In the United States, the death toll reached 675,000, five times the number of u. S. Soldiers killed in world war i. What was that deadly threat . [bell tolls] [bell tolls] many people died. We had just come from a few years before from mexico, where we were living. On account of the mexican revolution. I was about 10 years old, i was the oldest. My Four Brothers and sisters of the family, only my dad and my sister did not get it. My two brothers were in one room sick, i was sick in the other bedroom with my mother. My poor dad and sister had to be our attendants and do what they could do for us. Influenza gave you such high fever. Mother told me that i thought her black hair was a cat and i was afraid it was the delirium from the high fever. People are left very weak. That high fever. Public schools and Public Places closed. I guess for nearly two or three weeks. I was eight years old. We lived near my dads mother. She and her daughter and two grandchildren were living close to us. When they got the flu and got sick, my parents, we just moved in with them to where my mother could nurse them and take care of them. At that time, my mother was 25 years old. She had three children. She was expecting another baby in may. This was in february. She had taken care of eight patients, at one time, very sick patients with the flu, with no convenience, no modern facilities whatsoever. Mother had to get the wood to keep heat in the house to keep all of the fires going, plus do the nursing care with eight patients. My father always went by good morning, that was his indian name. At that time, he was working in tennessee for a dupont company. Every time anybody was sick, he would always bring up the story about how he got sick while he was in tennessee and how a lot of people from the village that had gone were brought back sick. They were brought back in a train. He said some of them had passed away in tennessee. In 1918, my mother was just 11 years old, but she remembers the lift on the south side of the village. She remembers that church bell would ring every day. There is a certain bell for the death. She said she remembers as a little girl how awful it sounded. [bell tolls] narrator in 1918, as now, most people didnt think of influenza as a disease that could lead to death. We suffered through the flu season every winter. In the u. S. , the flu season usually peaks between january and the end of march. The symptoms of a cold are usually running nose, sometimes lowgrade fever and just feeling a little wiped out. Influenza on the other hand is much more pronounced than that. People will generally have a high grade fever, absolutely no energy whatsoever, muscle aches, headaches, fairly dry cough. With a common cold, you may feel bad for a couple of days. With influenza, it is sometimes a couple of weeks or more. Of really severe, it can go on to cause pneumonia. Narrator complications from the flu caused an average of more than 200,000 hospitalizations every year in the u. S. And an average 36,000 people die from the complications. During seasonal influenza epidemics in the United States, there are certain groups that are higher risk for complications. Young children, in particular those less than two years of age, elderly people, particularly 65 and older, persons of any age who may have certain underlying chronic conditions, asthma, chronic lung disease, chronic cardiovascular disease. In addition, pregnant women are at higher risk for complications from seasonal influenza. Narrator while seasonal influenza is a Serious Health threat for people at risk of complications, the outbreak of influenza that swept the nation in 1918 and early 1919 killed over half a Million People in the u. S. When the population was only one third of what it is today. I was four years old at the time. I was living at the ranch. My mother was the midwife and she tended to the people, delivery of babies and all that kind of thing. She used to take me with her to go and visit the new mothers. I love to go see the new babies. I cried because at the time, she didnt want to take me with her because she was tending to the sick and the dying. The miracle about it is that she didnt get it. And according to her, none of us at home did either. She would tell me about how people died and they had no Funeral Services or anything like that. They would just carry them off to bury them. It was very hard for them to keep up burying the dead because they were dying so fast. The one thing that stayed in my mind because i used to hear it even later with the sounding of the nailing of boards together, making boxes. Coffins for the people. Narrator whether people called it influenza, the grip, or the flu, it was clear that this was not the flu that comes every winter. Today, we know that influenza is caused by a virus. We know that the virus spreads from one person to another through droplets when people cough and sneeze or through contact with a virus on someones hand or a contaminated surface. In 1918, no one knew what caused it, where it started or how to stop it. They were scared because it happened so rapidly. They didnt know what was going on, what was happening. Why. Narrator there were a few communities in the u. S. , small or isolated that they were sheltered from the waves of deadly disease that spread around the world. The influenza of 1918 even touched remote villages in alaska, sometimes killing every man, woman and child, or killing the adults and leaving the children with no one to care for