A review of The Fatal Strain: On the Trail of Avian Flu and the Coming Pandemic, by Alan Sipress

Last year pandemic influenza—specifically the H1N1, or swine flu, variety, which has killed about 10,000 Americans to date—garnered its share of headlines. Despite the Bush Administration’s extensive preparations and large investments in 20052008 to combat new aggressive strains of flu, our national response was too uncertain this past fall, especially with respect to over-promising and under-delivering the much needed vaccine. It was not nearly the sort of swift response necessary to contain a contagious disease.

In The Fatal Strain, Alan Sipress addresses how critical early and concerted action is in order to prevent widespread pandemic flu outbreak. Sipress, a reporter for the Washington Post, has traveled extensively through Asia’s avian flu hotspots, detailing the outbreaks and near misses that have emerged in the last decade.

He describes in bloody detail a Thai cock fight that may shock squeamish readers. But more shocking still is that even though “cockfighting has repeatedly been implicated as a killer,”the sport continues to spread disease within and across borders, throughout Thailand, Vietnam, Malaysia, and possibly, via smuggled birds, even to Indonesia.

What’s more, secretive government policies in southeast Asia aimed at protecting poultry and agricultural markets stifle proper warnings about health risks. The lack of modern communications such as cell phones delay the dissemination of necessary information to key health officials in time for them react and respond. And the close proximity between people and the birds that carry the disease greatly increases the risk of infection.

Sipress has a personal reason for writing his book. His great-grandmother died mysteriously back in Poland early in the last century, and Sipress describes the turmoil the untimely death imposed on the family, as the widowed great-grandfather abandoned his children, including Sipress’ grandmother, who drifted around Europe until being rescued by relatives in America. After his grandmother’s death, Sipress and his mother found some documents that enabled them to calculate his grandmother’s birth date, and hence the great-grandmother’s approximate time of death: 1918, the year of the great influenza. Armed with this likely proof, he writes, “the last great epidemic suddenly felt much closer” before adding ominously, perhaps at his publisher’s request, “So did the next.”

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Unfortunately for Sipress, this book is about H5N1, or avian flu, which was all the rage a few years ago, rather than H1N1, or swine flu, which emerged as the most recent threat. He acknowledges this briefly in his conclusion, noting that “swine flu remained unpredictable.” Still, it did not contradict his central message, which was “[a]gain, get ready.”

Although Sipress did not have time to fold much detail about swine flu into his book, one thing in this latest episode has been clear: both the Pan American Health Organization and the Mexican government had about two weeks in which to react quickly and fiercely to the virus, but were instead slow to get on the ball. We have been fortunate thus far that swine flu has been less deadly than feared, and that avian flu still has not been widely transmitted from human to human.The Fatal Strain shows that there are enough holes in the system that we may not be able to count on our luck holding out forever.