Deadly 1918 Epidemic Linked to Bird Flu, Scientists Say

NY Times ^ | October 5, 2005 | GINA KOLATA

[neverdem]

Two teams of federal and university scientists announced today that they had resurrected the 1918 influenza virus, the cause of one of history's most deadly epidemics, and had found that unlike the viruses that caused more recent flu pandemics of 1957 and 1968, the 1918 virus was actually a bird flu that jumped directly to humans.

The work, being published in the journals Nature and Science, involved getting the complete genetic sequence of the 1918 virus, using techniques of molecular biology to synthesize it, and then using it to infect mice and human lung cells in a specially equipped, secure lab at the Centers for Disease Control and Prevention in Atlanta.

The findings, the scientists say, reveal a small number of genetic changes that may explain why the virus was so lethal. The work also confirms the legitimacy of worries about the bird flu viruses that are now emerging in Asia.

The new studies find that today's bird flu viruses share some of the crucial genetic changes that occurred in the 1918 flu. The scientists suspect that with the 1918 flu, changes in just 25 to 30 out of about 4,400 amino acids in the viral proteins turned the virus into a killer. The bird flus, known as H5N1 viruses, have a few, but not all of those changes.

In a joint statement, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Dr. Julie Gerberding, director of the Center for Disease Control and Prevention, said, "The new studies could have an immediate impact by helping scientist focus on detecting changes in the evolving H5N1 virus that might make widespread transmission among humans more likely."

The work also reveals that the 1918 virus is very different from ordinary human flu viruses.

[neverdem]

ping

[neverdem]

FReepmail me if you want on or off my health and science ping list. Anyone can post any unrelated link as they see fit.

[mtbopfuyn]

And we only have one facility that makes vaccines...

[neverdem]

Ignore the second sentence.

[N. Theknow]

Wasn't it originally thought to be swine flu?

[Graymatter]

Could make resurrecting the dinosaurs look like a romp in Jurassic Park.

[Right Wing Professor]

Beat me by 2 minutes!

I asked the mod. to pull the dupe.

[ATOMIC_PUNK]

Emergency hospital during influenza epidemic, Camp Funston, Kansas.

Officers and nurses, X Section, Base Hospital, Camp Jackson, S.C. Emergency hospital during influenza epidemic, Sept. and Oct. 1918.

Tent settlement, influenza patients

http://nmhm.washingtondc.museum/collections/archives/agalleries/1957%20flu/1957flu.html

[I still care]

From a letter written by a WWI soldier:

Camp Devens is near Boston, and has about 50,000 men, or did have before this epidemic broke loose. It also has the Base Hospital for the Div. of the N. East.

This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed. All assembleges of soldiers taboo.

These men start with what appears to be an ordinary attack of LaGrippe or Influenza, and when brought to the Hosp. they very rapidly develop the most viscous type of Pneumonia that has ever been seen. Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up.

There is no doubt in my mind that there is a new mixed infection here, but what I dont know. My total time is taken up hunting Rales, rales dry or moist, sibilant or crepitant or any other of the hundred things that one may find in the chest, they all mean but one thing here -Pneumonia-and that means in about all cases death.

The normal number of resident Drs. here is about 25 and that has been increased to over 250, all of whom (of course excepting me) have temporary orders-"Return to your proper Station on completion of work". Mine says "Permanent Duty", but I have been in the Army just long enough to learn that it doesnt always mean what it says. So I dont know what will happen to me at the end of this.

We have lost an outrageous number of Nurses and Drs., and the little town of Ayer is a sight. It takes Special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce, we used to go down to the morgue (which is just back of my ward) and look at the boys laid out in long rows. It beats any sight they ever had in France after a battle.

An extra long barracks has been vacated for the use of the Morgue, and it would make any man sit up and take notice to walk down the long lines of dead soldiers all dressed and laid out in double rows.

[neverdem]

Thanks for the pics and link!