them. The 1918 influenza struck some native peoples in the southwest very hard, too. I dont think the doctor resided here, but he came from albuquerque. A lot of our people, older people that didnt speak the english language. My dad would interpret for him. They would work from Early Morning until late night trying to visit every home in the pueblo. In the morning, when they got to some of the homes, they would find maybe two or three people in the family that had passed away during the night. Every day, they were burying people, the church bell would be tolling from morning till evening because of so many deaths. [bell tolls] narrator the bureau of Indian Affairs sent a doctor to investigate the situation in the pueblos near albuquerque, new mexico. He wrote, the strength of the pueblos was not taken with the aged or infants, but from the young adult life of the tribe. This was true around the world. With the influenza that hits us every fall and winter, most healthy adults are sick for a week or two and recover. When people die of the flu, its almost always the very young and the very old. But the influenza of 1918 was not only much more lethal than seasonal flu, the death rate was very high among young adults. Strong young men and women working to support and care for their family. My parents came to this country from romania. In 1918, my family was living in south philadelphia. I think it was a neighborhood of mostly immigrants. It was a hard life, it was a rough life. My mother and father and my two sisters all had the flu. It was a very sad period. There was a sadness over the city, people stayed in their houses because they were afraid. They said if it killed you, it did it fast. Because i remember them telling me that a young neighbor, they saw him coming home from work, and the next afternoon, they saw and carried out. He died. Narrator of all the cities in the u. S. , philadelphia had one of the highest rates of sickness and death. And the most disruption. The city resisted putting measures in place that might have limited the spread of the flu. Measures such as prohibiting public gatherings where the flu could spread easily. The city allowed a large parade to take place for the troops marching in world war i. Although the marchers wore masks, many people caught the flu from those who were already infected. Baltimore fared almost as badly as philadelphia. Soldiers at camp meade, south of the city became sick in midseptember. By early october, there were 2000 cases in baltimore. Officials hesitated to close schools and other meeting places, which would have reduced contact between the sick and the well. Hospitals and Funeral Homes were overwhelmed. The workers who kept the city and its businesses running were too sick to get out of bed. We got all of these men from down south to operate the mills and they were just thousands of men coming out of the mills. My father worked for the steel companies. The only black baker they ever had was my father. People were very kind to one another and it was a place everybody looked after one another. In the past, nobody lived there except for the men who were working at the steel place. The people who work in the steel died and the people around them didnt even know they were dead. Dont know how long he had been dead. They went to work. They would leave in the morning and he was dead in the evening. My mother was sick and everything. They quarantined us. We didnt visit nobody and nobody visited us accept this lady. She went around helping everybody who was sick. She never got sick or anything. Back in 1918, i was between 10 and 12 years old. I got the flu and it was just my mother and i. Two of my friends, we went to Elementary School together and both of them were stricken with the flu. I would go out to the hospital to go visit her. They put her out on the porch in the cold wintertime and they had blankets and a hood on, but she died. Both of them died. At a young age. People didnt understand. There was no vaccine, but your parents did the best they could for you. Narrator the influenza of 19181919, was a pandemic an outbreak of disease around the world which caused serious illness and death. Why was the influenza of 1918 so much more deadly than the seasonal flu we experience every winter . What was different about the influenza virus in 1918 . The seasonal influenza viruses that cause annual outbreaks, epidemics in the United States during our fall, winter and early spring, those are influenza viruses that are circulating among people worldwide. They are evolving and changing just a little bit, but they are human viruses. Some percentage of the u. S. Population and the worlds population gets infected every year. Some become ill. Some percent recover from a selflimited illness. All of these people who survive will have some immunity. Other people get vaccinated and we received some immunity through that vaccine. There are two ways to acquire immune protection. One is through natural infection, in which you recover and survive. And then you have immunity. The other is vaccination. Vaccination helps our bodies to produce antibodies against the specific virus strains in the vaccine. The influenza pandemic is different. An influenza pandemic is the emergence of a very new influenza a virus to which most of the population has not previously been exposed and does not have any immunity. No immune protection. What you see is very high numbers, very High Percentage of people becoming sick worldwide. Narrator in