October 5, 2012 7:36 pm

The next human pandemic

In his new book, ‘Spillover’, award-winning author David Quammen tracks the most deadly pandemics
David Quammen at his home in Bozeman, Montana©Ian Van Coller

David Quammen at his home in Bozeman, Montana

In 2000, David Quammen sat around a campfire in the middle of the forests of Gabon, in west Africa, with a dozen Gabonese gold miners. They had taken a break from digging for gold in equatorial mud to work as porters, bushwhackers and cooks for Mike Fay, a tropical field biologist who was traversing 2,000 miles of Central African forest, on foot.

“He took data every step of the way,” Quammen, an award-winning author, later wrote, “recording elephant dung piles and leopard tracks and chimpanzee sightings and botanical identifications, all going into his waterproof yellow notebooks in scratchy left-handed print, while the crewmen strung out behind him toted his computers, his satellite phone, his special instruments and extra batteries, as well as tents and food and medical supplies enough for both him and themselves.”

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Quammen struck up a conversation with two of these crewmen over a fireside dinner of fufu (“like an edible wallpaper paste”), about a rash of deaths in their home village four years earlier. They told Quammen about the group of boys that had gone hunting for porcupines, but instead found a dead chimpanzee. They brought it back to the village, where people cooked it and ate it. Two days later, all of them started getting sick, with vomiting, diarrhoea, fever, headache. Some of the family members who cared for them fell ill, too. In the end 31 people got sick and 21 died. One of the crewmen watched his brother and nearly all of his family die, holding his niece as she took her last breaths.

French virologists later determined that an Ebola virus was the cause of what the villagers called “the epidemic”. It had most likely crossed from the chimp to humans during the banquet, what scientists label a spillover event. Over the two weeks Quammen spent with the crew, Fay noticed a trend in the data he was collecting: the group had “stepped across 997 piles of elephant dung and not one dollop from a gorilla”. The apes, too, were dying from Ebola.

At the time, Quammen was writing a series of articles about Fay’s data-collecting trek for National Geographic. But the story of the Gabonese gold miners, and the utter lack of gorillas in prime gorilla habitat, stuck with him. Six years later, he began research for what would become Spillover: Animal Infections and the Next Human Pandemic. Published in the UK this month, Spillover charts the development and spread of the world’s deadliest viruses, in a literary crescendo that starts with a little-known horse virus in Australia, builds through frightening waves of Ebola and Sars, and peaks with HIV.

A colourised SEM micrograph of an HIV-infected cell©Getty

Colourised SEM micrograph of an HIV-infected cell

Quammen, 64, is a nonfiction writer known for weaving the complicated details of ecology and evolutionary biology into winding tales about Romanian dictators and Chinese rat farmers. He won the prestigious Stephen Jay Gould Prize this year from the Society for the Study of Evolution, for advancing the understanding of evolutionary science through books such as The Reluctant Mr Darwin and The Song of the Dodo.

Quammen spent six years researching Spillover, following field scientists in Bangladesh, Malaysia, Hong Kong, Uganda, the Netherlands and New York State, as they looked for the animal hosts of Nipah, Sars, Ebola, Marburg, HIV and Lyme disease. “I hope something interesting and non-lethal will happen,” he says of his field trips. “Preferably a non-lethal catastrophe.”

While bursts of headlines catch the attention of the wider public – “Swine flu closes 600 schools in the US”, “Mad cow disease panicking Europe as incidents rise” and even the recent “Disease outbreak in Saudi Arabia linked to Sars family” from two weeks ago – Quammen’s goal is to trace the history of all the disparate viruses and bacteria, and weave them together to reflect a real, growing, global pattern of emerging diseases.

Sixty per cent of all human infectious diseases are caused by either wild or domestic animals. Such spillovers have accounted for almost 100 million deaths in the past century, from the great influenza outbreak of 1918-20 to the current Aids crisis, which, as Quammen explains, had its human start in a spill­over from a chimp in Cameroon and has killed 30 million people worldwide.

