As 50 million would be dead. 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] music [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 the oldest, about 10 years old. 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. Public schools and Public Places closed. I guess for nearly two or three weeks. music 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 8 patients. music my father always went by tell us good morning, that was his indian name. He was working in tennessee for a dupont company. Everytime 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] 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 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. 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. 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. music 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 dying. The vehicle about it is that she didnt get it according to her, none of us 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. Where people called it influenza, the grippe or the spanish flu, it was clear 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. There were a few communities in the u. S. , small or isolated that they were sheltered from the ways of deadly disease that spread around the world. The influenza of 1918 even touched remote inuit 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] the bureau of Indian Affairs sent a doctor richardson 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. I think it was a neighborhood mostly of 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, it was like a sadness over the city. When you looked out, you saw hardly anyone walking around. People stayed in their houses because they were afraid. And they said that, it seemed that if it killed two, it did it fast, because i remember them telling me that a young neighbor, they saw him coming out, they watch the window, coming from work, and the next afternoon, they saw him carried out. He died. Of all the cities in the u. S. , philadelphia have one of the highest rates of sickness and death. The city resisted putting measures in place that might have limited the spread of the flu. Measures of such as prohibiting public gatherings where the flu could spread easily. 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 and they were just thousands of men coming out of the mills. My father worked for the steel companies. The only black bigger they ever had with my father. Baker they ever had was my father. People were very kind to one another and it was a place everybody looked after one another. The people who work in the steel died in 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. To 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 are 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. 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. All other people get vaccinated and we received some and unity through that vaccine. There are two ways to acquire indian protection. One is immune protection. One is through natural infection, in which he recover in survive. The other is vaccination. Vaccination helps our bodies to produce antibodies against strains in the vaccine. The influenza pandemic is different. It is the emergence of a very new influenza a virus to which most of the population has not previously been exposed and is not have any immunity. No immune protection. What you see is very high numbers, very High Percentage of people becoming sick whirlwind. In the last 100 years, new influenza viruses have caused four pandemics in 1918, 1957, 1968 and 2009. Ultimately, they come from birds, while waterfowls, geese and ducks. They can get into domestic poultry, chickens. They can also get into human beings directly, takes, various 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. I have a variety of mutations that occur for a number of reasons, these types of viruses can, under certain circumstances about 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 person to person. The most 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. 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. Whatever the reason, it is pretty clear that pregnant women in 1918 or very high risk. Pregnant women are going to be in the younger age ranges. But not pregnant women and men in those age ranges were also at risk. In any flu pandemic, people die from an ammonia, but it tends to 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 hapened. Otherwise healthy young adults constituted a fairly large percentage of the depths. Why that happened deaths. Why that happened is a mystery. music brevet, michigan is northwest of gnome, election 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. Was a medical student in sweden. I just thought i would travel to the United States and get a masters degree in biology. One thing led to the next and i decided to go for my phd. One day, we had a visitor. 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 been made frozen since 1918. At that time, it has been 40 years. 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 thesis . I happen to have worked during the summer of 1949 for a paleontologist in alaska. The paleontologist at work on the peninsula and knew the missionaries in the villages there. With his help, he was able to review records from the following 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 have 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 fly me to another village at the bering strait. I found out where the musgrave was, clearly marked with a large 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 the elders. The oldest woman of the largest family makes decisions were 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. I asked him 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 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 protective. They understood what that scene 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 take. Dig. About a foot down, i came onto permafrost. I started the fire, climbed up on the bluff, and there was a mass grave. I 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 biologist. I had a pathologist, one of the professors in the department in iowa to perform the postmortem examinations. 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 writing. Breving. About three days later, we were down six feet and then we found three perfectly preserved bodies the postmortem found them and their lungs were perfectly preserved. We think the villages, grave closed the grave, and i took pictures. I started to try to grow the virus trying to find a live influenza virus. Week after week after week i got more and more discouraged. Eventually, i had no more specimens. In the virus was dead. And there went to 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, pick an apologist. Back in my became a pathologist. That 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. Pathologist use the tools of molecular biology and genetics to make diagnoses and provide insight into patient care decisions. Did you 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 the 1980s. In 1993, i moved to the armed forces to set up a new group dedicated to pathology. One of the things we have to do for both sides of that was to work out ways to recover genetical material from typical biopsy material. 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. In my mind was to after the 1918 flu. We thought it might be possible to recover remnants of the violence preserved in the autopsy tissues of people who died in 1918. When we started the project they were really to fundamental questions that we wanted to answer. That is one, why was this virus so particularly virulent. Why did it kills too many people, especially Young Healthy adults . Secondly, where did this virus come from we were hoping to learn from what we see in 1918, to apply to the future that we could understand how pandemics form and why. Particularly flu viruses cause more disease than. Others these tissues were extremely old. It was not clear that we could actually recover any genetic material at