Science Vs - Hunting an Invisible Killer

Episode Date: October 2, 2020

An adventuring Swedish doctor takes on a decades-long medical mystery: What exactly was the 1918 flu? We talk to Dr. Johan Hultin, Eileen Hultin, Dr. Jeffery Taubenberger, Ann Reid, Rita Olanna and Annie Conger.  Here’s a link to our transcript: https://bit.ly/30mnvt6 Check out Radiolab’s episode on the 1918 flu here: https://bit.ly/3n9cxkm And the book Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused it by Gina Kolata: https://bit.ly/3ipCeJU This episode was produced by Rose Rimler with help from Wendy Zukerman, along with Michelle Dang, Hannah Harris Green and Nicholas DelRose. We’re edited by Blythe Terrell. Fact checking by Eva Dasher. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Bobby Lord, Emma Munger, and Marcus Thorne Bagala. Special thanks to: Abbie Ruzicka, Abigail Collins, Davis Hovey, John White, Robyn Russell, Rachel Cohen, Warren Kakoona, Brian Crockett, Trefon Angasan, Brad Angasan, Matt Ganley, Dr. Adam Lauring, Dr. Matt Memoli, Prof. Susan Jones, and everyone else we spoke to for this episode. Plus a big thanks to Brendan Klinkenberg, Walter Rimler, the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. Today on the show, the hunt for one of the biggest killers of the 20th century. It's almost inconceivable how bad it was. There are reports of people turning blue and getting this sort of like weird death looking face because they weren't getting enough oxygen. That's producer Rose Rimler. And we're talking about the 1918 flu. It's estimated that it killed as many as 100 million people worldwide. And while a lot of us have heard quite a lot about this flu, as Rose started researching it, one thing that really surprised her was how little science knew about what was killing people at the time.

They knew about flus. They had the word influenza. But they didn't know exactly what a virus was because they didn't have microscopes that could see anything that small. I just think about how much comfort I get from the fact that we know certain things about the coronavirus. Like, we know how it enters the body, how it can attack the lungs. We know it's a coronavirus. I don't know, I get comfort from that. And so this idea that back then there was this invisible thing just sweeping through cities and killing all these people, I feel like is terrifying to think about. I agree. That would make the pandemic even scarier. It would take it from like global public health emergency, you know, scary to like Stephen King novel level of scary. This like invisible supernatural beast haunting us. That's what I imagine it must have felt like in 1918.

And this weird invisible beast, it would stay invisible to science for decades. Because even after we learned what a virus was, it was too late. Yeah, because the way that you can start to study a virus is you take it from someone who's infected with it. And by the time we knew what viruses were, there was no one around who was infected with this flu anymore. They'd either recovered or they died. Oh. So there was really no way for science to know what had killed all these people?

No, not really. And for a long time, scientists just sort of resigned themselves to the flu itself is lost to history. And that was the prevailing thought for decades. And so without knowing what actually killed these people, science couldn't answer really basic questions about this pandemic. Like, why was it so deadly? Could this virus come back and kill us all again? And solving this scientific riddle, it would take almost 100 years, an unlikely hero, and an adventure to the edge of the world and back again. It was so ghoulish. It was such a weird fixation that he had.

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Download Bumble and try it for yourself. Welcome back. Today, we're on the hunt for one of the worst diseases in modern history, the 1918 flu. If you heard Radiolab a few months ago, they had a great episode on this flu and told a Cliff Notes version of this story. But today, our producer Rose Rimler is taking us on the whole wild ride. And it starts in the most unlikely place. Basically, next door to Rose. Yeah, so the scrappy hero of our story is Johan Holten.

And I found out he's actually my neighbor. He lives just a few miles down the road from where I'm staying here with my dad in California. Amazing. So it's an amazing coincidence. I looked him up in the phone book. I called his house. His wife answered. She said, come on over.

You can interview him. Mask on. Yeah. Masked up. Six feet apart. Sunny on the hands. Yep. Yeah. Masked up. Six feet apart. Sunny on the hands. Yep, yep. Okay, Johan, your visitor is here.

So, Rose, this is Johan. It's so nice to meet you. Yeah, he is. Nice meeting you. Do you mind if I call you Johan? I'm delighted. So what does he look like? He has white hair.

Of course, he's retired. He's 95. He used to be an athlete. And apparently he was still hiking around the hills here up until he was 93. Life goals. He's Swedish and still has a little bit of an accent. Don't get old. I shall tell you that.