[neverdem]

Thanks for the letter. It sounds like a doc wrote it.

[Judith Anne]

Thank you so much for the pictures.

[Judith Anne]

That's a very touching letter. Thank you.

[Judith Anne]

Excellent thread. Thanks.

[From many - one.]

I'm not too knowledgeable about the vaccines for flu, but if they have the genetic makeup of both the bird flu and the 1918 flu, and, if they chose to invest the money, would it be possible to create a double vaccine that would at least ameliorate the disease?

[Thunder90]

What would stop Al-Queida from getting their hands on this once it becomes epidemic? The terrorists would go to any lengths to obtain a sample, then spread it around the US by infecting "Suicide carriers". The uses of this virus as a bioweapon is infinate to an enemy of this country, especially if the leg work was done by nature.

[neverdem]

What would stop Al-Queida from getting their hands on this once it becomes epidemic?

Probably nothing. Only idiots would you this as a weapon because there's just as much chance that it would come back to their loved ones as well. At least that's what I'm telling myself since this was announced to the world.

[NewRomeTacitus]

(from "A Short History of Nearly Everything" by Bill Bryson, published in 2003:)

"Almost 80% of American casualties in the First World War came not from enemy fire, but from flu. In some units the mortality rate was as high as 80%.

A fifth of the victims suffered only mild symptoms, but the rest became gravely ill and often died. Some succumbed within hours, others held on for a few days.

In the United States, the first deaths were recorded among sailors in Boston in late August 1918, but the epidemic quickly spread to all parts of the country. Schools closed, public entertainments were shut down, people everywhere wore masks. It did little good. Between the autumn of 1918 and the spring of the following year, 548,452 people died of the flu in America. The toll in Britain was 220,000, with similar numbers dead in France and Germany. No one knows the global toll, as records in the Third World were often poor, but it was not less than 20 million and probably more like 50 million.

In an attempt to devise a vaccine, medical authorities conducted tests on volunteers at a military prison on Deer Island in Boston Harbor. The prisoners were promised pardons if they survived a battery of tests. First the subjects were injected with infected lung tissue taken from the dead and then sprayed in the eyes, nose and mouth with infectious aerosols. If they failed to succumb, they had their throats swabbed with discharges taken from the sick and dying. If all else failed, they were required to sit open-mouthed while a gravely ill victim was helped to cough into their faces.

Out of - somewhat amazingly - three hundred men who volunteered the doctors chose sixty-two for the tests. None contracted the flu - not one. The only person who did grow ill was the ward doctor, who swiftly died. The probable explanation for this is that the epidemic had passed through the prison a few weeks earlier and the volunteers, all of whom had survived that visitation, had a natural immunity.

Much about the 1918 flu is understood poorly or not at all. One mystery is how it erupted suddenly, all over, in places separated by oceans, mountain ranges and other earthly impediments. A virus can survive for no more than a few hours outside a host body, so how could it appear in Madrid, Bombay and Philadelphia all in the same week?

The probable answer is that it was incubated and spread by people who had only slight symptoms or none at all. Even in normal outbreaks, about 10% of people have the flu but are unaware of it because they experience no ill effects. And because they remain in circulation they tend to be the great spreaders of the disease.

That would account for the 1918 outbreak's widespread distribution but it still doesn't explain how it managed to lay low for several months before erupting so explosively at more or less the same time all over. Even more mysterious is that it was primarily devastating to people in the prime of life. Flu normally is hardest on infants and the elderly, but in the 1918 outbreak deaths were overwhelmingly among people in their twenties and thirties. Older people may have benefited from resistance gained from an earlier exposure to the same strain, but why the very young were similarly spared is unknown. The greatest mystery of all is why the 1918 flu was so ferociously deadly when most flus are not. We still have no idea."

---

Later in the book Mr. Bryson illustrates how this planet belongs to microbes and they just let us live here. The more we learn the more we understand how truly bizarre organic life truly is.

