Credit 87
In 1867, the United States bought Alaska from Russia. A half century later, Alaska was still a wilderness. Gold miners’ camps, villages inhabited mostly by white people, and tiny Inuit (sometimes called Eskimo) settlements dotted the countryside. Transportation was chiefly by snowshoe, boat, and dogsled.
On October 20, 1918, the steamship Victoria, out of Seattle, Washington, docked at Nome, on the southern tip of Alaska’s Seward Peninsula, with tons of supplies and sacks of mail. When Victoria sailed, several sailors infected with the devil virus were on board, though they did not yet show symptoms. Within a day or two of the ship’s arrival, however, half of the town’s 2,000-odd white residents had the flu. Many died. Fear reigned. Ebenezer Evans, a schoolteacher, reported: “As one walked the streets of Nome, it seemed a city of the dead.” Travelers soon spread the infection to larger, more distant towns like Anchorage and Fairbanks.12
Before getting sick themselves, traders and mail carriers delivered the killer virus to the native population. The Inuit were “virgin soil”—that is, all but defenseless against diseases originating outside their area. Geographic isolation deprives the human immune system of chances to “update” itself, to adapt to novel diseases. Should these diseases manage to reach them, victims lack the memory cells to kick-start an immune reaction. So, finding no opposition, the virus easily slashed through the remote Inuit settlements.
When terrible rumors reached Nome, city officials asked gold miners to inspect the backcountry. Stunned, the miners found the disease had devastated the Inuit community. Despairing people, panicked by horrific symptoms, committed suicide. Unable to hunt moose, seals, and walrus, entire families died of starvation. Huskies, Arctic sled dogs, are little more than domesticated wolves. Though they are loyal and obedient when well fed, hunger makes them ferocious. A report stated:
In many cases were found living children between their dead parents, huddling close to the bodies for warmth; and it was found that [sled dogs]…had managed to reach the bodies of the Natives and had eaten them, only a mass of bones and blood evidence of their having been people.
Gold miners had to build fires to soften the permafrost so they could dig graves to bury victims’ remains.13
Now, after thirty-three years, Johan Hultin planned to search for the virus in those remains. He’d already visited Alaska during his 1949 summer vacation with Otto Geist, a fellow scientist, looking for bones of prehistoric horses. Hultin wrote Geist, who referred him to Christian missionaries. They helped him get church records from isolated Alaskan villages, giving the names of those who had died during the pandemic and the location of their graves. When Hultin checked this data against a permafrost map, he decided the best place to look was Brevig Mission, a tiny Inuit village a hundred miles north of Nome. The village had been home to eighty people in 1918; flu killed seventy-two of them within five days, November 15–20. Missionaries melted a patch of permafrost, buried the dead in a mass grave, and marked the site with two wooden crosses.
Pathologist Johan Hultin at the Alaskan dig site where victims of the 1918 flu were buried in a mass grave. (1997) Credit 88
In June 1951, Hultin traveled alone to Brevig Mission, his expenses paid by a small grant from Iowa State. After he explained his purpose, village elders gave him permission to open the grave and take samples of lung tissue from the bodies. Public health workers had vaccinated villagers against smallpox, so the elders understood why Hultin’s findings might help prevent another flu pandemic.
