existed, but there was not yet any conflagration. Nonetheless, frantic
Hong Kong authorities bought up a large share of the available world supply of the antiviral medication
rimantadine as a precaution.
Then in mid-December the “missing link in the epidemiology of avian influenza” suddenly revealed
itself: chickens started dropping dead on poultry farms and in the city's markets. The poultry epidemic
that had vanished in the spring was now everywhere: H5N1 infected at least 20 percent of the city's chick-
ens, as well as a few domestic ducks and geese. (Not surprisingly, other influenza A subtypes with H9,
H6, and H11 hemagglutinins were also identified in birds, although none was yet a homicide suspect.)
The virus load in the city's birds seemed to be approaching some kind of ominous critical mass, but there
was no precedent for understanding the consequences of such a large-scale animal epidemic in the heart
of a great city. Public-health workers, however, did establish that most of the sick humans had had direct
contact with poultry, which made it less likely that H5N1 had succeeded in passing from person to per-
son. 83 On the other hand, some of the infected poultry had come from Guangdong and scientists worried
that a stealth epidemic—either undiagnosed or concealed for political reasons—already existed in other
parts of the Pearl River Delta. (Evidence later would emerge of an epidemic among geese in Guangdong
the previous year.)
Hong Kong's local government could not make public-health decisions for the rest of China, but it
acted decisively to protect its own citizens. Warned by scientists that there was not a second to lose, on
27 December authorities ordered the destruction of all 1.6 million live poultry within the city and its en-
virons; they also embargoed the import of live birds from Guangdong and disinfected the city's markets.
The bird cull, as agriculture official Clive Lau explained to reporters from Asia-Week, was a dismal busi-
ness:
One evening, Lau was at the command center and phoned a four-person team on a farm with 20,000
chickens. In four hours they had killed 35. The unpenned birds were proving remarkably elusive.
“You start killing and killing and killing,” says Lau. “And there are still thousands of birds.” Often
the reluctant butchers had to break necks and slit throats. The birds struggled and scratched. Some
people threw up from the smell. Others broke down and cried.
Lau is father to a one-year-old boy and five-year-old girl. All the while, he fretted that he could
catch the virus and pass it to them. Back home, the first thing he did was shout, “Get away from
me!” He threw his bloody shoes outside, stripped to his underwear and ran to the bathroom, yelling
at his family not to come near. After cleaning up, throwing away his clothes and scrubbing his
shoes, Lau at last said hello to his children. He wanted to kiss them, but didn't dare. 84
Other Hong Kong residents were no less apprehensive. The day before the slaughter, a Filipina do-
mestic worker was diagnosed with bird flu, and the whole city worried whom would be next—every
sneeze, cough, and fever that winter was a source of anxiety. Day after day, week after week, health work-
ers nervously tested and retested every case of serious influenza or respiratory distress. Apart from the do-
mestic worker who died in mid-January, they found no further trace of H5N1, and so the economic crisis