Specter 12-20-10

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http://slidepdf.com/reader/full/specter-12-20-10 1/950 THE NEW YORKER, DECEMBER 20 & 27, 2010

LETTER FROM CAMEROON

THE DOOMSDAY STRAINCan Nathan Wolfe thwart the next AIDS before it spreads?

BY MICHAEL SPECTER

Wolfe’s world consists of “bacteria, parasites, and viruses”; animals are “a tiny little addendum.” Photograph by Martin Schoell

“L ook up,’’ Nathan Wolfe barked.I didn’t respond immediately, so

the next suggestion came with an el-bow to the ribs: “Take your head out of that map.” We were standing on theside of “the road,” a dirt highway thatpasses through the center of Min-dourou, a dusty logging village insoutheastern Cameroon. Wolfe, thedirector of Global Viral Forecasting,

and several colleagues were in themidst of a ten-hour drive from the cap-ital, Yaoundé, to a town called Ngoila,one of the many sites that G.V.F. has

established in the past decade to mon-itor the emergence of deadly virusesfrom the jungles of Central Africa. Henodded toward a couple who had justpulled up beside us on a Chinese mo-torcycle. The driver wore ip-ops anda red tracksuit. His passenger, dressedin a pale-blue shirt and a matching pill-box hat, looked as if she were on her

way to church. But that wasn’t where

they were headed. Her right arm was wrapped around the driver’s waist. Inher left, she clutched the lengthy tail of a freshly killed agile mangabey, a mon-

key often found in the lush forests of the region.

“Those monkeys are viral ware-houses,” Wolfe said to me, as the cou-ple drove toward the market, drag-ging their bloody merchandise behindthem. Mangabeys carry many virusesthat infect humans, including one that

may cause a rare form of T-cell leuke-mia and another, simian foamy virus,the ultimate impact of which is not yetknown. Wolfe is a forty-year-old biol-ogist from Stanford University; a swar-thy man with a studiously dishevelledlook, he comes off as a cross between apirate and a graduate student. He isalso the world’s most prominent virushunter, and he spends much of his timesifting through the blood of wild ani-mals. “When I see a monkey like that

dragged through the street, bloody, onthe way to market, it’s like looking at aloaded weapon,’’ he said. “It scares me.”

For much of the ride from Yaoundé,

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Wolfe had been expounding upon thehealth dangers posed by bushmeat, thecommon term for tropical wild game,

which includes monkeys, gorillas,chimpanzees, porcupines, scaly anteat-ers, cane rats, and other animals. Hu-mans have subsisted on bushmeat formillennia, and in this part of Africa it

remains a principal source of protein—sometimes the only source. CentralAfricans consume at least two milliontons a year. It is not easy to convincesomebody whose only alternative ishunger and malnutrition that eatingmonkeys or apes can be more of athreat to him than it was to his an-cestors. Yet the health risks are enor-mous—not just for the Africans whokill and eat them but for billions of others throughout the world. If not for

the consumption of bushmeat, AIDS, which has so far killed thirty millionpeople and infected more than twicethat number, would never have spreadso insidiously across the planet. Thatpandemic, the most lethal of moderntimes, began nearly a century ago, inCameroon, when a chimpanzee virus

was transmitted to the blood of some-one who almost certainly hunted,butchered, or ate it.

Deadly viruses have always threat-

ened humanity, but a virus can travelonly as far as the cells it infects. For mostof human history, that wasn’t very far. Afew hundred years ago, if H.I.V. hadpassed from an ape to a hunter, that per-son would have become sick and died.He might even have infected his entire village, killing everyone around him. Butthat would have been the end of it. There were no motorcycles to carry the infectedcarcasses of slaughtered apes to marketsin Yaoundé, and, for that matter, no air-planes to ship them to Paris or New York. Forests had been impenetrable forthousands of years. In the past few de-cades, however, new roads, built largely by logging companies, have broughteconomic opportunity to millions of Africans, along with better medicine,clean water, and improved access to ed-ucation. Yet, seen from the perspectiveof a virus, those roads, combined withair travel, have created another kind of opportunity, transforming humanity into one long chain of easily infectedhosts—no less vulnerable in Californiathan in Cameroon.

Genetically, we are not an especially diverse species; an epidemic that cankill people in one part of the world cankill them in any other. “There is simply no greater threat to humanity than a viral pandemic,” Wolfe told me. “Whatis more likely to kill millions of peo-ple? Nuclear war or a virus that makes

the leap from animal to man? If, tomor-row, I had to go to Las Vegas and placea bet on the next great killer, I wouldput all my money on a virus.” The No-bel Prize-winning molecular biologist Joshua Lederberg once expressed asimilar sentiment, writing that viruses were “the single biggest threat to man’scontinued dominance on this planet.”For most experts, the question isn’t whether another deadly virus will ap-pear, either naturally or from a lab in

the form of a biological weapon, but when. “We cannot afford to let anotherepidemic likeAIDS get out of control,” Wolfe said. “Why are we sitting aroundpassively waiting until new diseases in-fect half the globe?”

