WASHINGTON — The descriptions are haunting.
Some victims felt fine in the morning and were dead by night. Faces turned blue as patients coughed up blood. Stacked bodies outnumbered coffins.
A century after one of history’s most catastrophic disease outbreaks, scientists are rethinking how to guard against another super-flu like the 1918 influenza that killed tens of millions as it swept the globe.
The NIH’s Dr. Jeffery Taubenberger calls the 1918 flu the mother of all pandemics.
He should know.
While working as a pathologist for the military, he led the team that identified and reconstructed the extinct 1918 virus, using traces unearthed in autopsy samples from World War I soldiers and from a victim buried in the Alaskan permafrost.
That misnamed Spanish flu “made all the world a killing zone,” wrote John M. Barry in “The Great Influenza: The Story of the Deadliest Pandemic in History.”
Historians think it started in Kansas in early 1918. By winter 1919, the virus had infected one-third of the global population and killed at least 50 million people, including 675,000 Americans. By comparison, the AIDS virus has claimed 35 million lives over four decades.
Three more flu pandemics have struck since, in 1957, 1968 and 2009, spreading widely but nowhere near as deadly. Taubenberger’s research shows the family tree, each subsequent pandemic a result of flu viruses carried by birds or pigs mixing with 1918 flu genes.
But researchers hope they’re finally closing in on stronger flu shots, ways to boost much-needed protection against ordinary winter influenza and guard against future pandemics at the same time. “We have to do better and by better, we mean a universal flu vaccine. A vaccine that is going to protect you against essentially all, or most, strains of flu,” said Dr. Anthony Fauci of the National Institutes of Health.
Labs around the country are hunting for a super-shot that could eliminate the annual fall vaccination in favor of one every five years or 10 years, or maybe, eventually, a childhood immunization that could last for life.
Fauci is designating a universal flu vaccine a top priority for NIH’s National Institute of Allergy and Infectious Diseases. Last summer, he brought together more than 150 leading researchers to map a path. A few attempts are entering first-stage human safety testing.
Still, it’s a tall order. Despite 100 years of science, the flu virus too often beats our best defenses because it constantly mutates.
Back then, there was no flu vaccine — it wouldn’t arrive for decades. Today vaccination is the best protection, and Fauci never skips his. But at best, the seasonal vaccine is 60 percent effective. Protection dropped to 19 percent a few years ago when the vaccine didn’t match an evolving virus.
If a never-before-seen flu strain erupts, it takes months to brew a new vaccine. Doses arrived too late for the last, fortunately mild, pandemic in 2009.
Lacking a better option, Fauci said the nation is “chasing” animal flu strains that might become the next human threat. Today’s top concern is a lethal bird flu that jumped from poultry to more than 1,500 people in China since 2013. Last year it mutated, meaning millions of just-in-case vaccine doses in a U.S. stockpile no longer match.
Yet lingering mysteries hamper the research.
Scientists now think people respond differently to vaccination based on their flu history. “Perhaps we recognize best the first flu we ever see,” said NIH immunologist Adrian McDermott.
The idea is that your immune system is imprinted with that first strain and may not respond as well to a vaccine against another.
“The vision of the field is that ultimately if you get the really good universal flu vaccine, it’s going to work best when you give it to a child,” Fauci said.