The Flu Hunters

When a mysterious and deadly flu virus struck Hong Kong last year, medical detectives from around the world, fearing a repeat of the 1918 epidemic that killed more than 20 million, sprang into action.

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Webster was in Memphis driving home from a Saturday at work when his wife told him he had received a call from the CDC. He called back, waited, called again, and this time got the news: "The virus is moving."


On Dec. 1, Queen Elizabeth Hospital sent Lim a specimen from a 54-year-old male who had developed a fever and a cough and soon had to be admitted, apparently suffering from pneumonia. Four days later, Lim's lab succeeded in growing a virus extracted from his specimens. The next day, the patient died. Lim tested the virus with her H5 reagents. Again, a positive.

Lim knew that she had another specimen in her lab, taken from a 13-year-old girl admitted to Prince of Wales Hospital so sick that she had been placed on a respirator. The hospital had identified the underlying virus as Influenza A but wanted Lim to determine the subtype. Lim asked her lab technicians to come in early the next morning, Saturday, Dec. 6, to test specimens from the two patients. Both again reacted to the H5 reagents.

By then the CDC's Fukuda was already in the air, aware only of the initial two cases--not Lim's most recent discoveries. That weekend Lim's daughter complained of a sore throat. Instantly the dispassionate virologist became a frightened mother. She barred her daughter from all sports and canceled her piano lessons.

As his plane crossed the Pacific, Fukuda consoled himself with the fact that in six months only two cases of H5 flu had occurred. Upon his arrival, a medical officer with the Hong Kong Department of Health greeted him warmly, then gently told him of the latest discoveries. "The good news," the officer said, "is we will have a nice dinner. The bad news: there are two more cases."

This brought the total to four. Two patients had died. One was on a respirator. Fukuda, a member of the pandemic planning committee, suddenly had a glimpse of what it might be like to confront an explosive outbreak. It is one thing to plan rationally, he says. "It's another thing all of a sudden to be struck with a sense that, my God, what will happen if there are a thousand cases like this? What will happen to all of those people? How will hospitals cope? How will any of us cope?"

In short order, more cases began turning up throughout Hong Kong. On Dec. 4, a 24-year-old woman developed a fever, sore throat and cough, and complained of dizziness. Five days later, she was in the intensive-care unit on a respirator with a confirmed case of H5 influenza. On Dec. 7, a five year-old girl began vomiting and developed other flu symptoms. H5 again. On Dec. 12, another child, a cousin of the five-year-old, came down with a fever and was hospitalized with H5. And a new outbreak of H5 had turned up on a fourth chicken farm in the New Territories.

In Fukuda's war room, Room 58 of the health department's downtown headquarters, a large whiteboard listed all the cases and tracked their medical progress. A big downward arrow meant death. With new urgency, Fukuda and the CDC hunted the sources of infection, collecting 3,000 blood samples and helping question some 2,500 people.


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