Booknotes

Ms. GINA KOLATA, AUTHOR, "FLU:" I got in--I never really thought much about the flu. It just seemed like something that came around every year, and people would just get sick and then they'd get better again. And I'd never really been interested in it at all. But then a few years ago--I'm--I'm a reporter for The New York Times, and I wrote an article for The Times about a really miraculous discovery. There is a guy at Walter Reed Army Medical Center and he was reporting in a--in a technical journal called Science magazine that he had somehow managed to get some lung tissue from a soldier who had died in 1918. And in that lung tissue, there was still fragments of the virus that had killed him.

And when I interviewed this man, Dr. Taubenberger, about his work, he told me about the influenza pandemic of 1918 and I was stunned. I just had never seen--I'd never heard of anything like this. It was the worst infectious disease epidemic in recorded history. It killed so many people that if something like that came by today, it would kill more people than the top-10 killers wrapped together--1.5 million Americans or something, if something of that--with that morality rate came by today.

And I just found out by looking at the CDC--some papers by the Centers for Disease Control that 99 percent of the people that died in this epidemic were under age 65, so it was--it was an astonishing, devastating epidemic. And what made it a story for me was this idea that all these years later, almost a century later, molecular biology had advanced to such a state, and there is just incredible serendipity involved, that somebody could actually have some lung tissue that still had those viral genes in there and ask the question: What was this virus? How could an influenza virus become such a killer? And could it happen again? And if so, would you recognize it in time?

Ms. KOLATA: Yes. Historians keep--keep making the--racheting the number upward. People now think that 40 million is an underestimate, which used to be sort of the median estimate. And I heard that most recently, there was a meeting of historians and people who were interested in this flu in South Africa, and they're saying that they think that the true number worldwide was closer to 100 million and that possibly 20 million died on the Indian subcontinent alone.

Ms. KOLATA: It's a simple little virus. It's just got eight genes and it only lives in--in human lungs. And while it's there, its only job is to take a lung cell and make it into a virus factory. So the virus gets in, just like every other virus, it tur--takes a cell's machinery and--and forces it to just make new viruses. And then the cell dies and the viruses escape and they infect a new cell. It's a simple little thing.

Ms. KOLATA: What happens is--there are four hallmarks of influenza, I--I've heard. One of them is that you--you get a fever and you take to your bed and you have muscle aches and pains. Let's see, there's four of them. Muscle aches and pains, fever, you co--you have a cough. You don't always ha—you don't always sneeze, but you have a cough.

Ms. KOLATA: I think I had it once.

Ms. KOLATA: I did. When I had it, I said, `So this is the flu.' It was so bad. It was five days of torture. I still remember those muscle aches. They were the worst--and the high fever.

Ms. KOLATA: That's a really good question. The first time it came into the United States in a big way, it showed up at a place called Camp Devens, which is near Boston. And people thought, at the time, that this might be germ warfare because they couldn't believe it was something like the flu. Many people insisted on putting the word influenza in quotation marks. It was during World War I, and there were these rumors that there had been this greasy cloud floating over Boston Harbor with these germs in it that were killing people, or that maybe the Germans had put something into Bayer Aspirin that would kill people. But when it arrived at Camp Devens, it was the most horrible thing that anybody had ever witnessed. They had--so many young soldiers were dying that they had to have special trains to take away the dead. The bodies were stacked up like cord wood, as people said when they were there.

And it was--it got--it was so shocking that the--that the surgeon general sent a contingent of three of the leading doctors in the United States to go out and say, `What is going on at Camp Devens?' One of them later wrote his memoirs, and he said, `I can't even bear to think about this thing.' This was Camp Devens in the fall of 1918, when the deadly influenza virus demonstrated the inferiority of human inventions in the taking of human life. He said that he--that these are memories burned on his brain that he would like to remove, if he possibly could. And when they described what happened when they—when these doctors wanted to see an autopsy, they said they--that there were so many dead in Camp Devens that they had to step over the bodies just to get into the autopsy room, the bodies of the dead that hadn't been removed yet.

