AIRBORNE

by Genese Sodikoff

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In this political climate of upheaval and uncertainty, writing about emerging pandemics seems, all of a sudden, off-topic. Why dwell on disease when the bedrock of liberalism is being pulverized? We are entering unknown waters on a rising tide of anger and fear. The United States, the second largest CO2 emitter after China, is poised to back out of the Paris climate agreement, gut the Environmental Protection Agency, exploit public lands, and unfetter fossil fuel extraction. This means that in addition to sea-level rise, extreme weather events, drought, famine, jeopardized drinking water, and biodiversity loss, species and microbes will continue to be pushed into new geographic ranges, triggering more frequent disease outbreaks and what is likely to be a global pandemic.

Take, for example, wild aquatic birds, many species of which are already endangered by the loss of watery habitats and climate warming. Population ecologists have modeled how global warming disrupts the innate choreography of bird migrations and the availability of marine food sources. When the timing is thrown off, wild and domestic birds come into more frequent contact where previously they may have bypassed one another. In terms of sheer human self-interest, migratory waterfowl pose a risk to our meat sources. Wild birds are reservoir hosts of influenza A, and they can carry it their intestines without getting sick. Through excretions landing in soil and water or through direct contact, wild birds can transmit the virus to domestic birds and trigger outbreaks of the highly pathogenic “bird flu” (H5N1). The disease devastates commercial poultry flocks, and although human infections are relatively uncommon, they are often fatal.

Bird flu (H5N1) gained notoriety during the 1997 outbreak in Hong Kong, but its existence was known as early as the late 1870s. Since then, outbreaks have occurred in Korea, Thailand, Viet Nam, Japan, China, Cambodia, Laos, and then extended into Europe, the Middle East, West Africa, and the United States. When flu is detected in a farm bird, whole flocks must be culled. From December to May 2015, nearly 34 million birds died or were culled across 15 states in the Midwestern United States due to outbreaks of three different strains of bird flu. The gravest danger lies in viral mixtures and re-assortments. If the avian and swine influenza viruses meet inside a pig's body, the viruses can combine to create a new subtype that transmits easily mammal-to-mammal via airborne droplets.

Disease outbreaks are social phenomena and political events. Epidemics flare up in terrains shaped by power-brokering over oil drilling, mining, fracking, factory farming, conservation, and vaccine distribution. Poor, rural areas of the globe have been hit especially hard by epidemics, when vaccination and quarantine efforts hit snags, and human survival often depends on one's status and privilege. Infectious disease outbreaks also ferment rumors about the state, the healthcare agents, and large corporations that want to eradicate disease carriers through genetic manipulation. Some of these rumors went viral during the 2014 Ebola Virus epidemic in West Africa and with this year's Zika Virus in Brazil. The same thing happens in rich countries. Not a year into his first term, Obama confronted a swine flu (H1N1) pandemic that killed 1000 people and risked infecting many more. Vaccine production hit a bottleneck, and conspiracies circulated about the safety and effectiveness of the vaccine supply (the administration was accused of colluding with corporate interests to foist unnecessary vaccines on citizens). In the end the swine flu was milder than expected.

For most of us living in well-off countries, the flu shot is our only glimpse of the vast network of biosecurity devoted to flu surveillance and control. Medical anthropologists have been examining various tentacles of the biosecurity network in flu epicenters, immersing themselves in the worlds of poultry farmers and scientists. Deep long-term study yields data about scientists' and farmers' work, as well as human-bird interactions that laboratory analyses cannot or do not always capture.

Scientific studies of bird flu outbreaks and efforts to control them began in Hong Kong as early as the 1970s, according to anthropologist Lyle Fearnley, of Singapore University of Technology and Design, who explains how the interfaces of wild and domestic birds in flu epicenters, such as Poyang Lake in China, became “sentinel indications of future pandemic dangers.” Sentinel is a military term referring to a soldier who stays on the look out for the approaching enemy. These wild-domestic bird interfaces bring avian influenza from the sky to poultry farms to human homes. Also examining bird flu in Hong Kong, Frédéric Keck, an anthropologist at the Centre National de la Recherche Scientifique, argues that the entire territory of Hong Kong gradually became a sentinel post of avian influenza overlaid with invisible viral pathways. Although sentinel posts can alert the world to impending danger, they also become tragic and anxious places when flu strikes.