[neverdem]

Thanks for posting that.

[phantomworker]

What would stop Al-Queida from getting their hands on this once it becomes epidemic?

Probably nothing. Only idiots would use this as a weapon because there's just as much chance that it would come back to their loved ones as well. At least that's what I'm telling myself since this was announced to the world.

Unfortunately, the way they worship suicide bombers and all, I am sure they are idiots. I often see Arab-types walking around shopping malls, and I wonder if they are walking around with typhoid or spreading around some weird virus. I guess it's not worth getting paranoid about it, but it seems easy enough for them to do, doesn't it?

[carton253]

I don't think you should count on the fact that a "sucide flu carrier" would not do something because of the impact on a loved one... I don't think that would even enter their thinking...

[spetznaz]

Maybe I am being paranoid here, but to me it seems rather risky to 'resurrect' the virus as recently happened. The spanish flu is basically death incarnate, and having it back from the void just makes the world a more dangerous place.

[ModelBreaker]

Aren't all living humans descendants of survivors of the 1918 flu. So shouldn't it's effect be attenuated this time if the new H5N1 flu is mutating to be similar to the 1918 flu?

[NewRomeTacitus]

Typing practice while seeing the chance to share what was recently learned. I've become a compulsive hand-washer but haven't reached the Felix Unger Purel stage yet.

While "common sense" would seem to dictate that our enemies would forgo using such things as weapons (like the combatants of WWI learned about chemical warfare), we have to keep in mind that their deranged way of thinking brooks no respect or value for life at all. They regard all non-Islamists as subhumans that should be converted or slaughtered - the "innocent people" their American fronts mentioned in their supposedly anti-terrorist fatwa do not include non-believers.

In short, I wouldn't put it past them.

[JustDoItAlways]

I sure hope they are not publishing the genetic sequence of this flu.

Because it is actually easy to build a virus from the ground up these days if you have the lastest protein resequencer used to make vaccines.

And once you have the virus, it is easy to make vaccines for it. So as a terrorism weapon, you just vaccinate the poeple you want to survive first and then release the virus. The western world goes into total panic as it will take at least a year to produce and vaccinate everyone after you have isolated the virus.

Viruses will eventually be the weapon of choice across the world. When that happens, it will not be a fun world to live in.

[Ciexyz]

btt

[MissRepresent]

That is so sad to read and very frightening

[GOPJ]

Do you think this version of the bird flu will be as bad as the 1918 version?

[GOPJ]

And once you have the virus, it is easy to make vaccines for it. So as a terrorism weapon, you just vaccinate the poeple you want to survive first and then release the virus. The western world goes into total panic as it will take at least a year to produce and vaccinate everyone after you have isolated the virus.

What's the best way to protect yourself from getting infected -- assuming no vaccine?

[MissRepresent]

I am wondering about all of the people still in shelters. It can't be good having a lot of people housed in one area.

[steve86]

Aren't all living humans descendants of survivors of the 1918 flu.

Actually, there are people alive now who were born before 1918. Please tell me you realized that.

So shouldn't it's effect be attenuated this time if the new H5N1 flu is mutating to be similar to the 1918 flu?

Acquired characteristics (other than genetic mutations) are not inherited.

People still alive no longer have any antibodies to the 1918 flu.

[GOPJ]

It can't be good having a lot of people housed in one area.

Any high concentration of people would do the trick...

[NewRomeTacitus]

1.Total isolation from disease vectors until the virus peaks and recedes or mutates,

2.Exposure to a diminished, non-lethal form of the virus (the same thing as a vaccine), which just might kill you anyway, or

3.Prayer.

[ModelBreaker]

Aren't all living humans descendants of survivors of the 1918 flu. Actually, there are people alive now who were born before 1918. Please tell me you realized that.

Should have said 'almost everyone.' So shouldn't it's effect be attenuated this time if the new H5N1 flu is mutating to be similar to the 1918 flu? Acquired characteristics (other than genetic mutations) are not inherited. People still alive no longer have any antibodies to the 1918 flu.