And then when they--when they watched an autopsy take place, the military doctor opened the chest of a young man who had died and there were his lungs, sodden and heavy in his body, filled with fluid, totally useless. The man had essentially died because his lungs had filled with fluid. And a doctor there, who had been pretty much imperturbable, nothing could shake him, turned and said, `This must be something--this must be a plague.' He could not believe it.

Ms. KOLATA: The bottom picture? These are the sam--these are some of the samples of lung tissue from people of 19--nine--1918. You might think, `Well, what was this virus? And how'd we ever know?' And what was really miraculous was there is a military warehouse--people have described it as something like the Library of Congress of the dead--started by Abraham Lincoln. Every time that a military doctor does an autopsy, he's supposed to put the--some of the ti--the tissue and the person's medical records in this big warehouse. There were--were people who died of that flu in 1918, and at the time, doctors took little snippets of the lung tissue, soaked them in formaldehyde, wrapped them in paraffin and sent them to the warehouse. And Dr. Taubenberger—Jeffrey Taubenberger at Walter Reed, finally, at the end of this century, put in a requisition for some people who had died of that flu and asking if he could find some lung tissue that had some viral genes in it. And those pic—that picture you just saw is of the little pieces of paraffin wax with the lung tissue in it. And inside that lung tissue, after all these years, there is still that flu virus from 1918.

Ms. KOLATA: Yes, I have.

Ms. KOLATA: Yeah, there are--they're in boxes and jars and things. And—and they're--it's this big sort of corrugated metal warehouse with--and eve—and with cement floors. I guess it's to protect it from burning down, or maybe because it's more cheap to make that way. And they have these big racks of box after box after box. And there's a man there named Al Riddick, and his job is to--when somebody says, `I think I'd like to get some lung samples from a--well, what was asked for in this case, was people who died of influenza in 1918 and who died very, very quickly because they didn't want the person to have gotten the flu virus and then lingered and, meanwhile, the virus that was left in their lungs had died. And he co--and so there's actually--the records since 1917 have been computerized, so he can get a computer printout of where to look. He goes over with his ladders and his hook and he takes down these boxes and in them are samples. I mean, there's cancer tumors, there's brain tissue, there's all sorts of stuff in that warehouse. And this was lung tissue.

Ms. KOLATA: Right.

Ms. KOLATA: From right after the Civil War, yes. From then on, they've been just steadily accumulating them just sort of like a pack rat's paradise. And it was--it was a brilliant idea because when they started this, who would ever know what you would use it for? And the idea that in 19--in 1918, no one had ever found a human influenza virus, so the idea that somebody some day could come back and make some use of this material was just brilliant.

Ms. KOLATA: OK.

Ms. KOLATA: They know it was a flu virus. They have--there's only eight genes in a flu virus. At this point, they have three lung samples from people who died in 1918 who have those genes in them. Put it--getting them out is pushing the limits of molecular biology and they--takes a long time. They describe it as put--like putting together a mosaic, a very detailed mosaic, piece by piece, to put those genes together. They've gotten three of the eight genes completely put together now. They chose some of the--they're choosing them in the order of their likelihood that they think they're going to get an--an easy answer to what ca--made that virus so deadly.

Unfortunately, the first three genes have told them that it's a flu virus. That it's related to bird viruses and pig viruses, but they have not provided the answer yet to why it was dangerous.

Ms. KOLATA: One person that I saw, but I'm sure there's others.

Ms. KOLATA: No, no. I was the only person there.

Ms. KOLATA: It was--it was pretty big. It was this huge, like, warehouse thing.

Ms. KOLATA: Yeah. Well, right near it.

Ms. KOLATA: A few miles away in Maryland, just over the border.

Ms. KOLATA: Well, by the time I started to write the book, I knew, sort of, that there was a story. And I write books for myself. I li--I read fiction for fun. And I like a--I wouldn't write a book unless I thought there was a story, because if you just have chapter after chapter, like a textbook, for me, it's not something I would pick up and read just because I wanted to read it. So that's what appealed to me, was that there was--there was a--there was a drama there. There was competition. It showed all the--the strengths and weaknesses of the search for scientific data and evidence.