Wolfe compares the current ap-proach to infectious epidemics to thetreatment of cardiovascular disease inthe nineteen-sixties. At the time, doc-tors could do little more than wait un-til heart-attack or stroke victims were

rushed to the hospital, and then dotheir best to keep them alive. As ourknowledge of factors like diet, smok-ing, and blood pressure deepened, theemphasis shifted largely from treatingheart disease to preventing it. “When

you know what the risks are, then your job is to lower them,’’ Wolfe said. “And with viral epidemics we are begin-ning to know what the risks are. Yet,by the time we mobilize, it is invari-ably too late. Look at H1N1”—the2009 inuenza pandemic that infectedas many as ninety million people in theUnited States alone and hundreds of millions throughout the world. “Sincethe strain turned out to be unusually mild, people said we made too muchof a fuss. There was the sentiment—I have heard it expressed numeroustimes—that the public health serviceoverreacted by trying to vaccinate asmany people as possible. That’s wrong.

Wrong. Wrong. Wrong.” Wolfe’s voice rose half an octave with each word. “They did exactly what they should have done, and even that didn’t

help much. If H1N1 had been more virulent, it would have killed millionsof people. Maybe tens of millions.Once it got out there, that thing burnedright through the forest. We caught anamazingly lucky break, but let’s notkid ourselves. Luck like that doesn’tlast.”

Wolfe continued his soliloquy formuch of the trip into the jungle—evenafter an unfortunate pit stop notable fora painful run-in with a column of redants. To reach Ngoila, we had to crossthe Dja River the only way possible: by ferryboat. Instead of an engine, how-ever, the pilot relied on an elaboratepulley system and on the willingness of passengers to haul on the rope them-selves. The crossing may well havebeen the highlight of Wolfe’s week:

he joined the tow line and guilted meinto pulling, too. We made it to Ngoilaas darkness fell.

After a restorative meal, Wolfe saidit was time to look for bats, noting thatthey were among the most dangerous viral reservoirs on earth. At that, he andI marched into the pitch-black forest,accompanied by several members of histeam and the thunderous honking of Epomopsbats.

Most virologists spend their work-ing lives in laboratories, lookingat slides, focussing on specic proteinsand, often, on a single disease. Nathan Wolfe’s life conforms more to the pat-tern of a nineteenth-century explorerthan to that of a twenty-rst-century bi-ologist. Instead of big game, however, Wolfe’s trophies are viruses. A fastidi-ous man who shaves his beard to a roughstubble every few days (and does thesame thing to his head every few weeks), Wolfe has an office in San Francisco, where Global Viral Forecasting isbased, and another at Stanford, wherehe is the Lorry I. Lokey Visiting Pro-fessor in Human Biology. He spendsat least half his time in California butdoesn’t seem entirely at home there—unless the conversation turns to infec-tious diseases. Then Wolfe is all in. Hecan talk for hours about hemorrhagicfevers, river blindness, the Barmah For-est virus, and malaria—which, he willbe happy to tell you, once nearly killedhim. Wolfe nds the idea of the vi-rome—the collective genetic structure

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of every virus on earth—so captivatingthat he once described the world to meas a place that consists almost entirely of “bacteria, parasites, and viruses,” add-ing that “animals really have to be seenas a tiny little addendum.” The un-

dergraduate seminar he teaches at Stan-ford each spring, on the ecological sig-nicance of microorganisms, is calledViral Lifestyles.

A few decades ago, Wolfe’s micro-bial obsession would have been con-sidered eccentric. The victory overcommunicable diseases seemed as-sured. In 1967, William H. Stewart,the Surgeon General, told a gatheringof health experts at the White House,“It is time to close the books on infec-tious diseases.” That statement wasnot wholly without justication. Inthe West, at least, polio, typhoid, chol-era, even measles—all major killers—had essentially been vanquished. Small-pox, which was responsible for thedeaths of more people than have diedin any single war, soon disappeared.

Since then, however, at least fty dangerous new viruses have passed fromanimals into humans. Some are so wellknown that their names are enough tomake people anxious: Ebola,SARS,avian inuenza. There are dozens of other diseases, like Lassa fever, brought

on by a disabling hemorrhagic virus rstdiscovered in Nigeria two years afterStewart’s testimony, as well as thosecaused by the Nipah, Hendra, andMarburg viruses, which are less fre-quently mentioned yet just as frighten-

ing. These illnesses are called zoono-ses—diseases that pass to humans fromanimals.

Wolfe is determined to break thispattern of disease transmission, whichbegan ten thousand years ago, with therise of agricultural communities anddomesticated livestock. In 2008, withfunding from Google.org, the SkollFoundation, the Department of De-fense, the National Institutes of Health,and others, he founded Global ViralForecasting, with a goal that was bothremarkably simple and stunningly am-bitious: to detect pandemics as they begin and stop them before they spread.