I understand that Lamarck was wrong (mostly). But I assume that pretty much everyone on earth was exposed to the 1918 flu. Some died and some lived. There was surely some genetic factor in whether you lived or died.

I have read that the bubonic plague is less virulent in people who are, for the most part, descendants of people who survived the plague that was the plague when it first hit.

[libsl]

My grandmother's older sister died of the flu epidemic in 1920, not long after an older brother returned home from France as a WW1 soldier. The sister had a twin brother who also had the flu but he didn't die. I've often wondered if the older brother brought the disease back with him.

[GOPJ]

1.Total isolation from disease vectors until the virus peaks and recedes or mutates...

How long before a person could get the mail out of the mailbox? (Assuming mailman is infected, but not showing symptoms)

[bioprof]

"What's the best way to protect yourself from getting infected -- assuming no vaccine?"

Actually, handwashing is the best defense....sounds simplistic, but it 's important.

One thing about deaths due to influenza: most deaths are caused by secondary infections - usually pneumonia- produced by bacteria. Bacterial infections can be controlled with antibiotics. They had no effective antibiotics in 1918. That's one of the reasons ( not the only one ) that there were so many deaths. The reason for the secondary infections is that the flu virus damages the cells that line the trachea ( breathing tube ) ----these cells help to prevent bacteria from sliding down into the lungs. They're a first line barrier, if you will. Once the barrier is broken down ( by the flu virus ) it makes it easier for bacteria to get into the lungs. There are cells in the lungs that will ingest the bacteria, but they can get overwhelmed if too many bacteria enter.

Short version -----wash your hands ----secondary infections can be controlled with antibiotics. Also - the bird flu is NOT easily transmitted from person - to - person.......there is little evidence to support that the 60 or so ( since 2003 ) human cases got infected from another person - most got infected from handling infected birds. No need to turn into panic mode on this one......just like SARS....this too shall pass.

[GOPJ]

...these cells help to prevent bacteria from sliding down into the lungs. They're a first line barrier, if you will.

Is this where the "gargle with salt water" came from? A pre-antibiotic solution? Thanks for the help.

[steve86]

I don't believe any genes were ever isolated to explain individual differences in resistance to the flu, other than perhaps race itself (I am foggy on remembering that). Perhaps if the 1918 flu is reconstituted and retroactive genetic studies are done, it might be possible to do that. However, anecdotal stories suggest that susceptibility was entirely random, given exposure to the flu.

I don't know about generational susceptibility to the plague. I'm sure the plague evolves over time as well. Yersinia pestis is a bacterium, of course.

[steve86]

You should refer to the flu preps thread.

As bioprof suggested, keep clean.

Beyond that, assuming you do get infected, I have settled on NAC (N-acetyl cysteine), Resveratrol, and Elderberry Root. Most drinkers of Pinot Noir already know about the middle one. Each of these has double-blind evidence suggesting anti-viral action, particularly with respect to influenza. Google each plus influenza and you will find the studies.

Amantadine, a prescription anti-viral, is still effective against most present strains of H5N1. Tamiflu is becoming less so.

[steve86]

One other thing -- don't take anything that excessively stimulates the immune system (apparently Elderberry is not a problem). This could exacerbate a "cytokine storm", where the immune system begins destroying lung tissue itself. I understand that cytokine storms are implicated in the deaths of many influenza patients.

[bioprof]

I can only guess that the "gargle with salt water" helps to keep the tissues ( mucus membranes ) hydrated.....when they're hydrated, they're able to do their barrier work a lot more effectively. Things get nasty when they dry out - and - with a stuffy nose - people tend to "mouth-breathe" which tends to dries the membranes up. Always better to breathe through your nose, because the nose filters and moisturizes the air before it goes down your respiratory tract. With a lot of these things, I take the old grandmother maxim......couldn't hurt! ( and yes, chicken soup really DOES work! ).

