Viruses never take sick leave. Not vacations, holidays not even Christmas off. After seven years with Atlanta's Centers for Disease Control and Prevention, Matt Clarke just learned that the hard way.
Instead of spending Christmas Day in Georgia with his wife and baby boy, he's in Hong Kong, working 18-hour days to keep tabs on a new influenza strain all the world is watching anxiously.
"I told my wife to [video'] record every-thing our son does during the holidays," said Clarke, who lives in Norcross and is missing his first Christmas ever with his wife, parents and his four Atlanta siblings. "Jackson is only 14 months, and he'll change so much while I'm over here. But it is exciting to be involved with this investigation."
Clarke, a statistician who collects all the medical data, last week joined four medical CDC investigators and a public information officer who had flown in earlier. The team is assisting Hong Kong public health officials with a new flu strain that's suspected of having sickened 15 Hong Kong residents, killing four of them.
How long the team will be in Hong Kong is unknown. Though a Jan. 9 return date is tentatively scheduled, that could change depending on the number of flu cases and the course the virus takes. Some fatigued team members could also be replaced.
Clarke's wife, Wanda, says she's going ahead with their usual Christmas Day activities, visiting parents and grandparents, just doing all the driving herself. "I really miss Matt's help with Jackson. I think I took him for granted for that..... He could have turned down the assignment, since it was the worst possible timing, but we felt it was an opportunity he couldn't pass up."
Dubbed "bird flu" by Hong Kong media, the local outbreak worries global health authorities because it's spread by one of the most common animals in China - chickens, in one of the most crowded cities in the world, which is also a thriving port and tourist destination.
Scientists fear this new strain of influenza could be the one they've feared for decades, the one that jumps on a jet or ship and causes the next global influenza epidemic, killing millions.
Not exactly Christmas cheer. But that's just the reality of emerging infectious diseases-eases these days. CDC workers know they could be asked to go anywhere at any time to probe and prevent any number of exotic or very common and very dangerous diseases.
Recent examples: Monkeypox in Congo, Ebola in Zaire, typhoid fever in central Asia, unexplained infant deaths in Malaysia, and the Memorial Day 1993 "mystery illness" in New Mexico that turned out to be the world's newest strain of hantavirus.
"Microbes are unpredictable," says Dr. James Hughes, director for the CDC's National Center for Infectious Diseases in Atlanta. "We do live in a global village and there is no better example of that than what's occurring right now in Hong Kong. If this new strain spreads person-to-person, it's possible it could get from Hong Kong to here within 24 hours.
"We're extremely indebted to the CDC team that's over in Hong Kong during Christmas," he said. "The whole global public health should be indebted to them."
Also putting in exhaustive hours during the holidays is the CDC's 15-person influenza research team, who are holed up in Clifton Road laboratories studying the thousands of specimens sent daily from China. Headed by Dr. Nancy Cox, they confirm whether blood samples collected from family, friends, schoolmates and coworkers of Hong Kong flu victims also contain the flu strain, known as A H5N1.
So far, none do, meaning the strain is not spreading person-to-person, said Dr. Brian Mahy, director of the CDC's division of viral and rickettsial diseases in Atlanta. More good news: Far fewer cases than usual of any type of flu are being reported in Hong Kong this December.
But this new strain of influenza is also packed with bad news: The strain has never before sickened humans, so people who have developed immunity to more common flu strains have no natural defenses against this one. It also appears to be making a unique jump from animals directly to people.
These worries drive the round-the-clock work on understanding this strain's transmission and genetic composition and the development of a vaccine. Besides Atlanta, research on the Hong Kong strain continues nonstop over the holidays in Tokyo, Melbourne and London. "This is a great opportunity to be involved in a very important investigation for Hong Kong and the world," said Dr. Seymour Williams, a CDC epidemiologist who with epidemiologist Anthony Mounts spent the past few days collecting blood samples from 90 schoolchildren to check possible transmission from one of the 5-year-old flu patients.
The potential of an influenza pandemic motivates the CDC's home team and Hong Kong field team into the 18-hour days interviewing patients and searching for clues in chicken eggs when they should be home dipping eggnog.
"Walking around one day, I was thinking about the whole reason we're here is to figure out something that is really important," said Dr. Keiji Fukuda, chief of CDC's epidemiology influenza branch and leader of the Hong Kong investigation. "I have to admit, though, my empathy has gone up for other people who are out in the field and away from home, for what-ever reason.
"I miss that typical 'timeout' that comes around the holidays time to sort of slow down and take stock of things that are most important," said Fukuda, who said his work never before had taken him away from his wife, Holly, and their children, Simone, 5, and Sophie, during Christmas. "We'll have to wait, but hopefully, there'll be time to pause after we return."
About 10 percent of the 6.5 million Hong Kong residents are Christian, so signs of a Western Christmas are scarce. There is a decorated Christmas tree set up in the popular tourist hotel lobby where CDC workers are staying, and twinkling lights can be seen from their 14th-floor view of the city's spectacular harbor. Poinsettias are also planted in people's yards among colorful walking gardens.
Also, brightly wrapped gifts of fruitcake and other foods have been given by Hong Kong public health officials who are working side by side with the Americans, said Barbara Reynolds, the CDC public information officer sent over last week to assist with the barrage of local and international media inquiries. The team was invited to holiday meals Christmas Day and Christmas Eve in Atlanta, because Hong Kong is 13 hours ahead with the Hong Kong Health Department and employees of the U.S. Consulate. They'll be working on new flu cases but plan to call home.
Christmas and the day after, called Boxing Day (an English tradition still in place despite last year's relinquishing of Hong Kong from the British Empire), are both local holidays, but stores and restaurants remain open and busy. Open-air poultry markets throughout the city also should be busy this time of year, as chicken is a favorite holiday dish. Buying chickens live and taking them home to prepare them fresh is common in Hong Kong. However, poultry sales have plummeted 70 percent since the flu outbreak. About 75,000 of the chickens sold in Hong Kong daily come from mainland China. Tuesday, an indefinite ban was ordered on their export.
Reports of chickens dying from the infection are also on the increase. It's the handling of the birds, not eating them, that is considered risky, local authorities are telling Hong Kong residents. However, as front-page stories in the English-language newspaper, South China Morning Post, attest, the new "bird flu" has scared some into changing their eating habits.
Flu fears and knocking on people's doors to inquire about their contact with chickens was not on the top of CDC influenza specialist Carolyn Buxton Bridges' Christmas list.
Idaho mountains and memories were. She had tickets to fly to Boise on Christmas Eve to spend her first Christmas in four years with her parents, Dick and Marilyn Buxton.
Instead, her husband, Dan Bridges, is flying over to Hong Kong to spend a few days with her.
"If you have to be away for Christmas, I can't think of a better place than Hong Kong, " said Buxton Bridges. "This is exactly why I wanted to work at the CDC to be involved in this level of public health effort."
This page last reviewed November 17, 2004
United States Department of Health Human Services