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The Viral Network

The Viral Network: A Pathography of the H1N1 Influenza Pandemic

Theresa MacPhail
Copyright Date: 2014
Edition: 1
Published by: Cornell University Press
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  • Book Info
    The Viral Network
    Book Description:

    InThe Viral Network, Theresa MacPhail examines our collective fascination with and fear of viruses through the lens of the 2009 H1N1 pandemic. In April 2009, a novel strain of H1N1 influenza virus resulting from a combination of bird, swine, and human flu viruses emerged in Veracruz, Mexico. The Director-General of the World Health Organization (WHO) announced an official end to the pandemic in August 2010. Experts agree that the global death toll reached 284,500. The public health response to the pandemic was complicated by the simultaneous economic crisis and by the public scrutiny of official response in an atmosphere of widespread connectivity. MacPhail follows the H1N1 influenza virus's trajectory through time and space in order to construct a three-dimensional picture of what happens when global public health comes down with a case of the flu.

    The Viral Networkaffords a rare look inside the U.S. Centers for Disease Control, as well as Hong Kong's virology labs and Centre for Health Protection, during a pandemic. MacPhail looks at the day-to-day practices of virologists and epidemiologists to ask questions about the production of scientific knowledge, the construction of expertise, disease narratives, and the different "cultures" of public health in the United States, Europe, Hong Kong, and China. The chapters of the book move from the micro to the macro, from Hong Kong to Atlanta, from the lab to the WHO, from the pandemic past in 1918 to the future. The various historical, scientific, and cultural narratives about flu recounted in this book show how biological genes and cultural memes become interwoven in the stories we tell during a pandemic. Ultimately, MacPhail argues that the institution of global public health is as viral as the viruses it tracks, studies, and helps to contain or eradicate. The "global" is itself viral in nature.

    eISBN: 978-0-8014-5489-9
    Subjects: Anthropology, Health Sciences, Sociology

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Acknowledgments
    (pp. vii-x)
  4. List of Abbreviations
    (pp. xi-xiv)
  5. Prologue to a Pathography
    (pp. 1-17)

    In January 2004, I was sitting on the ferry from Jiangmen to Hong Kong, returning from a sightseeing holiday in Guangdong Province. The region was still reeling from the 2003 SARS epidemic, and television commercials urged citizens to be “vigilant and prepared” against its possible recurrence in the spring. In addition to the SARS virus, another recent outbreak of the avian influenza virus H5N1 in China’s southern neighbor, Vietnam, had caused a mounting fear of a future “bird flu” pandemic. Worry over virus outbreaks was spreading across Southeast Asia faster than the viruses themselves. As I sat on the ferry,...

  6. 1 Seeing the Past or Telling the Future? On the Origins of Pandemics and the Phylogeny of Viral Expertise
    (pp. 18-47)

    In late March 2009, a new strain of the Influenza A (H1N1) virus began to unfurl out of a remote region in Mexico. It seemed to many as if the developing pandemic might be the denouement of a harrowing story that public health workers had been telling and retelling for decades. Epidemiologists and virologists working on viruses have been sounding warning sirens about the potential for another lethal—and global—outbreak of infectious disease since the discovery of HIV/AIDS in the early eighties. Sporadic admonitions related to the collective weakness of our pandemic preparedness highlighted the very real threat posed...

  7. 2 The Invisible Chapter (Work In the Lab)
    (pp. 48-74)

    Prior to the 2009 H1N1 pandemic, I had no practical experience working in a lab. I hadn’t become accustomed to the near-constant whirring of a centrifuge or the patient ticking of an old-fashioned egg timer in an otherwise hushed lab. Hadn’t developed any sensory memory of the distinct smell of particular chemicals or the feel of my fingers encased in thin latex gloves. Hadn’t ever learned to deftly handle the various instruments or tools: pipettes, Petri dishes, plastic tubes, gel boxes. Hadn’t stuffed the large pockets of a white lab coat with various pens and small, bright Post-it notes reminding...

