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At least 40 million died of the 1918-19 "Spanish flu," the most deadly disease episode in history. Influenza cases were treated at places including this army ward in Kansas in 1918. (National Museum of Health and Medicine, Armed Forces Institute of Pathology)

The Flu Hunter

For years, Robert Webster has been warning of a global influenza outbreak. Now governments worldwide are finally listening to him

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Editor’s Note, April 27, 2009: The Center for Disease Control and World Health Organization confirmed the existence of over 40 human cases of swine flu in the United States after a more severe outbreak in Mexico claimed the lives of 149 people. In 2006, Smithsonian magazine profiled Robert Webster, a scientist who researches modern influenza viruses and how they spread from animals to humans.

Robert Webster was in the backyard of his home in Memphis doing some landscaping. This was in the early winter of 1997, a Saturday. He was mixing compost, a chore he finds enchanting. He grew up on a farm in New Zealand, where his family raised ducks called Khaki Campbells. Nothing pleases him more than mucking around in the earth. He grows his own corn, then picks it himself. Some of his friends call him Farmer Webster, and although he is one of the world’s most noted virologists, he finds the moniker distinguishing. He was going about his mixing when his wife, Marjorie, poked her head out the back door and said, “Rob, Nancy Cox is on the phone.” Cox is the chief of the influenza division at the Centers for Disease Control and Prevention, in Atlanta. Webster went to the phone. He has a deep voice and a thick accent, which people sometimes confuse with pomposity. “Hello, Nancy,” he said.

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Cox sounded distressed. She told him there had been a frightening development in Hong Kong—more cases, and another death.

Oh my God, Webster recalls thinking. This is happening. It’s really happening this time.

Some months before, a 3-year-old boy in Hong Kong had developed a fever, a sore throat and a cough. The flu, his parents thought. But the boy grew sicker. Respiratory arrest set in, and he died. The case alarmed doctors. They could not recall seeing such a nasty case of the flu, particularly in a child so young. They sent off samples of his lung fluid for testing, and the results showed that he did indeed have the flu, but it was a strain that had previously appeared only in birds. H5N1, it’s called. Webster is the world’s preeminent expert on avian influenza, and it was only a matter of time before the test results made their way to him. But he was not yet troubled. He thought there must have been some sort of contamination in the lab. H5N1 had never crossed over into humans. Had to be a mistake, he thought.

That was until Cox interrupted his gardening to tell him about the new cases.

It immediately occurred to Webster that he should be on an airplane. “I had to go into the markets,” he told me recently. “I had to get into the markets as fast I could.” He meant the poultry markets, where chickens are bought and sold by the hundreds of thousands. The little boy who died a few months before had been around some chickens, as have most little boys in that part of the world, where families often live side by side with their chickens, pigs, ducks and dogs. If H5N1 was, in fact, in the markets, as Webster suspected, that was the beginning of his worst-case scenario: the virus could mutate in the chickens and perhaps other animals, and then acquire the know-how to pass from person to person, possibly initiating a pandemic that, he thought, might kill as many as 20 million people.

Webster has been predicting and preparing for such an event for his entire career as a scientist. His lab at St. Jude Children’s Research Hospital in Memphis is the world’s only laboratory that studies the human-animal interface of influenza. It was Webster who discovered that birds were likely responsible for past flu pandemics, including the one in Asia in 1957 that killed about two million people. He has spent a good part of his life collecting bird droppings and testing them for signs of influenza. Some of that collecting has taken place while he and his family were on vacation. One evening in Cape May, New Jersey, his school-age granddaughter ran toward him on the way to dinner saying that she had discovered some poop for him. He was so pleased.

A couple of days after Cox’s phone call, Webster stepped off a plane in Hong Kong. He stopped at the University of Hong Kong to drum up some help to sample chicken droppings in the market. He also phoned his lab in Memphis and some scientists in Japan whom he had trained. He told them to pack their bags.

It occurred to Webster that there was a problem. The problem was H5N1. Neither he nor any members of his staff had ever been exposed to the virus strain, meaning they did not have any antibodies to it, meaning they had no defense against it. If they became infected, they would likely meet the same fate as the little boy who died.

They needed a vaccine. Four decades before, Webster had helped create the first widespread commercial flu vaccine. Until he came along, flu vaccines were given whole—the entire virus was inactivated and then injected. This caused numerous side effects, some of which were worse than the flu. Webster and his colleagues had the idea to break up the virus with detergents, so that only the immunity-producing particles need be injected to spur an immune response. Most standard flu shots still work like this today.

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