Why the race to stop the next flu outbreak starts at state fairs and the beach

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• Judy Woodruff:

  We resume our look now at how prepared we are for the next influenza pandemic.

  Not the seasonal flu, whose strains emerge every year and we take a flu shot to prevent. Public health officials are watching bird and swine populations for the flu we can't predict — looking for the viruses we have never seen and have no vaccines against.

  William Brangham reports for our regular coverage about the Leading Edge of science, technology and medicine.

• William Brangham:

  At this county fair in northern Ohio, young people come to show off and sell the animals they have raised.

  Dr. Andrew Bowman is here for a much different reason. He's looking for the first rumblings of a potential flu pandemic among these guys.

  (OINKING)

  He takes a simple nasal wipe that he will later test for flu. He and his team will do this thousands of times at fairs across the country this year.

  Pigs get the flu, just like people do. They get fevers, they sneeze and cough. And when they're brought together for fairs and competitions, that flu can spread.

  Every year, tens of millions of Americans come to fairs like this one. And Dr. Bowman says that, every once in a while, that virus can move from the pigs into humans.

• Dr. Andrew Bowman:

  You know, we think about this certainly occurring in Southeast Asia, other places of the world, where we have a different animal-human interface. And that, we think, doesn't happen in the U.S.

  But if you think about what we do at shows and fairs, we certainly have animals from multiple places coming together, and we create that animal-human interface that's conducive to influenza transmission.

• William Brangham:

  The good news is, this type of flu usually stops after it makes that interspecies jump, meaning, one of us gets sick, but not more. It doesn't spread from person to person.

  The bad news, given how flu viruses mutate — that could change any minute.

• Dr. Andrew Bowman:

  In the worst case, a couple hundred cases in a given year. It's quite low. But realize, right, any one of those could be the one that starts the next pandemic.

• William Brangham:

  Then there's the viral threat from the sky. Each spring in Cape May, New Jersey, migratory birds making their way from South America to the Arctic stop here. These ruddy turnstones and red knots are refueling for the trip by feasting on the millions of tiny eggs left by these mating horseshoe crabs.

  And when the birds are here, so are flu researchers, like Dr. Lisa Kercher.

•  Dr. Lisa Kercher:

  There is no other place that we know of that carries this much influenza in these birds.

• William Brangham:

  It's amazing. It just looks like a beautiful beach.

•  Dr. Lisa Kercher:

  Exactly. But there's a lot more going on here than just birds on the shore and a nice sunny day.

• William Brangham:

  Collectively, the birds carry dozens of flu strains in their stomachs. Usually, it never bothers them. And by collecting their fecal samples, these scientists from St. Jude Children's Research Hospital can track how those strains are evolving.

  They scour and scoop along the beach. They net other birds, swab them, and then release them. It's not because they're afraid these birds will pass flu directly to people. That rarely happens. It's because all flu originates in birds. They're the natural world's biggest reservoir of the virus.

  With so many species converging and mingling here, this is a hotbed for viral research.

•  Dr. Lisa Kercher:

  We want to know what they're leaving behind. Right? So that's why we're out here collecting all the samples. But what also we're concerned with is: These birds and other wild birds that migrate, they often mix with domestic bird populations.

  And when they mix with domestic birds, domestic birds can get very sick from…

• William Brangham:

  That's ducks and chickens and…

•  Dr. Lisa Kercher:

  Ducks and chickens and things in your backyard.

• William Brangham:

  Every time a major flu pandemic has killed lots of humans, it's followed some version of this pattern — flu moving from wild birds to domestic animals and then into us. In that process, new strains of virus can be created.

  And that's what everyone is on the lookout for. Usually, when one of those novel strains makes the jump into humans, it then hits a dead end. It doesn't spread further. But if that strain manages to adapt, so it can then go human to human, watch out.

  So transmitting on, if I get sick, and seriously sick, and then I'm able to pass that to other humans, that's a problem.

• Dr. Andrew Bowman:

  That's a pandemic. It would go to an outbreak and then on to a pandemic. And that's — that would be the most severe outcome that we could worry about.

• William Brangham:

  That's exactly what happened back in 2009. The H1N1 virus jumped from pigs to humans in Mexico and California. And then it quickly spread. Within six weeks, it had spread to multiple countries. Within months, nearly every nation on Earth had cases. It was a true pandemic.

  H1N1 proved incredibly contagious, but luckily not that deadly. Still, somewhere between 150,000 and 500,000 people died across the world, and more than 12,000 in the U.S. But those were still below the seasonal flu's usual toll. Public health officials say the world dodged a bullet.

• Dr. Rick Bright:

  We made a decision to invest heavily in preparing our nation for pandemic influenza.

  And that was critical for the government to work with our industry partners.

• William Brangham:

  A big part of Dr. Rick Bright's job is to get the U.S. ready for the next pandemic. He helps oversee vaccine research and development for the federal government.

  Vaccines have for years been made using chicken eggs. They are a superb vehicle for growing virus.

  Bright says 95 percent of all flu vaccines globally are made this way. This facility is contracted by the vaccine maker Sanofi Pasteur to churn out hundreds of thousands of eggs every day if a pandemic were to break out.

  But Bright says this process, which can take six to nine months, is still too long.

• Dr. Rick Bright:

  Thirty-three million people will die while we're waiting for a vaccine…

• William Brangham:

  Thirty-three million?

• Dr. Rick Bright:

  … in a pandemic scenario. So we have to count every day that passes from identification of something novel to when we can deliver that vaccine not only in just days, but also in lives lost.

• William Brangham:

  To shorten that window, the government started a partnership with the pharmaceutical company Seqirus to operate this plant in Holly Springs, North Carolina.

  Here, they have stockpiled vaccines against some of the more troubling novel strains that have emerged in the past, just in case they reemerge. They're also creating new vaccines using cells from mammals, instead of eggs.

  Bright says this could save weeks, maybe months.

• Dr. Rick Bright:

  These they can actually have growing year-round, if they needed the surge very quickly, to make more vaccine for a crisis or expand even more for a pandemic response.

• William Brangham:

  But almost everyone agrees the shape-shifting nature of the influenza virus means all these efforts are still not enough.

• Dr. Rick Bright:

  Everything we think we know about influenza changes almost every day, because of the way this virus grows, mutates and spreads. We must look to the future, invest in innovation, reduce those bottlenecks, and make sure everyone has access to a vaccine for pandemic influenza when and where they need it.

• William Brangham:

  While that vaccine work is under way, surveillance teams across the country keep an eye out, watching the virus, looking for the emergence of the next potential pandemic.

  For the "PBS NewsHour," I'm William Brangham.

• Judy Woodruff:

  And, tomorrow, William concludes the series by focusing on the hunt for a universal flu vaccine.