Wolfe and his rapidly expandingteam of researchers have created an ex-tensive network of viral listening postsin the villages of Central Africa, andthey have compiled a registry of virusesin many other places where pandemicsoften start: China, Malaysia, Madagas-car, and Laos. In the past decade, thegroup has collected more than a hun-dred and fty thousand blood samplesfrom hunters and their families, as

well as from the animals that they kill,butcher, and eat. The scientists screenthe samples to determine whether any humans have been infected with virusesthat came from animals. Virologistsrefer to the activity of viruses as they leap from animal to man as “viral chat-ter.” Wolfe and his colleagues monitor

samples for early warnings of an epi-demic, just as, he often says, analysts “atthe National Security Agency scour theInternet, listening for clues of impend-ing terrorist attacks.”

When Wolfe is in the eld, he func-tions more as an anthropologist thanas a biologist. The institute tries to keeptrack of hunters in scores of villagesthroughout Cameroon, the DemocraticRepublic of Congo, Gabon, and othercountries. Outreach teams offer health-

education classes and collect blood andtissue samples. This program, calledHealthy Hunters, is pure social work. Itisn’t easy for a foreigner (or anyone else)to tell rural Africans how to conducttheir lives. Customs vary widely. “Onone of my rst visits to a village sitein Cameroon, I was with my ex-wife,’’ Wolfe recalled recently. “When we ar-rived, the chief looked at her and askedme, ‘Ça c’est pour moi ?’ It took a secondfor me to get what he was asking.’’

The team tries to put local scien-tists out front and never to arrive in a village empty-handed. Before we left Yaoundé, Wolfe helped load a dozensoccer balls into the back of a LandCruiser. It is virtually impossible todrive by a eld in Cameroon withoutseeing a group of boys kicking some-thing around—fruit, rolled-up wads of cotton, sometimes an actual ball.

Everywhere Wolfe and his col-leagues go, they stress, in graphic de-tail, the critical point that primates arenot for eating. They long ago learnednot to push or proselytize. Hard sellsbackre—and usually aren’t necessary.In Central Africa, where people live in

wattle huts and dine on bushmeat, viruses like Ebola and H.I.V. are not vague or distant horrors. They are pres-ent always, like an endless war, killingneighbors and destroying lives.

The institute’s research has yieldeddisturbing results. In October, a groupthat included Wolfe published a re-port demonstrating that human parvo-

virus 4, which was thought to spread

“His Highness is changing his relationship status.”

• •

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solely through shared needles, is farmore prevalent in sub-Saharan Africathan had previously been believed.Needles and blood transfusions couldn’tpossibly account for all the cases. Moreominously, working with researchersfrom Cameroon and the Centers forDisease Control, in Atlanta, Wolfe

discovered that the simian foamy virus, which is endemic in Old World pri-mates, infects one per cent of those

who come into regular contact with go-rillas and other monkeys. That amountsto thousands of people walking aroundCameroon with a retroviral infectionthat may or may not lead to illness. Be-fore the study was published, the virus,

which earned its evocative name be-cause cells infected by it look foamy under a microscope, had never been

known to pass between wild animalsand hunters. None of the people in-fected with S.F.V. have shown signs of sickness. Yet, as H.I.V. has demon-strated, it can take years for a retrovirusto cause symptoms of a disease.

Wolfe hopes to create a databasecontaining genetic information fromthose viruses, a resource that biologi-cal engineers could use to assembleeffective vaccines from standard molec-ular parts. Building such vaccines,

while a long way off, is a fundamentalgoal of synthetic biology. Americanbioterrorism experts have shown par-ticular enthusiasm, though: any pro-cess that might protect humanity fromnatural viruses could also be deployedagainst viruses made by man.(This is just one reason thatthe Department of Defenseand other federal agencieshave been highly supportiveof Wolfe’s research.) “Themore we learn about how these viruses are transmittedto humans, the more likely

we will be able to stop them,’’Anthony S. Fauci, the direc-tor of the National Institute of Allergy and Infectious Diseases, said. “It is al-

ways better to prevent a disease than totreat it.”

Detecting viral pandemics beforethey spread will be hard; respondingto them before they spread will beharder still. “When it comes to under-standing the origins of human dis-eases, you would be surprised how lit-

tle we know,” Wolfe said. “Where dothe major diseases come from? How does a particular virus make the transi-tion into a human host? Is it inu-enced by certain types of behavior orcertain parts of the world? Why aresome viruses so much more deadly than others? We have no answers for

many of those questions.” Even if sci-entists succeed in identifying new vi-ruses before they escape into the widerpopulation, pandemics won’t disap-pear. “We know a lot about heart dis-ease,’’ Wolfe said. “But it still killsthousands of people every day.”