Working by himself, Hultin thawed the grave site with fires and put in sixteen to eighteen hours a day, digging. The work was hard and sweaty, but he kept going with pick and shovel. At a depth of six feet, he found the body of a little girl. “She was a child about six years old,” he recalled. “She was beautiful, with her black braids. She was well preserved, and I knew there’d be many, many more.” Hultin called for help, and three scientists came from Iowa State. The team enlarged the hole, removing bits of lung from five other bodies. To prevent decay, Hultin sealed these samples in thermos bottles with dry ice taken from fire extinguishers.14
Preserved lung specimen slides from the U.S. 1918 flu epidemic. Credit 89
Back at Iowa State, Hultin thawed the samples and sprayed tiny amounts of the dissolved lung tissue into ferrets’ noses. Yet, try as he might, his experiments failed; none of the animals came down with influenza. “Oh,” Hultin recalled years later, “it was disappointing, disappointing. I used up all the material, and got nothing from it.” Though Hultin never finished his doctorate, he graduated from medical school and spent nearly his entire career as a pathologist at a hospital in California. Yet he did not take defeat easily. Hultin’s failure, like a dull toothache, continued to nag at him. If another chance ever came, he said, he’d gladly take up the hunt for the devil virus. Dr. Jeffery K. Taubenberger gave him that chance.15
Born in 1961, Taubenberger grew up in a German immigrant family; his father was a career officer in the U.S. army. Jeffery became interested in science at an early age. What fascinated him was that scientists were, in a sense, overgrown children. “Scientists,” he says, “are people who refuse to grow up. You know that kids are incredibly curious; the first thing they do when they start talking is to ask Why? Why, why, why? Because they want to know….[But] when children ask why-why-why, they expect someone else to give them the answer. When scientists ask why-why-why…they want to find the answer themselves.”16
After graduating from medical school, Taubenberger became a civilian pathologist at the Armed Forces Institute of Pathology (AFIP). The AFIP was a gift of President Abraham Lincoln, the “Great Emancipator,” who dealt the deathblow to slavery during the Civil War. In 1862, a year before issuing the Emancipation Proclamation, Lincoln created the AFIP by executive order. Its aim was to collect examples of all aspects of human disease. Though the AFIP shut its doors in 2011 because of congressionally ordered base closures, many of its activities were taken over by a new organization, the Joint Pathology Center (JPC) in Bethesda, Maryland.
Today, the JPC “library” has over three million items. Technicians fix each item in formalin, a chemical preservative, and then embed it in a half-inch-thick wax wafer about the size of a thumbnail. To study a specimen, scientists use a machine to slice the wafer thinner than the thinnest paper and then dye the tissue a color that highlights its features. Finally, they mount it on a glass slide to look at with whatever type of microscope they think can best reveal its secrets.
Taubenberger is an expert in restoring genetic material found in decayed tissue samples, a difficult, time-consuming task requiring specialized equipment and methods and infinite patience. It is like putting each tiny splinter of a shattered glass windowpane in its right place. In 1995, the scientist wondered if he could find the 1918 flu virus in lung tissue from autopsies of soldiers who’d died during the pandemic. “I really wanted to see if there was some way we could make use of this vast, wonderful collection,” he recalled.17
Taubenberger ordered seventy-eight samples from the AFIP collection. He and colleague Ann H. Reid soon found “really really teeny tiny” fragments of flu virus genes in lung tissue from Roscoe Vaughan, a twenty-one-year-old private who died at Fort Jackson, South Carolina, in September 1918. Though able to “sequence” these fragments—assemble them in the correct order—they had too few to draw a detailed picture of the elusive genes. The researchers had hit a brick wall. To update the scientific record, Taubenberger published their findings in the March 1997 issue of the magazine Science. That article caught the eye of Johan Hultin.18
