Plague and Profit - The Monster at Our Door: The Global Threat of Avian Flu - page 47

The government of Vietnam, previously praised by the WHO for its competent handling of the SARS
outbreak, was altogether more cooperative, but the country's poverty and the dispersed character of its
largely backyard poultry industry posed huge obstacles to creating effective viral firebreaks. Poor farm-
ers suppressed news of infections and concealed valuable birds such as fighting cocks; in addition, in
face of rising anger in the countryside, the government was reluctant to extend the radius of culls around
sick flocks beyond one half kilometer—the WHO recommended three kilometers—or to exterminate the
domestic ducks that were the infection's probable reservoir. Similarly, the disinfection of farms and the
disposal of contaminated poultry manure were Sisyphean tasks that always risked further transmission of
the virus, typically via the boots or clothing of cleanup workers. No sooner was an outbreak suppressed
in one part of the country than another appeared in a different province. Small children, who frequently
played outside with chickens and ducks and were constantly exposed to poultry waste, were particularly
vulnerable to these seemingly ineradicable village outbreaks. 198
Indonesian President Megawati Sukarnoputri, meanwhile, balked at the task of killing millions of
chickens, and so her government initially proposed a vaccination campaign instead. After angry protests
from the rest of the ASEAN bloc, Indonesia finally agreed to slaughter birds, but with a half-heartedness
that reassured few critics. The WHO, however, continued to have the most difficulty with Beijing. “We
have repeatedly said there is a brief window of opportunity to act within China,” warned a WHO repres-
entative at the beginning of February 2004, “This latest news [outbreaks in Hunan and Hubei] strongly
suggests that the window is getting smaller with each passing day.” Another WHO official told the Asso-
ciated Press that “mass culling is not taking place at the speed we consider absolutely necessary to contain
the virus.” 199 The Lancet, for its part, warned in February that China's “animal-disease surveillance is
as good as absent, a vacuum into which global health might hopelessly and terrifyingly fall.” 200 When
leading influenza expert Robert Webster suggested in another Lancet article that the time had come to
consider closing down China's live-animal markets, he was ignored. 201
February was, indeed, a terrifying month, with new human victims in Vietnam and Thailand and fur-
ther avian outbreaks in China and Indonesia. WHO teams, reinforced with a cadre of top experts from
American, European, and Japanese laboratories, struggled with the imminent possibility of a global pan-
demic against which the world would have little protection. An experimental vaccine developed in 1997
was ineffective against GenZ, which was also resistant to amantadine, the cheapest and most common
antiviral. (Hong Kong researchers feared this was further evidence of human tampering in the evolution
of H5N1 and urged an investigation of chicken feed to test for amantadine-like molecules.) 202
Most disturbingly, the new strain was more lethal than any influenza in scientific experience. In the
course of the viral pneumonia it engendered, GenZ was stunningly adept at inducing deadly “cytokine
storms” in which victims' own berserk immune systems destroyed their lungs and other organs; two-thirds
of GenZ's victims (twenty-two out of thirty-three) had died by 9 March, and, unlike its 1997 cousin, it rel-
ished toddlers and teenagers as well as adults. 203 With each passing day, scientists feared they would meet
its reassortant offspring, ready to conquer the world, but despite their repeated warnings only one coun-
try—Canada—had undertaken truly serious preparations to meet the pandemic threat. 204 In the mean-
time, only the dismal, dirty work of the slaughter—some 120 million chickens were eventually buried
alive, burnt to death, electrocuted, or gassed—offered any hope of preventing a fatal rendezvous between
a nightmare virus and a vulnerable humanity.
Then in mid-March, the plague suddenly seemed to relent. The last deaths were a twelve-year-old
in Vietnam, who passed away on 15 March after a long struggle, and a poultry worker in Thailand who
died the following day. On 16 March, China announced that it had eradicated the virus in all forty-nine
hot zones; this triumphalist statement alarmed the FAO and the OIE, who cautioned against premature