Like snakes, viruses have a reputa-tion as malevolent, poisonous, anddeadly. In fact, most snakes are harm-less, and dangerous viruses are rare. Inorder to inict serious harm, a virus

has to clear several biological hurdles.First, it has to remain unrecognized by the human immune system—to evadeany protective antibodies. The virus

would also need to make humans sick.(Most do not.) Finally, it would haveto spread efficiently—for example,through coughing, sneezing, or shak-ing hands. Many viruses fulll one of these criteria; some fulll two; farfewer meet all three. “Look at H.I.V.,’’

Wolfe said. “We would have to call

that the biggest near-miss of our life-time. Can you imagine how many peo-ple would already have died if H.I.V.could be transmitted by a cough?”

Viruses mutate rapidly, particularly in comparison with the glacial pace

of human evolution. Whatseems benign one day can be-come deadly the next. Cold viruses are usually consideredlittle more than nuisances, butSARS, a virus from the samefamily as many colds, is lethal.So is avian inuenza. “Whenit comes to predicting what a virus will do, we don’t evenknow what it is we need to

learn,” Wolfe said. “We are really justat the beginning.”

He continued, “There was a mo-ment in the nineteenth century before we had charted all the mammals in the world, and we found so many new spe-cies that people would say, ‘Oh, gosh, we will never document the diversity of animal life on this planet.’ And withmammals that now seems silly, because

you would have to search your entirelife to nd a new primate. That early moment of discovery is where we arenow with viruses. . . . I don’t want tooversell it. But in theory, at least, therecipe is simple. You plug the danger-ous viruses into some sort of vaccinepipeline. Get all the vaccine parts lined

up, put them together, and get them tothe people.” Wolfe’s optimism is easy to em-

brace. Nonetheless, the barriers toachieving control over our biologicalsurroundings are daunting. “I won’tsay viruses can be conquered,’’ DavidBaltimore told me. Baltimore, the for-mer president of Caltech, received aNobel Prize for his work in elucidat-ing the mechanics of retroviruses. “Notcompletely. But they don’t have to

conquer us, either.”

T he morning after we arrived inNgoila, Matthew LeBreton, the

ecology director of Global Virus Fore-casting, stood in a laboratory in theback of the group’s spare but well-equipped outpost. He slipped on asurgical smock, a pair of latex gloves, aface mask, and safety glasses. Then hepicked up a live fruit bat and dangled itat arm’s length. There are three dozen

species of bats in southeastern Camer-oon. LeBreton can identify all of them.Bats are well known for transmittingrabies, but they carry other debilitatingmicrobes as well; fruit bats, for exam-ple, are believed to be the principalsource of the Ebola virus. “The more

you know about bats the more you aregoing to know about viruses,’’ Le-Breton told me as he laid the choco-late-brown specimen on a digital scale.“We try to process them carefully andoften.”

LeBreton took urine and fecal sam-ples from the bat. He worked delib-erately, but with speed, spreading thebat’s wings and pricking them to ob-tain a blood sample, which he depos-ited in a vat of liquid nitrogen. He thenturned to me and said, “Now we set thebat free.’’

Later that morning, we drove toMbalam to watch Joseph Diffo, who was born in a similar Cameroonian vil-lage, discuss the dangers of bushmeat with local hunters and their families.Diffo has a master’s degree in zoology

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and has worked with G.V.F. as a wild-life technician since 2004. He servesas the site coördinator for eld sam-pling and hunter-education programs. The hunters had gathered early, set-tling into couches and armchairs thatthey had dragged to the village square.Diffo, a husky man in blue work pants

and a red checkered shirt, passed arounda sheaf of photographs. The group sud-denly became quiet.

“Do you see that boy?” Diffo asked,pointing to a recent picture of a localchild whose face and body were covered with the type of blistering lesions thatfor centuries were the hallmark of smallpox. “Why do you think he lookslike that?” Nobody answered—but any of them could have. “His father founddead monkeys lying in the forest,’’ Diffo

continued, speaking in French. “Hebrought them home to feed his family.’’At least one of those animals had beeninfected with monkeypox, which, whilemilder and less contagious than small-pox, can be deadly. “If you see a groupof animals lying in the forest, do notpick them up,’’ Diffo said. “Whateverkilled them can kill you.” It is a messagethat Diffo repeats constantly as hepasses through the villages of CentralAfrica. He comes armed with gruesome

pictures of dead primates, posters ex-plaining the health dangers posed by hunting bushmeat, and bars of soap forpeople to use after killing or butcheringtheir prey.

The audience was receptive; the re-pulsive pictures seemed to have an im-pact. Everyone collected a large bar of soap, and none of the questions thehunters asked were hostile, exactly.“What can you get us to replace thismeat?’’ one of them asked. Killing pri-mates may be dangerous for society and ecologically ruinous, but his chil-dren still needed to eat. “We don’t haveanything else to give them,’’ he said.

Diffo cast a worried glance at Wolfe, who was watching from the side. “Weknow that,’’ Wolfe said. “And we’re working on it. But there is no easy way out.”

Nathan Wolfe’s rst obsession was

with chimpanzees. “I alwaysloved them,’’ he told me one evening,

while we sat on the veranda of ourhotel in Yaoundé, where his Cameroo-

nian operations are based. “I spent years thinking about nonhuman pri-mates, and there came a moment, incollege, when I realized that, no mat-ter how often we claim otherwise, hu-mans are not the center of the world.