the last 100 years, new influenza viruses have caused four pandemics in 1918, 1957, 1968 and 2009. Ultimately, they come from birds, wild waterfowl, geese and ducks. They can get into domestic poultry, chickens. They can also get into human beings directly, pigs, various aquatic mammals, horses, dogs and cats. They can take any of these and in theory, and that getting into people by either coming directly from a bird or going through a circuitous route in another animal. By a variety of mutations that occur for a number of reasons, these types of viruses can, under certain circumstances adapt themselves to other species. As they propagate themselves in these other species, they adapt themselves better to spread from pig to pig or bird to burn or bird to bird or from person to person. The host we worry about the most is the human species. One of my dads sisters lived pretty close to us. She had a family of four children and her husband and she was expecting. She had taken the flu, and of course she passed away. She was very sick. She passed away. The ladies that used to take the flu and were pregnant all died. And my mother didnt get it. We dont know why women died of influenza at a high rate, but it has been documented for over 500 years. One of the biggest risk factors of a fatal outcome from influenza is pregnancy. Whatever the reason, it is pretty clear that pregnant women in 1918 were very high risk. Pregnant women are going to be in the younger age ranges. But nonpregnant women and men in those age ranges were also at risk. Why this happened, we dont know. In any flu pandemic, people die from pneumonia, but it tends to the older folks, people with chronic diseases, pregnant women, infants and so on. This time, in 1918, something very different happened. Otherwise healthy young adults constituted a fairly large percentage of the deaths. Something that had never been seen before. Why that happened is a mystery. Narrator brevet, michigan is northwest of nome, alaska on the bering sea. The fact that it exists today is remarkable because of the 80 residents in 1918, only five adults and three children survived the flu pandemic. Over 50 years ago, a young men with an interest in viruses found his way to the village. I was a medical student in sweden. I decided to travel to the United States and get a masters degree in virology. One thing led to the next and i decided to go for my phd. One day, we had a visitor. Very prominent virologist. I remember his talking about everything that had been done to find out what was it that caused the 1918 flu. At the end of his comment, he said somebody ought to go to the northern part of the world and try to find a victim of the 1918 spanish flu pandemic buried in the permafrost. That victim is likely to have remained frozen since 1918. At that time, it has been 40 years. And then he went to something else. And in the 15 seconds, i happened to be there. Immediately, i went to my faculty advisor to ask, could that be a subject for my phd . I happened to have worked during the summer of 1949 for a paleontologist in alaska. Narrator the paleontologist had worked on the peninsula and knew the missionaries in the villages there. With his help, he was able to review records from the fall of 1918. He found that the military had very good records showing the location and thickness of the permafrost in alaska. The basis of that came to be decided on three villages. I showed up in june. I went to the first village called nome, a rather large city. Went into the mass grave at the cemetery and discovered that the river that normally had flowed on the side of the village some distance away had changed course since 1918 and have come into the village and melted this permafrost. You could see it. Then, i engaged in bush pilot to bush pilot to fly me to another village at the bering strait. I found out where the mass grave was, clearly marked with a large cross. I figured there was no permafrost here. The bush pilot flew me to another place. There was no way to land. I had to land at the beach some distance away in another village, and then i had to cross the border with a whaleboat. I had to walk about six miles in soggy tundra that was just beginning to melt. They had a village counselor of council of the elders. And it is a matriarchal society. The eldest woman of the largest family makes decisions or heavily influences decisions. Little did i know that that was going to be very important later on. Fortunately for me, there were three survivors of the 1918 pandemic. Still alive. So i asked them to please tell the other members what it was like in that november week when 90 of the village died. Then i said, if you allow me to enter the grave and if im fortunate enough to find the right specimen, i will take it back to my laboratory, and if everything works out well, it will be possible for us to develop a vaccine. When the next pandemic comes, we will have a vaccine to immunize and protect you. They understood what vaccine was because they had been immunized against smallpox. The matriarch was in favor about that. That influenced the decision, so they allowed me to open the grave. I went out on the grave site and started to dig. About a foot down, i came onto permafrost. Very hard, frozen ground. I started a fire, climbed up on the bluff, and there was a mass grave. It started to melt the permafrost. On the end of the second day i came down about four feet, and there i found the first victim, a young child, a girl, estimated 12 