[NewRomeTacitus]

The overuse of antibiotics for viral infections may literally be the death of us all. We get more than enough of those through ingesting processed meats. Then there's the increased lead levels, lowered atmospheric oxygen, the unknowable effects of man-made molecules, the erosion of our shielding ionosphere by accumulated chlorofluorocarbons, imbalances in the oceans' phytoplankton...

We can (and should) be as careful as possible but the problems and worries surrounding us can easily rob us of the joy of living if we let them. Yes, we're doomed - we're all going to die sooner or later. The latest research finds our existence here as beings able to ponder these things to be improbable to the extreme. Still, scientists over the last generation have been shocked to find living organisms thriving at astonishing scales of temperature, vast depths and in rocks hundreds of millions of years old.

I look at our existence as the wonder that it is and thank whatever made that possible (after the aspirin, vitamins, soak and coffee, of course).

Time is our most precious commodity. I'm not going to spend too much of it worrying.

[sinanju]

"Then Dr. Taubenberger got a third sample, from a woman who had died in Alaska when the flu swept through her village, killing 72 adults, leaving just 5. The dead were buried in a mass grave in the permafrost, and a retired pathologist, Johann Hultin, hearing of Dr. Taubenberger's quest, traveled from his home in San Francisco to the gravesite in Alaska at his own expense, dug up the grave with the villager's permission, extracted the woman's still frozen lung tissue, and sent it to Dr. Taubenberger."
____________________________________________________________________

Natives of the americas, Australia, South Pacific, etc. were the hardest hit. The "Spanish Flu" inflicted an especially searing legacy on Alaska. Inuit and Indian culture never recovered, so many of their elders were wiped out, leaving a generation of orphans.

As an aside, the Discovery channel did an interesting special on this quest to find the virus in permafrosted remains. Dr. Hultin's story was almost heartwarming in a way and a hilarious contrast to a massively funded and ballyhooed expedition to Spitzbergen to dig up the frozen corpses of miners who also died in the pandemic. One little old man working on his own accomplished what this other pompous three-ring circus (with it's own PR flack and matching outerwear, no less) could not.

Dr. Hultin politely addressed the village council and explained what he was trying to do and why. They simply couldn't refuse him. Several locals even volunteered their assistance. Proper courtesy was observed and the remains were carefully reinterred. Very diplomatic.

[NewRomeTacitus]

The history of science is rife with unrecognized people who found their accomplishments attributed to others. While many are now aware of how Edison took credit for much of Tesla's hard work, few know that Clyde Tombaugh actually found Pluto (widely attributed to Percival Lowell), nor that Robert Oppenheimer was hailed as for envisioning neutron stars when an unpleasant colleague named Fritz Zwicky, who worked just down the hall from him, beat him to it by five years.

Had Zwickey been less obnoxious he would also have been rightfully recognized for being the first to postulate supernovae and black holes.

[JustDoItAlways]

The scientists working on the virus have noted that various anti-viral drugs we have now, have worked fairly well for mice infected with the virus.

TamiFlu, for instance, was very effective. TamiFlu is an anti-flu drug that normally cuts the symptoms of the flu by about a third. But for some flus it works really well and for others it doesn't work at all.

In the current bird flu outbreak of the H5N1 bird flu, TamiFlu hasn't worked at all.

[jb6]

Al Quida lacks the knowledge/equipment for genetic engineering and the majority of those who survive (which will still be the majority of people) will be immune to the same virus (why the Spanish flu hasn't come back). Sure they could wait a few generations and unleash it again, but the majority of the deaths from this virus will be in China, SE Asia, India, Middle East, and Africa....all the poor, garbage ridden places.

[GOPJ]

A "How to Protect Yourself from Bird Flu" thread might be needed in the future. Seems you're up to writing it -- thanks in advance...

[jb6]

Anti-biotics do absolutely nothing against viruses, they're against bacteria.