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In my attempt to read a history of the 1918 influenza pandemic informed by modern knowledge of viruses, I have so far managed to read a hagiography of Great White Male scientists associated with Johns Hopkins plus some chapters on the 1918 pandemic (Barry), and an account of the search for the causes of the 1918 pandemic plus one chapter on its history and a long digression into the political fallout of the swine flu vaccination in America in 1976 (Kolata). Surely the book I thought I was going to read exists and I just haven't found it yet... right?
Kolata's book is a delightful antidote to Barry's endless chapters on Welch, whose sole contribution to the pandemic was a single field trip followed by getting it himself, and Lewis, who wasn't involved at all; she mentions them both to say that they were noted and notable, but did not contribute to knowledge of the causes of the pandemic. Bye-bye, Welch and Lewis!
Kolata has a fascinating account of efforts at the time of the pandemic and shortly afterward to figure out its causes. Very gross and often dubiously ethical efforts, involving spraying gunk from sick/recovered people's noses and mouths into healthy people's noses and mouths, in varying degrees of filtration, to see if it would get them sick.
An early American experiment with prisoners failed to get any of them sick. Barry details this but annoyingly does not explain why. Apparently it's still somewhat mysterious, but according to Kolata, the most likely explanation was that the prisoners had all been asymptomatically infected and so had immunity, or that the secretions from flu victims were collected too late in the disease process, when the virus itself was mostly gone and the people were dying of the cytokine storm reaction to it, and so were no longer infectious. Or a combination of both.
In 1918 - 1919 three Japanese doctors performed an experiment which Barry doesn't mention at all, choosing instead to spend chapters detailing the efforts of Johns Hopkins scientists which went nowhere. The Japanese doctors experimented on healthy subjects, including volunteer doctors and nurses. They filtered sputum and blood from flu victims to remove all bacteria, then introduced the filtrate to their subjects in multiple ways. They did the same with bacteria extracted from flu victims. The results were exactly what you'd expect if the cause was a virus: the no-bacteria filtrates gave all the subjects influenza, and the bacteria-only didn't. Subjects who'd already had the flu didn't get sick regardless.
These results were so convincing that... the world at large decided they were too neat to be believed. 100% of the subjects got infected from hypothetical viruses, and 0% from bacteria. No way!
[world's biggest facepalm.]
Later experiments determined that ferrets can get influenza. The notes on how difficult ferrets were to work with are pretty hilarious. Apparently lots of scientists got bittenand possibly got ferrets down their trousers before they threw up their hands and anesthetized the ferrets before trying to stick things in their mouths and up their noses. This work led to a series of experiments looking at connections between flus that can infect humans, pigs, ferrets, and finally mice. (Most animals don't get or transmit human influenzas.) In 1934 several groups of scientists working independently found that swine flu and human flu viruses are not identical, but are related; antibodies from one can provide partial immunity to the other.
Meanwhile, the 1918 influenza seemed to have vanished. But there had been a swine flu outbreak at the same time, and that was still around. And survivors of the 1918 pandemic all had antibodies to the current swine flu virus, while people born after the pandemic did not. So, was the current swine flu virus in fact the 1918 pandemic virus, mutated to no longer infect humans and living on in pigs?
Kolata then has a very charming chapter about a Swedish scientist, Johan Hultin (whose wife Gunvor was also a scientist, in radiation biology), who worked on influenza in the US and got interested in finding original samples of the 1918 virus. They had earlier traveled to Fairbanks, Alaska, and went around with a paleontologist digging up mammoth tusks. It occurred to Hultin that as Alaska has permafrost, some bodies of flu victims might still be preserved. In 1951 he took an expedition to Brevig, where 72 of 80 people died of influenza in November 1918, and were buried there.
In a surprising and pleasingly ethical manner, Hultin visited the current town and survivors/descendents, told them what he wanted to do and why, and asked their permission to exhume some bodies and take samples. They agreed. He then discovered how hard it is to dig in ground that's frozen solid, and ended up having to melt down to the bodies. But he did it, and took samples.
It did not occur to him that he might be unleashing the virus on the world all over again. They did take precautions, but it was 1951 and they were wildly inadequate. Luckily, there were no consequences. But alas! Upon his return to his lab, he totally failed at extracting any virus from the samples. He tried infecting animals. He tried growing it in eggs. Nothing.
Kolata then jumps ahead to 1976, when an American private at boot camp died of swine flu. At that point scientists could isolate viruses and quickly found that 1) yes, it was swine flu, 2) it seemed closely related to the one that was theorized to have caused the 1918 pandemic.
Kolata then spends a long, rather dry chapter dissecting the political ramifications of the US decision to attempt to rush-vaccine the entire country to prevent a pandemic. This turned out to be unnecessary and ended up very expensive and embarrassing, as a number of people sued after they vaccinated and got sick. Kolata's view is that most if not all of the post-vaccination illnesses and deaths were coincidental and not caused by the virus. Nevertheless, the US government had to pay out a lot of money and also looked bad.