Urban fringe

Ethnographic studies can themselves alert the world about life transformed by bird flu. Anthropologist Natalie Porter points out the extent to which poultry saturates all our lives: “Poultry flesh and fetal matter comprise our breakfast scrambles, barbecue dinners, and baked desserts. Chicken eggs propagate our flu vaccines. Ducks' downy feathers beckon our touch, and their waddling bodies beg to be fed.”

Dr. Porter started her long-term fieldwork in Viet Nam after the 2003 bird flu outbreak, when over the next few years 45 million birds were slaughtered, and an alarming number of people got sick: 106 cases of human cases and 52 deaths occurred. Poultry farmers' daily tasks bring them into intimate contact with birds. She labored alongside farmers and veterinarians, picking up chicken droppings, vaccinating ducks, bringing birds to the crowded urban food markets, and she observed people at home as they made the occasional ritual sacrifice of a chicken to the ancestors, processing the birds in their homes. In rural Viet Nam, as in many other countries, chickens serve as tributes to dead ancestors meant to ensure harmonious relations with the dead. Through these varied encounters, Dr. Porter saw constant opportunities for pathogen spillover, points at which influenza could potentially breach the species barrier between fowl and human.

She deploys the term “viral economies” to describe the social life of flu epicenters, where global health interventions spark contests over living biological property (such as birds and viruses) and access to veterinary resources and knowledge. The mood of Vietnamese people post-outbreak was anxious. She told me that people were afraid to consume poultry or eggs for years afterward, even though the price of chicken had been steadily dropping due to the availability of cheaper supermarket chicken. KFC (the fast food chain) even resorted to offering the large sum of 1,000,000 dong, the Vietnamese currency, to anyone who died of the company's chicken (strange comfort!). Multinational efforts to combat the disease through a country-wide vaccination campaign for fowl helped to tamp down the feeling of panic. Initially meant as an emergency measure, the vaccination campaign has persisted, becoming part of routine farm life. Rural poultry farmers, some of whom maintain small, free-range flocks and others who have scaled up, now must present vaccination certificates for their fowl to cross village boundaries. Avian influenza in Viet Nam persists. The threat of outbreak lurks on farms and in wet urban markets packed with live poultry and other food animals, but the Vietnamese state downplays the risk because it is economically costly.

A theme emerges: we cannot disentangle ourselves from our animals or entirely remove ourselves from the flow of pathogen traffic. What else is there to do really, but to embrace the reality of our porous species bodies, pathogens coursing from one creature to another as we eke out our lives? How do you contain a virus that is boundless, swooshing around the skies in bird bodies, and inconstant?

Bioengineering is one defensive strategy: scientists have created a genetically modified chicken that cannot infect other birds with influenza (though it can die of it). It remains to be seen, however, if people will flock to buy GM chickens or whether a viral strain will find its way around the genetic fix. Vaccines are our best weapons now.

Yet flu viruses resist biochemical meddling over time, and it's hard to stay ahead of viral mutations and re-combinations. We store influenza strains from animal reservoirs and stockpile vaccines, preparing for pandemic, as Dr. Keck explains. The strategy is imperfect. Certain strains may no longer be circulating, or vaccines may be ineffective. Useless vaccines are incinerated. Fowl vaccination campaigns contribute to the evolution of viruses as well, since some poultry inevitably miss out on shots and end up keeping a viral strain in quiet circulation. “In a sense,” Dr. Keck writes, “the epidemic never stops beginning, as a phylogenic ancestor can always be found in a collection of samples that was previously unknown or not analysed.”

What we have is a pernicious feedback loop of livestock production, global warming, and rising levels of avian influenza as migratory birds change their flight paths. The endless human demand for meat, which drives the proliferation of mega-farms,adds to greenhouse gas emissions (methane, specifically). Greenhouse gasses cause the climate to warm, and this diverts the flight paths of aquatic birds. Contact between wild and domestic birds intensifies, and viruses have greater opportunity to transform.

Landscape4

We live and labor alongside increasingly risky animals, as we must, hoping technology can keep pace with cures, but we stop short of changing the food and fuel production systems that underlie disease emergence. Influenza viruses mutate and thrive in environments shaped by excessive human desires. The loud promise of unbridled growth and the denial of climate change are symptoms of a pathogenic terrain.

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