1918 Influenza Pandemic:  What Happened?

1918 "Spanish" flu Distinguishing features:

nw079037501a.jpg (16666 bytes)







Finding Virus Samples for Study

In 1951, scientists from the University of Iowa exhumed bodies of victims of the 1918 flu that had been buried in permafrost in Teller Mission, an Inuit fishing village on the Seward Peninsula of Alaska. This village, now called Brevig Mission, suffered extremely high mortality rates during the influenza pandemic in November 1918. According to available records, influenza spread through the village in about 5 days and killed 72 people, representing about 85% of the adult population.

During the 1951 expedition, samples of lung, brain, and other organs were taken for histologic analyses and viral culture. All attempts to culture live influenza virus from these specimens were unsuccessful. Molecular genetic analyses of the samples were impossible at that time--indeed, the double-stranded structure of DNA, with its implications for molecular genetics, was not determined until 1953.

In 1995, my laboratory initiated a project to characterize the 1918 influenza virus genetically using archival formalin-fixed, paraffin-embedded autopsy tissues of 1918 flu victims stored in the National Tissue Repository of the Armed Forces Institute of Pathology (AFIP). A search of the archives revealed over 70 autopsy cases of U.S. soldiers who died of influenza pneumonia in the fall of 1918. We used techniques to isolate RNA that had been optimized for fixed tissue specimens based on previous studies.


Origin and Evolution of the 1918 "Spanish" influenza virus Hemagglutinin gene.  Reid, A. et al. PNAS, 96, pg 1661 (1999)




Transmission electron micrograph of influenza A virus, early passage.



3 types of flu viruses: A, B, and C.  1918 was A.  Two major proteins: hemagglutinin (HA) and neuraminidase.  HA responsible for virus binding



Hemaglutinin (HA) responsible for


Structure HA:


Chime Model:  Hemagglutinin antigen

Chime Model: Neuraminidase

HA binding site:


For cross-species transfer need changes in binding specificity.


1918 HA has:

Structure Files:


Stevens, J. et al. Structure of the Uncleaved Human H1 Hemagglutinin from the Extinct 1918 Influenza Virus.  Science, 303, pg 1866 (2004)

Gamblin, S. The Structure and Receptor Binding Properties of the 1918 Influenza Hemagglutinin. Science, 303, pg 1838 (2004)



How travel/Where originated?

  1. How did the virus get to Europe when it had been dead in Kansas for awhile?  Did it live in a host with out affecting them?
  2. Do they know how this strand of the flu started?
  3. What organism would have been in the manure that is not killed by being burned?  Is it similar to the one which causes mad cow disease?
  4. If the war hadn't been going on would the virus have spread as rapidly and as vastly?  Would response to it have been different? 22-25, Beth R
  5. Did the flu get passed to people from other countries because of the war and our troops carrying the virus?


Who got it?

  1. Why were people 21-29 the strongest, the most likely to die fromt he flu?
  2. Why weren't the robust young soldiers more immune to influenza than the young, old, and weak?  9-11 Gail A
  3. Were civilians in Europe as greatly affected by this influenza as the population of the U.S.? (6-9 ES)
  4. Why or how was it that influenza killed primarily people 21-29 rather then then the young and old who tend to be more prone to illness?
  5. Why weren't the very young and elderly most suspectible to the virus?  What made them more immune?
  6. Why were some people more susceptible to getting influenza than others and also, some able to recover from it?

How did it end?

  1. How did the flu just go away? 1-5 molly
  2. If soil were dug up today where the bodies were buried, would the virus still be alive in that area?
  3. How did the virus suddenly tire out and end the spread of influenza? Was it that everyone had been exposed to it and that all that were going to die from it had already died?
  4. How was it possible for the bacteria causing influenza to leave as quickly as it came if no vaccine was ever found to prevent it?
  5. How long could the flu live in a dead body and be able to infect other people?

Virus/Disease Biology

  1. Do scientists know what the influenza virus looks like, what its makeup is?  Can they find this makeup or use it to "solve" this virus and prevent it from causing great destruction again?  What progress is being made in the study of the influeza virus?
  2. What physiological change occurs in the body (difference in cells, function of cells, etc.) when fluid collects in the lungs?  Could this lead to the identification of the flu virus and how it works?  26-28 Margaret G
  3. Seeing that the HIV-virus is a s mutable as influenza, and given that it is constantly being transmitted from one person to the next; is it possible for the HIV-virus to change from Blood-borne to airborne?



  1. Does a flu shot protect against all strains of the flu? And if so, how does it accomplish this?
  2. Do people know what some of the contributing factors are that started the outbreak?
  3. What were some of the other folk remedies that people tried, and were people ever able to make medicines that worked?
  4. Was there anything that could have been done that we know of now that would have helped control the outbreak.
  5. If the scientists knew that the flu was a virus did they have the technology to produce a vaccine
  6. With the advancement of technology since 1918, has a vaccine ever been discovered to prevent future cases of influenza, or could there be an outbreak in the future with the same or worse results?  19-21 Maggie M
  7. During the flu epidemic, many people where trying to capitalize on it by marketing many different quick-fix remedies that were supposed to either prevent or eliminate the onset of the flu. Do you see any similarities between the capitalizing on epidemics in America today as in those times? Hint: Obesity. 29-31 Chad H

Big Questions

  1. Would it have been immoral to not send the troops to Germany so the virus would not be spread to other people 12-14 Lindsay
  2. Does an epidemic like this or others in history like the Black Plague, need to occur for some reason?  Is there some philosophical answer why nature permits these epidemics to occur?  Is it for population control, human realization of our limited power, understanding of being thankful when times are good?  Is there some underlying reason or purpose to epidemics?  Do they just occur by chance or is there some underlying force deemed against humanity?
  3. How likely is this to happen again in the future, and could we have a vaccine to combat it?32-35 Cheri S.


  1. How can someone's temperature rise so high that they don't die but there hair changes color?
  2. How was the virus able to spread so quickly throughout the body without symptoms being shown until it was too late?15-19, Katie A
  3. Why did the fever from influenza in the film cause people's hair to turn to white?
  4. How does a high fever make one's hair turn white?
  5. When people started getting the influenza virus in the year 1918, they usually died of pneumonia; however today when people get the flu they usually do not die, but just have a temporary fever and tiredness. What can account for the difference in response to the virus between people in 1918 and people in the year 2000?