Nineteen-year-old US Military Pvt. David Lewis set out from Fort Dix on a 50-mile hike along with his unit on 5 February 1976. On that bitter chilly day, he collapsed and died.
Post-mortem specimens unexpectedly examined optimistic for an H1N1 swine influenza virus.
Virus illness surveillance at Fort Dix discovered one other 13 circumstances amongst recruits who had been hospitalized for respiratory sickness. Extra serum antibody testing revealed that over 200 recruits had been contaminated however not hospitalized with the novel swine H1N1 pressure.
Alarm bells immediately went off throughout the epidemiology neighborhood: Might Pvt. Lewis’ loss of life from an H1N1 swine flu be a harbinger of one other world pandemic just like the horrible 1918 H1N1 swine flu pandemic that killed an estimated 50 million individuals worldwide?
The US authorities acted shortly. On 24 March 1976, President Gerald Ford introduced a plan to “inoculate every man, woman, and child in the United States.”
On 1 October 1976, the mass immunization marketing campaign started.
In the meantime, the preliminary small outbreak at Fort Dix had quickly fizzled, with no new circumstances on the bottom after February.
As Military Col. Frank High, who headed the Fort Dix virus investigation, later instructed me, “We had shown pretty clearly that (the virus) didn’t go anywhere but Fort Dix … it disappeared.”
Nonetheless, involved by that outbreak and witnessing the large crash vaccine program within the US, biomedical scientists worldwide started H1N1 swine influenza vaccine analysis and growth packages in their very own international locations. Going into the 1976-77 winter season, the world waited – and ready – for an H1N1 swine influenza pandemic that by no means got here.
However that wasn’t the tip of the story.
As an skilled infectious illness epidemiologist, I make the case that there have been unintended penalties of these seemingly prudent however finally pointless preparations.
What was odd about H1N1 Russian flu pandemic
In an epidemiological twist, a brand new pandemic influenza virus did emerge, however it was not the anticipated H1N1 swine virus.
In November 1977, well being officers in Russia reported {that a} human – not swine – H1N1 influenza pressure had been detected in Moscow. By month’s finish, it was reported throughout the complete USSR and quickly all through the world.
In contrast with different influenzas, this pandemic was peculiar.
First, the mortality fee was low, a few third that of most influenza strains. Second, solely these youthful than 26 have been frequently attacked. And eventually, in contrast to different newly emerged pandemic influenza viruses up to now, it did not displace the present prevalent H3N2 subtype that was that yr’s seasonal flu.
As a substitute, the 2 flu strains – the brand new H1N1 and the long-standing H3N2 – circulated aspect by aspect.
Right here the story takes one more flip. Microbiologist Peter Palese utilized what was then a novel method known as RNA oligonucleotide mapping to review the genetic make-up of the brand new H1N1 Russian flu virus.
He and his colleagues grew the virus within the lab, then used RNA-cutting enzymes to cut the viral genome into lots of of items. By spreading the chopped RNA in two dimensions based mostly on measurement and electrical cost, the RNA fragments created a singular fingerprint-like map of spots.
A lot to Palese’s shock, after they in contrast the spot sample of the 1977 H1N1 Russian flu with a wide range of different influenza viruses, this “new” virus was basically an identical to older human influenza H1N1 strains that had gone extinct within the early Fifties.
So, the 1977 Russian flu virus was really a pressure that had disappeared from the planet 1 / 4 century early, then was by some means resurrected again into circulation. This defined why it attacked solely youthful individuals – older individuals had already been contaminated and turn into immune when the virus circulated a long time in the past in its earlier incarnation.
However how did the older pressure come again from extinction?
Refining the timeline of a resurrected virus
Regardless of its title, the Russian flu most likely did not actually begin in Russia. The primary revealed studies of the virus have been from Russia, however subsequent studies from China supplied proof that it had first been detected months earlier, in Could and June of 1977, within the Chinese language port metropolis of Tientsin.
In 2010, scientists used detailed genetic research of a number of samples of the 1977 virus to pinpoint the date of their earliest widespread ancestor. This “molecular clock” information steered the virus initially contaminated individuals a full yr earlier, in April or Could of 1976.
So, the perfect proof is that the 1977 Russian flu really emerged – or extra correctly “re-emerged” – in or close to Tientsin, China, within the spring of 1976.
A frozen lab virus
Was it merely a coincidence that inside months of Pvt. Lewis’ loss of life from H1N1 swine flu, a heretofore extinct H1N1 influenza pressure abruptly reentered the human inhabitants?
Influenza virologists all over the world had for years been utilizing freezers to retailer influenza virus strains, together with some that had gone extinct within the wild. Fears of a brand new H1N1 swine flu pandemic in 1976 in the US had prompted a worldwide surge in analysis on H1N1 viruses and vaccines.
An unintentional launch of one in all these saved viruses was actually potential in any of the international locations the place H1N1 analysis was happening, together with China, Russia, the US, the UK and doubtless others.
Years after the reemergence, Palese, the microbiologist, mirrored on private conversations he had on the time with Chi-Ming Chu, the main Chinese language knowledgeable on influenza.
Palese wrote in 2004 that “the introduction of the 1977 H1N1 virus is now thought to be the result of vaccine trials in the Far East involving the challenge of several thousand military recruits with live H1N1 virus.”
Though precisely how such an unintentional launch could have occurred throughout a vaccine trial is unknown, there are two main prospects.
First, scientists may have used the resurrected H1N1 virus as their beginning materials for growth of a stay, attenuated H1N1 vaccine. If the virus within the vaccine wasn’t adequately weakened, it may have turn into transmissible individual to individual.
One other risk is that researchers used the stay, resurrected virus to check the immunity supplied by standard H1N1 vaccines, and it unintentionally escaped from the analysis setting.
Regardless of the particular mechanism of the discharge, the mixture of the detailed location and timing of the pandemic’s origins and the stature of Chu and Palese as extremely credible sources mix to make a powerful case for an unintentional launch in China because the supply of the Russian flu pandemic virus.
A sobering historical past lesson
The resurrection of an extinct however harmful human-adapted H1N1 virus took place because the world was scrambling to stop what was perceived to be the upcoming emergence of a swine H1N1 influenza pandemic. Individuals have been so involved about the potential of a brand new pandemic that they inadvertently brought about one.
It was a self-fulfilling-prophecy pandemic.
I’ve no intent to put blame right here; certainly, my major level is that within the epidemiological fog of the second in 1976, with anxiousness mounting worldwide a few looming pandemic, a analysis unit in any nation may have unintentionally launched the resurrected virus that got here to be known as the Russian flu.
Within the world rush to go off a potential new pandemic of H1N1 swine flu from Fort Dix by means of analysis and vaccination, accidents may have occurred anyplace.
In fact, biocontainment amenities and insurance policies have improved dramatically over the previous half-century. However on the similar time, there was an equally dramatic proliferation of high-containment labs all over the world.
Overreaction. Unintended penalties. Making issues worse. Self-fulfilling prophecy. There’s a wealthy number of phrases to explain how the perfect intentions can go awry.
Nonetheless reeling from COVID-19, the world now faces new threats from cross-species jumps of avian flu viruses, mpox viruses and others. It is important that we be fast to reply to these rising threats to stop one more world illness conflagration.
Fast, however not too fast, historical past suggests.
Donald S. Burke, Dean Emeritus and Distinguished College Professor Emeritus of Well being Science and Coverage, and of Epidemiology, on the College of Public Well being, College of Pittsburgh
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