From Earth in Transition
Children playing along a river bank spot hundreds of bloated pig carcasses bobbing downstream. Hundreds of miles away, people are grossed out by the rising stench from thousands of dead ducks and swans piling up along river banks. Meanwhile, three unrelated humans stagger into three different hospitals, gasping for air. Two quickly die of pneumonia and the third lies in critical condition in an intensive care unit.
It's the classic scenario for the birth of a global pandemic. And it's in the news today from China.
Last week, I wrote about the 16,000 pigs (so far) who'd been found floating down the river through Shanghai. And the 1,000 ducks.
I didn't mention the three humans who'd been admitted to hospitals in the region, gasping for air, two of whom died quickly while the third remains, as of this morning, in intensive care.
Today, in Foreign Policy magazine, Pulitzer Prize-winning journalist Laurie Garrett connects the dots in a red-alert global warning entitled "Is This a Pandemic being Born?" (Subscription may be required.)
Garrett, a senior fellow for global health at the Council on Foreign Relations, provided much of the science background for the movie Contagion. She knows her stuff. She writes upfront that we don't know much yet, but that we are certainly looking at a new virus, H7N9. It's possible that we're simply witnessing something that's already run its course and has affected very few people. It's equally possible that we're witnessing the birth of something very dangerous to humankind.
Initially, the dead pigs and ducks looked to most people like just another environmental horror along the banks of rivers that are already shockingly polluted. The pigs might just have been dumped, like so much other toxic garbage, by factory farms and pig brokers upstream.
But by the end of March, at least 20,000 pigs and tens of thousands of ducks and swans had washed upon riverbanks that stretch 1,500 miles from Lake Qinghai along the Sichaun River. And Lake Qinghai is a key site for people investigating bird flu. Garrett writes:
The lake is the most important transit and nesting site for migratory aquatic birds that travel the vast Asia flyway, stretching from central Siberia to southern Indonesia. In 2005, a mass die-off of aquatic birds in and around Lake Qinghai resulted from a mutational change in the long-circulating bird flu virus, H5N1 -- a genetic shift that gave that virus a far larger species range, allowing H5N1 to spread for the first time across Russia, Ukraine and into Europe, the Middle East and North Africa -- it has remained in circulation across the vast expanse of Earth for the last seven years.
Thousands more birds and pigs may have have died without being counted – perhaps buried or burned by farmers wanting to keep them out of sight of the authorities.
Around the same time as the first pigs and birds were seen dead, three people were admitted to separate hospitals. First Li, an 87-year old retiree, was hospitalized in Shanghai with severe respiratory distress and pneumonia. On March 4, he went into severe cardio-respiratory failure and succumbed. Around the same time:
A 27-year-old butcher or meat processor [named Wu] fell ill with respiratory distress, was hospitalized, and died on March 10.
The day Wu succumbed, a third individual, a 35-year-old woman identified as Han, was hospitalized in the city of Nanjing, though she came from distant Chuzhou City, in Anhui province, about 300 miles northwest of Shanghai. Han is reportedly in critical condition, in intensive care. To date, no connection between the three individuals has been found.
The elderly Li may have been part of a family cluster of illness, as his 55-year old son died of pneumonia in March, and another 67-year-old son suffered respiratory distress, but has survived.
China's new National Health and Family Planning Commission has now announced that all three humans were infected with H7N9, a virus never previously found in humans. Garrett writes:
It is therefore extremely worrying to find two people killed and one barely surviving due to H7N9 infection.
One very plausible explanation ... is that the H7N9 virus has undergone a mutation -- perhaps among spring migrating birds around Lake Qinghai. The mutation rendered the virus lethal for domestic ducks and swans. Because many Chinese farmers raise both pigs and ducks, the animals can share water supplies and be in fighting proximity over food -- the spread of flu from ducks to pigs, transforming avian flu into swine flu, has occurred many times. Once influenza adapts to pig cells, it is often possible for the virus to take human-transmissible form. That's precisely what happened in 2009 with the H1N1 swine flu, which spread around the world in a massive, but thankfully not terribly virulent, pandemic.
If the pigs, people, and birds have died in China from H7N9, it is imperative and urgent that the biological connection be made, and extensive research be done to determine how widespread human infection may be.
If [the two dead humans] are a "two of three," meaning two dead, of three known cases, the H7N9 virus is very virulent.
... The mystery is deep, the clock is ticking, and the world wants answers.
If we were imagining how a terrible pandemic would unfold, this could certainly serve as an excellent script.
Yesterday, the Hong Kong government's Centre for Health Protection issued a press release warning people about H7N9, including advice to, among other things, avoid direct contact with birds and their droppings, and to avoid crowded places and people with fevers. The government also advises people traveling to or from Hong Kong to monitor their own health and report any flu symptoms to a doctor immediately.
Sounds just like the opening sequence in the movie Contagion.