Mystery fever

<strong>China Syndrome: the true story of the 21st century's first great epidemic</strong>

Karl Ta

Much is made in the west of China's booming economy. But there are inevitable downsides to what has been described as the "greatest mass urbanisation in the history of the world". In China Syndrome, Karl Taro Greenfeld probes one of them: the Sars (Severe Acute Respiratory Syndrome) epidemic of 2003, in which an estimated 884 people died, and which only narrowly escaped becoming a devastating pandemic of 15-20 per cent mortality.

It is thought that Sars originated in the city of Shenzen, in southern China's Guangdong province. Early on, Greenfeld swoops in on the aptly named Fang Lin, an illegal immigrant to the city from the countryside, who finds a job handling and slaughtering exotic wild animals for restaurants. "Wild flavour", as it is known, is an important ingredient in China's new culture of conspicuous consumption. Thanks to lax regulation, the trade in snakes, camels, otters, monkeys, badgers, bats, pangolins, geese, civets, wild boars - anything that can be trapped or hunted - has become a multimillion-dollar industry. Animals are kept in filthy conditions in the backs of restaurant kitchens, where they are butchered only after diners have made their choice. Fang Lin would emerge after a night's work covered in the blood and excreta of panicked animals, and would chain-smoke to kill the stench.

It is in this overcrowded, pollution-ridden environment that a virus hops over the species barrier, from civet cats to humans. Sars is born. But it has yet to be identified. The disease that emerges is a terrifyingly contagious mystery fever, developing swiftly to a horrific pneumonia, fatal in many cases, and with a high incidence among healthcare staff.

Meanwhile, in Hong Kong, sensitive and alert after the 1997 outbreak of avian flu, a handful of migratory birds are found dead of the H5N1 influenza. The fear that the new, atypical pneumonia in China, word of which spreads through medical networks, might be the dreaded, mutated avian flu is tested repeatedly, after samples of body effluvia pass perilously and illegally from mainland China to laboratories in Hong Kong. The negative results only add to the rising panic.

The story unfolds like a whodunnit, with a large cast of rogues, victims and heroes. The chief villain is the Chinese government, so secretive and paranoid that it seems it would rather unleash a deadly virus upon the world than be castigated for letting foreigners blame China for it. As one microbiologist comments: "Human lives just aren't as valuable in China." But the author reminds us that this ostrich-like attitude is not unique; indeed, it mirrors the Reagan administration's response to Aids in the 1980s.

The heroes are the medical and nursing staff who continue to care for patients, knowingly putting themselves at risk, and the journalists who "bomb" the hospital corridors and wards looking for the truth. But human nature is ever contradictory, and the competitive instinct of scientists to be the first to identify the virus, and of journalists for a scoop, sometimes impedes the life-saving sharing of information.

At the 11th hour, with a change of party secretary enabling a high-level volte-face, due infection precautions are installed. But the end is far from happy. A whistle-blowing senior surgeon is put under house detention; reporters are arrested. The wild animal markets, having been outlawed, go underground; but within months the government is talking about reinstating them. In Vietnam, in 2004, the government covers up cases of avian flu rather than upset the preparations for the South-east Asian Games.

Leopards don't change their spots; governments spin and conceal; humans take monstrous risks; and lethal viruses (our only natural predators) lurk in the undergrowth. This book is a parable for our times.