ot test. Test test n uqau this isnr ani vrac captioning to with my mother, my dad, and my four sisters. And people would do things for us. Influenza gave you such a high fever, mother told me that it was dilerium from an iv. People were left with a high fever and the schools, all of the Public Places and every place was closed. Officials res dated to close schools and other meeting places that would have reduced contact between the sick and the well. Hospitals and sfun really homes were overwhelmed and the workers that kept the city and their businesses running were too sick to get out of bed. They went around and got all of these men from down south to operate the mills and there was thousands of mills coming. My father worked for a steel company, and the only black baker they ever had was my father, henry lindsey. But people were very kind to one another. In the morning, they come back and he was dead. We didnt visit nobody. Nobody visited us except this lady. This mrs. Thorton. She went around helping everybody that got sick and back in 1918 i was between 10 and 12 years old i would say and i got the flu and it was just my mother and i. We went to Elementary School together. I would go out to the hospital to go visit her. And they put her out on the porch in the cold wintertime, and they had blankets and a hood on her, but both of them died at a young age. People didnt understand and there was no vaccine but parents did the best they could. The influence of 1918 and 1919 was a pandemic. A outbreak of disease around the world that caused serious illness and death. So why was it so much more deadly than the seasonal flu we experience every winter. What was difference about the virus in 1918 . The seasonal influenza viruss, they are circulating among people worldwide and they are evolving and changing just a little bit, but theyre human viruss, so some percentage of the u. S. Population and the worlds population gets infected every year. Some become ill. Some percent recover from a self limited illness, and all of these people that survive will have some immunity. Other people will get vaccinated. There are two ways to acquire immune protection. One is through natural protection in which you recover and survive and then you have immunity. The other is through vaccination, and vaccination stimulates our bodys immune system to produce antibodies against strains that are contained in the vaccine. The pan determine sick difference. It is the emergence of a very new virus, much of the population has not previously been exposed and does not have any immunity. You see very high numbers. A very high number of people getting sick worldwide. New influenza viruss have become pandemics. Ultimately it comes from birds, wild waterfowl. They can also get into human beings, bigs, various aquatic mammals, horses, dogs, cats, they can take any of these pets and in theory they can get into people by coming directly from a bird or from another animal. By a variety of mutations that occur for a number of reasons, these types of viruses can, under certain circumstances, adapt to another species and as they propagate themselves in the other species, they adapt themselves better to spread from big to big, person to feperson, and the host we woy about the most is the human species. She was expecting, and she had taken the flu, and of course she passed away. She was very sick, and she passed away. The ladies getting the flu that were pregnant that we knew died and my mother didnt get it. We dont know why pregnant women die of influenza die at a high rate. Whatever the reason, it is clear that pregnant women in 1918 were very high risk. Why this happened, we dont know. Salespeople will always die it from pneumonia, but it is usually the older folks. Pregnant women, infants, so on. This time in 1918 something very different happened, otherwise healthy young adults died at a very high rate and constituted a fairly large percentage of the total deaths. Why that happened is a mystery. Northwest of nome, alaska on the bering sea. Of the 80 residents of 1918 only five adults and three children survived the pandemic. Over 50 years ago, a young man with an interest in viruss found his way to the village. I was a medical student in sweden and i decided to go to the United States and get a masters degree in virology. And then i went from my ph. D and one day we had a visitor. And i remember he was talking about everything that had been done to find out what was it that caused the 1918 flu. And then like a 15 second comment he said somebody ought to go to the northern part of the world. And try to find a victim of the 1918 flu in the permafrost. That victim is likely to have remained frozen since 1918. At that time it was something of 35 or 40 years. And then he went to something else, and i happened to be there and heard it, i asked my advisor if that could be a subject for my ph. D. He said yeah, go ahead. I worked in the summer of 1969 for a palentologist. He was able to review copies of Mission Records from the fall of 1918. He said the military had very good records showing the location and thickness of the permafrost in laz. I showed up in june. I went to nome. And went into the cemetery and kiss covered that the river that would normally be on the side of the village at some distance today. But it came in and melted the permafrost and then i got a bush pilot to fly me to another village and the bluff had fallen to the beach and almost excav e excavated. So there was no way to land. I had to longstanding on the beach at some distance away. It was really about six miles in the soggy tundra. We are heavily influenced by this decision. And little did i know that that would be very important later on. Fortunately there were three survivors of the 1918 pandemic. Still alive. So i asked them to please tell the other members what it was like that november when we ran 90 of the village and died. I said if you allow me to enter and im fortunate enough, if everything works out well, it will be possible for us to develop a vaccine. So in the next pandemic coming, we will have a vaccine to immunize and protect you. They understood what vaccine was. So that influenced the decision to allow me to so i started to dig, and it started to freeze the ground. So we started a fire and we climbed up on the bluff, and i started to melt the perma frofr. On the end of the second day i found the first victim, a young child. But the condition of her body at four feet from the surface was so good that i was confident that down deeper there will be even better. 