So in about 1950, when Johan's in his mid-20s, he decided to leave Sweden for the U.S. I came over from Sweden as a graduate student. He went to the University of Iowa. And one day, he and his buddies in Iowa are gathered around, and they're talking about how it's still kind of nuts that science doesn't know what exactly the 1918 flu was. And some people are saying, it's a shame.

There's no way we can find it. But in this conversation, there just happens to be a visiting professor who says, you know, it's possible that there is a live sample of this virus still left somewhere on Earth. So he said someone actually should go up to Alaska, the frozen north, to find frozen bodies who died in 1918 and they were buried in the permafrost. They may still be frozen. The idea here is that in the permafrost, people don't decompose.

Their lungs would still be intact. And if they had died from the flu, then the virus might still be alive inside their lungs, kind of like in a suspended animation. Oh, so if we can find people who died from the flu but haven't completely rotted, like still have preserved lungs, then we might be able to find the virus still in their lungs and science could take it and study it. Yeah, exactly.

That is wild. But this visiting professor, he just throws out this idea into the wind. He doesn't think anyone's actually going to do it, right? That's what it sounds like. He didn't really say like, this must happen. He was just like, you know, what might work. But little did he know who was listening. Johan was kind of the perfect person to overhear that comment because Johan loves a good adventure. And in fact, he had just come back from a trip to Alaska, where he had explored and made a lot of connections. It was a tremendous adventure.

And so this day in Iowa, he's like, oh, I could actually do that. I could go back to Alaska and I could find this virus there. And I could help science understand what it was and why it was so deadly. Okay, so he gets it in his head that he's going to go on this wild goose chase, effectively. What does he do next? So he flies up to Alaska and he gets on progressively smaller and smaller airplanes to go to really small towns that aren't near major cities, mostly. And he scouts around to see if people buried there would be buried in land that was still frozen. And eventually he ends up in a place called Breving Mission,

which is a really small town right on the edge of the Bering Sea. And that's what I grew up in, with the ocean in front of me right there, and listening to the waves during the summer and fall, up until it freezes. This is Annie Conger. She's a retired school teacher and a member of the native village of Brevig Mission. It's a place that can get so cold that icicles form on your eyelashes. And the land there is mostly tundra, so like low grasses and shrubs. And you can see around for miles. There's so much to see. It's a beautiful country. So back in 1918, the flu made it up to Alaska.

And when it did, it really devastated a lot of the small towns there. And Breivik Mission was one of them. We lost our great-grandparents. Annie grew up hearing stories about what happened there from people who survived it. One thing that would happen was people would get these really high fevers. And the fever was unbearable. They would run out of their houses

and roll around in the snow to cool off. And they died really quickly. Once it hit, it hit, and they were gone the next day. People who survived it did not want to talk about it. It was just something horrible. But you could see in their eyes how much it affected them, because it was just horrendous to see, you know, your family, your community dying one after the other during that time. When Johan was in Breivik, he also spoke to one woman who had survived it. She'd been there. She saw it.

90% of the villagers died. I mean, she was, her family died. She was telling the story, but she was a little kid then. It's a terrible calamity. Almost all the adults died, and some children. And it happened so fast that all these people were buried together, about 72 in total. No coffins, they're just placed in a mass grave in the frozen ground. And this grave is still there.

It's basically a pit in the grassy tundra right along the water. It's marked with a big cross. And that mass grave was actually why Johan was in Breivik in 1951. He thought the bodies buried there might be his best shot at finding flu victims, victims that still had the virus in their lungs. One of the first things he does is he goes to the community elders and he asks, is this okay if I dig up this mass grave for science? And what he says is that he's ultimately hoping to find a vaccine or some way to stop the virus from ever coming back.

And so the community says, OK, you can dig up the grave. So here it is. Yes, yes, yes, please. And I started out. So what did he do? He just starts digging? Pretty much. He had some tools with him, but nothing fancy. A spade and a pickaxe. Yeah, this is it. And this was really hard to work with

because the ground was frozen. So he had to make campfires out of driftwood to melt the earth bit by bit. So I just started out digging in the grave and a couple of, about two feet down, there was a little girl.

A little girl? A little girl. 12 years old or something. There, in the permafrost, he found the body of a girl. And she was pretty much perfectly preserved. Looking in

good shape. Just like she had died yesterday. Oh, my God. She had actually died 30 years prior. But she still had her hair and braids. The ribbons were still there. Her dress was still intact. Oh, my God.