We are players in a much bigger andmore compelling drama. A lot of my

work is just an attempt to gure out what that drama looks like and where,exactly, we do t in.”

In the early nineteen-nineties, while studying as an undergraduateat Stanford, Wolfe became interestedin the self-medicating behavior of an-imals, and the fact that, as he later

wrote, “not all pharmacists are hu-man.’’ Many species use plants asmedicine in much the same way that

we do. Kodiak bears routinely chew the root of Ligusticum, an herb morecommonly known as bear root. They

spit the juice onto their paws and mas-sage it into their fur; researchers sus-pect it acts as an antibacterial agent.Birds also use plants as drugs, and they even appear to treat themselves withants, in a procedure known as “anting,”rubbing them vigorously through theirplumage, until the ants secrete pro-tective chemicals. (Wolfe’s interestin self-medicating behavior is not

wholly dispassionate. About a yearago, he switched from cigarettes to thePloom—a high-tech nicotine-delivery system. To “ploom,” one drops an alu-minum pod of tobacco into the cham-ber of a Plexiglas cigarette holder thatlooks like it was designed for George

Jetson. The Ploom delivers a mea-sured, vaporized dose of nicotine,

without tar or other cancer-causingchemicals. Wolfe loves to light up inrestaurants and theatres, and since no

THE BLUE HAMMOCK

Behind the toolshed, among the nettles,and rusting horseshoes, I buried the key.

The white dog watched me, whimpering,

as if he disapproved of what I was doingbut when I unearthed a bone and threw ithe bounded away, barking, into the eld.

I replaced the spade in the shed, strode off to the blue hammock, and climbed into it.

Swaying from side to side, I began to humthe tune from the rst spaghetti Western,

where Clint raises his poncho and shoots,

then lights up another cigarillo. Above methe silver birch with my initials stretchedupward to its far-off father, the moon.

They would never, ever nd that key, andin the morning I would head for Lisbon,

where I’d rent a room in hilly Alfama,then translate the entire work of Brecht.

The seagulls are huge there, and musical. The crows spend most time on the ground.

—Matthew Sweeney

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smoke escapes, nobody notices. “It’s atotal win-win for me,’’ he said, betweenpuffs on the strange device, which wasinvented by friends of his from Stan-ford. “Direct delivery of nicotine

without the risk of death.’’) Wolfe spent his junior year in the

zoology department at Oxford, where

he steeped himself in the theories of alongtime hero, Richard Dawkins, as well as in the work of other evolution-ary biologists. After graduating, Wolfebegan doctoral studies at Harvard,under the guidance of the British pri-matologist Richard Wrangham andthe noted neuroscientist Marc Hauser.

Wolfe intended to continue his ex-ploration of the primate medicinal ar-mamentarium, but Wrangham wasn’tencouraging. “He said that learning

how chimpanzees medicate them-selves would make a perfectly interest-ing thesis,’’ Wolfe recalled, “but to havean impact you are going to have tounderstand the underlying infectiousdiseases.’’ Wrangham told Wolfe thathe needed to become an expert in vi-ruses and parasites.

Soon, Wolfe says, “I got completely hooked on viruses. It is an area of ec-static ecological complexity.” While ingraduate school, Wolfe spent several

summers in Uganda, where eachmorning he foraged for dead mosqui-toes among the feces in gorilla andchimpanzee nests. “Not so glamorous,’’he said, shrugging. “But I was tryingto nd viruses in their blood. The idea

was to get mosquitoes after they hadhad a blood meal. I think I got aboutve.”

At the time, Wolfe was married toa social anthropologist he had met atHarvard. They argued energetically,but not in the way other people argue.“I was completely enamored with theidea that the best way to look at humanbehavior was to look at the behavior of animals,” Wolfe said. “I believed inevolutionary psychology. She was acomplete postmodernist.’’ He forcedthe last two words out of his mouth asif they were razor blades. “We hadfundamentally different views of thenature of human behavior. I would al-

ways say, ‘At the end of the day, we are just animals with some nice frostingon top.’ This drove her crazy. She wasinterested in how unique we are. The

ghts got pretty intense.” Divorce may have been inevitable—but it took a

while. First, she received a grant tostudy in Thailand, and Wolfe fol-lowed her, moving from Harvard toBorneo.

Wolfe’s job there was to rescueorangutans that had become stranded

in isolated parts of the forest wherethey could no longer survive. He wouldshoot the animals with tranquillizerdarts, then move them to a reserve

where they would be safe. Wolfe wasalso able to do research for his doctoraldissertation, on pathogens found inorangutan blood. “If you are trying togure out what out there can infect us,then looking at apes makes a lot of sense,” he said. “They have virtually thesame physiology as humans—but live

in these incredibly diverse terrestrialecosystems. And they are up to theireyeballs in the blood of different typesof animals.”