What today’s scientists are searching for, and what Quammen wants to bring to the attention of lay people, are the diseases of the future.

“There’s no reason to assume that Aids will stand unique, in our time, as the only such global disaster caused by a strange microbe emerging from some other animal,” he writes. “Some knowledgeable and gloomy prognosticators even speak of the Next Big One as an inevitability. If you’re a seismologist in California, the Next Big One is an earthquake that drops San Francisco into the sea, but in this realm of discourse it’s a vastly lethal pandemic.”

. . .

When he’s not chasing biologists through the Congo, Quammen usually rises in the morning around 6.30am. He heads down the wood stairs of his modern craftsman house in Bozeman, Montana, grabs a handful of dried fruit in the kitchen, and ducks into his office. He sits at the blond wood desk and opens his white Mac laptop. Harry, his lumbering 130lb Italian shepherd dog, thumps down on the carpet, keeping watch at the door. Quammen reads a bit to wake his brain up.

Viruses from animal hosts

Marburg, Nipah

Bats have been one of the commonest sources of ‘spillover’

Hendra

Named after the suburb of Brisbane where it emerged among horses

Sars

A civet sold in a Chinese market is blamed for the spread of Sars

A bar-headed goose©Minden Pictures

Avian flu

The H5N1 strain has been passed by wild fowl such as bar-headed geese to domestic poultry

“I drink coffee until I go into a trance and then I start writing,” he says. “I’ll rummage through my notebooks and journal articles for half an hour, and write a sentence. Then I’ll rummage through things for another 20 minutes and write another sentence … Then it’s in the second draft that I improve the rhythm and the music.”

The literary scores that result are reminiscent of William Faulkner, Quammen’s greatest influence. When I visit Quammen in Montana, he tells me that it is Faulkner’s 115th birthday. He pushes some books aside on a shelf to reveal a bust of the great American novelist, and a framed photograph of him as a young man.

Quammen studied the structure of Faulkner as a Rhodes Scholar at Oxford university, analysing the sophisticated, impressionistic backbone of works such as The Sound and the Fury and As I Lay Dying. “I use it every day,” he says of his graduate studies. “I don’t like books that are too orderly. I like books that are organic, that have complicated structures, that are surprising page by page but have a sense of inevitability to them once you see the whole thing.”

Quammen grew up in the suburbs of Cincinnati, alternately running through the woods and writing poems and skits and stories. He moved to Montana in 1973, shortly after graduating from Yale, and continued a similar pattern: fishing, cycling, skiing – and writing. He wears the typical male uniform of the state, blue jeans and an earth-toned button-down cotton sports shirt, a grey moustache to match a head of grey hair.

His first book, published when he was 22 years old, was To Walk the Line, an autobiographically inspired novel about the friendship between a black man and a white man in racially charged Chicago in the late 1960s. It was 13 years before he published another one, this time a spy novel. Over the course of his next two books, Quammen realised his true calling was writing nonfiction. “I was a white, middle-class guy from a happy childhood in Ohio,” he says. “Who needs that guy to be a fiction writer?”

But Quammen’s quiver of fiction devices are what set his books apart from those of the academics and scientists writing about the same things. In Spillover, Quammen transforms those virology nerds, and their secret scientific languages, into characters in a plot: the Australian veterinarian who wrestled with horses thrashing from Hendra virus; the infectious disease doctor in Singapore who took mucus samples from the first coughing Sars patients; and the Alabama-based Aids researcher who traced the early spread of HIV to prostitution rings in the Belgian Congo.

“I’ve tried to turn a really serious, dire, complicated subject into a guilty pleasure,” he says.

Quammen’s chilling accounts of victims in the wrong place at the wrong time give readers a way to relate to these diseases, and a reason to care about the details of the coronavirus – where each viral particle is surrounded by a crown of knobby proteins – and the bat that passed it to a palm civet, a mongoose-type mammal, which passed it to other civets clustered together in a frenetic open market in south-east China, which were all sold to people shopping for dinner.