years of age. The condition of her body at four feet from the surface was so good that i was confident that down deeper they would be even better preserved adults and so on. 72 bodies in the grave. I didnt come alone to alaska, i had my faculty advisor, influenza virologist. I had a pathologist, one of the professors in the department in iowa to perform the postmortem examinations. There were four. I was out ahead of them to scout the grave and test. A day later, they came to the same beach where i had landed earlier. We traveled the same way back to breving. Now there were four of us the digging and we could do it very rapidly. Three days later, we were down six feet and then we found three perfectly preserved bodies. The pathologist performed postmortem on them and their lungs were perfectly preserved. We thanked the villages, closed the grave and i took pictures. I started to try to grow the virus, trying to find an alive influenza virus. Week after week after week i got more and more discouraged. Eventually, i had no more specimens. And the virus was dead. And there went my phd. I could see it fly out the window in a nonairconditioned office. I decided to go back to sweden to continue my medical education. I was extremely fortunate as offered to continue medical school in iowa. I got my md there, became a pathologist. Back in my mind, i have this memory of not getting my phd and all of the effort that went into that and it just collapsed. Pathology is a specialty of medicine where pathologists use the tools of molecular biology and genetics to make diagnoses and provide insight into patient care decisions. You can make diagnoses of Infectious Diseases by looking for the genetic material of the infectious organism, the virus or bacteria. I was in the National Cancer institute at the pathologist in as a pathologist in the 1980s. In 1993, i moved to the armed forces to set up a new group dedicated to pathology. Both for clinical molecular pathology as well as research. One of the things we have to do for both sides of that was to work out ways to recover genetic material from typical biopsy material. It goes back to the civil war. They have a huge collection of millions of tissue samples reflecting all aspects of clinical disease to emerging infectious disease, including autopsies of soldiers who died of flu in 1918. I wanted to think of a project that would highlight the utility of having such an old archive as well as our new molecular techniques. The way that was came together in my mind was to after the 1918 flu. We thought it might be possible to recover remnants of the virus preserved in the autopsy tissues of people who died in 1918. When we started the project, there were two fundamental questions we wanted to answer. One, why was the virus so virulent . Why did it kill so many people, especially young and healthy adults . And secondly, why where did the virus come from . We were hoping to learn from what we see in 1918 to apply to the future. So we could understand why pandemics form and why some viruses cause more diseases than others. These tissues were extremely old. It was not clear that we could actually recover in a genetic material at all from the samples. We had to work out techniques and continue to refine the techniques to extract nucleic acids, dna and rna, from the samples. We started the project in 1995. It took over a year to find a first positive case, once we found the first positive case and started to generate sequence convinced we had found he 1918 virus, we were concerned there would be in adequate amounts of material available to us to sequence the whole virus. In march 1997, in science news there it was. 1918 pandemic virus found. The whole sequence had been discovered by jeffrey ton berg. I said, if you need more specimens, let me know and i will go back to alaska. Ive been there before. I can go back. I didnt hear anything and i thought, he thinks im a nut. He happened to be on vacation. We were extremely excited about the possibility. We hope that if we could recover genetic material from a frozen victim, the quality would be improved. He called me and said, can you go . I cant go this week. But i can go next week. Now this time in 1997, it was in august. A much better time to dig in the ermafrost. He knew all of the excavation that i had carried out in 1951 and he also knew that i had to get permission to do it again. So he said it was very difficult. You may not be able to get ermission this time. But i will introduce you to rita olama. Little did i know that her grandmother was it never would have happened otherwise. Crucial. Dr. Holton presented his case to the brevig village council. He made sure they understood that the virus was dead and could not cause disease. I also told them how important it is because your participation, this is where it begins. If youre part of the team now, im specimen collecting at the Armed Forces Institute of pathology. These are the three, but it begins with you. And i got the permission to go. No one wants to go in a grave with bodies. I will do it myself. So one of the members said, would you like to have some elp . Four young men assigned by the illage council to help me. They knew where the grave was. I marked it off. At the end of the first day we were down about four feet and i didnt see anything at all and five feet and the following day. I noticed some bodies at seven eet. Next to the skeleton was a woman. And perfectly preserved. Clothing had fallen off and rotted away. Could