Monday 16 July 2012

Coffee, perfume and pandemics - part 2


      If you don't like the thought of drinking excrement coffee, you could always eat the whole cat. That's what a lot of people used to do in Guangdong province, at least until 2003 when a lethal and highly contagious disease that became known as Severe Acute Respiratory Syndrome (SARS) emerged in South China and killed 800 people across the world in the space of a few months. The mysterious disease hit hard in the Hong Kong Special Administrative Region (SAR), but the coincidence of the acronym was bitterly resented in the territory that has more than once acted as a warning beacon to diseases emerging from mainland China. It took several months and hundreds of deaths before the finger was pointed at civet cats in Guangdong’s notorious animal markets.
     Months earlier, in February 2003, the World Health Organization office in Beijing had received an email about an unidentified disease that had left more than 100 people dead in Guangdong province within a week. By the middle of February the Chinese Ministry of Health admitted to the WHO that something nasty had emerged, but they said only five people had died, and whatever it was, it was coming under control. In reality a global epidemic was just warming up.
     On February 21 a doctor from Guangdong province checked into a room on the ninth floor of the Metropole Hotel in Hong Kong’s Kowloon district. He died in Hong Kong within two weeks, as did a Canadian tourist who checked out of the same hotel and headed back to Toronto. By the time he died, five people in Toronto were showing symptoms. Two others who had stayed on the ninth floor of the Metropole were sick in Hong Kong, while another person started showing symptoms in Vietnam.
     It was clear that a vicious disease had been unleashed but no one knew what it was. Panic spread like a contagious infection when healthcare workers started falling sick one after another.
    By the end of March thousands of people in Toronto were under quarantine, and in Hong Kong hundred had been hospitalized, including 213 residents of a single housing estate called the Amoy Gardens.
    In April the WHO issued its most stringent travel advisory in its 55-year history -- don't go to Hong Kong or Guangdong province. Total cases passed 2,000 and a Morgan Stanley economist estimated that the global cost of the outbreak so far to be around US$30 billion.

Beijing station 2003 (photo:WSJ)
      In mid-April the WHO announced that the mystery virus was a coronavirus, more familiar to vets than human doctors, but this one was of a type never seen before in animals or humans.  Retail sales in Hong Kong were down 50 percent from a month earlier, and restaurant takings were down by 80 percent.
     It was a depressing and eerie time to be living and working in Hong Kong, as I was.
     It was in late May that masked palm civets in Guangdong markets were first linked to the virus. Infection had appeared to slow down by then, but the toll continued to rise. A Hong Kong university team was among the first to confirm that traces of a coronavirus “very similar” to human infections of SARS was found in the faeces of caged civets at crowded animal markets.  
    Hong Kong banned the import of civet meat immediately, and the mainland started culling captives. Some Guangdong districts upped the killings to stray dogs and cats too, especially cats because people wrongly assumed a zoological connection in the name.
    
Photo: HKU Faculty of Medicine
It is easy to cull civets in the mainland because thousands are farmed, ironically for the "wild meat" trade. The meat is an expensive delicacy with a flavour described as fruity by some, gamey by others, and with purported medical benefits such as the inevitable stimulation of the libido.

     The Cantonese are proud of their wildlife cuisine, and amongst their famous dishes the Dragon Tiger Phoenix soup is still prized today, more than six years after the civet cull, as a local specialty. The dish translates to real animals as snake, civet and chicken, although since the ban kittens are said to have taken the place of civets.
    SARS cases dropped off by the end of 2003, but after a handful of late infections around the New Year Guangdong went into another killing campaign, announcing the destruction of 10,000 civet cats. Civet catchers raided dark and stinking markets in hazard suits, and carted off the caged mammals to be drowned in pools of disinfectant. 
     Animal rights groups and environmental campaigners raised a stink from the start but Chinese authorities, much maligned for their secrets and lies in the early stages of the disease, were now determined to stamp it out. And if that meant stamping out civets, so be it. In any case all the captives were already condemned to the cooking pot so what was the difference?
    
Research chase the SARS virus (photo WHO)
     But even the WHO called restraint in the war on civets. The problem was that no one had proved whether civets had infected people, or people had infected them. Or worse still was another party involved?
    "For all we know they could be an intermediary carrier," said a WHO representative in China.  Six years on we think they were.
    Horseshoe bats are another south China delicacy, even their faeces have medicinal value according to traditional medicine. They were found in cages near civet cats in the infamous Guangdong markets and more than a year after the 10,000 cat cull, virologists determined that these flying mammals were the real reservoir spieces for the disease, though the virus didn't pass from them directly to people.
    One of two things happened, which would shed different light on the civet cull. Either bats infected another animal that infected humans before we passed it to civets, and therefore the cull was useless. Or else bats infected civets who in turn passed the disease on to people.
    A 2006 study on the evolution of the virus, sponsored by the United States’ Defence Advanced Research Projects Agency (DARPA) concluded that civets must have been infected by humans. But other studies have put it the other way round, not only did civets get infected before humans but they acted as amplifiers for the virus, so they did deserve to die.
    Either way there have been hardly any cases of SARS since 2004.
    Whatever we eventually conclude about the transmission of SARS, it's clear that human built markets were a vital processing point for the virus, where cages of bats sat next to civet cats, both handled by sweaty, grimy people. 
     There is a good chance that in a healthy environment, South China's wild meat cuisine is wholesome, and perhaps even good for you, as traditional medicine practitioners claim. But that's a big if in a densely populated part of the world where economic pressures have seriously depleted the natural environment. Not only that, but "wild" is a misnomer when applied to animals intentionally bred for the market. 
    Ultimately it's not really the animals that spread disease, it's the economy that throws all of us too close together and forces a prolonged and intense interaction between species. And as China gets wealthier, the newly rich look to traditional templates to help them decide what to do with their spare cash. So more and more people partake in exotic cuisines and medicines, stimulating the market further, intensifying human contact with strange beasts. 
    The surprising thing is that the events of 2003 and 2004 didn't force the masked palm civet to local extinction. Hong Kong didn't take part in the cull, as AFCD recognised that our shy forest dwellers were never likely to come close enough to human populations to infect them with anything. And in the mainland, whilst authorities were prepared to round up captive beasts in markets, they didn't have the resources to send hunting parties into the forests. So the wild civets survived despite the premium that would have been put on their heads by slashing supply in the markets. Intermittent reports of crackdowns in the mainland show that the meat trade has continued too.
    No doubt completely oblivious to the huge impact it had made on the world, the species continues to make a quiet living in the heart of Hong Kong, to the delight of at least one elderly historian and his posh neighbours. 

Great drawing lifted from an aromatherapy website offering dodgy looking civet essential oils in amber glass bottle.

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