The Flu Hunters

When a mysterious and deadly flu virus struck Hong Kong last year, medical detectives from around the world, fearing a repeat of the 1918 epidemic that killed more than 20 million, sprang into action.

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Like Webster, virologists around the world were galvanized. The CDC, alerted by Claas, quickly tested its own copy of Lim's virus and confirmed the finding. In San Francisco, Dr. Keiji Fukuda, chief epidemiologist for the CDC's influenza section, was doing a clinical rotation at Mount Zion Hospital when he received an urgent call from the agency's head of surveillance. "Whenever you get a call like that," he says, "you know it's probably not great news." Shortridge was vacationing in England when his phone went wild. "The first thing that crossed my mind was, 'Is this the start of a new pandemic?' " he recalls.

To anyone who knew influenza, the news instantly raised the specter of 1918. Or worse, as this was a purely avian virus against which most humans would have no defense. The world, moreover, was far more densely populated, and high-speed travel now linked all the major cities. In 1918, when transportation was still painfully slow, the pandemic circled the globe in a matter of months. Traveling by jet, a new killer virus could reach Tokyo in three hours and New York City within a day.

The fact that the new virus did not seem readily transmittable from person to person was a consolation, but flu experts know that influenza viruses are utterly unpredictable. In Hong Kong the big question was this: Would the H5 reassort with a common human strain to produce a new virus that was as lethal as H5 but could be passed along by a human sneeze? Or would this new H5 virus, through repeated exposure, find some other way to adapt to human hosts? "That's an interesting point," says Shortridge, "because it raises questions about the 1918 pandemic. Did a similar sort of thing happen?"


Back in Washington, Taubenberger and Reid had decided to concentrate on the seven cases in which the victim had died most quickly, figuring that these specimens would be most likely to retain the genetic remains of the virus. They found plenty of RNA, but none of it looked like flu--until, after a full year's work, they came to Private Roscoe Vaughn.

Vaughn was a 21-year-old soldier at Camp Jackson, S.C., who reported for sick call on Sept. 19, 1918, at the peak of the pandemic. He complained of chills, fever, headache and a bad cough. He had trouble breathing. A week later, at 6:30 a.m., he died. At 2 p.m., his body was autopsied, and specimens were extracted, preserved and sent to Washington.

Using an array of powerful if arcane gene-hunting tools, Taubenberger and Reid slowly picked their way through the shattered genetic landscape of Private Vaughn's cells. This time they got lucky. They found small pieces of flulike RNA. Their subsequent analysis showed that the virus was an H1N1 influenza unlike any flu virus identified during the past 80 years. The closest known strain was Swine Iowa 30--the pig flu isolated by Richard Shope in 1930 and kept alive at various culture repositories ever since. Their findings suggest that the 1918 virus came to people from pigs, not from birds--although Taubenberger cites studies by Webster and others indicating that human viruses and the pig flu of the 1930s may share a common avian ancestor. This suggests that sometime before 1918, a bird virus could have entered the mammalian population and, through reassortment, produced the pathogenic flu virus known to man.


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