August 1997 found Hultin retired and living in San Francisco. Though a few weeks short of his seventy-third birthday, he was dynamic, bursting with energy. As he liked to say, “I’m going to settle down when I get old.” Physical activity—skiing, hiking, camping, mountain climbing—kept him in top shape.19
Upon reading Taubenberger’s article, Hultin wrote him about his Alaskan trip and fai
led experiments. “If you need more specimens, let me know, and I will go back to Alaska. I’ve been there before. I know where it is. I can go back,” he said. A few days later, Taubenberger called, asking, “When can you go?” Hultin replied, “Next week.”20
After forty-six years, Hultin returned to Brevig Mission alone, traveling at his own expense, $3,200 withdrawn from his bank account. Again he explained his aim to the village council, and again he was allowed to explore the mass grave. “Would you like some help?” a council member asked. Hultin did, and four young Inuit men were assigned to work beside him.21
An Inuit woman and child. Frozen bodies of flu-stricken Inuit were instrumental in Hultin’s quest for information about the influenza virus. (1906) Credit 90
On the third day of digging, at a depth of seven feet, they found four frozen bodies, including that of an obese woman in her thirties. She was particularly well preserved. “Her lungs were magnificent, full of blood,” Hultin recalled. “I sat on an upside-down pail and looked at this [body], and I got the flash in my mind. Maybe this is where I can find it.” So he named her Lucy, from lux, the Latin word for “light,” hoping she would shed a bright light on her killer.22
Hultin removed Lucy’s lungs and parts of the others’ lungs with gardening shears he’d borrowed from his wife. After he and his Inuit helpers closed the grave, Hultin sliced up and placed the specimens in preserving fluid, then wrapped, labeled, and packed them up in four identical batches. Back in San Francisco, he sent the packages—by different carriers, to ensure at least one made it—to Taubenberger, who called ten days later. “Johan,” he said, “we have it….We have lots of specimen, great material, and this is going to be wonderful.”23
Taubenberger and Hultin, known as the “Indiana Jones of the scientific set.” (Date unknown) Credit 91
Taubenberger’s team soon found what they were looking for. “It was absolutely thrilling! Absolutely amazingly thrilling!” he told an interviewer. There, projected onto the screen of an electron microscope, were images of bits of influenza genes nearly identical to those in the sample from Private Vaughan. From that moment on, “flu just took over my life,” the scientist recalled. Yet it was not until October 2005 that his team assembled all eight viral genes in their correct order. Even so, no one could explain exactly why the devil virus behaved the way it had. Nevertheless, at last scientists knew what mutations were most likely to trigger another 1918-like pandemic.24
H5N1: AN EMERGING MENACE
On May 21, 1997, three months before Johan Hultin left for Alaska, a three-year-old boy named Lam Hoi-ka played with a cuddly yellow chick at a Hong Kong day-care center. Six days later, he died of an infection that caused his lungs, brain, liver, and kidneys to fail. To find the exact cause of death, city health officials sent freeze-dried samples of infected tissue to laboratories in Europe and America. The samples revealed that the child was the first person ever to die of “bird flu.” Virologists classify the strain that killed him as H5N1, based on the protein spikes it uses to break into and out of cells.
CDC investigators rushed to Hong Kong. After careful analysis, they found no further evidence that H5N1 had crossed over to humans. “It had not spread to even one other person, so we just wrote it off as a freak occurrence…and that would be the end of it,” said a relieved Keiji Fukuda, the team leader. He’d spoken too soon. By December, eighteen more people had come down with bird flu; six of them died.25
The Hong Kong victims except Lam Hoi-ka had something in common: all had recently visited or worked in markets that sold live chickens, ducks, and geese. Flu viruses, we recall, swap genes from birds, humans, and pigs inside a pig “mixing vessel.” Swapping may allow a new viral strain to jump to people, which is bad enough, but if people can transmit the infection to one another, it is disastrous. Before 1997, virologists believed a bird flu virus could not bypass the pig mixing vessel and infect humans directly. Yet, for reasons still not fully understood, H5N1 did exactly that in 1997.