Ms. KOLATA: This is, like, my--well, it depends on whether you count non-commercial or commercial books. I guess commercial, fourth.

Ms. KOLATA: Twelve years.

Ms. KOLATA: Science magazine here in Washington, where Jeffrey Taubenberger published his first paper.

Ms. KOLATA: Oh, you don't even want to know, it's so silly. I was--I wanted to be a writer, I really did, but I was studying science. And at this time, I was just sort of dropping--you know, sort of changing graduate schools. I was in ma--I was studying mathematics, getting a ma--I was going to be a--get a PhD and decided to get a master's instead. So I just applied to every place in the Washington area, because I was married then and I just couldn't move around so easily, and tried to get a writing job.

Science gave me a job that was not as a writer. It was as a--really boring job, selecting reviewers for manuscripts. And I said, `I'll take this job, but you have to understand that I--I'm--I'm doing it to sort of worm my way into the writing department.' So I took the job. And then shortly after I took it, I said, `Now I'd like to write an article for you on my own time, for free. Take it or leave it. Just, you know, do you mind if I do it?' And they said, `OK,' and they published it. And then I did another and another and another, and that's how I did it.

Ms. KOLATA: Originally? Baltimore.

Ms. KOLATA: University of Maryland. and then I spent a year and a half in a graduate program at MIT in molecular biology before I decided that that was not for me, either. So I tried Science.

Ms. KOLATA: It's actually really mostly a subscription magazine and it's scientists and policy-makers who usually read it. But they have a new section that's written for--it's supposed to be written for anybody to read. It's—it can get kind of technical, but the idea is to write something so that a physicist who wants to know what they're doing in molecular biology doesn't have to know any of the stuff that led up to this discovery. It's just like writing a--a normal news story. All they have to do is just read it and they'll understand what's exciting.

Ms. KOLATA: It's owned by the American Association for the Advancement of Science, a non-profit group.

Ms. KOLATA: Nature. It's, like, Science's big competitor. It's a British magazine--very similar, has a news section, written by Science. It has mostly scientific articles.

Ms. KOLATA: There's no comparison. When you think about just the number of dead--now as I--I think I said a little bit earlier, 1.5 million Americans would die if something like this came by? To--in a typical flu season, 20,000 die. And most of them are very old or have some other sort of chronic medical condition that really weakens them. Here 99 percent of them were under age 65. It was a very peculiar death curve. It was shaped like a W. The young—very young died and then people between the ages of 20 and 40 died in huge numbers. That's the middle of the W. And then at the end, some of the old people died.

Ms. KOLATA: Sure.

Ms. KOLATA: Yeah.

Ms. KOLATA: He was writing "Look Homeward, Angel," and I--that's fiction, but I asked a number of people and they said it's a description of his brother's death, was actually his brother's real name and it was a description that was not fictionalized. It was really what happened when his brother died of the flu.

Ms. KOLATA: OK. Should I tell you why first?

Ms. KOLATA: OK. I think that when I talk about the flu, or when people who are--are living today talk about the flu, it's almost impossible for us to ima--imagine what it was like. I tried as much as I could to put the words in of people who had been there, because when you've been there and seen it, it has a sort of a--of a--an emotion that we can't--I can't capture and I don't think anybody else that I've spoken to has been able to capture. So the reason I put the Thomas Wolfe description in was of all the descriptions I had read about people dying of the flu, this one just really touched me. It was--it—it almost brought me to tears. It was the saddest thing. And you can imagine yourself in that room watching somebody die like this. And it was--it was one of those--those moments that, you know--I--I mean, I--I can't forget this passage, and that's why I put it in.

`Wolfe came home to a death watch. His brother was lying in a sick room upstairs while his family waited for what they feared was inevitable. Wolfe went upstairs to the gray-sh--to the gray-shaded light of the room where Ben lay al--where Ben lay'--I'm sorry--`and he saw, in that moment a searing recognition, that his beloved 26-year-old brother was dying.' Now here's the quote of how he died.