72 bodies in that grade. I had a pathologist. I had professors in iowa perform the postmortem evaluations. A day later they came to the same beach where they landed earlier, and we determined the same way back now that there is four of us, about three days later, we were down six feet, and then we found three three perfectly preserved priorities. And the postmortems found them, and they were perfectly preserved. And we were left, close to the grave, and we took pictures across all of the time. So we got to try to grow the virus. Trying to find a live influenza virus. I got discouraged and i had no more specimen. And the virus was dead. And in their condition, by the way, i decided to go back to sweezen to continue my medical education. And it was amendment freedomly fortunate. And i got my md there. Became a pathologist. But in my mind i had a memory of getting my ph. D and it all collapsed. A specialty of medicine where they use the tools of molecular biologist, you can look for the genetic material. I was in the 80s, and i moved to the armed forces. And one of the things we had to do for both sides is recover genetic material. It goes back to the civil war and there is a huge collection of millions of tissue samples reflecting all aspects of tumors and Infectious Disease including sold skriers that died of flu i 1918. I wanted to think of such a ar kie chive. When we started the project, there was two fundamental questions that we wanted to answer and that was one, why is this virus killing so many people especially young, healthy adults, and secondly where did this virus come from. We were hoping to learn from what we saw in 1918 to apply to the future and understand why pandemics happen. These tissues were not clear that we could recover any genetic material at all. We had to work out techniques to extract the acids from the samples. And it took over a year to find a first positive case. Making sure we could find influen influenza. Once we started to compare it, we were convinced that we found the 1918 virus, but we were really concerned there would be inadequate amounts of material. In march of 1997 in science news, there it was, the 1918 pandemic virus found. The sequence had been discovered. I wrote a letter saying if you need more specimens let me know and i will go back to alaska. I have been there before b, i kw where it is, and i can go back. And i didnt hear anything, and i thought he knows, he happened to be on vacation. So he didnt get his mail. We were extremely excited about the possibility. We hoped that if we could recover material from the frozen victim, that the quality of the material might be improved over what we had in the formal and fixed blocked. And he said when can you go, and i said i cant go this week, i cant go next week, and i called up and this time when i came, the second time in 1997, it so happened it was in august. It was a much better time to dig in the permafrost. Another missionary is still there, and he knew of the excavation that i had had in 1951. He also knew that i had to get permission to do it again. He said it is very difficult. You may not be able to get permission this time. But i will introduce you to rita olana. And little did i know that her grandmother was jenny olana. The doctor presented his case to the Village Council including rita olana. He made sure they understood that the virus was dead and could not cause disease. I said your participation, this is where it begins. Youre part of the team. The village, and i am a specimen collector, and these are the three and it begins with you and i got the permission to go. So i said i will do it myself. And so one of the members said could you like to have some help . Four young men, eskimos assigned by the Village Council assigned to help. So i marked it off at the end of the first day, we were down to about four feet, and i didnt see anything at all. And then at five feet, and the following day, and i noticed there was some bodies at seven feet. There was a skeleton, and then next to the skeleton was a woman. And perfectly preserved. With the clothing had fallen off and rotted away, but i could see the skin. And i took the rib cage off and there, exposed the lungs. And they were the textbook picture of a person who had died from acute viral pneumonia. Exactly what i needed. Inside, of course also, that had protected the lugs from the occasional shaws of the pemra frost. There was not that much food around, and so to find one that had extra calories, storage calories, was just remarkable. And here was a woman who had ample food, a good husband, good seal and walrus hunter, brought all of this food for her. Can you imagine how fortunate . And then i decided i needed to make new crosses. I had the forecast of the original. I knew howal they were and everything. I finished my work for the crosses, and by 8 00 the next morning the High School Kids came and they helped me put the crosses in. About an hour later the bush pilot landed and i had all of my specimens on board. The advantage that we had is that the formal and fixed autopsy samples were very limiting, and even though the quality of rna was lower we had so much more material to work with it became clear that we would be able to sequence the rest of the virus from that material. We thought it would take weeks and weeks. It was ten days later and he said we have it. The specimen is good. Lots of specimen. Great material and this is gofding to be wonderful. It was a great day for me. It started in 1955 and finally in 97, there it is. But again, without the eskimos nothing would have come. The effort to sequence the entire genome took ten years. It was a very leborius process. The information that had to be put together as a total. So a sequence, the stretch of the little piece. And so he has it, ewe looking at it here. And she is fully built, and doe this piece fit here, or here, or is it this way, and what comes to the left and the right. And day after day and month after month, putting these things together year