I mean, look at this. And that was really amazing. I remember it never forgets. Why wasn't he horrified? Well, I think he was. I think there were two things going on. One is just how incredibly sad it was. And I do think Johan felt that,

and he still feels it today when he looks back on it. But on the other side, he realizes that this whole grave is full of people who are well-preserved, and that means that they may still have the virus in them, sort of in a suspended animation, which is what he was hoping to find. Oh, right. Because if the bodies hadn't have been well-preserved, and there had been signs that they were rotting,

or that this wasn't in a perm frost, this all would have been for-preserved and there had been signs that they were rotting or that this wasn't in a perm frost. This all would have been for nothing. Exactly. I was just astonished at finding this and realizing what it meant, that here I have a goldmine of information about the disease. Fantastic. I remember it so clearly. So we call some colleagues who are waiting in Fairbanks and they come out to help him.

And all together they dig a little bit more. And so they end up uncovering a few more bodies. And then they open up these bodies' chests and they take some pieces from their lungs. So they crack open these corpses and then scoop up a sample of their lungs. Yeah. And then they cover everyone back up. They go and say thanks to the community and they're ready to go back to Iowa. But there's a problem. They have to keep these samples really cold, of course.

That was like the whole point, that the lungs were cold for many years and never decomposed. But it's going to take a little while to get back to Iowa, so they have to keep them cold. And they had thought of this ahead of time. They brought thermoses and they brought dry ice, but they didn't bring enough dry ice. And by the time they needed it, it was all gone. My God, here's the end of our experiment. So what do they do? So Johan thought, it's over. And then he has an idea, which is that maybe the answer lies in fire extinguishers.

What? So fire extinguishers, at least certain types, when you squeeze the lever, it makes a big cold cloud. That's what puts out the fire. And Johan's like, wait, that could be the answer. So I could put a nozzle from the fire extinguisher right in and blast it. So when they get to Anchorage... We went from hardware store to hardware store to hardware store to fire departments

that rounded up all the carbon dioxide fire extinguishers that existed in that place. You bought all of Anchorage's? All of them, yes. Oh my gosh. Basically, every time they get off the plane, because they have to get off frequently to refuel or to change planes, Johan takes the fire extinguisher, takes the thermos where he's got these samples in and... Squeeze the handle and a big poof comes up.

Big noise and everybody's there by wondering what it was. Oh my gosh, does this work? Well, so they get back to Iowa. He gets back to campus. And this is where the story goes from like this adventuring in the field to kind of adventuring in the lab. So now he's got sort of classic grad student drudgery work, which is he has to grow the virus out. So what he was hoping was that the virus was alive, but sort of in a suspended state and he could kind of wake it up. So one way he does that is taking the human tissue that he's

collected, he grinds it up, and then he injects it into animals to see if they get sick. Injected it into live animals and guinea pigs and rabbits every day, day after day, week after week. Johan tried over and over again, and he ended up using all the human tissue that he had brought back. But the lab animals never got sick, which meant... The virus that I was looking for was dead. And it was all for nothing. If the virus had been alive,

would that have been dangerous? Yeah, that is the flip side of this coin. I think it was a risk. I mean, if the virus was alive, maybe Johan or one of his buddies could have gotten infected. And then, you know, and spread it to other people.

And then, whoopsie and spread it to other people. And then whoopsie-daisy, the flu was back. Oh my gosh. But it was dead, so none of that happened. Yeah. They did take some precautions. Johan says his professors weren't that worried, so he wasn't that worried. But, you know, when I look back, it feels a little bit like a sign of the times.

It was the 50s. People were looser with biohazard standards. These days, you just can't release any viruses anymore, can you? They really frown on it. So, you know, the fact that the virus

ended up being dead, maybe that was for the best. Well, bad for me because there was my PhD thesis. Okay, okay. So what happens next?

So Johan never finished his thesis, and he moves on with his life. He becomes a doctor. But he never stops thinking about Brevig Mission and the grave. His wife Eileen says he even brought it up on one of their first dates. And I kept hearing about this grave with 72 bodies in it and how Johan had gone and dug. And he kept telling me this.

And I almost wondered whether I should see this man again because it was so ghoulish. It was such a weird, a weird fixation that he had. After the break, we crack the case of the missing 1918 flu virus wide open. Welcome back. So we just heard that Johan's trip to Alaska, where he dug up the bodies, was a bust.

And Rose Rimla is here. Hey, Wendy. To tell us what happens next. So his project didn't work because the virus was already dead. But he kept thinking, as the years passed, what if there was a way to use the dead virus to be able to understand this killer? Johan's hope was that science would find a way. And eventually, he was right. But it took until the 90s.

That's when science had come up with a way to get information out of a dead virus. Oh, so now we have the technology. Now we have the technology and Johan's about to make history. On this one day, he was so excited he'd been reading the science magazine. I remember where it was. May I interrupt, sir? Absolutely. We were in Costa Rica. Johan is retired at this point and he's on vacation.

