The Spanish Flu, 1918 - Part Two

For almost three decades since the last major outbreak of the infamous Spanish Flu, there was no improvement in our understanding of the disease or its cause. That is not to say there were no efforts made by the scientists, because there was plenty of incentive to catch the killer virus. However, we simply lacked the tools and know-how to trace the now almost non-existent virus. As no samples were preserved during the war or the years following the war when the virus was rampant, the doctors had only epidemiological records of the symptoms and deadliness. However, that all changed when a discovery was made about the residents of a Mission in Alaska during the 1918 pandemic outbreak of the virus.



The voyage to Alaska


On October 12, 1918, nearly 75 citizens of Seattle died from the flu and that is when Governor Thomas Riggs ordered the last of the steamers for the season headed up north from Seattle to be scrutinized for passengers showing symptoms. They left no stone unturned to keep the flu from spreading overseas once again. Then S. S. Victoria docked at Nome. Before leaving Seattle, the ship's passengers and crew had been checked by three physicians, separately and independently, to assure that no one who exhibited symptoms would be traveling. Despite all that effort, 31 men died of the flu on board during the voyage to Nome and when the ship arrived at the harbor, all passengers and crew were quarantined for 5 days and all freight and mail were fumigated. But it was too late to contain the flu and it soon spread throughout Alaska making its way through York and Wales following the mail carriers and soon arrived at a small village named Teller. The entire population of the Teller Mission near the village was decimated by the flu. Of the 80 people, mostly Inuit natives, living at the mission, 72 had died of the flu within the short period between November 15 - 20, and the local government ordered a mass grave to be dug over the hill near the mission to bury the dead.

The search begins


In 1951, a 25-year-old Swedish microbiologist and a Ph.D. student at the University of Iowa, Johan Hultin set out on an expedition in hopes of acquiring samples of the virus from the remains at the mass grave near the Teller Mission, now known as the Brevig Mission. What made the grave such a point of interest was that due to the cold weather that was typical of the region, the specimen was likely to be preserved well, and therefore, the place was a better candidate than other burial sites mainland. He obtained permission from the elders and set up a dig site. With the help of some of his colleagues from the University, he was able to acquire lung tissue samples from five different bodies. Technology proved to be a huge bottleneck in his endeavors. During his trip back, he had boarded a DC-3 propeller-driven airplane that had to make multiple stops along the way. He needed a way to keep the samples well preserved. Therefore, at every stop, he would deboard the plane and refreeze the samples with carbon dioxide from a fire extinguisher. At the university, Hultin attempted to inject the lung tissue into chicken eggs to get the virus to grow. However, it did not. His initial attempt failed as none of the samples could give him the results.

Johan Hultin in 1951

Lucy

A second opportunity arose in 1997 when Dr. Taubenberg and his team successfully sequenced a part of the virus genome from lung tissue samples of a 21-year-old male U.S. service member stationed in Fort Jackson, South Carolina. The serviceman had been admitted to the camp’s hospital on September 20, 1918, with a diagnosis of influenza infection and pneumonia. He had died six days later on September 26, 1918. Learning about this advancement from a science journal, the now 72-year old Dr. Hultin wrote a letter to Dr. Taubenberg and they teamed up on a 5-day excavation back at the Brevig Mission. This time, however, Hultin made a remarkable discovery. About 7 feet deep inside the permafrost, they discovered the preserved body of a young Inuit woman who Hultin named "Lucy". Also, unlike last time, this time Hultin was better equipped to transport the samples. He placed the samples in preserving fluid and shipped them to Dr. Taubenberg and his fellow researchers at the Armed Forces Institute of Pathology (which was later disestablished in favor of the AIRP). There, Dr. Taubenberg, Dr. Ann Reid, and a team of pathologists discovered the H1N1 virus in those tissue samples from Lucy. They also discovered that the 1918 virus had an origin based on a less virulent strain of the virus that started infecting humans somewhere between 1900 and 1915. The original virus had more avian adaptations whereas the mutated 1918 strain had more human-like or swine-like adaptations (depending upon the method of analysis). This breakthrough not only helped close the case on the Spanish Flu but also opened up the possibilities to the discovery of a number of deadly viruses of avian origin and gave us a new perspective on how safe we actually are.


The pictures above are from and after the 1997 Brevig expedition. On the left is Dr. Anne and Dr. Taubenberg studying the virus genome and on the right is Dr. Hultin at the burial site collecting samples.


The 1918 pandemic was a cautionary tale about the catastrophic nature of a virus outbreak if not contained at the most nascent stages. In spite of the war, our biggest challenge in those years became a virus. Thank you for reading.