A total stranger to the human immune system, H5N1 kills most of its victims. In the sixteen years after the Hong Kong outbreak, it infected more than 600 people, killing nearly 400, an astonishing 60 percent of victims. (The 1918 devil virus infected much of the human race yet killed only 2.5 percent of its victims.) The only good thing is that, while H5N1 may jump from birds to humans, it stops there—at least for the present. But virologists fear it is only a matter of time before it mutates to the point where it can travel from person to person, igniting a pandemic.26
Strains of the bird flu continued to reoccur in Hong Kong. Here, officials wearing masks and protective suits dispose of chickens following the discovery of the virus in a wholesale market. (2014) Credit 92
This is why WHO and CDC virus hunters focus on China. It is the world’s largest nation in population, with about a fifth of the human race, and the third largest in area; only Russia and Canada have more territory. China also has the world’s largest number of domesticated birds. Hong Kong is the most densely packed city on the planet. Guangdong Province, in which it lies, has 86 million people, tens of millions of pigs, and about 650,000 birds per square mile.27
Rice, Guangdong’s chief food crop, grows in water. Farmers raise ducks on their farms, but also on flooded rice paddies. Wild waterfowl share these paddies. Although they have H5N1 in their guts, it seems not to bother them. However, wild birds defecate in paddy water; scientists have found an estimated ten billion flu viruses in a single quart. As a result, it is impossible to prevent wild birds from infecting their domesticated cousins. As Hong Kong virologist Yi Guan explains, “I cannot control them. I cannot lock my sky.”28
Chinese farmers from all over the country send their ducks and geese to urban poultry markets. Before being sold, these birds are kept in crowded cages along with chickens, a favorite food throughout Asia. “Without chicken, there will not be a banquet,” says a Chinese proverb. Since customers demand freshness, most chickens are sold in “wet markets”—wet because butchers kill the birds right in front of their customers. Hygiene is not a high priority in these places. Buyers and sellers are invariably exposed to bird blood, feathers, and droppings, and therefore to H5N1. Virus-laden droppings also contaminate feed, vehicles, shoes, clothing, and water.29
A gram (0.035 ounce) of H5N1-containing duck feces can infect more than a million birds. The effects are as horrific for chickens as the 1918 devil virus was for people. H5N1 simply “melts” chickens. “The invader commandeers every organ and tissue of a bird, from the top of its comb to the tips of its…feet. The [chickens] bleed from their eyes, beaks, and anuses. One moment they are pecking away; the next they fall over dead. In the end they just ‘melt out,’ resembling rubber caricatures of themselves.”30
Well aware of the danger, investigators continually inspect Chinese poultry markets. The slightest trace of H5N1 brings death not only to infected birds but to every other bird as well. In December 1997, after several people died of bird flu, Hong Kong authorities decided to stop the feared epidemic before it began. Over a weekend, health workers killed every chicken, duck, and goose in the city, over 1.5 million birds in all. “Everyone is covered with protective gear—moon suits and all,” a virologist wrote. “They put the birds in bags and then used gas on them. Then they were deposited in the landfills.”31
The Hong Kong slaughter was only a temporary fix; it could not eliminate bird flu. Radiating from China, H5N1 has reached South Korea, North Korea, Japan, Vietnam, Cambodia, Laos, Thailand, India, Pakistan, Indonesia, and the Philippines. In those countries, more than 400 million chickens and other domesticated birds were killed between 2004 and 2010, at an estimated cost of $20 billion. Scarcity caused prices to rise, affecting the poor, those least able to afford this protein-rich food.32
Migrating waterfowl have spread H5N1 as far away as Europe and the United States. In 2003, the Dutch military slaughtered 30 million chickens. Police officers also raided private homes, searching for pet chickens to
kill. In 2004, H5N1 roared through Asia again. In Vietnam, health workers burned chickens alive, not to be cruel but to make sure they destroyed the virus as quickly as possible. In Thailand, virologists ordered 11 million birds killed; they also learned that the fiercest animals were no match for this tiny virus. Bangkok, the capital, is home to the world-famous Sriracha Tiger Zoo. When H5N1 killed 45 tigers, zookeepers removed raw chicken, bought at a local market, from the tigers’ diet. No matter; infected tigers passed the disease to other tigers, forcing keepers to destroy another 102 animals. Before 2004, tigers were thought to be immune to bird flu. Obviously, H5N1 was mutating, with scary results.33
As the bird flu spread, millions of fowl were exterminated and dumped in quarantined locations. (2016) Credit 93
In 2015, bird flu reached the United States in a big way. Apparently, migrating Canada geese brought H5N1 to the Midwest, a major producer of chickens and turkeys. The disease spread so rapidly that public health officials ordered 46 million birds destroyed. Most were in Iowa, the nation’s top egg-producing state, and Minnesota, the leader in turkey production. As a result, the price of eggs and products made from eggs skyrocketed. Thanksgiving turkeys, too, became more expensive.34
Very, Very, Very Dreadful Page 14