One day, he received a messagefrom his mother saying that an Army officer named Donald Burke was look-ing for him. Burke, the chief virologistat the Walter Reed Army Institute of Research, in Silver Spring, had met

Wolfe at a public-health conferencethe year before, and the men had spent

hours talking about their shared obses-sion with viruses. Burke’s job, loosely dened, was to keep the United StatesArmy safe from epidemics. For practi-cal reasons, the military has alwaysmade the control of tropical diseases apriority. Malaria, for example, hasoften caused more sickness and deathamong soldiers than bullets or bombshave. In 1943, in the midst of thePacic campaign, General DouglasMacArthur complained, “This will bea long war if for every division I havefacing the enemy I must count on asecond division in hospital with ma-laria and a third division convalescingfrom this debilitating disease!”

In the nineteen-eighties, Burke’s

studies of H.I.V. prevalence amongmilitary recruits were the rst to pro-

vide a meaningful snapshot of the epi-demic in the United States. The Pen-tagon wanted an AIDS vaccine urgently,and Burke was asked to direct theeffort. He started by exploring genetic

variations within the virus itself. As

with many infectious agents, includingpolio and inuenza, H.I.V. comes inseveral strains. A vaccine that will work for one will not necessarily work forall. Distinct regional variations arecommon: a single strain, for example,has been predominant in Europe andthe United States, another in SouthAfrica, and still another in SoutheastAsia.

As Burke studied the data, how-ever, he saw something remarkable.

There was one place where every strainof H.I.V. could be found: Central Af-rica. “If you looked at Cameroon andGabon, you would see the roots of theepidemic,’’ Burke said. “But nobody had any idea why.” Burke, who is now the dean of the school of public healthat the University of Pittsburgh, de-cided to investigate further.

Virologists and medical anthropol-ogists had long known that chimpan-zees and other apes carry viruses similar

to those which infect humans. That’shardly surprising, since those animalsare our nearest evolutionary relatives.Still, nobody had made an explicit con-nection between the diseases of non-human primates and AIDS. “I certainly had never heard the word ‘bushmeat’before I went to Cameroon,’’ Burketold me. “Let alone the possibility thatbushmeat was associated with theemergence of viruses.”

Burke made his rst trip in 1996, atthe invitation of Colonel Eitel Mpoudi-Ngole, a warm, garrulous man who ranthe country’sAIDS program, and who was commonly referred to as ColonelSIDA—the French acronym for AIDS.“You did not have to spend much time watching people hunting chimps to un-derstand that this was very clearly a pos-sible route of exposure,” Burke said.“There was blood everywhere, and noprecautions taken by the hunters ortheir wives.”

Burke and Mpoudi-Ngole selectedfteen linguistically and geographi-cally diverse villages in locations across

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Cameroon where they could test theblood of people who came in close con-tact with animals, particularly pri-mates. It may now seem like an obvi-ous undertaking, but essential ideas areoften obvious only in retrospect. WhenI met Mpoudi-Ngole in Yaoundé, hetold me that, by drawing attention to

that link, Burke had done more to im-prove the health of Africans than hadany other person alive.

Burke asked Wolfe to run the op-eration. Wolfe agreed, but told Burkethat he wouldn’t be free for at leasta year. Burke said he would wait.“That may have been my best scienticdecision,’’ he told me, only partly in

jest. Wolfe lived in Yaoundé for ve

years, beginning in 2000, and says he

loved every minute of it. He clearly feels at home there. Social skills are asimportant as scientic prowess to some-one who spends so much of his lifemoving from one research outpost tothe next, and Wolfe has a knack formanagement. He has been able to re-cruit prominent scientists who are de-

voted to him. “Nathan inspires me andhe inspires everyone we work with,’’

Joseph Fair, the organization’s chief science officer, told me when I met

with him in Yaoundé. Like others on Wolfe’s team, Fair left a lucrative jobto join the effort—and has never re-gretted his decision. “We work fteen-hour days and on Saturdays and Sun-days, and you do not get people to dothat if they are not enthusiastic,’’ hesaid. “Nathan makes people feel very good about what they do. Nobody leaves.” (In 2008, Wolfe made a simi-lar choice, walking away from a tenuredposition in epidemiology at U.C.L.A.to become a full-time virus hunter.“Try explaining that one to your Jew-ish mother,” he said.)

We had come to Yaoundé to attenda meeting of military leaders andhealth officials from several CentralAfrican countries. The subject waspandemic preparedness. Wolfe, Fair,and the rest of the team were out every night, listening to West African musicand eating tilapia, fufu, and cassava

with friends and any number of Army generals. Wolfe was clearly the event’smain attraction, and he was treated

with deference by military officials

8/8/2019 Specter 12-20-10


from Cameroon, Equatorial Guinea,Gabon, and Congo—people whorarely agree on anything.