see the skin. I started to do the postmortem and then 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 pneumonitis. Exactly what i needed. The subcutaneous fatty layer is an fatty inside. They had protected the lungs from the occasional thaws of the permafrost that had reached seven feet down. The eskimos are not theres ot much food around. They were active and hardworking. To find one who had extra calories storage, it was just remarkable. And here was a woman who had ample food. Ad a good husband. Good hunter. Brought all this food for her. Imagine how fortunate. Then i decided before i leave and going to make new crosses to show my gratitude to the village. I had photographs of the original crosses. I knew how tall they were and everything. I finished my work with the crosses at 1 00 and by 8 00 the next morning, the High School Kids came and helped me put the rosses in. About an hour later i got all my specimens on board and shipped them. The advantage was that the former tissue samples were extremely tiny. Just the size of a fingernail. He was able to provide large ections of an entire lung. We had so much more material to work with. It became clear that we would be able to sequence the virus from that material. I figured it would take weeks and weeks before he had any inkling if the specimens were good. 10 days later he called and said, we have it. Specimen is good. And there are lots of specimens. Great material. This is going to be wonderful. T was a great day for me because it started in 1950 five and finally in 1997, made t. Without the eskimos in brevet, nothing would have happened. The effort to sequence the entire genome of the virus took 10 years. It was very laborious process. More than 13,000 pieces of Genetic Information that had to be put together in total. If you get a sequence of the ene, he has that looking at it ere. In this piece, is it here or this or is that this weight . What comes to the left and the right. Day after day, month after month. Putting these things together. So 13,000 pieces had to come rom this proper place. Its incredible. Its clearly virus that was human adapted. Genetically its very birdlike in its sequence. Its very avianlike. We think it is an entirely avianlike influenza virus that somehow adapted to humans. We now know that there are a number of mutations in several of the genes that are absolutely crucial in the adaptation to humans. So you can imagine using these mutations as a screening tool to assess the significance of bird strain as to whether or not it was moving along the path that would make it adapted to humans. If we identify changes that were crucial to allow a bird virus to replicate in humans, you could design drugs that might lock or bind to that particular change to prevent a bird virus from actually functioning in humans. The 1918 flu had as its most unique feature at the fact that it had a high propensity to affect young adults. Even having the entire sequence of the virus in front of us, we could not understand why it behaved in that manner. People in that particular age group might have had the wrong sort of immunity to the 1918 virus. Some kind of immune response that actually made them more susceptible to die. And people older than 45 or 50, there might have been preexisting immunity to viruses similar to the 1918 virus. We are trying to identify influenza virus positive tissue samples from before 1918 to try to help us figure out this problem. Jeffrey thunbergs righthand oman would stand up with a plaque to present it to the village council. If this is his work, brings antiviral drugs and good vaccines, it began with rita and jenny. Another question about the death toll was how people died after they became ill with the flu. The doctors examined not only the autopsy tissues in the collection but also autopsy reports from all over the world of people who had died of pandemic influence up. The vast majority of people dying died because of secondary bacterial pneumonia. We think a very virulent could spread down into the lungs and cause disease that would ultimately actually kill the person. The evidence of the bacterial pneumonia helps explain why you had such high mortality in military camps particularly. While this is very important in trying to find what happened in 1918, it has significant implications for pandemic planning in the future. We have seen the explosion of information about influenza. Primarily the sequencing of the 1918 virus but also the unusual events associated with the h5n1 virus, the bird flu virus. We have been watching this particular Avian Influenza virus for over 18 years now. These viruses are highly transmissible from bird to bird and they can destroy a flock of birds. But the most important thing from the Public Health perspective is that humans who have very close contact with the infected bird occasionally become infected by this virus. Over 60 of those who have become infected have died. Many more people have been exposed to the virus that have become infected. In order for this Avian Influenza virus to cause a pandemic, we would have to see a number of changes that would occur in the virus so that the virus could be transmitted easily from human to human to human. The fact that the Avian Influenza viruses that we are monitoring so closely have been circulating for 10 years and still havent caused a pandemic doesnt mean that these viruses will not cause a pandemic. We dont know for past pandemics and how long those viruses actually circulated, caused