species divide. As a microbiologist, he long probed the mysteries of avian influenza at the U.S. Department of Agriculture’s elite poultry research lab in Athens, Georgia. Once the disease launched its unprecedented attack on Southeast Asia, WHO called for reinforcements, and Perdue crossed to the human health side, signing on to the agency’s global influenza program in Geneva. From there, he was repeatedly dispatched to investigate human outbreaks. WHO is in a bind, he told me. As long as the virus remains primarily an animal disease, the agency must often defer to agriculture officials, who have priorities beyond fighting infectious disease—for instance, promoting livestock development. “It’s sort of animal health versus human health. It’s challenging,” Perdue said. “The problem is, once it becomes a human virus and WHO is clearly engaged, then maybe it is too late, because then it’s off and running.”
The trail of the fatal strain led me from one end of Southeast Asia to the other. I tracked the virus across nine countries, through hospitals and laboratories, into chicken coops, rice paddies, wet markets, and cockfighting rings. Yet few places were as remote and none as awesome as the floodplain of the Tonle Sap.
For much of the year, this lake in northwestern Cambodia is modest, covering slightly more than a thousand square miles at depths of about a yard. But each June, monsoon rains swell the Mekong River and its tributaries, forcing the water to back up into the lake and transforming it into the largest freshwater body in all of Southeast Asia. The lake’s waters overflow the banks and inundate another five thousand square miles, covering nearly a tenth of Cambodia’s area. Fields and forests are submerged. Then, with the coming of the dry season each October, the waters drain away.
Over the generations, Cambodians have adapted to the furious but predictable mood swings of their habitat. Many have built their homes on stilts to stay clear of the rising waters. Some inhabitants migrate with the shoreline, dismantling their dwellings as the water advances and reassembling them farther out. Others live on houseboats or floating homes of thatch, palm fronds, and clapboard mounted on bamboo rafts. This ecosystem has also made the shores of the lake and the surrounding floodplain a unique wintering ground for Asia’s wild birds.
It was the birds that brought me to the Tonle Sap. The monsoon was only weeks away, and soon they would migrate to summer breeding grounds in China, Japan, Siberian Russia, and even across the Bering Sea to North America. What if the birds were infected? Would the virus follow the multitude of flyways that radiate out from the Tonle Sap?
Few outside of Cambodia had heard of this wilderness. Yet here, in utter silence but for the occasional ruffle of wings, with no other sign of human life on this vast, flat expanse, I wondered whether a plague could be taking shape. If so, no place on Earth would be left untouched.
I came to the Tonle Sap floodplain looking for the virus. I found an insight. I realized we’re all living on a floodplain.
Several times each century, a novel flu strain emerges, often from the fountainhead of Southeast Asia. Death and disorder wash across the face of the planet. Sometimes they just skim the surface; other times they deluge all that lies before them. Then they recede. This cruel cycle isn’t as predictable as that of the Tonle Sap waters. But it is equally inevitable.
Those who live around the Tonle Sap have adapted with forethought and creativity to nature’s challenge. They have learned to ride out the flood. We have yet to do so.
For much of the last generation, the silence has been deceiving. Not since 1968 had a new flu virus menaced humanity and circled the world. But the outbreaks of avian flu that multiplied over the early years of this new century made it hard to continue mistaking luck for a change in the laws of nature. “The present situation is unique,” Margaret Chan has admonished from her bully pulpit in Geneva. “In the past, pandemics have always announced themselves with a sudden explosion of cases, and taken the world by surprise. For the first time in history, we have been given an advance warning.” She calls this an “unprecedented opportunity” for countries and communities to get ready.
Then swine flu broke out. Researchers initially concluded it was spreading as vigorously as each of the three last pandemic strains. But soon it seemed the attack rate was no greater than that for ordinary flu bugs. Still, the epidemic’s ultimate course remained uncharted. Public health officials once more were making fateful decisions, whether, for instance, to embark on a crash vaccine program amid scientific uncertainty. Like all flu viruses, especially those so new to us, swine flu remained unpredictable. Its message, however, was unmistakable. Again, get ready.
Though governments have recently taken steps to gird the world for a pandemic, too little has been done. As I write, epidemic planning for hospitals and public health systems remains wanting. Preparations in other essential sectors, in particular those to ensure supplies of food, water, electricity, and fuel and to maintain public order, are even more deficient.
It’s surprising how few people know the horrors of 1918. Perhaps that cataclysm is overshadowed in memory by the final months of World War I, a conflict that recast the geopolitics of the world and defined a generation. Perhaps epidemics exist outside of history, ideology, and meaning, and their imprint vanishes like footsteps on the beach, especially when people have no one to blame for their tragedy, no grievance to harbor. It could be that people simply want to forget suffering. Or maybe we believe, as an advanced civilization, we’ve moved beyond plagues. By that reasoning, 1918 belongs to another, remote era of little relevance to today.
After I started this book, I told friends and colleagues what I was writing. The response wasn’t what I expected. Time after time, they would mention relatives who had died during the Spanish flu, a grandfather’s brother, a distant cousin. My architect told me his uncle and two other kin are buried in Jamaica after perishing in 1918. Then, several months before I finished the first draft, I discovered evidence of another visitation.
Growing up, I’d heard the story about how my grandmother’s mother, Yetta, had died as a young woman back in Poland. No one seemed to know precisely when, and no one ever mentioned the word
My grandmother, we heard, was eight at the time. It turned her life upside down. Soon after, Grandma’s father abandoned the family, leaving her to care for her younger sister and brother. They drifted from place to place, sleeping one night here, another there. Grandma found odd jobs to feed them, even working for a time picking fruit in orchards around Warsaw. Ultimately, her two maternal uncles sent for the children. The pair had earlier immigrated to New York, where one became a political pamphleteer and the other, according to family lore, hosted the longest continuously running pinochle game in the Bronx. Grandma left her homeland and crossed the ocean.
We’d never done the math to determine what year great-grandmother Yetta died. We couldn’t, because we didn’t know when Grandma was born. Grandma had lied on her American immigration papers to pass for a few years older so she could line up work. Over the rest of her life, the birth date on her government papers was fiction. When she finally passed away in 2006, she herself wasn’t sure how old she was. But my mother later came across Grandma’s marriage contract in an old file. On the back of this crumbling religious document, the date of the wedding was noted in pencil. With that clue, we could calculate Grandma’s birth date. She had been born in 1910. It meant Yetta had died, and our history pivoted, eight years later in 1918.
The timing wasn’t absolute proof that flu had been the killer. But the odds were overwhelming. The last great epidemic suddenly felt much closer. So did the next.
Acknowledgments
One of the secrets of foreign correspondence is how indebted we are to our local assistants. They translate not only language, when necessary, but culture. They help us conceive our stories, arrange logistics, navigate politics, identify the sources and subjects to interview, and, after all that, do old-fashioned reporting, sometimes at great personal risk, with rarely a byline to show for it. So the initial thanks have to go to Yayu Yuniar, a dogged, delightful journalist in Jakarta. Long before Indonesia confirmed its first human case of bird flu, Yayu dove into the
