Slaying the Viral Dragon

Published March 1, 2011 11:17 AM by Gail Guterl

Alan Sipress' book is a story of David and Goliath, only in reverse. Unlike the oversized Goliath, the "giant" in Sipress' book The Fatal Strain: On the Trail of Avian Flu and the Coming Pandemic, is tiny. It is so miniscule it cannot be seen without special magnification; yet it is powerful enough to insinuate itself into the human body and kill. The David in this tale is man, much larger than any infectious agent, but totally at the mercy of this invisible virus that is one-hundredth the size of the average bacterium.

In Sipress' tale, David/man is doing his best to track the avian virus wherever it is hiding around the world, analyze its characteristics and, if lucky, find a way to prevent it with a vaccine. The Davids of the epidemiologic world belong to groups like the World Health Organization (WHO) and the CDC. They respond rapidly to rumors of flu in small villages, darting from Vietnam to Laos to Cambodia, Hong Kong, China and Indonesia, investigating the source of viruses and verifying their symptoms at the bedside and characteristics in the lab.

Sipress, economics editor at The Washington Post, traveled to nine Asian countries to research this book, acting like an eco-detective seeking the source of avian flu - formally called influenza A virus subtype H5N1.

His opening chapter leaves one wondering if this war is already lost before any major battles have been waged. As Sipress vividly describes in chapter one, Dowes Ginting, a 32-year-old Sumatran, is very sick and seeks care in a local hospital. Seeing other members of his family die in the hospital after having the same symptoms he has, Ginting flees to the hills, encountering (and possibly infecting) many people along the way. He seeks a cure from a local witch doctor and works hard to evade the WHO flu specialist who is tracking him. When they finally meet up, Ginting agrees to give Timothy Uyeki, MD, a throat sample but he refuses to go back to the hospital. After all, he has three more treatments left with the witch doctor!

Multiply this by millions of cases and Goliath will certainly turn the tables on David. Viruliferous birds all over Asia and their proximity to populous areas may make it impossible to contain any outbreak of H5N1.

But, in the name of quality patient care and global health, all healthcare professionals must rally around the Davids waging battle against these tiniest of enemies. This includes relentless infection control and vigilance when assessing patients. In this war against a killer, everyone is a David and everyone's efforts count.

How are you fighting the battle?