Pranom Says

The first sign of trouble in village number 19 was the dead chickens.
Pranom says chickens started to die in the middle of August.
They died one each day,
And by the end of August, they were gone.
Sakuntala got sick on the 2nd of September.
She came here when her mother took a job 200 miles away.
Sakuntala was 11—old enough to help care for the children.

Pranom sits in a blue plastic chair in front of her home.
The house is a rickety structure of wood, bamboo,
And corrugated metal raised up on stilts.
Pranom says the chickens lived under the house.
Also under the house is an empty hammock.
Pranom says that's where Sakuntala used to sleep.
No one connected the chickens to Sakuntala's fever.

Pranom says, after five days, the fever didn't come down,
So we took her to Dr. Boom's clinic.
She suspected that the girl might have dengue fever.

A team of disease experts
Were just about to launch a program
To detect cases quickly and prevent the disease from spreading.
The team was sponsored by government health agencies
It had already helped to contain a deadly outbreak of SARS.
But, Dr. Dowell says others moved relatively slowly.
When this disease adapts to people,
It tends to explode through the population.

Dr. Dowell says there's no experience
With trying to contain a pandemic at its source.
It certainly didn't happen in 1918.
It didn't happen in 1957 or 1968, either.
In all previous pandemics,
By the time people recognized
That there was a pandemic strain circulating,
The possibility for containing that virus at its source had long passed.

On September 7th, Sakuntala's doctor was worried
That the fever wasn't coming down.
She sent the girl to the hospital a few miles away.
Pranom phoned Sakuntala's mother, who rushed up from 200 miles away.
Pranom says, she met me at the hospital—
We, the three of us, stayed in the same bed that night.

On September 8th She was transferred to another hospital.
She died that day.
Sakuntala was cremated on September 11th
Without ever being tested for the virus.
Sakuntala's mother began to feel ill at her daughter's funeral,
But she returned to her job.
She developed pneumonia during the next week.
She died on September 20th in a hospital 200 miles away.

The investigators with the ministry of health
Quickly realized that mother and daughter
Probably had the same disease.
Dr. Dowell got a bad feeling.

Dr. Dowell says the most feared event
Is that the virus will acquire the ability
To transmit efficiently from person to person.
You can imagine, when the ministry detected
Two cases in one household
They were quite concerned
That this might signal the beginning of a pandemic
And that this was the first time
That this virus was being passed from person to person.
To search for clues, our team headed to the hospital
Where Sakuntala had died.
And we were about to get more disturbing news.
It's about a four-hour drive,
And by the time we got there,
Pranom was in the hospital.

Pranom had begun to feel ill just after her niece's funeral.
Pranom says I had high fever.
I went to see the doctor,
He said that I got influenza.
But, after eight days, the fever didn't subside.
I felt rash on my body, but my feet and hands were cold.
By sheer chance, she arrived at the hospital
The same day Dr. Dowell did.
Dr. Dowell knew she might have the disease.

Dr. Dowell says, suddenly, we had not just two people
But possibly three in the same family
With similar symptoms,
And everybody was quite concerned.

In the days after Pranom was admitted to the hospital,
Dr. Dowell began to get reassuring reports.
No one else in the family was infected.
Neither was anyone else in the village
Or, any of the doctors and nurses
Who'd cared for Sakuntala and her mother.
It was becoming clear that the virus
Had not adapted to spread easily among people.
But, Dr. Dowell says it's almost certain
That Sakuntala did infect her mother
During the night they spent in the hospital.
Pranom agrees.

Pranom says, I think it's very likely that she got it from her daughter,
Because she hugged her little girl,
And also she kissed her all the time
When she was admitted at the hospital.

Since the episode,
Radio messages tell people how to handle birds safely.
Public health workers look for possible cases among farmers and villagers.
And Dr. Dowell's team has helped to make sure that every hospital is focused.

Dr. Dowell says, it's just luck that the virus that killed Sakuntala
Was not well adapted to people.
The next time, he says, the world can't depend on luck.

There's a man-sized statue of a rooster at the hospital entrance,
Wearing a surgical mask.
Dr. Rangsimanphaiboon is the hospital's director.
He likes to show the bird to visitors.
Where did the idea for the bird come from?
Dr. Rangsimanphaiboon says, It was my idea.