“H ey, let’s go look at some blood,” Wolfe called, summoning me

to what has to be the coldest labora-tory in West Africa. The institute—a

series of fortied bungalows—sits inthe middle of a secure camp on thegrounds of the Cameroonian Mili-tary Health Research Center, in central Yaoundé. It doesn’t feel particularly military, though—or, for that matter,secure. Just a few hundred yards away,scores of merchants—who seem to havecornered the global market on extensioncords, plug adapters, and USB char-gers—sell their wares along the wideavenues of the capital.

The health-research complex has itsown water supply, a liquid-nitrogenplant, and a series of freezers set atminus eighty degrees Celsius—an idealtemperature for preserving tissue speci-mens. Wolfe stood in the middle of arow of cylinders, each lled with cryo-genically preserved samples of bloodand tissue, taken from hunters, bats,cane rats, gorillas, spot-nosed monkeys,chimpanzees, and scaly anteaters.

Looking Californian in a maroon

sport shirt and sneakers, he quickly un-screwed one of the cylinders. A gust of nitrogen vapor swirled out. The speci-mens in these containers make up per-haps the most comprehensive library of human and animal blood work in Af-rica. Hunters throughout the country now routinely carry lter paper, and when they kill a wild animal the hunt-ers deposit a few drops of blood on thepaper and seal it in a baggie (providedby G.V.F.). They can send the sampleto the lab or wait until somebody comesto collect it. The idea arose from amethod used by Matthew LeBreton topreserve dead snakes. “Everybody killssnakes. It is almost a reex for humans,’’LeBreton told me. For years, he trav-elled the length of the country, compil-ing what would become the denitivebook on the reptiles of Cameroon. “I would go to villages and ask people to just throw them in a pot of formalin, which preserved the snakes until I couldcollect and catalogue them.’’

Neither LeBreton nor Wolfe be-lieves that it pays to be too picky about

the specimens they obtain. “You do not wait for perfection,’’ LeBreton told me.“When . . . we work with bats, we canget specimens into liquid nitrogen inthe eld. You can’t get better speci-mens. They are frozen instantly. But itis critical for our work that we not waitfor something to be perfect. Because it’s

never perfect.’’ The blood samples have already pro- vided enough data for scores of scienticpublications. Last year, scientists reliedon the G.V.F. registry to identify thesource of Plasmodium falciparum, theform of malaria that has probably killedmore people than any other living or-ganism. The origins and the evolution-ary history of the parasite have alwaysbeen murky. Because malaria is so wide-spread among humans, and so deadly,

for years the most common scientictheory held that humans passed the dis-ease to other primates. To test the hy-pothesis, Wolfe, Stephen Rich, of theUniversity of Massachusetts, and othersexamined the genetic structure of a hun-dred samples of the chimpanzee versionof the malaria parasite—P. reichenowi . They identied eight strains that collec-tively were far more genetically diversethan the human form. In fact, P. falciparum could, in most cases, be con-

structed from the genes of the chimp virus. That could only mean that thehuman form came from chimps, not theother way around.

Wolfe’s team has also used its bloodsamples to search for variants of a viruscalled H.T.L.V.—human T-lympho-tropic virus—which infects millions of people and causes leukemia and neuro-logical illnesses. There had been twoknown strains—H.T.L.V.-1 andH.T.L.V.-2—and researchers foundevidence of both viruses in the primateblood samples; they also discoveredtwo new viruses, which they namedH.T.L.V.-3 and H.T.L.V.-4. “This isan astonishing array of viruses,’’ Don-ald Burke told me. “We have no ideahow easily those viruses adapt to hu-mans. Or how easily they can be trans-mitted between humans. But we betterget prepared. Because, frankly, what wealready know should be enough tofrighten us all.”

This year, Wolfe joined with a teamof African, French, and American re-searchers to report a twentyfold increase

in the incidence of monkeypox inCongo since the early nineteen-eighties.At rst glance, the results were inexpli-cable. Then a pattern emerged: Vac-cinia, the vaccine used so successfully to eradicate smallpox, also protectsagainst monkeypox. After the lastknown case of smallpox occurred, in So-

malia, in 1977, however, the virus wasconsidered officially eradicated. In mostcountries, the vaccinations soonstopped, and when they did, a criticalline of defense against monkeypox waslost. “The eradication of smallpox is oneof the triumphs of medical history,’’ Wolfe said. “But nothing in biology issimple.”

Wolfe sat atop a freezer and dangledhis legs like a schoolboy. The monkey-pox nding was particularly gratifying

to him because it demonstrated the un-foreseen complexities of biological sys-tems. “There is a thought experimentthat I like,’’ Wolfe said. (“Thought ex-periment” is a phrase he uses often.)“Let’s just say you had a light switch onthe wall and you could ip that switchand destroy every virus on the planet. Would you ip that switch? Almost ev-eryone would say yes. But the effect onthe planet would be so profound thatlife as we know it would cease to exist.”