In Costa Rica, I happen to have the latest issue of that. He's sitting under a tropical fruit tree reading Science Magazine and he comes across a paper on the genetics of the 1918 flu. Just by chance and there was a story about a fellow named Taubenberger, Jeffrey Taubenberger. Hello, I'm Jeffrey Taubenberger. Sounds like you got Jeffrey Taubenberger. That's Jeffrey Taubenberger. Any questions? Yes.

Who is this guy? Today, he works at the National Institute of Allergy and Infectious Diseases, which is where Anthony Fauci works. But back in 1997, he was at the Armed Forces Institute of Pathology. It's a huge concrete bunker with no windows. It's just a huge cement, steel-reinforced block. So it's a horrible environment to work in. Jeff and his colleague, Ann Reed, were toiling away in this bunker.

Here's Ann. We both went to work really early. We would both get to work about six in the morning. And we would, you know, make a pot of coffee and sit down and talk in the morning about what we were going to do. And here's what they were doing. The team was trying to piece together the genetic code of the 1918 virus. And they were using slices of lung tissue that had come from soldiers who died of the flu back in World War I. I used to call Jeff Eeyore because he was always a glass half empty kind of guy. Jeff was worried that this wouldn't work because the samples they had, which were stuck in paraffin wax, they were teeny tiny.

About the size of a fingernail. That's it. And maybe a quarter of an inch thick. That's it. I think most people at the Institute thought it was kind of a crazy idea. We didn't think it would work. The virus was completely degraded. And so you could only detect little pieces of it at a time. And my boss at the time actually suggested that maybe we stop working on it after about six months with no success, saying that, you see, this isn't going to work, and you're kind of wasting resources, so maybe you shouldn't do that. Well, that's very discouraging.

But luckily, I didn't listen. So in that science paper, Jeff and Anne explained that they were having a little bit of luck finding the virus's genetic code in these samples. And Anne, who's basically the tigger of this partnership, was really excited about it. Every time I got another 80 bases of that virus, I was the first person who'd ever seen it. And we were the first people to maybe have the answer to where this virus came from and why it was so lethal. But before they could answer those questions, they needed more bits of virus, which meant they needed more samples. And when Johan reads this paper written by Jeff and his team under that fruit tree in Costa Rica, he's like... My God, maybe he would be interested in the specimen from Alaska. He's looking in paraffin blocks,

and I have a source of frozen bodies in Alaska. I can go back there. This is like the Mighty Ducks when they're coming back. You need to see some newer movies. So Johan wrote a letter explaining who he was and saying he would be happy to go back to Alaska and bring specimens back for Jeff. And Jeff came into my office with it. I remember it being like three or

four pages and with this sort of amazing story of his efforts in the 50s and how he had not succeeded. So he never got his PhD and went to medical school instead. Sort of incredible. And I think we both looked at each other and thought, this can't be real. This has got to be like a joke or a prank or something. It just sounded too crazy to be real. But Jeff called him and it was totally legit. And he was completely willing to fly back up there and do this project again. And so I was immediately thinking in the lines of a kind of a typical scientific thing. OK, if we're going to go to Alaska and do this, we'd have to write grants. We'd have to think, you know, that maybe we could do this in two years. And on a phone call where I described

that, he said, next week, I can go next week. Johan was like, there's no need for grants or anything like that. I'm just going to fly up there with my own money. I'll just get it rolling. Eileen was less excited. I was horrified. Why? He was 73 or 74 by this time.

And I know he's kind of crazy. I know that there is an element of Johan which is, you know, I can do this, which is not always totally realistic. And I did not think it was realistic. Her biggest doubt was she didn't think that the village would allow him to dig in the grave this time. I said, they will not let you. They may have let you open that grave in 1951.

I said, the world is very different now. They will not let you. And he said, well, I'm going to try. He spends a couple days getting ready. Scurried around like an eager beaver to put a duffel bag together. And flies back, does the multiple flights to get back to Breivik Mission. And funnily enough, there is someone there who remembers him. And she says to Johan,

I remember my grandma talking about this young guy who came up there and wanted to dig in a cemetery. He spoke to Rita Olana, and she is the granddaughter of the woman who Johan talked to the first time around when he was a young man. Oh, my gosh. And so I called Rita. I talked to her a little bit about it. And she said she was on board pretty much right away because she believed in the mission. If they found something to fight the next pandemic,

I know that would really help. It would benefit the whole world. In the end, they decided to give him permission to dig again. This time, more of the bodies have decomposed. He doesn't have as good of luck. But he eventually does find one body, which still has tissue preserved. And importantly, her lungs are still there and they're still in pretty good shape. So when Johan sees this body, he gives the person a nickname.

