THE BLOG
01/10/2012 04:17 pm ET Updated Mar 11, 2012

The Viral Storm

The village of Pang Thruk in the Kanchanaburi province of Thailand is like many in this part of the world -- humid, lush, and spilling over with sounds of wildlife. Located in the west of the country near the border of Burma, Pang Thruk is home to about three thousand people whose livelihoods depend on the sugar and rice they grow. In December 2003, it was also home to Kaptan Boonmanuch, a six-year-old boy who would be among the first people to die of a brand-new human virus.

Kaptan loved riding his bicycle, climbing trees, and playing with his plastic toy Dalmatian that pulled three puppies in tiny brown wagons as it barked mechanically. Kaptan also enjoyed helping his family on the farm.

Nearly every family in Pang Thruk kept egg-laying chickens; some also kept roosters for cock fighting. Kaptan's aunt and uncle lived just down the road on their open-air farm of around three hundred chickens. Each winter in the village a few chickens would die from suspected infections or colds, but in December 2003 chicken deaths increased dramatically. That winter, as on many farms in this region, the chickens in Kaptan's uncle's farm suffered from severe diarrhea, strange behavior, and weakness. All of them either died naturally or were culled as a result of their illness -- and Kaptan helped with the dead. A day or two before the New Year, according to reports, the boy carried one of the sick squawking chickens home. That walk home would have lasted no more than a few minutes.

A few days later Kaptan grew feverish. A clinic in the village diagnosed him with a cold, but after three days without improvement, his father, Chamnan, a rice farmer who worked part time as a driver, took him to a public hospital. X-rays revealed that the six-year-old had pneumonia, and he was kept in the hospital for observation. A few days more and Kaptan's fever spiked to a dangerous 105 degrees. His father paid the equivalent of thirty-six dollars for an ambulance to speed him to better care at Siriraj Hospital in Bangkok, more than an hour's drive away.

Upon arrival, Kaptan presented with shortness of breath and fever. Tests revealed that both lungs were affected with severe pneumonia, and the boy was transferred to the pediatric intensive care unit and put on a ventilator. A series of bacterial cultures tested negative, showing that the infection was likely caused by a virus. More detailed testing using a molecular technique called the polymerase chain reaction, or PCR, revealed that Kaptan was likely infected with an atypical type of influenza -- perhaps one not yet seen (or seen widely) in humans.

After eleven days of illness, the boy's fever finally began to cool off. However, despite intensive care, his respiratory distress worsened. Just before midnight on January 25, physicians took Kaptan off the respirator. His lungs drowning in fluids, he became Thailand's first known death from H5N1, which would soon become known around the world as "bird flu."

As sad as Kaptan's death was -- and the reports go on to describe the boy's funeral and the family's mourning in tragic detail -- the reality is that children in the developing world die from diseases like this all the time. And infectious diseases, which scientists in the 1960s predicted would be eliminated in short order, remain some of the most important killers today. But when it comes to global risk, all deaths are not equal. Most deaths from infectious diseases are localized events that, while dire for the victims and their families, present limited risk to the planet as a whole. But some, like Kaptan's, signal a potentially world-altering event: the first human infection by an animal virus that may wipe out millions, or hundreds of millions, of people throughout the planet -- permanently changing the face of humanity.

The main objective of my work is to hunt down these events -- the first moments at the birth of a new pandemic -- and then work to understand and stop them before they reach a global stage. Because pandemics almost always begin with the transmission of an animal microbe to a human, it's work that takes me all around the globe -- from rain forest hunting camps of central Africa to wild animal markets of east Asia. But it also takes me to cutting-edge laboratories at the U.S. Centers for Disease Control and Prevention (CDC) and disease outbreak control centers at the World Health Organization (WHO). Tracking down these potentially devastating bugs has led me to study how, where, and why pandemics are born. I work to create systems that can accurately detect pandemics early, determine their likely importance, and, with any luck, crush those that have the potential to devastate us.

As I've lectured on this work around the world and taught undergraduates in my virology seminar at Stanford University, it's hard to ignore a growing general interest in these topics. Everyone recognizes the raw power that pandemics have to sweep through human populations and seemingly kill indiscriminately. Yet, given the importance of these events, large questions remain remarkably opaque:

How do pandemics start?

Why are we now plagued with so many pandemics?

What can we do to prevent pandemics in the future?

This book is my attempt to answer these questions -- an effort to assemble the pieces of the pandemic puzzle.

Excerpted from THE VIRAL STORM: The Dawn of a New Pandemic Age by Nathan Wolfe, published October 11th by Times Books, an imprint of Henry Holt and Company, LLC. Copyright © 2011 by Nathan Wolfe. All rights reserved.

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