Everyone involved mostly felt that they'd been too quick to rush to a vaccination and should have listened to the people who thought the swine flu was no big deal. Reading this chapter now, my sympathies are entirely with the scientists who thought they needed to move fast to prevent another pandemic. They were wrong... but they easily could have been right.
Flu: The Story Of The Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It
Kolata's book is a delightful antidote to Barry's endless chapters on Welch, whose sole contribution to the pandemic was a single field trip followed by getting it himself, and Lewis, who wasn't involved at all; she mentions them both to say that they were noted and notable, but did not contribute to knowledge of the causes of the pandemic. Bye-bye, Welch and Lewis!
Kolata has a fascinating account of efforts at the time of the pandemic and shortly afterward to figure out its causes. Very gross and often dubiously ethical efforts, involving spraying gunk from sick/recovered people's noses and mouths into healthy people's noses and mouths, in varying degrees of filtration, to see if it would get them sick.
An early American experiment with prisoners failed to get any of them sick. Barry details this but annoyingly does not explain why. Apparently it's still somewhat mysterious, but according to Kolata, the most likely explanation was that the prisoners had all been asymptomatically infected and so had immunity, or that the secretions from flu victims were collected too late in the disease process, when the virus itself was mostly gone and the people were dying of the cytokine storm reaction to it, and so were no longer infectious. Or a combination of both.
In 1918 - 1919 three Japanese doctors performed an experiment which Barry doesn't mention at all, choosing instead to spend chapters detailing the efforts of Johns Hopkins scientists which went nowhere. The Japanese doctors experimented on healthy subjects, including volunteer doctors and nurses. They filtered sputum and blood from flu victims to remove all bacteria, then introduced the filtrate to their subjects in multiple ways. They did the same with bacteria extracted from flu victims. The results were exactly what you'd expect if the cause was a virus: the no-bacteria filtrates gave all the subjects influenza, and the bacteria-only didn't. Subjects who'd already had the flu didn't get sick regardless.
These results were so convincing that... the world at large decided they were too neat to be believed. 100% of the subjects got infected from hypothetical viruses, and 0% from bacteria. No way!
[world's biggest facepalm.]
Later experiments determined that ferrets can get influenza. The notes on how difficult ferrets were to work with are pretty hilarious. Apparently lots of scientists got bitten
Meanwhile, the 1918 influenza seemed to have vanished. But there had been a swine flu outbreak at the same time, and that was still around. And survivors of the 1918 pandemic all had antibodies to the current swine flu virus, while people born after the pandemic did not. So, was the current swine flu virus in fact the 1918 pandemic virus, mutated to no longer infect humans and living on in pigs?
Kolata then has a very charming chapter about a Swedish scientist, Johan Hultin (whose wife Gunvor was also a scientist, in radiation biology), who worked on influenza in the US and got interested in finding original samples of the 1918 virus. They had earlier traveled to Fairbanks, Alaska, and went around with a paleontologist digging up mammoth tusks. It occurred to Hultin that as Alaska has permafrost, some bodies of flu victims might still be preserved. In 1951 he took an expedition to Brevig, where 72 of 80 people died of influenza in November 1918, and were buried there.
In a surprising and pleasingly ethical manner, Hultin visited the current town and survivors/descendents, told them what he wanted to do and why, and asked their permission to exhume some bodies and take samples. They agreed. He then discovered how hard it is to dig in ground that's frozen solid, and ended up having to melt down to the bodies. But he did it, and took samples.
It did not occur to him that he might be unleashing the virus on the world all over again. They did take precautions, but it was 1951 and they were wildly inadequate. Luckily, there were no consequences. But alas! Upon his return to his lab, he totally failed at extracting any virus from the samples. He tried infecting animals. He tried growing it in eggs. Nothing.
Kolata then jumps ahead to 1976, when an American private at boot camp died of swine flu. At that point scientists could isolate viruses and quickly found that 1) yes, it was swine flu, 2) it seemed closely related to the one that was theorized to have caused the 1918 pandemic.
Kolata then spends a long, rather dry chapter dissecting the political ramifications of the US decision to attempt to rush-vaccine the entire country to prevent a pandemic. This turned out to be unnecessary and ended up very expensive and embarrassing, as a number of people sued after they vaccinated and got sick. Kolata's view is that most if not all of the post-vaccination illnesses and deaths were coincidental and not caused by the virus. Nevertheless, the US government had to pay out a lot of money and also looked bad.
Everyone involved mostly felt that they'd been too quick to rush to a vaccination and should have listened to the people who thought the swine flu was no big deal. Reading this chapter now, my sympathies are entirely with the scientists who thought they needed to move fast to prevent another pandemic. They were wrong... but they easily could have been right.
Flu: The Story Of The Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It
