be done but to find him and put him in quarantine immediately.
“Have you produced an electron micrograph?” Henry asked Catherine.
“Yes, we have a negatively stained sample that revealed typical influenza particles, but it was weird.”
“Weird in what way?”
“There were no neuraminidase proteins.”
Henry suppressed a groan. This meant this was not influenza A, and the only flu treatment in widespread use—neuraminidase inhibitors, such as Tamiflu—would be useless. Until now, pandemic flu had always been of the A type. Now they had a new contender, with qualities that had never been combined before. It was a totally novel virus.
“Have you considered that it could be an influenza C?” Marco asked.
“Yes, of course, but when we put it through electrophoresis”—the process of separating charged molecules in a cell according to their size—“we found that the virus has eight genomic segments.” That was a characteristic of influenza A, rather than C or D, which had seven RNA segments. “We’ve never seen anything like it,” she concluded.
As the call was ending, Catherine pleaded, “Henry, we need you back here. You’ve been gone for two weeks now. With you and Marco both in the field, we’re shorthanded at the top.”
“I’ll be back as soon as possible,” Henry said. “I just want to make sure there’s no contagion here in the kingdom. Give me another week.”
“A week!” Catherine said in dismay.
Maria weighed in, offering to send another team from WHO to oversee the hajj surveillance.
“How long would that take?” Catherine asked.
“I can get them to Jeddah in three days,” Maria said.
As soon as the conference was finished, Henry called Jill.
“I’ll be home on Friday,” he said exultantly.
12
Jürgen
In Henry’s mind loomed the specter of the 1918 influenza, which had infected 500 million people and killed as many as 20 percent of them. The victims were disproportionately young and vigorous adults. No one knew exactly where it originated; it was termed the “Spanish” flu because, during the First World War, Spain was neutral, and the press was free to report on the outbreak. Later investigations suggested that the first cases had been in Haskell County, Kansas, or in the Ford Motor plant in Detroit, or in China, or Austria—no one really knew. But once it got into the compressed quarters of the military camps and troop transports, it became a raging beast, leapfrogging efforts to contain it, spreading through cities and even the smallest villages around the globe, killing far more people than the war itself. The bewildering disease—repeatedly misdiagnosed as cholera, dengue, meningitis, and typhoid—was a more dreadful adversary than anything the contemporary medical establishment had ever encountered. Some infections took a week to manifest symptoms, but some victims were fine at lunch and dead by dinner. And like the Kongoli virus, the Spanish flu was hemorrhagic. Sudden nosebleeds were common. Lungs dissolved into a bloody froth.
The idea that Kongoli would simply flame out was in all likelihood a wishful fantasy. Still, it had happened before. In February 1976, at Fort Dix, New Jersey, a young recruit named David Lewis collapsed and died after a five-mile march. After more than two hundred soldiers fell ill around the same time, doctors detected two strains of influenza A at the post. One of them, H3N2—a variant of the earlier Hong Kong flu—was labeled A/Victoria. It was highly infectious, but of average virulence. The other strain, which had killed Private Lewis and infected perhaps one other person, was unknown, so the post doctors sent it to the CDC.
It was H1N1, with the same genetic architecture as the Spanish flu. This time it was called “swine flu,” because pigs had been the reservoir for the disease. (In 1918, the transmission had likely been the other way around—from humans to pigs.) Pigs were often blamed for being virus factories because they were an almost perfect bridge between avian influenzas and human diseases. Once inside a pig, the virus adapted itself to mammals and, having breached the species barrier, was ready to conquer the world.
In 1976, alarmed by the situation at Fort Dix, President Ford called for an all-out effort to immunize the population against the swine flu as quickly as possible. Drugmakers were released from liability to speed the development of vaccines. Then another mysterious outbreak took place that August at an American Legion convention in Philadelphia, killing twenty-nine people. The initial diagnosis of swine flu was wrong—it turned out to be an atypical pneumonia that would later be called Legionnaires’ Disease—but the press and the political establishment whipped up so much public