REDERICK, Md. — For most of the world, the Zika virus materialized out of thin air to become an international public health crisis. Andrew Haddow had been preparing for it his whole life.
Haddow isn’t quite like the other white coats wandering the halls of this highly secured US Army medical research center at Fort Detrick. He was born into this work — literally.
His grandfather, Alexander Haddow, was one of the scientists who identified the Zika virus in Uganda in 1947. Throughout his childhood, his father, Alastair, an infectious diseases specialist, would tell him bedtime stories about Alexander’s adventures, tales of witch doctors and wild animals.
Andrew grew up to become the third generation of Haddows to study diseases. Like his grandfather, he concentrated on maladies spread by mosquitoes. Among those was Zika, which had lingered mostly undetected in the decades since Alexander’s discovery.
Haddow, in short, was positioned like few others to see a danger that most didn’t. Factored into his belief that Zika had the potential to unexpectedly explode: its broad geographic range, the fact that it was transmitted primarily through mosquitoes, and the historic difficulty in diagnosing the disease.
For most of this decade, Haddow had been one of the few scientists on the planet worrying about Zika.
“I think people in our community remember our warnings,” he told STAT during a recent hour-long interview in a Fort Detrick library.
In September 2012, Haddow spoke at a conference by the Society of Vector Ecology during a symposium focused on “lesser-known emerging pathogens and novel transmission cycles.” He titled his presentation “Zika Virus: 60 years of silent transmission?” The meeting attracted about 200 people.
The first known outbreak of Zika had been in 2007 on Yap, an island in the Pacific Ocean. But it was little more than a curiosity for most researchers in the field. A scientist who attended the 2012 conference, Greg Lanzaro of the University of California, Davis, said scientists in the field “would have heard of it, but I doubt that they knew very much about it.”
A 2013 outbreak in French Polynesia was the first time that the virus’s most serious health risks became apparent, but, even then, Zika was virtually unknown to the broader public until late last year when Brazil declared a public emergency.
“It’s one of those things where you’d rather be wrong,” Haddow said.
But he was right. Now the World Health Organization has declared the frightening complications associated with Zika virus — babies born with abnormally small heads and a neurological condition that causes paralysis — a global health emergency. Haddow has been busy fielding phone calls and emails from researchers on the front line.
Bedtime stories inspire a career
Haddow, who speaks with wide-eyed excitement about his work, doesn’t want to be seen as a prophet. He certainly doesn’t seem to be seeking adulation either. He’s so self-effacing that he’s reluctant even to reveal his age; his answer is he grew up in the 1980s.
But the fact remains he was way ahead of the curve on Zika.
“He was probably one of only a few people interested in these viruses a few years ago,” said Scott Weaver, director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch, who oversaw Haddow’s postdoctoral work there starting in 2009.
Weaver was one of the other few. The same year Haddow came to Texas, Weaver co-wrote a paper that identified Zika as a potential widespread threat.
“I’ve told several people that if anybody had applied to work on a grant on Zika 10 years ago, you would have had no chance,” Weaver said. “This was very far outside the box.”
Haddow’s prescience can be traced back to his upbringing.
His grandfather Alexander spent upwards of three decades in the East African jungle, living the life that would become bedtime stories. Stories were all that he had when it came to his legendary kin: Shortly after Haddow was born, Andrew’s parents flew him to Scotland so he could be held by his ailing grandfather, who soon died of cancer.
It was Haddow’s father, who had sometimes lived with his father in the bush, who filled his own son’s imagination with tales of adventure.
“I grew up with some pretty crazy stories,” Haddow said — before recounting one.
Alexander and his team were out looking for mosquitoes in the forest when they came across a fallen tree. As they set up camp near it, a witch doctor predicted that the man standing on the tree when it was raised would soon die. That man was Alexander.
A few days later, he was struck with a life-threatening case of encephalitis. His colleagues dug a grave, and Alexander was read his last rites. But, as Haddow tells the story all these years later, while Alexander lay there he heard the priest’s voice and woke up. The local people came to believe that Alexander was even more powerful than the witch doctor.
From an early age, Haddow said, he knew “I wanted to be doing that kind of stuff.”
“My dad’s a very good storyteller,” he said. “That was a pretty good sell.”
His home life deepened that ambition. He recalled that, when the three Haddow children were feeling sick, his father would require them to take swabs and would study them before he would let them take antibiotics. Their kitchen would always have little plates with samples sitting next to the toaster.
The practice started when Haddow was 4 or 5. “I thought it was normal,” he said.
His career has let him live out his jungle adventure dreams. While working on the Cambodian-Thai border in 2010, Haddow said he was charged by an elephant, endured a 100-year flood, and came down with encephalitis and tick paralysis over the course of a few months.
Later that year, he also co-wrote a paper confirming a Zika case in Cambodia.
Zika is ‘likely here to stay’
Haddow’s biggest contribution to Zika research came the next year, when he and several colleagues published a paper suggesting that Zika had been spread person-to-person, likely through sexual contact, the first documented case. Earlier this month, the Centers for Disease Control and Prevention reported that someone living in the Dallas area had contracted Zika through sexual transmission.
“That was the first ‘something is probably different about this’” evidence regarding Zika, Haddow said of the 2011 paper.
Nonetheless, interest in and funding for studying Zika were scant. Haddow counts himself lucky that he had a supervisor in Weaver at Texas who gave him leeway to pursue his passions and two grants, including one from the National Institutes of Health, to pay for the research he was able to do.
“It was frustrating because you see what’s happening and you want to be able to do some work on it,” Haddow said. “If the funding isn’t there, then you can only do limited research.”
Weaver laments that CDC funding to help young scientists train to identify and study mosquitoes in the field was cut several years ago, after being jumpstarted by the West Nile virus scare in 1999. Haddow’s interest in that kind of work, spurred no doubt by years of stories about his grandfather’s exploits, is one of the traits Weaver appreciates.
“We keep slipping back into this situation where we don’t have adequate expertise and people with the traditional skills required to go out and do field studies to really understand what the risk is for these kind of viruses,” Weaver said. “Hopefully Zika will rekindle the recognition that we need more people like this.”
The Zika virus story — starting with its discovery in 1947 followed by anonymity; slowly ramping up with the 2007 Yap island outbreak, the 2011 finding of sexual transmission, and the 2013 French Polynesia cases; and culminating in the current crisis — might not be the last of its kind either.
First, Haddow expects Zika to settle into a pattern like dengue fever, lurking in the jungle before emerging for the occasional outbreak. He also acknowledges that there are other obscure viruses — he studied the Spondweni virus, a Zika cousin, while at Texas — with the potential to make a similar leap.
“The [Zika] virus is likely here to stay,” he said.
While Zika becomes the dominant global health issue of early 2016, Haddow is mostly staying put in his lab here at the Medical Research Institute of Infectious Diseases. Although he’s still studying viruses, with an emphasis on those transmitted by mosquitoes, he’s not a major player in the Zika response. The Army doesn’t have as big a role as the CDC or NIH.
He said he talks with researchers there, offering advice when he can, and he is a member of the Global Virus Network’s Zika task force, which was formed earlier this month.
It’s clear, though, that Haddow is still coming to terms with a new reality, one in which the obscure virus with a special place in his family history has become a major news story. Parallels between Ebola and Zika have been en vogue since the latter appeared on the world stage; Haddow offered instead a notable contrast before disappearing down the hallway to get back to work.
“With Ebola, people were already studying it,” he said. “With this, nobody was studying it.”
“And then it was like, ‘Whoa.’”