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COVID-19 Evokes Comparisons to Last Century’s Spanish Flu

By David E. Hubler
Contributor, EDM Digest

Much of the world continues to wrestle with the novel coronavirus pandemic during which more than 16.4 million cases have been detected and over 650,000 people have died, according to Johns Hopkins University & Medicine.

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So perhaps it’s easy to forget that just over a century ago, civilization battled — and eventually overcame — the deadliest pandemic in history that infected 500 million people worldwide.

Caused by an H1N1 virus with genes of avian origin, the Spanish flu pandemic claimed an estimated 20 million to 50 million victims. Other estimates — lacking today’s worldwide computer capabilities and highly accurate medical records — put the death toll closer to 100 million, or three percent of the world’s population.

Scientists still do not know for sure where the H1N1 influenza pandemic originated, although theories have pointed to France, China, Britain or the United States.

The First Known US Case of the Spanish Flu Appeared in Kansas and Began Spreading

The allegedly first known case in the U.S. was reported on March 11, 1918, at Camp Funston in Fort Riley, Kansas. Private Albert Gitchell, an Army cook, reported to the military hospital, complaining of the cold-like symptoms of sore throat, fever and headache.

By noon, over 100 of his fellow soldiers had reported similar symptoms. “In September 1918, a second wave of the epidemic hit North America and this time it could not be ignored. It had mutated since its Fort Riley appearance and was now deadlier than ever,” Doctor’s Review reported. By the time the Spanish flu died out in 1919, an estimated 675,000 Americans had died from the influenza.

As in the current pandemic, “victims ranged from residents of major cities to those of remote Alaskan communities.” Even President Woodrow Wilson reportedly contracted the flu in early 1919 while he was negotiating the Treaty of Versailles, which ended World War I.

King Alfonso XIII was one of the first Spaniards to get the illness, noted the UK’s Royal Central. “These stories created a false impression that Spain was especially hard hit by the flu, giving rise to the pandemic’s nickname, ‘Spanish flu.’”

More likely, Doctor’s Review surmised, “Spain had this fatal flu named in its honour because of the freedom enjoyed by the Spanish press at the time. Because of its neutral position in World War I, Spain was not subject to wartime censorship, which in turn meant that the press could freely and passionately report on the extent of local outbreaks. This widespread coverage mistakenly gave the world the impression that the flu was more prevalent there than anywhere else.”

The Spanish Flu Traveled to Europe with American Soldiers Heading to Aid the Allies wrote: “The disease soon traveled to Europe with the American soldiers heading to aid the Allies on the battlefields of France. (In March 1918 alone, 84,000 American soldiers headed across the Atlantic; another 118,000 followed them the next month.) Once it arrived on a second continent, the flu showed no signs of abating: 31,000 cases were reported in June in Great Britain.”

As the British series “History of the 20th Century” noted: “Towns and cities were declared danger zones for months at a time. In June 1918 160,000 inhabitants of Berlin were down with influenza. Half the people of Manchester [England] contracted the disease and the death rate was 7.9 percent. London had a total death roll of 15,054….”

Mortality was high in people younger than five years old, 20 to 40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20- to 40-year age group, was a unique feature of this pandemic, according to a history of pandemics from the Centers for Disease Control and Prevention.

Tracking and Recreating the 1918 Spanish Flu Virus

The Spanish flu pandemic died out between 1919 and 1920 and “generations of scientists and public health experts were left with only the epidemiological evidence of the 1918 pandemic virus’ lethality and the deleterious impact it had on global populations.”

But in 1951, Johan Hultin, a 25-year-old Swedish microbiologist and Ph.D. student at the University of Iowa, set out on an expedition to a small outpost in Alaska in the hopes of “finding the [origins of the] 1918 virus and in the process unearth new insights and answers.”

His destination was Brevig Mission, where in 1918 around 80 adults lived, mostly Inuit Natives. But “between November 15 and 20, 1918, the pandemic claimed the lives of 72 of the village’s 80 adult inhabitants,” the CDC story relates. The dead were buried in a mass grave which was frozen in permafrost and left untouched until Hultin’s arrival.