Lucy, that comes from Latin, light, shedding light on. Johan had a sense the instant he saw Lucy. That was a dramatic moment for him. So he takes samples from Lucy's lungs. And, you know, this is the 90s, so the technology has advanced. He doesn't have to deal with the weird fire extinguisher thing this time. He puts the samples in chemicals to preserve them. And then he carefully mails them to Jeff.

He does this in different packages because he's a little bit anxious at the idea that they could get lost in transit. That would be it. There's no more in the world. That is it. It was that precious. All the packages all arrived safely in our lab. None of it was lost in the mail. So Jeff and his team get to work.

The first step was to see if little pieces of the virus were there at all. And about a week later, he called the Holtons. The phone rang. I picked it up, and it was Jeffrey. And he said, is Johan there? And I said, yes. And I handed the phone over to Johan. And his face absolutely lighted up

and they chatted and I realized it was very good news. He said we have it Johan we have it. Knowing the history of the disease this is big stuff. And how did it feel for you personally to have accomplished that goal? It felt very good. He's Swedish. You don't answer questions like that. You're very modest. It's a question of modesty and it's a question of feelings and you don't get into feelings if you're Swedish, do you dear? No. Really, I need a bourbon or something. I'll fix you a bourbon. So Johan's work was over. And now it's up to Jeff and Anne.

They have to take these samples and eke out the rest of the genetic code of the virus. And they hope that once they have that, they can figure out why it was so deadly. Here's Anne. It took us seven years to sequence the whole virus. And they hope that once they have that, they can figure out why it was so deadly. Here's Anne. It took us seven years to sequence the whole virus. Seven years. Yeah. You can do it on your coffee break now. Yeah. I mean, when the coronavirus was sequenced in a week, I'm like, oh my gosh. If only. So it was a slog, but by 2005, they had the whole sequence at hand. And that meant that they had the identity of one of the worst killers in world history. Which made big news. The genome of the Spanish influenza virus has finally been completely sequenced.

The 1918 flu virus that killed tens of millions of people around the world is back. For now, researchers are hoping that it may help develop vaccines to protect against any future global flu pandemic. You know, it was a huge medical mystery, probably considered one of the biggest medical mysteries of all time, that you have the worst infectious disease outbreak since going back to the Black Death that we knew nothing about. And other scientists felt the same way. One scientist said, and I quote, this is huge, huge, huge. So what did they work out? Why so huge? Three huges, yeah. Once they had this genome, pretty much right away they could work out two things. One, they figured out where it came from, and they also figured out where it went.

So they learned that it came originally from birds, wild birds. And then as far as where it went, even though it seems like the flu just sort of mysteriously disappeared, it actually didn't go anywhere. It stuck around and mutated. From a genetic standpoint and from the standpoint of the virus, the 1918 flu never went away fully. We can tell from the sequence that it kind of turned into seasonal flus that still go around today. That's amazing. And to this day, scientists are still pouring over this flu, trying to learn more about it and figure out what makes it tick.

They want to learn why exactly it was so deadly, how it can be used to make a vaccine in the future. It's all really like exciting, burgeoning research. And it's pretty wild to think that this whole branch of study is possible in large part because of Johan. You know, my friendly neighbor from Sweden. I have an expression that everything doesn't go wrong all the time. Now and then, things do not go wrong. That's Science Versus. If you want to hear more about stories from the 1918 flu, you should check out that Radiolab episode. It's called Dispatches from 1918. And there's a great book written about this whole

adventure by Gina Collada called Flu. This episode was produced by Rose Rimler with help from me, Wendy Zuckerman, along with Michelle Dang, Hannah Harris-Green, and Nicholas Delrose. We're edited by Blythe Terrell. Fact-checking by Eva Dasher. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Bobby Lord, Emma Munger and Marcus Thorne-Bagala. Special thanks to Abby Ruzicka, Abigail Collins, Davis Hovey,

John White, Robin Russell, Rachel Cohen, Warren Kakuna, Brian Crockett, Trifawn Angerson, Brad Angerson, Matt Ganley, Dr. Adam Laring, Dr. Matt Memoli, Professor Susan Jones, and everyone else we spoke to for this episode. Plus, a big thanks to Brendan Klinkenberg, Walter Rimler, the Zuckerman family, and Joseph LaBelle Wilson.

I'm Wendy Zuckerman. I'll fact you next time. What would you say you're most proud of? Finding a limb. Isn't that cute? Yeah, that was a nice answer. You get lots of brownie points for that.