after year into 13,000 pieces, we found this proper place. And it is incredible. It is clearly a virus that was human adapted, but jeanet genetically it is very bird like. We think it is a virus that adapted to humans. We now know there is a number of mutations that are crucial in the adaptation to humans. You can imagine using them as a screening tool to assess the significance of bird strain. If we identify changes that were crucial to allow a bird virus to replicate in humans, you could describe drugs that might block or bind to that change to prevent a bird virus from functioning in humans. It had as its most unique feature, the fact that it had a high propensity to kill young adults. Even having the entire sequence of the virus in front of us we do not yet understand why it behaved in that manner. I think people in that particular age group might have had the wrong sort of immunity to the virus. Some kind of response that made them more susceptible to dieing. In people that were about 45 or 50, there may have been immunity to viruss that were similar and were trying to identify influenza positive virus viruse. Ann reid was sent up with a black and sent to the Village Council. If this was the work, antiviral drugs and good vaccines and the savings of hundreds of mills of lives, it began with rita olana. Another question about the death toll was how people died after they became they cramenned the tissues, and also autopsy reports from all over the world of people that dies of pandemic influen influenza. The vast majority of people that died died because of pneumonia. It caused such an extensive reaction in the lungs, that bacteria like strep that is commonly carried in the throat of individuals could carry down and cause a disease that could kill the person. The evidence of the pneumonia helps explain why you had such high mortality in military catches largely. While this is very important, it also has significant implications for pandemic planning in the future. We have seen an explosion because primarily, i think, sequencing of the 1918 virus, but also the unusual events with the h1n1. We have been watching this for ten years now. Theyre highly transmissble and they can destroy a flock of birds, but the most important thing is that humans who have very close contact with the infected birds occasionally can become infected by this virus. Over 60 of those who have become infected have died. Many more people have been exposed to the virus than have been infected. For this to cause a pandemic, we would have to see a number of changes that would occur in the virus to so that the virus could be transmitted easily from human to human to human. The fact that the Avian Influenza viruss that were monitoring so closely had been circulating for ten years and still had not caused a pandemic doesnt mean that the viruses will not cause a pandemic. We dont know how long they circulated, caused infections in humans, and gained that ability to be transmitted efficiently. We dont know enough about past history to predict the future. We cant predict what influenza will do. As they continue to look for answers in the 1918 flu virus, we can also turn to the men and women that responds by taking it upon themselves to care for relatives, neighbors, and communities. A doctor with the Public Health service wrote to a colleague serving in france. We have all been awfully busy with the flu. I made about 30 calls a day for a month and everyone else did as much or more. The Public Health service and the red cross opened a hospital where we treated the mexican part of town. We had about 10,000 cases in el paso and the mexicans died like sheep. The white population faired nearly as badly. I was three days behind in my calls. The other doctors all had the same experience of course. When other people learned of the many deaths in the southern part of the city near the border with juarez many valolunteered use tear cars as a ambulance to pick up the sick and deliver them to hospitals in the town. An old school was turned into a hospital for flu patients, el pea paso residents volunteered as drivers and nurses, and clerks. That epidemic helped the community to get together because everybody helped that could, gave their help, whatever the people needed, so that helped the community. There was a shortage of doctors and nurses in the 1918 influenza pan determine ek. So many of the physicians and nurses were serving in the war effort. So you had a mixture of Trained Medical personnel and those with some training and those who were basically very civically minded. Nurses were putting their lives on the line. They were stepping into a deadly pandemic because they believed it was their calling and they wanted to do what they believed was their duty. I think the activities and the volunteers was absolutely crucial. This is a story of forgotten people that rose to the gravity of the moment. In villages, the whole village would be sick at once. There was no one to provide food or shelter. These things can make a difference. The conclusion was that the single most important thing was good nursing care. Not medicines, doctors, hospitals. But you would think that cant be true, what is chicken soup going to do. I believe the data, theyre strong, and some of the best and smart e smartest said it again and again, good nursing care. Even though no one knows what caused the influenza, some communities took the steps to stop the spread of the disease. At our group they look at exactly what they did to stave off the epidemic. What worked, what didnt work, and what were their records. And what we find is that those that acted very early with a sweet of classical Public Health interventions, things like quarantine, closure of schools, banning public gatherings, if they acted very early, kept these measures on for long time, and used more than one of these measures at the same time, those cities had a much better record in terms of cases and deaths than those cities that did not. I think there is a mountain of stuff that were learning that applied to people today or in the near distance future. We learned from the experiences of the 1918 and 1919 pandemic. But that is just one of the influences to help us deal with it better than the world was in 1918. There are extraordinary