Hultin believed that within the burial ground he might still find traces of the 1918 virus itself, frozen in time within the tissues of the dead villagers.

Ultimately, Hultin successfully obtained lung tissue from five bodies buried at the site. “Once back in Iowa, he attempted to inject the lung tissue into chicken eggs to get the virus to grow. It did not. In the end, perhaps unsurprisingly, he was unable to retrieve the 1918 virus from this initial attempt.”

However, in 1997, Hultin read an article in the journal “Science” by Jeffery Taubenberger and his colleagues, “Initial Genetic Characterization of the 1918 ‘Spanish’ Influenza Virus.” In it, Taubenberger and his team described their initial work to sequence part of the genome of the 1918 virus. They had successfully extracted RNA of the 1918 virus from the lung tissue of a 21-year-old male U.S. servicemember stationed in Fort Jackson, South Carolina.

“The serviceman had been admitted to the camp’s hospital on September 20, 1918, with a diagnosis of influenza infection and pneumonia. He died six days later on September 26, 1918, and a sample of his lung tissue was collected and preserved for later study.”

Based on the 1918 virus’ sequence data Taubenberger assembled in 1997, he and his fellow researchers initially claimed that the 1918 virus was a novel influenza A (H1N1) virus that belonged to a subgroup of viruses that came from humans and pigs, as opposed to birds.

Hultin telephoned Taubenberger to ask whether he would be interested in lung tissue from victims of the 1918 virus buried in the Alaskan permafrost. The idea was to reconstruct the 1918 pandemic virus and study how it had killed so many. The work, as reported in the October 2005 issue of Science, was done using a technique called reverse genetics to re-create a living 1918 virus. Taubenberger’s answer to Hultin was of course yes.

So 46 years since Hultin’s first trip to the Alaskan gravesite, at age 72 and paying for the entire endeavor, he returned to Brevig Mission. He again gained permission to excavate the gravesite and he also hired locals to assist in the work. The excavation took about five days, but this time Hultin made a remarkable find.

Buried and preserved by the permafrost about seven feet deep was the body of an Inuit woman. Hultin named her “Lucy.” Hultin would learn that she was an obese woman who likely died in her mid-20s due to complications from the 1918 virus. Her lungs were perfectly frozen and preserved in the Alaskan permafrost.

Hultin removed the lungs, placed them in preserving fluid, and shipped them to Taubenberger and his fellow researchers. Ten days later, Hultin received a call from the scientists to confirm that positive 1918 virus genetic material had indeed been obtained from Lucy’s lung tissue.

When reconstructed in a lab, the Spanish flu virus gave scientists valuable information about the origins and characteristics of the 1918 pandemic.

Discoveries from Spanish Flu Victim Lucy and the Lessons for COVID-19 Vaccine Researchers Today

“The fully reconstructed 1918 virus was striking in terms of its ability to quickly replicate, i.e., make copies of itself and spread infection in the lungs of infected mice,” the CDC account said. “For example, four days after infection, the amount of 1918 virus found in the lung tissue of infected mice was 39,000 times higher than that produced by one of the comparison recombinant flu viruses.”

One well-documented effect of the 1918 virus that the scientists discovered was “rapid and severe lung damage. In 1918, victims of the pandemic virus experienced fluid-filled lungs, as well as severe pneumonia and lung tissue inflammation. Within four days post infection, mice infected with the 1918 virus experienced similar lung complications, suggesting that this was a unique aspect of the 1918 virus’ severity.”

These conditions closely mirror some of the symptoms of COVID-19, the respiratory disease caused by the novel coronavirus. Scientists in several nations are now working feverishly to create a vaccine against the present pandemic. Here’s hoping it won’t take another near half-century to rid the world of this deadly disease that, unlike the 1918 Spanish flu pandemic, shows no sign of fading away on its own.

David E. Hubler brings a variety of government, journalism and teaching experience to his position as a Quality Assurance Editor. David’s professional background includes serving as a senior editor at CIA and the Voice of America. He has also been a managing editor for several business-to-business and business-to-government publishing companies.

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