8/11/2014

Why was 1918 flu pandemic so deadly? Research offers new clue - Medical News Today

Why was 1918 flu pandemic so deadly? Research offers new clue
Tuesday 29 April 2014 - 3am PST
Flu / Cold / SARS
Infectious Diseases / Bacteria / Viruses

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Academic Journal

Public Health

In 1918, as one global devastation in the shape of

World War I came to an end, people around the
world found themselves facing another deadly
enemy, pandemic flu. The virus killed more than
50 million people, three times the number that fell
in the Great War, and did this so much faster than
any other illness in recorded history.
But why was that particular pandemic so deadly?
Where did the virus come from and why was it so
severe? These questions have dogged scientists
ever since. Now, a new study led by the University of
Arizona (UA) may have solved the mystery.
Michael Worobey, a professor in UA College of
Science's Department of Ecology and Evolutionary Biology, and colleagues describe their findings in
the Proceedings of the National Academy of Sciences.
They hope the study not only offers some new clues about the deadliness of the 1918 pandemic,
but will also help improve strategies for vaccination and pandemic prevention, as Prof. Worobey
explains:
"If our model is correct, then current medical interventions, especially antibiotics and vaccines,
against several pneumonia-causing bacteria, could be expected to dramatically reduce mortality, if
we were faced today with a similar set of pandemic ingredients."

The 1918 pandemic killed predominantly young adults

One of the questions that has been particularly vexing is why the 1918 pandemic human influenza
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Why was 1918 flu pandemic so deadly? Research offers new clue - Medical News Today

A virus killed so many young adults in the prime of life, he says, adding: "It has been a huge
question whether there was something special about that situation, and whether we should expect
the same thing to happen tomorrow."
Usually, the human influenza A virus is
deadlier to infants and the elderly. But
the 1918 strain killed many people in
their 20s and 30s, who mainly died from
secondary bacterial infections, especially
pneumonia.
For their investigation, the researchers
developed an unprecedentedly accurate
"molecular clock," a technique that looks
at the rate at which mutations build up in
given stretches of DNA over time.
Evolutionary biologists use molecular
clocks to reconstruct family trees, follow
lineage splitting and find common
ancestors of different strains of viruses
and other organisms.

Researchers reconstructed the origins of the 1918 pandemic

virus, the classic swine flu and the postpandemic seasonal
H1N1 flu virus lineage that circulated between 1918 and 1957,
to find out why the 1918 pandemic was so deadly.

Prof. Worobey and his team used their

molecular clock to reconstruct the origins of the 1918 pandemic virus, the classic swine flu and the
postpandemic seasonal H1N1 flu virus lineage that circulated between 1918 and 1957.

Genetic material from bird flu virus picked up just before 1918
They found that a human H1 virus that had been circulating among humans since around 1900
picked up genetic material from a bird flu virus just before 1918 and this became the deadly
pandemic strain.
Exposure to previous strains of flu virus does offer some protection to new strains. This is because
the immune system reacts to proteins on the surface of the virus and makes antibodies that are
summoned the next time a similar virus tries to infect the body.
But the further away the new strain is genetically from the ones the body has previously been
exposed to, the more different the surface proteins, the less effective the antibodies and the more
likely that infection will take hold.
This is what the authors suggest happened to the young adults in the 1918 pandemic. In their
childhood around 1880 to 1900, they were exposed to a supposed H3N8 virus that was
circulating in the population. This virus had surface proteins that were very different from those
of the H1N1 pandemic strain. Their immune system would have made antibodies, but they
would have been ineffective against the H1N1 virus.
But people born either before or after those decades would have been exposed to a virus much
more like the 1918 one and their immune systems were thus better equipped to fight it.
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Why was 1918 flu pandemic so deadly? Research offers new clue - Medical News Today

Prof. Worobey notes:

"We believe that the mismatch between antibodies trained to H3 virus protein and the H1
protein of the 1918 virus may have resulted in the heightened mortality in the age group
that happened to be in their late 20s during the pandemic."

He says their finding may also help explain differences in patterns of mortality between seasonal
flu and the deadly H5N1 and H7N9 bird flu viruses.
The authors suggest perhaps immunization strategies that mimic the often impressive
protection that early childhood exposure provides could dramatically reduce deaths from
seasonal and new flu strains.
In February 2014, Prof. Worobey and colleagues began challenging conventional wisdom about flu
outbreaks, when in the journal Nature, they reported the most comprehensive analysis to date of
the evolutionary relationships of flu virus across different host species over time.
Among other things, they challenged the view that wild birds are the major reservoir for the bird flu
virus. Instead of spilling over from wild birds to domestic birds, they say the more likely scenario is
the other way around - that new strains jump from domestic to wild birds.
Written by Catharine Paddock PhD
View all articles written by Catharine, or follow her on:

Copyright: Medical News Today

Not to be reproduced without the permission of Medical News Today.

References
Genesis and pathogenesis of the 1918 pandemic H1N1 influenza A virus; Michael Worobey, Guan-Zhu Han, and
Andrew Rambaut; PNAS online 28 April 2004; DOI:10.1073/pnas.1324197111; Abstract
University of Arizona news release 28 April 2014.

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