advantages. Some are simple like experience of what seemed to work in some cities like social distancing, avoiding crowded places, things not necessarily fully appreciated. Some cities did it and did well. But most importantly we had technical advances that we didnt have. We didnt have vaccines for flu. We didnt even know what the microbe was. They thought it was maybe a bacteria and not a virus. Number two we have antiviral drugs. We didnt have it then. We have antibiotics to treat the secondary complications. We have much better technologies to treat acutely and seriously ill individuals. Like efficient good respirators, intensive care units, people who have expertise in medicine. That is acute care medicine. All of these things we did not have back then and we have them now. Our parents and grandparents had little warning or chance to prepare. We know now that influenza has caused pandemics. Public Health Officials have been preparing for the next flu pandemic knowing it could be as mild as 1968 or as severe at 1918. The world is now watching the h1n1 flu virus that emerged in spring of 2009. We know it is in almost every country of the world already. Fortunately so far the 2009 h1n1 doesnt seem to have that level of severity. It is affecting people differently than seasonal flu strains. The illness is most common in young people, children and young adults, and were seeing hospitalizations and deaths for people with conditions that increase their risk of complications. Pregnant women have been heavily hit by this virus. In the United States and reports around the world. They suggest that native populations may have a higher risk of severe illness. We want to be ready and we want to make sure theyre served. Everyone has the experience throughout the world that the best way to contain influenza is by getting an effective and safe vaccine. Even in more modern technology you dont make a vaccine overnight. You to first find out what the virus is youre dealing with and then grow through a multistep process to get enough vaccine to protect the population. That multistep process usually takes several months, usually along the line of six or more months. It is a very important part of our response, but it is important to say it is not the only part of it. We have a whole series of mitigation efforts and a whole series of communication efforts. Public Health Officials are fighting the spread of influenza with the things we learned as children. Stay home when sick. Wash your hands for 20 seconds, practice cough and sneeze et qu ettiqute. But you know, we are in a community that hugs, shakes, that have elevators to ride on to go to different parts of a building. We go Grocery Shopping and we need to push carts. Everything duo we have to touch something that other people touch. That hand washing bit is very critical. These good habits and vaccinations also present the spread of season flu. An annual immunization for the seasonal flu helps people stay healthy and helps Health Workers prepare to vaccinate the population during a pandemic. They are widely available every year. Te is very important for people particularly who are 65 and over to take the immunizations. It is important to have it every year and the vaccine is a covered medicare benefit. Based on what i know, and what i have been observing with this virus, and based on what i know about influenza vaccines, the risk is much higher than any theoretical risk. It is important for people to know that not getting vaccinated also puts you at risk. 100,000 people get it, and the 2009 h1n1 vaccines are being made the same way the season flus are made. A long term goal for scientists working on flu vaccine is to develop a vaccine that would protect against all seasonal and bpandemic influenz. It is to identify the components of all influenza viruss, and then you have to put that in a form that when you injekt ct itr you spray it, that person will make a response that is very robust. It is a high priority project. Every year we have fewer elders to remind us of the terrible time that they and their families endured in 1918 and 1919. But we need to keep those memories alive. There are a lot of things to remember when we study the 1918 flu. Pandemics can be very serious, and they can be widespread. There is a severity. You must always prepare for the worst case scenario. Even if you might have a span determine take occurred in 1969 or an intermediate that occurred in 1967. It could be that it becomes less severe and it affect a lot of people. It could be material and very difficult to manage. It could be that it continues on the way it has been so far. Only time will tell and we have to be ready to pivot and respond differently. The one thing you could predict is that it is unpredictable. We still know much less than we would like about influenza. But the experiences of the individuals that endured the pandemic continue to contribute to our understanding of the disease. Infinitely better prepared now than we were back in the beginning of the 20th century. For more information, visit www. Flu. Gov. We are featuring American History tv programs this week as a preview of what is available every weekend. Today a look at the modern presidency. Beginning we three white house speech writers talking about the process of turning a president s policies and politics into a speech. American history tv tonight on cspan 3. Every saturday night we take you to College Classrooms for che lectures in history. Why do we know of lizzy lizzy borden. It was the transportation of the minds of the american people. Were going to talk about both sides of the story here, right . The tools, the techniques of slave owner power and the tools and the techniques of power that were practiced by enslaved people. Watch history professors lead discussions with their students on topics from the American Revolution to september 11th, lettu lectures in history. Find it where you listen to podcasts. Our mission continues. To provide an unfiltered view of government. You can watch all of the Public Affairs programming or listen on our radio app. Or, through our social media feeds. Cspan created by private industry. As a Public Service and brought to you today by your television provider. Next on reel america a look at the development of the