Wolfe may be the viral world’s most vigorous apologist, but he isn’t wrong.Viruses can kill, yet they are also essen-tial. In fact, vaccinia, which defeatedsmallpox, is itself a virus closely relatedto cowpox. In some parts of Japan, therehave long been high rates of infection with H.T.L.V.-1, which can cause leu-kemia. People who are infected withthat virus, however, are far less likely todevelop stomach cancer than those whoare not. In a study that followed a thou-sand people, participants were two anda half times as likely to develop stomachcancer if they were free of H.T.L.V.-1than if they were infected.

Bacteria, the dominant life form onearth, are often controlled by viruses. They help regulate marine photosyn-thesis, and without them there wouldlikely be no algae and no sh in the sea.In fact, earlier this year a team of re-searchers from M.I.T. managed to pro-gram viruses to mimic the process by which plants use sunlight to manufac-ture the chemicals they need to live.“The reason we think of viruses as neg-

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ative entities is that physicians are thedrunks looking under the lamppost fortheir keys,” Wolfe has written. “If youare just looking for negative viruses, thatis all you are going to nd.”

O n a good day, a hunter in Messok-Messok, a dense jungle settle-

ment not far from Ngoila, straggleshome with an antelope slung over hisshoulder. Or a cane rat. Monkeys,chimps, and gorillas are disappearing,so they are increasingly hard to nd.But every so often somebody gets lucky.Late one afternoon, a village man walked into town carrying the body of a crowned monkey, which he turnedover to his wife, a pregnant twenty-two-year-old named Sandrine. She laidthe crowned monkey, so called for the

soft tuft of white hair spread across itsskull, on a mat of bright-green palmfronds that she had placed on the oorof the hut. Then she grabbed her ma-chete. With practiced speed and im-pressive precision, Sandrine slit themonkey’s gut, reached in, and pulledout its intestines. The ground was soondrenched with blood, and so were herhands. Wolfe, LeBreton, and I stoodten feet away, with several members of their team, who were wearing gloves

and waiting to collect tissue and bloodsamples. As the young woman quar-tered the animal and sliced off its tail,the scientists pulled their face maskstight. I asked Wolfe if he ever offeredsuch precautions to the villagers, and whether it bothered him to see this woman risk her life.

“Of course it bothers me,’’ he said.“But here are the choices: We can donothing. We can try to blend in and work without masks or gloves. I won’tallow my people to take those risks.If you are asking if this is fair, then theanswer is hell no. But it is not possi-ble to get hunters and their wives to wear gloves. We try to convince themnot to butcher if they have cuts on theirhands.

“The bigger question is what can we do for these people?’’ he went on.“How can we help them change theirlives? Gloves are going to solve noth-ing. These people need economic op-portunities and agricultural choices.”(One of Wolfe’s colleagues, a medicalanthropologist, is working on just this

issue. With support from U.S.A.I.D.,she is attempting to determine thebest way to change the behaviors thatcause so much risk.) He pointed toSandrine, who stood examining her

work in the soft afternoon light. “Sheknows that this is risky,” he said. “Butit is not as risky for her as all the other

choices in her life. We can worry all we want about viral pandemics, butthat is not what keeps her up at night.She needs to care about dinner. And,until we recognize that, the rest meansnothing.”

There are no cell-phone towers inthis part of Cameroon. No money.

The best roads are mud paths cut by logging companies to move massiveand ancient trees, some of which are solarge that specially constructed trucksare required to cart them out of the

jungle. Wolfe realizes that moderntechnology and globalization haveconnected viruses to humanity in dan-gerous ways, but he also sees in theman opportunity. “The forces that droveus into the age of pandemics can alsohelp prevent them,’’ he said. G.V.F.has started to focus on mobile commu-nications—Wolfe considers the accu-mulation and analysis of “big data’’ acrucial advance for epidemiology. Herecently hired a Stanford medical stu-dent, Lucky Gunasekara, who has abackground in mobile technology. The

team wants every hunter to have aphone. If somebody is feeling sick, ornds ve dead gorillas in the forest,or if a doctor sees an unusual rash, atext message can get that informationout at once. Viral listening posts won’t

work unless villagers are able to sharetheir knowledge. “If Twitter can pre-

dict movie sales or stock-market move-ments, and Google searches can show us where the next u outbreak will be,surely we can nd tools to help this

woman,’’ Wolfe said. “If we connectthese people more carefully to thelarger world, we could begin to addressmany of these problems.”

Sandrine had just nished preparingthe meat for dinner. I asked her if sheunderstood how risky it was to plungeher hands into the intestines of a deadmonkey. “Yes,” she said. “I know thatbushmeat is dangerous. That it can killmy children.” She was also aware thatthere had been an outbreak of Ebolarecently in Congo. I wondered whethershe or her husband had ever seen deadmonkeys or gorillas in the forest. Shenodded, gazing at the dark foliage asnight began to fall.

“What did you do when you saw them?” I asked.

She turned to me and smiled. “Ithanked God, picked them up, andbrought them home for dinner,” shesaid.

“Don’t be silly—mathematically, there will always be a middle class.”

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Specter 12-20-10

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