SHOCKING H5N1 info in book on 1918 flu

Flu by Gina Kolata (1999)

EXCERPTS from Chapter 8 - Incident in Hong Kong

Dr. Nancy Cox was on vacation in Wyoming when she got the call from her lab in Atlanta. Virologists there had done what they thought would be a routine test to determine the strain of an influenze virus isolated from a patient that past May. But when Cox, who directs the influenza lab at the CDC heard the result, her heart started to pound and she felt adrenaline rush through her body. The virus was of type H5N1. IT was a flu strain that should never have infected a human being. Even worse, Cox was told, it infected a child in Hong Kong. And he had died.  

The question leaped to Cox's mind; is this the first sounding of a fatal pandemic?

As a reference lab for influenza, Cox's lab had sets of antibodies to flu strains that no one ever expected to see in humans. These were strains of flu viruses that infect birds. While very occasionally a bird flu mutates and kills birds, for the most part bird flus are entirely benign. Instead of infecting cells of the lung and causing sickness, the virus lives peacefully in cells of the birds' intestines,causing no symptoms. In theory, a bird flu could not infect a human because the virus should require cellular enzymes found in bird intestinal cells but not in human lung cells. Yet if, against all oddds, a bird flu virus was infecting people, it would have hemagglutinin and neuraminidase proteins that had never been seen before by a human being. No human would be immune to such a virus. The whole world was at risk.

Worse yet, if a bird flu did jump to humans, and if the event happened in Asia, the scenario fit all too well into a chilling story developed by two leading flu virologists Dr. Webster of St. Jude Children's Research Hospital and Dr. Shortridge of the University of Hong Kong. Webster proposed that the worst flu pandemics, the one in 1918 being at the far end of bad, start with a bird flu. But before it can infect a person, it has to be humanized - that is, to change in a way that would alow it to keep the birdlike features that make it so infectious and yet acquire human flu like properties that would allow it to grow in the lung cells of a human. That crucial step, Webster said, typically takes place in pigs.

Now, as Cox looked at the lab records from the little boy who died in Hong kong, she knew she was seeing an unprecedented and possibly horrifying event. Here was a flu virus. It came from Hong Kong. It was a bird virus, but unlike any other bird flu virus ever known, it seemed to have skipped the pig step altogether. Dr. Keigi Fukuda said, an infection of a human being with a bird flu "had never happened before".

In september, when the investigators concluded their study, they reported that it appeared the boy really was infected with and H5N1 flu virus. But the virus did not seem to be spreading in the human population. They went home, relieved and satisfied that they had done a thorough job and that the situation was under control.

We kept looking back and thinking, "okay this case occured in may ..It's now September and we haven't had an additional cases. That's a good sign".  Then, right before thanksgiving, Cox got a phone call from Hong Kong. "We were informed that additional cases had occured" she said. She was shocked. Now that the virus had appeared again, the bone chilling fear came back. Was this 1918 all over again?

The number of cases kept mounting. From November until the end of December, 18 people were hospitalized, eight ended up on respiraators, six died. "the cases we were seeing were such sever cases" Fukuda said.

Shortridge was haunted by the thought that another 1918 pandemic might be starting and that the decisions he and other scientists made could determine whether the world was ravished by disease and death or whether a disaster was stopped in its tracks. "it was absolutely terrifying. You could feel the weight of the world pressing down on you" he said.

One day as Shortridge strolled through a chicken market he came upon a terrifying sight. "We saw a bird standing up there pecking away at its food, and then very gently lean over, slowly fall over , to lie on its side, looking dead. Blood trickling from the cloaca. It was a very unreal,bizarre situation. I had never seen anything like it" . And then he witnessed it in another chicken, and another. "we were looking at a chicken Ebola".

"When I saw those birds dying like that, it really hit home what might have happened in the 1918 pandemic" Shortridge said.  "I thought, "my God. What if this virus were to get out of this market and spread elsewhere?" It was an unbelievable situation and totally frightening".

Then the culling of chickens began.

Shortridge and Webster, in the meantime, are developing a surveillance system for flu viruses in Hong kong's birds and pigs. So far, Webster said, "there is no evidence of H5N1 in this part of the world".

The H5N1 scare, he said "was a dress rehearsal". Nancy cox is relieved, but still wary. The story is a triumph of epidemiology because what might have been a deadly pandemic was stopped in it's tracks. That bird flu episode, was a wake up call for alot of people who had forgotten how devastating influenza can be. I think it was important for all of us to take heed and get our pandemic planning efforts reorganized".

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The book was written in 1999, and those were only excerpts of the chapter and not the chapter in it's entirety.

And they thought they had stopped it in it's tracks......