73 “will stop or spread”: “Hong Kong Tests Show Human-to-Human Transmission of Bird Flu Difficult,” Agence France Presse, Dec. 27, 1997.
73 “measures are sufficient”: Keith B. Richburg, “Hong Kong Killing All Chickens in Fight Against ‘Bird Flu’ Virus,”
73 more bad news: For discussion of the poultry outbreaks in late December 1997, see L. D. Sims et al., “Avian Influenza in Hong Kong 1997-2002,”
75 would kill every last chicken: For an overview of the 1997 poultry outbreaks and government response, see Kennedy F. Shortridge et al., “Interspecies Transmission of Influenza Viruses: H5N1 Virus and a Hong Kong SAR Perspective,”
75 The government pressed: Robin Ajello and Catherine Shepherd, “The Flu Fighters,”
75 bloody chaos: Billy Wong Wai-Yuk, “Tears of Anger, Rivers of Blood,”
76 On the third day of the slaughter: “Tung Handling of Flu Crisis Attacked,”
76 In a front-page editorial: “Only Time Will Prove Wisdom of Dramatic Move,”
76 the “botched” operation: “Taking Charge,”
76 nearly 350 chickens: Kennedy F. Shortridge, “Poultry and the Influenza H5N1 Outbreak in Hong Kong, 1997: Abridged Chronology and Virus Isolation,”
76 more widespread than expected: Kennedy F. Shortridge et al., “Characterization of Avian H5N1 Influenza Viruses from Poultry in Hong Kong,”
77 a pandemic had been averted: Kennedy F. Shortridge, J. S. Malik Peiris, and Yi Guan, “The Next Influenza Pandemic: Lessons from Hong Kong,”
77 its most successful: Several researchers have held up Hong Kong as the model. See, for example, Robert Webster and Diane Hulse, “Controlling Avian Flu at the Source,”
78 Their main exposure: Anthony W. Mounts et al., “Case-Control Study of Risk Factors for Avian Influenza A (H5N1) Disease, Hong Kong, 1997,”
78 would resurface in 2001: On this outbreak and Hong Kong’s response, see Yi Guan et al., “Emergence of Multiple Genotypes of H5N1 Avian Influenza Viruses in Hong Kong SAR,”
78 the virus struck yet again: For an overview of the poultry outbreaks in 2001- 2002, see L. D. Sims et al., “Avian Influenza in Hong Kong 1997-2002,”
Chapter Three: The Elephant and the Lotus Leaf
This chapter draws on interviews with WHO infectious disease specialists and other officials in both Geneva and Asia, public health officials and medical professionals in Thailand, and internal documents from WHO.
81 “Influenza has been an epidemic illness”: Prasert Thongcharoen,
82 blame the spiraling death toll on the weather: Newin Chidchob, deputy agriculture minister, is quoted in “Thailand Declared Free of Bird Flu,”
85 researchers had confirmed: Arthit Khwankhom and Sirinart Sirisunthorn, “Govt Ignored Chula Warning,”
86 “We were fighting”: “What Happened When the H5N1 Virus Visited Thailand,” lecture at the Asia Medical Forum, Lancet 2006, Singapore, May 4, 2006.
87 “Irresponsible media”: Tini Tran, “WHO Says SARS Helped Asia Prepare for Bird Flu; Poultry Culls Continue,” Associated Press, Jan. 16, 2004.
87 “There’s absolutely no evidence”: Alisa Tang, “Thai Cabinet Seeks to Boost Confidence of Chicken-Wary Public,” Associated Press, Jan. 19, 2004.
88 a confidential tip: Internal WHO report, Jan. 20, 2004.
90 broader resurgence of infectious disease: For an excellent exploration of what was optimistically called the Health Transition and subsequent setbacks, see Laurie Garrett,
91 Storm clouds were gathering: See, for example, David L. Heymann and Guenael R. Rodier, “Hot Spots in a Wired World: WHO Surveillance of Emerging and Re-emerging Infectious Diseases.”
91 WHO’s rapid response: David L. Heymann and Guenael Rodier, “Global Surveillance, National Surveillance and SARS: Commentary,”
93 Subsequent study: Kulkanya Chokephaibulkit et al., “A Child with Avian Influenza A (H5N1) Infection,”
94 followed right behind: For a synopsis of Thailand’s experience with avian flu in 2004, see Thanawat Tiensin, et al., “Highly Pathogenic Avian Influenza H5N1, Thailand, 2004,”
95 “It’s not a big deal”: Sutin Wannabovorn, “Thailand Confirms Two Human Cases of Bird Flu as Infection spreads Through Asia,” Associated Press, Jan 23, 2004.
97 teams were running short: Tipawayan Kwankhauw, “Anger and Tears as Thailand’s Farmers Cull Millions of Chickens,” Agence France Presse, Jan. 25, 2004.
100 mixing vessel: See, for instance, S. Scholtissek et al., “The Nucleoprotein as a Possible Major Factor in Determining Host Specificity of Influenza H3N2 Viruses,”
