Frozen Pandemic
Decoding the 1918 H1N1 Influenza Virus
Seventy-Two year old Dr. Johan Hultin had seen this desolate place before. He knew some of the horrific secrets buried beneath the permafrost. He had been there in 1951 while the crosses yet stood to mark the site. Now only their rotted stumps remained. For Hultin, the stumps were a metaphor for the dream that was dashed after his last visit. Though he had tried valiantly, he had failed to crack the frozen secret. His dissertation would never be written, his PhD never to be awarded.
The 1918 Influenza Pandemic had hit the little village of Brevig Mission, Alaska very hard. About 90 percent of its 100 or so souls had perished in five days of absolute terror. Decades later, as the science of Epidemiology improved, people wondered about the 1918 flu. What was it? Would it ever come back? Would we be ready if it did? Science had made great strides. If we knew more about the virus, maybe we could be ready for its return. A curious young graduate student at the University of Iowa heard these questions and thought he might be able to find the answer.
Johan Hultin approached his advisors with the idea. It would form the basis for his dissertation. Somewhere beneath the Artic permafrost lay a secret ready to be unlocked. Perhaps humanity could be protected from a return of this deadly disease. His advisors agreed. The quest was on.
First Hultin enlisted the help of a friend, Otto Geist, who was a Research Assistant in Paleontology at the University of Alaska. Geist researched the impact of the 1918 pandemic on Alaska. Using his knowledge of the terrain, he narrowed the search to a couple of villages north of Nome. In the summer of 1951, Hultin, Geist, and two of Hultin’s professors made the long journey to one of Alaska’s remotest inhabited places. It took a trip with a bush pilot, a native whaleboat and a hike to get the four them to the village of Brevig Mission.
You don’t just walk into an Inuit settlement and start digging up the graves of their ancestors. Hultin and the team used diplomacy and logic. They found three survivors of the pandemic to explain the gravity of the flu outbreak to the populace. This helped to convince the village matriarch that their mission was worthwhile.
Soon the group was hard at work thawing and digging in the frozen ground. They found the first bodies at about four feet. Quickly extracting their samples, they found that preserving them would be a challenge. Their dry ice supply had evaporated. Improvising, they put the tissue samples in their vacuum thermos bottles and tried to cool them with a shot from a fire extinguisher.
Back home in Iowa, the team was unable to gain much in the way of scientific information from the degraded tissue. In 1951 there just wasn’t the technology to do much viral research on old tissue. Their mission a failure, Hultin gave up on his goal of a PhD at the University of Iowa. Instead he earned his MD. For years he would ask himself, “If only….”
Fast forward to 1997. While skimming through the journal Science, Hultin saw an article by Virologist Jeffrey Taubenberger of the Armed Forces Institute of Pathology. Taubenberger was trying to analyze the gene structures of the 1918 Influenza Virus. He was using tissue samples that the Army had taken from the pandemic’s victims in 1918. His task was made difficult by the small size and age of the specimens. Hultin decided they needed to talk.
It wasn’t long before Hultin was back on the trail of his fifty-year old quest. He landed at Brevig Mission and looked up the village matriarch. As luck would have it, she was the granddaughter of the lady who had helped him so much in 1951. Immediately sensing the importance of the mission, she tasked 4 husky tribal members to help with the digging.
As they toiled away under the Midnight Sun, they found a problem. The first bodies they unearthed were mere skeletons. The climate had warmed considerably since the 1950’s. The village’s permafrost wasn’t so permanent after all. It was not until they had dug 7 feet down that they found an intact specimen.
It was the body of a 30 something female. The fact that she was overweight had helped preserve her internal organs form the occasional thaw. Hultin named her Lucy. Then he did a quick autopsy. The lungs showed the tell-tale signs of damage from the virus. He had found his Holy Grail!
After taking the specimen, Hultin tenderly reburied Lucy with all the respect he could muster. Then, before leaving Brevig Mission he found some timbers. In a final act of reverence, he duplicated the two original crosses he had seen in 1951. Students from the high school helped him erect them. Lucy and the others would not be forgotten.
Back in the lower 48, Taubenberger and his associates went to work on Lucy’s lungs. They were able to identify the 1918 Influenza Virus and decode its entire genetic sequence. They even replicated it in the lab. This research helped lead to better vaccines and therapies to treat modern versions of the flu and other viral diseases. The 1918 virus was identified as H1N1. It would reappear many years later. Thanks to Lucy, this time we would be ready.
In 2009 a new version of the H1N1 virus would threaten our health again. Some say we botched our response to the threat of the new virus and cite the fact that 12,500 Americans died from it. This somehow justifies the delayed response to the current COVID-19 Coronavirus outbreak. The facts concerning our response to the 2009 H1N1 pandemic say otherwise.
The 2009 virus first appeared on our doorstep via neighboring Mexico. The first US case was identified on April 15. Thanks to the work of Taubenberger and others, we could already test for it. It proved to be H1N1. Within a week an alarmed CDC activated its Emergency Operation Center to deal with the emerging threat. Within two weeks the CDC had accelerated the development of a real time test making it much easier to identify those infected. The test worked well and was immediately shared with governments throughout the world. By the end of April, the government had declared a public health emergency.
Recognizing the threat, the CDC immediately began working on a vaccine. Trials started in July. The vaccine was approved by the FDA on September 15. Yes, it did take time to ramp up production of the vaccine. You need to grow strains of the virus to make the vaccine. That takes time, too much time. By December 100 Million doses had been made. Once the vaccine had been developed it was routinely included in the annual flu shots for the years that followed. Consequently, the vast majority of people have been spared Lucy’s fate.
I hope that we can respond to the COVID-19 Pandemic quickly and responsibly. We can do the finger-pointing after it is whipped.
LDT
3/21/20
REFERENCES:
Influenza 1918. PBS Documentary
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