infections in humans and then gained that ability to be transmitted efficiently. So we dont know enough about past history to predict the future. The biggest lesson is we cant predict what influenza will do. As scientists continue to look for answers in the 1918 flu virus, we can honor the men and women who responded to the Health Crisis by taking it on themselves to care for their neighbors, relatives and communities. Dr. John tappan was a physician n el paso. He wrote to a colleague serving at an Army Field Hospital in france. We have all been awfully busy with the flu. I made an average of 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 in the old school where we treated the mexican part of town. The epidemic here was fierce. We had about 10,000 cases in el paso and the mexicans died like sheep. Whole families were exterminated. The white population found almost as badly. I was three days behind in my calls. The other doctors all had the same experience of course. One People Living in other parts of el paso learned of the many deaths in the southern part of the city near the border with juarez, many volunteered to use their cars as ambulances, picking up the second delivering them to hospitals and other parts of town. Hen the school was turned into a hospital for flu patients, el paso ends from all over the city volunteered as nurses, drivers and clerks. You see we have been serving our country right here at home. The epidemic made the Community Get together because everybody helped, gave their houses or their help or whatever people needed. So that helped the community. There was a shortage of doctors and nurses during the 1918 influenza pandemic because so many of the physicians and nurses were serving in the war effort. You had a mixture of Trained Medical personnel and those with some training and those who were very civic lay minded individuals who wanted to participate in tending to the ill. The women who volunteered during the pandemic were literally 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 would say the activities of volunteers and particularly women volunteers was absolutely crucial. This is a story of unhung heroes and forgotten people who really rose to the gravity of the moment. In villages in alaska, the whole village would become second ones. Sick at once. Food or shelter. There would be nobody to provide food or shelter. These things can make a difference. Even in wealthy nations like the United States, the conclusion at the end of 1918 and 1919 was that the single most important thing that could save your life from flu was nursing care. Not medicines, doctors or hospitals but good nursing care. When you first read those things you are likely to say, that cant be true. What could they do in those days. What is chicken soup going to do. I believe the data. Theyre strong. Some of the best doctors and nurses said it again and again. Good nursing care. Even though no one knew what caused influenza in 1918, some communities took steps to prevent the spread of the disease. In our group we have been looking at 43 American Cities during that pandemic to see exactly what they did to stave off the epidemic or what they didnt do for that matter. What worked, what didnt work and what were their records. What we find is that those who acted very early with a suite of classical Public Health interventions, things like quarantine, closure of schools. Banning public gatherings. They acted very early before the epidemic had a chance to spread to a lot of people and kept these measures on for a 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 the cities that did not. I think theres a mountain of stuff that we are learning from the 1918 pandemic that applies to people today or in the near and distant future. We have learned from the experiences of the 19181919 pandemic. But thats only one of the factors that makes us better prepared to deal with influenza pandemics than the world was in 918. There are extraordinary advances. Experience of what seemed to work in some cities like social distancing and avoiding credit crowded places. Things that were not necessarily fully appreciated. Some cities did it ended well. But most importantly we have biomedical and health care and technical advances that we didnt have. We have vaccines. We didnt have vaccines than for flu. We didnt even know what the microbe was when they were dealing with it. Many people thought it was some strange form of bacteria and not necessarily a virus. Number two, we have antiviral drugs. For example tamiflu. We have antibiotics to treat the secondary complications, the bacterial complications of influenza. 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. All of these things we did not have back then. We have them now. Our parents and grandparents had little warning or chance to prepare. But we know now that influenza has caused pandemics at intervals for at least the last 500 years. Public Health Officials have been preparing for the next flu pandemic knowing that it could be a mild pandemic as in 1968 or severe as in 1918. The world is watching the new pandemic flu virus, the novel h1n1 flu virus which emerged in the spring of 2009. We know that the new 2009 virus is in almost every country of the world already. Fortunately so far the virus doesnt appear to have that level of severity that the 1918 one had. The 2009 virus is affecting people differently than seasonal flu strains. The illness is most common in young people. But we are also seeing