Spillover - By David Quammen Page 0,188

tell which was which. He was up to his elbows in gore. He wiped his hand. Blood leaked again into his cut, dribbled again into it from the chimp, and again he wiped. He had no way of knowing—no language of words or thoughts by which to conceive—that this animal was SIV-positive. The idea didn’t exist in 1908.

The chimpanzee’s virus entered his bloodstream. He got a sizable dose. The virus, finding his blood to be not such a different environment from the blood of a chimp, took hold. Okay, I can live here. It did what a retrovirus does: penetrated cells, converted its RNA genome into double-stranded DNA, then penetrated further, into the cells’ nuclei, and inserted itself as DNA in the DNA genome of those host cells. Its primary targets were T cells of the immune system. A certain protein receptor (CD4) on the surface of those cells, in the Cut Hunter, was not very different from the equivalent receptor (another CD4) on the T cells of the butchered chimpanzee. The virus attached, entered the human cells, and made itself at home. Once integrated into the cellular genome, it was there for good. It was part of the program. It could proliferate in two ways: by cell replication (each time an infected T cell copied itself, the retroviral genome was copied also) and by activating its little subgenome to print off new virions, which then escaped from the T cell and floated off to attack other cells. The Cut Hunter was now infected, though apart from a slash on the hand he felt fine.

Forget about Gaëtan Dugas. This man was Patient Zero.

Maybe he carried the chimp carcass, or parts of it, back to his village in triumph—as the boys of Mayibout 2 later carried an Ebola-filled chimp carcass back to theirs. Maybe, if he was Baka, he delivered the whole thing to his Bantu overlord. He didn’t want to eat it anyway. If he was Bantu himself, his family and friends feasted. Or maybe the chimp was a windfall from which he could afford to take special profit. If the season had been bounteous, with some duikers or monkeys killed, some forest fruits and tubers to eat, a good crop of manioc, so that his family wasn’t starving, he may have lugged his chimpanzee to a market, like the one in Moloundou, and traded for cash or some valuable item, such as a better machete. In that case, the meat would have been parceled out retail and many people may have eaten bits of it, either roasted or smoked or dried. But because of how the virus generally achieves transmission (blood-to-blood or sexually) and how it doesn’t (through the gastrointestinal tract), quite possibly none of those people received an infectious dose of virus, unless by contact of raw meat with an open cut on the hand or a sore in the mouth. A person might swallow plenty of HIV-1 particles but, if those virions are greeted by stomach acids and not blood, they would likely fail to establish themselves and replicate. Let’s suppose that fifteen different consumers partook of the chimp meat and that they all remained fine. HIV-negative. Lucky folks. Let’s suppose that only the Cut Hunter became infected directly from the chimp.

Time passed. The virus abided and replicated within him. His infectiousness rose high during the first six months, as virions in multitude bloomed in his blood; then the viremia declined some as his body mounted an early immune response, while it still could, and leveled off, for a period of time. He noticed no effects. He passed the virus to his wife, eventually also to one of the four other women with whom he had sex. He suffered no immune deficiency—not yet. He was a robust, active fellow who continued to hunt in the forest. He fathered a child. He drank palm wine and laughed with his friends. And then a year later, let’s say, he died violently in the course of an elephant hunt, an activity even more perilous than butchering chimpanzees. He was one of seven men, all armed with spears, and the wounded elephant chose him. He took a tusk through the stomach, momentarily pinning him to the ground. You could see the tusk hole in the dirt afterwards, as though a bloody stake had been driven in and pulled. Of the men who scooped him up, the women who prepared him for burial, none had an open cut and so they were

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