About the flu. It seemed like something that came around every year and people would get sick and then better again. Within a few years ago, i a ima reporter for the New York Times and i read an article about a miraculous discovery there was a guy at Walter Reed Medical Center and he was reporting in a technical journal of Science Magazine that he somehow managed to there were fragments of the virus that killed him and when i interviewed this man about his work he told me about the pandemic of 1918 and i was stunned. I had never heard of anything like this. It was the worst Infectious Disease epidemic in history. It affected us on many people te that have Something Like that came by today, it would kill more people than the top ten killers got together, 1. 5 million, something of that mortality rate. Had i just found out by looking at the papers for the centers for Disease Control that 99 of the people that i did the epidemic were under age 65, so it was an astonishing devastating epidemic and what made the story for me is almost a century later molecular biology have been sent by serendipity involved somebody could actually have lung tissue and ask the question what was this fire. The virus and how could it become such a cover and could it happen again and if so would we recognize it in time. Ryan mac a reference there may be as many as 20 to 100 million that died worldwide in 1918. Guest it is matching the number upward. People think 40 million is an underestimate biggert most recently there was a meeting of historians and people interested and if they think that the true number worldwide was closer to 100 million possibly 20 million died on the subcontinent alone. Cspan what is influenza . Guest it is in human lungs and while its there, to take a cell and make it to the virus factory so like every other virus it picks the cell. Cspan what happens to the body . Guest there or for hallmarks. One of them is you get a fever and take to your bed. You can have muscle aches and pains, fever, you can have a called. Cspan have you ever had a fight we . Guest i think i had it one. When i did i said this is the flu, five days of torture. I still remember those muscle aches. They couldnt believe that it was Something Like the flu. There were these rumors that there had been a cloud living over Boston Harbor it was the most horrible thing that anybody has ever witnessed. It was shocking that they continue to be the leading doctors in the United States to go out and sa see what is goingn at camp david. One wrote in a memoir i cant even bear to think about this thing. 1918 when the deadliest influenza virus devastated the taking of human life. He said there were memories burned into his brain he would like to remove if he could. Then describing what happened when they wanted an autopsy they said there were so many dead that they had to stick over the body is just to get the autopsy room. There were guys that havent been removed yet. And then when they watched an autopsy take place, the doctor opened up the chest of a young man and there were his lungs fill with fluid totally useless and a doctor there nothing could shake him turned and said this must be played. Host in your book explain what these are in the bottom picture. Guest the bottom these are some of the samples of lung tissue of people from 1918. What was this and how would we ever know and what was really miraculous is there is a military warehouse people described as the library of congress of the dead started by Abraham Lincoln and any time they do an autopsy they are supposed to put the tissue and medical records in the warehouse. At time they took pieces of the tissue and sent them to the warehouse. Cspan going back to this institute here at walter reed, have you been there . There are 3 million samples . Guest they are in boxes and things and it is burning down and if they have box after box after box. He died very quickly because he did and what the person that had gotten the flu virus and then lingered and meanwhile it had died and so since 1970 had been computerized city could get a printout and he goes over with his letters and folks. Cspan there were samples from back in the civil war. Guest right after and then on, yes. It was a brilliant idea because when they started this, who knows what you would use it for. No one had ever found of the influenza virus so the idea that they would come back and make use of this material was brilliant. Cspan i know i am jumping ahead. Guest at this point they hahave samples for those who did in 1918. Its pushing the limits of molecular biology and it takes a long time you describe it as putting together a very detailed mosaic. The first three things theres the flu virus related to the pig viruses that havent provided the answer yet to why it was dangerous. Cspan but we ask that this pathology institute. Theres only one person that works there . Did you get the sense that theres a lot of interest or traffic . How big of a facility as if . Guest pretty big. It was a warehouse. Ia few miles away in maryland just over the border. Cspan one thing i didnt expect to get out of the buck is the drama, theres personal stories in here that are fairly dramatic. Were you surprised a by the competition going on to find this . Guest i knew there was a story and i read fiction for fun. That is what appealed to me. There was competition in their shared all the strengths and weaknesses. Cspan go back to 1918 again was this a more devastating flu than what we hear about . Guest as i said earlier, 1. 