hospitalizations and death in particular in people who have conditions that increase their risk of complications. Pregnant women have really been heavily hit by this virus. In the United States and reports around the world suggest that native populations may have a higher risk of severe illness caused by the 2000 2000 9h1n1 strain. We want to be ready and make sure these populations are served and have good access to health care and the vaccination. Everyone has the experience throughout the world that the best way to contain influenza is by getting a very efficient and safe vaccine. Vaccines given the Current Technology and even in more modern technology you dont make a vaccine overnight. You have to first find out what the virus is you are dealing with and then go through a multistep process to protect the population. That multistep process generally takes several months usually along the line of six or more months. Vaccination is a really important part of our response to the 2009 h1n1 virus but its important to say its not the only part of it and we have a whole series of mitigation efforts and communication efforts. Public Health Officials are fighting the spread of influenza with the Health Hygiene we learned as children. A stay home when youre sick. Wash your hands frequently with warm water and soap for 20 seconds. Practice cough and sneeze etiquette and avoid touching your eyes, nose or mouth. At the start of a pandemic, thats the most efficient tool in addition to obviously social distancing like staying home when you are sick and so on. We are a community that hugs, that shakes, that has elevators that you need to ride on. We go Grocery Shopping and we need to push our carts. Everything you do, you need to touch something that other people touched. The handwashing that will be very critical. These good habits and vaccination also prevent the spread of seasonal flu and annual immunization for the seasonal flu helps people stay healthy and helps Health Workers prepare to vaccinate the population during a pandemic. These immunizations are widely available every year. Its very important for people 65 and older to take the immunization. Its important to have the vaccine every year and the vaccine is a covered medicare benefit. Theres no way he would get the flu from a flu shot. Based on what i know about influenza vaccines the risk of getting influenza or having a complication from influenza is much higher than any theoretical risk from the vaccine. Its important for people to know that not getting vaccinated also puts you at risk. 100 Million People get influenza vaccine every year in the United States. They have a strong safety track record. The influenza vaccines are being made exactly the same way. A longterm goal for scientists working on the flu vaccine is to develop a vaccine that would protect against all seasonal and pandemic influenza. We generally refer to that as universal influenza vaccine. I dont think its going to be easy to do what we are working n. I mean scientists in the field. To identify the components of all influenza viruses that dont change as the virus drifts or even shifts. Then youve got to put that in what we call an immunogenic form. Namely a form that when you inject it into a person or sprayed into the nose of a person that that person will make an immune response thats very robust. There are a lot of people working on it. Its a high priority project. Every year we have fewer elders to remind us of the terrible time they, their families and their communities endured in 1918 and 1919. But we need to keep those memories alive. Theres a lot of things to be learned from continuing to study the 1918 flu. I think the important lesson is that pandemics can be very serious but also pandemics can be widespread but not that serious. Theres a gradation of severity of pandemics. You always must prepare for the worst Case Scenario even though you might have a mild pandemic like occurred in 1968 or an intermediate pandemic that occurred in 1957. The current pandemic is much less severe so far than the planning scenarios that most of us have had. It could be that it becomes less severe and doesnt affect a lot of people. It could be that it mutates to a eadly virus. Which would be difficult to manage. Only time will tell. We have to be ready to prevent and respond differently if the virus changes. The one thing you can predict about influenza is that its unpredictable. We still know much less than we like about influenza. But the experiences of the individuals who endured the pandemic of 1918 and the research into that pandemic continue to contribute to our understanding of the disease. We are infinitely better prepared now than we were 100 years ago back in the beginning of the 20th century. For more information about pandemic influenza, visit flu. Gov and medicare. Gov. [captions Copyright National cable satellite corp. 2020] our cspan cities tour takes American History tv on the road to feature the history of cities across america. Ere is a recent program. I think people around here know a lot about the ranching history in this area. Texas tends to be very much about itself with its own history. I think this particular history is more about middle american regional story that hasnt really been told. So its almost like the isolation of the ranching history is texas, texas, texas, but one of the things we talked about this show, we pitched it as like looking about rather than always looking within. We are in the panhandleplains museum