Spillover: Animal Infections and the Next Human Pandemic

by David Quammen

One of those secondary cases was a sixty-four-year-old physician named Liu Jianlun, a professor of nephrology at the teaching hospital where Zhou had first been treated. Professor Liu began feeling flulike symptoms on February 15, two weeks after his exposure to Zhou, and then seemed to get better—well enough, he thought, to follow through on plans to attend his nephew’s wedding in Hong Kong. He and his wife took the three-hour bus ride from Guangzhou on February 21, crossed the border, spent an evening with family, and then checked into a large, midrange hotel called the Metropole, favored by businessmen and tourists, in the Kowloon district of Hong Kong. They were given room 911, across from the elevators in the middle of a long corridor, a fact that became central to later epidemiological investigations. Two fateful things happened that night at the Metropole Hotel. The professor’s condition worsened; and at some point he seems to have sneezed, coughed, or (depending on which account you believe) vomited in the ninth-floor corridor. In any case, he shed a sizable dose of the pathogen that was making him sick—enough to infect at least sixteen other guests and a visitor to the hotel. Professor Liu thereby became the second known superspreader of the epidemic.