(2 of 12)
While the outbreak highlighted the success of the surveillance network, it also showed how dangerously mutable influenza viruses can be and that, in their most sinister forms, they can be as deadly as any other disease known to man, more akin to Ebola than to the fevers and aches most people associate with flu. Virologists say the decision to kill all the chickens in Hong Kong--widely derided at the time--was in fact the smartest thing that could be done and that it might have prevented a more widespread disaster. "The question is," says Robert Webster, chairman of the virology department at St. Jude Children's Research Hospital in Memphis, Tenn., and a key actor in the quiet drama played out in Hong Kong, "did they close the stable door before or after the horses had gone?"
The CDC grabbed most of the headlines with its usual Ghostbusters aplomb, and even dispatched a public relations officer to accompany the agency's team of epidemiologists. But at least three investigations coalesced in Hong Kong. Only by following all three does the true significance of the outbreak become clear. Taken together, these threads weave a story that begins 80 years ago and winds forward through venues as varied as a high-security lab in Ames, Iowa, the ancient tissue collections of the Armed Forces Institute of Pathology in Washington and a frozen mass grave on Alaska's Seward Peninsula.
The Hong Kong Incident, as Webster calls it, arrived with cinematic timing--an almost supernatural confluence of event and inquiry. It occurred amid heightened sensitivity to the dangers of newly emerging viruses and just as several teams of researchers were closing in on the mysterious 1918 "Spanish flu," which killed more than 20 million people. At the same time, it turns out, public-health officials were quietly intensifying plans for the next great global epidemic, or pandemic.
While the rest of the world was wringing its hands over the remote threat from such exotics as Ebola and hantavirus, the health officials were busy staring down a far more likely global disaster and produced a closely held Pandemic Planning Document. In the course of their meetings, the planners are said to have wrestled with such issues as what to do if the President dies and how to deal with masses of dead or severely ill citizens, considerations reminiscent of civil-defense planning for nuclear war. The planners are so certain that another worldwide epidemic will occur that they refer to the present as the "interpandemic period."
The full story of the Hong Kong Incident begins in 1918 with the most lethal epidemic in human history, one that eclipsed even the medieval Black Death. "It's why we do what we do every year," says Roland A. Levandowski, the Food and Drug Administration's chief flu expert and a member of the pandemic planning group. "This experience in Hong Kong, even if it doesn't go anywhere, is a reminder that these things can happen."
The pandemic of 1918 remains a mystery. It began with a relatively mild initial assault on March 4, when the first reported case occurred at Camp Funston, Kans. Within four months, the virus had traversed the globe. The flu sickened millions but killed relatively few, and in the tumult of World War I, the first wave seemed pretty mundane.