5 million americans have died and in the typical season 20,000 by at most are very old or have a chronic condition that weakens them. Here 99 are under age 65. Then people between 20 and 40. And then at the end. Cspan i would like to ask you to read page 25 the authors brother and then where did he write this . Guest he was writing and people said if its the prescription of his mothers death was his brothers real name and a description that wasnt fictionalized but what happened when his brother died of the flu. Cspan can you tell us why you wrote this . Guest when i talk about the flu or people that are living today talk about it it is almost impossible to imagine what it was like. I tried as much as i could to put the words of the people that havpeople thathave been there bu have seen it it has an emotion i cant capture and i dont think anyone ive spoken to has been able to capture so the reason i took a description is this one just really touched me. It almost brought me to tears and you can imagine yourself in that room watching somebody die like this and is one of those moments i cant forget this passage and thats why i put it in a. His brother was lying in the sick room while the family waited for what was inevitable. He saw in that moment of recognition that erupted 26yearold. He made three quarters of an outline twisted below the cover it seemed not to belong to him and it was somehow distorted and his face had turned gray. Two red flags and fever and his beard was growing. It was somehow horrible. It recalled the vitality of care and then lifted the big constant grimace of torture and strangulation and inch by inch he gasped and the sound of the gasping was unbelievable orchestrating every moment with a final note and the next day. There was the unconsciousness and delirium. Returning to this popular song of wartime hes sentimental and moving and then in the unconsciousness his eyes almost closed with a non sensibility we lay quietly various trades without signs of pain and with a curious his mouth was firmly shut. They were praying even though he didnt believe in god or prayer. Whoever you are, be good to them tonight and show them the way. Whoever you are, be good, showing them the way. He heard only the rattle of his breath and suddenly the certain knowledge he lay still the body appeared before them. Then with a last gasp of a long and powerful respiration filled with the terrible one moment without support and then passed into the shades of death. Weve opened up the archives to look at the programs about pandemics. In 2012, Science Writers looked at diseases that originated animals but then spread to humans. They call these animals infections that pass to humans zoonoses. It can be a bacterium, it can be a protozoan like the creatures that cause malaria. It can be a fungus or a worm. It can be something called a prion which causes mad cow disease. They dont always cause disease. Its got a wonderfully gruesome name and youve got to find the light side of where you can find it and with all due respect to the people who suffer and the people who die and there are a lot of deaths in this book. Still, i didnt want this but just to be a painful. I wanted to be it to be a pleae learning experience and a page turner. I wanted it to be moments of suspense and mystery and discovery. It might be the funniest about that you ever read. [laughter] when they pass into humans they are harmless. If it causes mayhem than we call it a zoonotic disease and 60 of the Infectious Diseases of humans are zoonotic diseases and the other 40 everything comes from somewhere. Its the disease of humans where does that come from it probably came from the virus that causes the disease when they are pass passed. The 60 that are considered a zoonotic or passing back and forth. Theyve done it very recently. All of the influenza, west nile virus, hiv. I talk at some length about the ecological origins of the pandemic. And we now know that the pandemic strain of hiv passed from a single chimpanzee to a single human in a very small corner in central africa. In 1908 or earlier give or take a margin of error. There are some wonderful scientists that have worked on the genetics side that are precursors to hiv and those that are into chimps and monkeys and the diversity of hiv pandemic strain and of these scientists have managed to locate the spillover effect with a high degree of confidence. Theres always a certain provisioncertainprovision but we of competence, theyve located the southeast cameroon. One chimpanzee, one human presumably a human but killed the chimpanzee and then can cut himself on the hand, blood to blood contact and in the early part of the 20th century sometime around or before 1908. Michael and beatrice are the scientists that have done that work. So, there are these diseases and the spillover. One of his lengthy technical term i want to familiarize you with his reservoir host that is the kind of animal in which the bug, the virus, whatever it is lives permanently inconspicuously without causing disease, without causing mayhem in that particular creature. Why does that live there nondestructively . Probably because it has been in that species for millions of years and then an accommodation has evolved but it doesnt replicate cataclysmic lee it is slowly and doesnt generally cause sometimes. Then something happens, humans come in contact with it somehow maybe i will tell you a couple of ways that this can happen it sheds the virus and then becomes a zoonotic disease. As they study the field and focus on the different diseases. A new disease spills over in malaysia. Its killing pigs and pig farmers and villagers and pork sellers. This is a true case that happened in 1998 they named it after a particular village in malaysia then they went looking for the reservoir host. They found it in large fruit bats of the kind of flying foxes in asia. How did this occur . It finally tracked it through the route and here is what happened. People were cutting down forests for development, agriculture, timber itself, cutting down the forests destroyed fruit bat habitat. They were displaced and had to go looking for food and nectar somewhere else. They started going closer to the settlements. Some of those planted by humans were on pig farm was the second stream of income for those that ran these factories in northern and central malaysia. Some of them even planted mango trees close to their pigstys and in some cases even shading their pigstys. They come to the trees planted and drop the pope into the pigsty and they drop the virus. The pigs pick it up and get sick and get a very infectious respiratory disease. The pigs are coughing and passing on the virus from one to the other. They are mostly not buying however. It isnt killing that many but they become a is agricultural problem. And then it starts getting into the humans in that kills 109 people. It causes the government of malaysia to call preventively 1. 