Human outbreak

Astrid Joosten surrounded by South African children©Karlijn Bastiaansen/ED.nl

Marburg

Astrid Joosten died of Marburg, possibly after touching a rock in a cave

A microscopic image of the Hendra virus

Hendra

On its first emergence the virus killed 13 horses and their trainer

Sars

In 2002-03, Sars spread rapidly from Hong Kong to reach 37 countries

Avian flu

Scientists fear that an H5N1 strain adapted to human-human infection could be disastrous

There was Esther Mok, the young girl who went to Hong Kong on a shopping vacation, picked up Sars from a coughing, sneezing man staying in a hotel room down the hall from hers and brought it back to her home in Singapore where it eventually killed her mother, father, uncle, and pastor. She survived. Or Astrid Joosten, the Dutch woman who visited a python cave in Uganda, and touched some bat guano when she put her hand down on a rock, then later unwrapped a piece of candy and, as her widower believes, ingested Marburg virus. She later died back home in the Netherlands.

The death or near-death of these two women, otherwise young and healthy, inspires a sense of horror in the reader, over their tremendous bad luck, but also some sense of worldly injustice. While these women were not “responsible” for their illnesses, in the way that modern society holds lung cancer or cirrhosis or Aids patients “responsible” for theirs, Quammen points out in Spillover that there are indeed broader human causes for the increase in these outbreaks in recent decades.

Globalisation is a huge factor. As the human population reaches 7 billion, and an increasing number of us travel with greater frequency from Hong Kong to Toronto, from Maramagambo Forest in Uganda to Boulder, Colorado, the potential reach of infectious disease outbreaks has been vastly magnified. The chances for a new virus to spill over from a monkey or a bat into people has also increased as humans have intruded into the natural habitats where these animals live. When rainforests get cut down, displaced wildlife is forced to find food and new homes closer to villages and towns, multiplying the opportunities for exposure.

Sometimes, the proximity to these animals makes them more appealing lunch entrées to humans. “The worst thing about a timber concession in a tropical forest is not necessarily that all of the trees are going to be cut,” Quammen says, “but if you’ve got 500 men living in a camp there, those guys have to eat something, and chances are there will be paid hunters going out in the forest every day killing monkeys and bringing them back to feed those workers.”

Exotic animals are increasingly poached not just for subsistence, but also as a commercial product. The newly rich want to demonstrate their economic power by dining on hippopotamus, elephant or ape meat. Quammen recalls a court case of an affluent African immigrant in New York who had a shipment of bushmeat smuggled to Brooklyn for a taste of home. “Imagine a container of smoked monkeys coming from west Africa,” he says, “and what the epidemiological possibilities of that are.”

. . .

After all the time Quammen has spent reading and writing about viruses, after all the accounts of spouses, families, villages wiped out by disease, after shadowing so many scientists obsessed with the Next Big One, he remains level-headed about the threat of emerging diseases.

“When I first read about Ebola, the notion of getting on a plane and going to the place where that virus lived seemed to me foolhardy to the point of suicidal,” he says. “The more I learned about these diseases, the more my irrational fears were replaced by rational concerns. None of this is going to stop me from going back to central Africa and walking through the forest.”

With every new virus, biologists and infection control doctors learn more. Science has advanced almost as quickly as human travel patterns have expanded. Forecasting and diagnosis of new viruses have greatly improved, incorporating new technologies. Public health responses have become much faster and more co-ordinated across borders. And public awareness is slowly increasing as more scientific work is discussed in the media, and storytellers like Quammen translate it in books for general audiences.

 

Ultimately what he wants to leave readers with is not an alarmist fear of animals and disease, but a more comprehensive portrait of an interconnected world. “One of the salubrious things about infectious disease is that it reminds people that we are not separate from nature,” he says. “It’s a reminder of our connectedness to the rest of the living creatures on planet Earth.”

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April Dembosky is the FT’s San Francisco Correspondent. ‘Spillover: Animal Infections and the Next Human Pandemic’ by David Quammen is published by the Bodley Head (£20)

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