Spanish Flu Pandemic

Since 1862, while Americans were fighting each other during the U.S. Civil War, the United States military establishment has kept autopsy tissue samples of dead soldiers. Preserved in paraffin, these remains, together with surgical tissue samples, fill many warehouses near Walter Reed Hospital and are controlled by the Armed Forces Institute of Pathology. (Some folks refer to this Institute as the “Library of Congress of the dead.”)

Worried that another pandemic of Spanish Flu could develop, Dr. Jeffrey Taubenberger (Chief of Molecular Pathology at the Armed Forces Institute of Pathology) wanted to find tissue samples from WWI soldiers who died of the flu. And he wanted to track down the mass killer-virus which had escaped detection for eighty years.

Believing pneumonia-afflicted lung tissue, analyzed with modern knowledge and equipment, could provide 21st-century answers, Taubenberger searched for the best samples. Perhaps he recalled the observations of Isaac Starr, a third-year medical student from the University of Pennsylvania who gave first-hand reports (this is a PDF link) on the epidemic:

As their lungs filled … the patients became short of breath and increasingly cyanotic. After gasping for several hours they became delirious and incontinent, and many died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth. It was a dreadful business.

When Dr. Taubenberger found the best tissue samples however, he did not have enough material to work with. He and his research team, headed by molecular biologist Ann H. Reid, wanted to recover fragments of the virus’ RNA genome so they could understand its genetic code. If that were possible, perhaps the medical industry could be ready if Spanish Influenza were ever to strike again. But Taubenberger’s team ran into a serious problem: relevant tissue samples were depleted before their code-recovery work was finished.

How (and where) does one recover “evidence” from people who have been dead eighty years? Learning of Taubenberger’s need for more reliable samples, Dr. Kirsty Duncan (a Canadian scientist) looked to the frozen ground on a Norwegian island where flu victims had been buried. Her team’s search at Longyearbyen (look just south of the North Pole on this map) produced no new evidence. Flu victims there had been buried in, or over, the permafrost. But a retired Swedish pathologist living in San Francisco, who had tried to isolate the Spanish flu virus among the Alaskan Eskimos nearly fifty years before, was about to make an amazing contribution.

Native elders had given Dr. Johan Hultin permission to open a mass grave of Inuit (Eskimos) at Brevig Mission on the Seward Peninsula in 1951. (Nome, Alaska is also on the Seward Peninsula, at roughly 164 degrees longitude, 64 degrees latitude.) His search, at the time, did not produce his hoped-for results: to develop a Spanish Flu vaccine.

But what if Hultin resumed what he had started in the 50s? If he received permission again, what if he found a still-preserved flu victim? What if that victim had tissue samples Dr. Taubenberger’s team could use? With no technical or financial support, Hultin went to Brevig, Alaska. With him he took his wife’s pruning shears.

Again receiving permission from the Native Elders, Dr. Hultin reopened the mass grave and found what the Washington research team needed. An Inuit woman, whom Dr. Hultin called “Lucy,” had died in the flu epidemic. She was preserved in the Alaskan permafrost. Thanks to cooperation between Drs. Hultin and Taubenberger, tests revealed very positive results. With that 80-year-old tissue, the Armed Forces Institute of Pathology team continued their genetic-code quest and published their findings. Dr. Reid was even able to map out the hemagglutinin gene which is key to understanding the flu virus.

Although much more is now known about the killer virus, Reid acknowledges a significant problem. The more scientists learn, the deeper the mystery surrounding the Spanish Flu Pandemic.