H1N1 and the influenza pandemic of 1918

A few years ago I read the book ‘Flu. The story of the great influenza pandemic of 1918 and the search for the virus that caused it’ by Gina Kolata. (Actually it happened to be the German translation.) I found it very interesting and a pleasure to read. The recent public interest in the outbreak of influenza of type H1N1 in Mexico led me to take up the book again. I found it just as fascinating as the first time around and I ended up rereading the whole book. Things I had learned in the meantime allowed me to appreciate more aspects of the subject. In what follows I will describe some of the highlights.

The main subject of the book is the influenza pandemic of 1918. According to conservative estimates this killed 50 million people, more than died in combat in the First World War. In view of the magnitude of the catastrophe it is surprising that it is not more widely known. In 1951 Johan Hultin travelled to Brevig in Alaska and obtained samples from the remains of victims from 1918 which had been relatively well preserved in the permafrost.He had hoped that the virus might have survived but this was too optimistic. He could not do much with his samples at that time. Later it was clear to him that with more recent developments in molecular biology there were new possibilities of using this kind of material. Independently of this, in 1995 Jeffery Taubenberger and his colleagues at the Armed Forces Institute of Pathology started to try to obtain information about the 1918 influenza virus from remains of soldiers who had died at that time which were archived at the institute. They were able to determine part of the genetic sequence of the virus but the quantity of material they had was so small as to limit the possibilities. Hultin read their first publication on the subject in Science in 1997 and contacted Taubenberger, offering to return to Brevig to obtain more material. He was successful and this finally allowed Taubenberger’s team to determine the whole genome of the virus. This was completed in 2005. A few months later the virus was reconstructed at the Centers for Disease Control and Prevention (CDC).

There were two parts of the book which I liked less. This was not because the writing was any less good in those parts – what I did not like was aspects of the content. The first of these two parts concerned the fears of a pandemic in 1976 and the reactions to it. At that time a mass vaccination was carried out which was very expensive and probably not necessary. This just shows how difficult decision making can be in this kind of situation. The thing which I find disturbing is that the costs of this were dwarfed by a sum of over three billion dollars which the government had to pay to people who claimed to have suffered adverse consequences from being vaccinated. This is of course likely to affect decisions of this kind in the future. My conclusion
from this is that the worst virus is probably less dangerous than the mechanisms which take place within human society and prevent mankind from reacting to the threat of a virus in the most effective way. The second part concerns another expedition to obtain material from the influenza victims of 1918, this time in Spitzbergen. It was the idea of Kirsty Duncan. Here I want to describe my personal reactions. From the beginning I felt admiration for the efforts of Hultin and of Taubenberger and his team. In contrast, my attitude to Kirsty Duncan was immediately negative. The sequel only strengthened this impression. The expedition set up by Duncan was a failure – that could have happened to anyone. What I dislike most is the combination of a facade of integrity with the refusal to admit the truth. I find it impressive when people achieve something remarkable by working discretely and quietly rather than thriving on and exploiting publicity. I am happy that in this case luck was on the side of those who deserved it.

One interesting effect of the affair concerning the pandemic scare and the vaccination campaign of 1976 was that the idea came up that a rare side effect of the vaccination might be the disease called Guillain-Barre syndrome. This is a demyelinating disease of the peripheral nerves. It seems that at least some types of this disease are related to molecular mimicry, a subject mentioned in a previous post. In this case the disease can be triggered by the bacterium Campylobacter pylori. Perhaps this disease could be a valuable model for autoimmunity in general.

The progress of the present H1N1 epidemic can be followed in daily reports on the web page of the World Health Organization. Today (15th May) the official number of cases is 7520.

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