  8. 3 Quarantine, Epidemiological Knowledge, and Infectious Disease Research in Hong Kong
    (pp. 75-107)

    In March 2013, reports of a novel and deadly “bird flu” outbreak in China went viral. The Influenza A subtype at the center of the mounting media attention, H7N9, had never been known to infect humans. Typically, strains of H7N9 are found only in birds. Experts heretofore had remained uncertain about whether or not circulating avian influenzas, such as H7N9 or H9N2, would develop the capacity to regularly infect humans, or, crossover into a new host. But then the virus effectively jumped the species divide, infecting 132 people¹ and killing 37 (new lab-confirmed cases were still being sporadically reported to...

  9. 4 The Siren’s Song of Avian Influenza: A Brief History of Future Pandemics
    (pp. 108-131)

    As late as the summer of 2012, experts involved in the 2009 H1N1 response—social scientists, virologists, epidemiologists, and public health officials alike—continued to share and gather tales of the pandemic. Throughout workshops and debriefings that I observed or guided in my role as a consultant, people rehashed events and decisions in order to comprehend something beyond any individual ken. Maybe if we pooled our resources, the collective logic seemed to go, we might be able to grasp at a larger truth about the effectiveness of and gaps in global public health systems and preparedness. In trying to reconstruct...

  10. 5 The Predictable Unpredictability of Viruses and the Concept of “Strategic Uncertainty”
    (pp. 132-151)

    Uncertainty is a hot topic in the twenty-first century, much debated and discussed in policy and academic circles, as well as in popular media. One need only look to the ongoing global economic crisis, scientific research on the effects of manmade climate change, or the 2011 Fukushima Daiichi nuclear disaster to see examples of “uncertainty” playing out in the so-called real world. Especially observable throughout the 2009 pandemic, uncertainty is as rife within global public health as it is in economic forecasting. The ostensibly new, or reinvigorated, concept of uncertainty remains as pervasive inside the World Health Organization as it...

  11. 6 The Anthropology of Good Information: Data Deluge, Knowledge, and Context in Global Public Health
    (pp. 152-178)

    Walking down the halls of the Centers for Disease Control in the fall of 2009, I quickly became recognizable as the “Berkeley person” doing research on information-sharing and sense-making during infectious disease outbreaks. Two weeks into my tenure, I started being hailed by my academic association and playfully taunted with echoes of my research question: “Hey, Berkeley! Have you figured out the problem of information yet?”

    The joke belied the fact that people were often extremely eager to talk with me about the various issues associated with information in public health: gathering data, getting access to various types of data...

  12. 7 The Heretics of Microbiology: Charisma, Expertise, Disbelief, and the Production of Knowledge
    (pp. 179-203)

    In the Greek myth of Cassandra, the god of prophecy—Apollo—adorns his beloved with the gift of foresight and then, after she has spurned him, curses her to be forever ignored and mistrusted. Messages to her people, the Trojans, about what will befall them if they continue their various courses of action go unheeded; yet Cassandra never stops speaking her truth, never ceases in her attempts to compel the Trojans to heed her warnings. Only after the Trojans fall to the Greeks does she finally retreat into the temple of Athena—seeking protection from the goddess of wisdom and...

  13. Epilogue
    (pp. 204-212)

    As I was finishing this book, in late December 2013, narratives of influenza continued unabated. On December 20, the WHO issued a routine influenza report indicating that the flu season in North America was beginning to pick up its pace. The influenza virus in circulation was A(H1N1) pdm09—or the same virus at the heart of this pathography. In fact, two early-season clusters of cases in Texas had been particularly severe, killing four of those infected and drawing renewed attention to the 2009 H1N1 virus. The prodigal virus, given enough time, always seems to return.

    By the start of 2014,...

  14. Notes
    (pp. 213-222)
  15. References
    (pp. 223-232)