1 million pigs, required the killing of all of those that came from infected farms. Some of the forms people were so scared by the disease but they were abandoning their own farms and coming away from their own pig farms and at one point they were running loose through the villages into some cases abandoned and its like a nightmare scenario but it really happened running through the countryside. One fellow called it the onemile barking cough because you could hear these sick pigs coming and you knew that yours would be next. Real story. Encephalitis is the disease in humans. So, this is what the scientists do. They try to solve the ecology and evolutionary biology of these diseases. Where does it live, what is the host, how did humans come in contact, what are they doing in many cases its that kind of ecological disruption that causes the spillover and gets into an intermediate and there is the case they are referred to as the amplifier host the virus reproduces abundantly in them and then it gets into people. The case in australia is after a suburb of brisbane in a racing suburb 1994 horses suddenly started to die. He went into the hospital and the veterinarian never got sick. The trainer died. They isolated the virus from him, his organ and from the horses and found a new virus and named after the suburb. Then they did the disease protection. Where did the virus come from . A fellow who was the chief detective on the case, a veterinarian but doing a phd in psychology sampled animals, kangaroos, wombats, rats, mice, insects. He didnt find the virus. Finally he sampled fruit bats and found the virus that matched would have told the horses and the trainer and gave it the name hendra. It doesnt pass from human to human but it is a knock on the door a reminder to us of where these things come from, how they emerge and spillover and the fact they are not all independent cases and it reflects things we are doing on the planet and then they get into humans and in some cases cause a local outbreak that is easily controlled or comes to the end on its own and other cases they cause widespread suffering and death. Professor john berry discusses his book the great influenza, which provides a history of the 1918 influenza outbreak. Here is a portion of the talk from 2004. Now you have the enemy. The enemy of course is the virus. Now, all influenza viruses are bird viruses. There is no single virus just like a swarm of hornets they are all moving around like the adams kind of virus. When the influenza virus infects a sell it about six hours that single cell explodes in between 100,001,000,000 new virus particles escape from the cell and everyone is different. Most of them are so different they cannot affect another cell only 1 percent between 1,010,000 viruses from one cell. Are able to in fact a new cell but that mutation rate allows it to jump species. 1918 in any stretch but they are not all legal but those pandemics in 1957 and 1958 and while they killed considerably more people the normal for influenza 36000 people per year with 57 and 68 there were double about three or four times the normal but compared to 1918 it was just a severe epidemic season. Now the story really begins when the virus jumps to people nobody knows exactly for certain with that happened. Most pandemics have begun in asia however there was some overlooked epidemiology logical evidence that i managed to trip over that suggests this jumps species in kansas going from rural kansas which is in the Far Southwest corner of the state and to what is now fort riley and that had 56000 troops closely packed in the barracks and they were being trained to kill very far more effective at killing than anyone could imagine. As i say it was a war waged by nature against man hitting full force it took about six months for the virus to jump species. It wasnt efficient at infecting men the had to adapt the new environment and that took a while before it came at home in humans and became an efficient to invade humans but about six months after the jump, it became very lethal and simultaneously it exploded. One of the first places a hit the second frame was just outside of boston and from that position to another describing what was going on this starts what appears to be an ordinary attack of influenza and come to the hospital to rapidly develop the most vicious type of pneumonia that has ever been seen then they had the mahogany spots than two hours later you could see the cyanosis when you start to turn blue because of lack of oxygen that extends from their ears all over their face until it is hard to distinguish the colored men from the white that is how dark people were turning you cannot distinguish black from white. Only a matter of a few hours until death comes. To see one or two were 20 men die but they were dropping like flies averaging 100 deaths per day in all cases it would mean death we lost not we just number of doctors and nurses it took special trains to carry away the dead for some of those the bodies piled up something fierce they would say god be with you till we meet again. Now come as this virus spread across the world and throughout the United States , it put extreme pressures on the political system. In fact its a very good case study that is relevant unfortunately to relevant to talk about bioterrorism not to mention the possibility of another influence outbreak and it demonstrated the political system was not prepared to handle it. Chiefly because the politicians were so focused on the war and the unfortunate irony is that this hit when we were literally only for five weeks away from the end of the war so every enemy country we were fighting except germany itself had stopped. They had already sent out feelers for peace. But wilson and the entire administration were so focused that they did not do anything for Public Health that word in any way jeopardize the 100 percent the war effort that ruthless brutality to have the american spirit with. And as a result not only federal officials, but other mayors and governors all over the United States eventually lied. First they told people this was only ordinary influenza. The mitchell people fear kills more people land the disease. In philadelphia where they were actually planning a huge liberty rally hundreds of thousands of people were about to be in the streets very early of the outbreak so the general public was not aware there was a problem privately on