"Ben's long, thin body lay three-quarters covered by the bedding. Its gaunt outline was bitterly twisted below the covers in an attitude of struggle and torture. It seemed not to belong to him. It was somehow distorted and detached, as if it belonged to a beheaded criminal, and the sallow yellow of his face had turned gray. Out of this ground a tint of death lit by two red flags of fever. The stiff, black furs of a three-day beard was growing. The beard was somehow horrible. It recalled the corrupt vitality of hair, which can grow from a rotting corpse. And Ben's thin lips were lifted in a constant grimace of torture and strangulation above his white, somehow-dead-looking teeth, and inch by inch he gasped a thread of air into his lungs. And the sound of this gasping--loud, hoarse, rapid, unbelievable, filling the room, and orchestrating every moment in it, gave to the scene its final note of horror. The next day Ben dr--lew--drew--grew delirious.

"By 4:00, it was apparent that death was near Wolfe Road. Ben had brief periods of consciousness, unconsciousness and delirium, though most of the time he was delirious. His breathing was easier. He hummed snatches of popular songs, some old and forgotten, called up now from the lost and secret attics of his childhood. But always he returned, in his quiet humming, to a popular song of wartime, "...(Unintelligible) Sentimental," but now rapidly--but now tragically moving, just a baby's prayer at twilight. And then Ben sank into unconsciousness. His eyes were almost closed, their gray flicker was dulled, coated with a sheen of insensibility and death. He lay quietly upon his back, very straight, without sign of pain, and with a curious upturned thrust of his sharp, thin face. His mouse--mouth was firmly shut.

"Wolfe stayed with Ben that night fervently praying, even though he thought he could not believe in God or prayer. `Whoever you are, be good to Ben tonight. Show him the way. Whoever you are, be good to Ben tonight. Show him the way.'

"He lost count of the minutes, the hours. He heard only the feeble rattle of dying breath in his wild synchronic prayer. Wolfe fell asleep, then woke suddenly, calling his family with a certain knowledge that the end with neigh, then quieted, lay still. The body appeared to grow rigid before them. Then in a last gasp, breath drew--Ben drew upon the air in a long and powerful respiration. His gray eyes opened. Filled with a terrible vision of all life in one--the one moment, he seemed to rise forward bodily from his pillows without support a flame, a light, a glory. `And so,' Wolfe wrote, `Ben passed instantly, scornfully and unafraid, as he had lived, into the shades of death.'"

Ms. KOLATA: I don't know.

Ms. KOLATA: That's right. It's kind of an amazing statistic, because usually only a very small percentage of people actually get the flu. Everybody says they have it. They usually have some other disease. So this was an amazingly infectious flu. It just spread throughout the pop--it spread--it spread so quickly throughout the population that people couldn't even understand how it was moving so fast. And then it was 25 times more deadly than normal flus and seemed to be killing the young people, which is why they had such an amazing death rate from that flu.

Ms. KOLATA: In 1976, scientists were really afraid the 1918 flu was coming back again. They had--they thought that the 1918 flu was related to a flu that also infl--infected pigs at that time, because around the same time as people were dying of the 1918 flu, pigs, in huge numbers, got influenza and started to die. It's not clear if people gave it to pigs or pigs gave it to people, but it—but scientists became convinced that the 1918 flu was related to a swine flu.

In 1976, a young 18-year-old soldier at Ft. Dix went out on a march with his unit. He was feeling sick with the flu, but he really wanted to join them. It was a nighttime five-mile hike. He collapsed and was brought back to the hospital and died. He had a swine flu, they finally discovered. And this was really strange. A young and healthy guy getting flu--a swine flu and dying. It was the very end of the flu season. It takes six months to make enough vaccine to protect the population.

And so President Ford asked the most eminent doctors in the country and flu experts, `What should we do?' Do you say, `Well, let's wait until next season and see if there's a problem?' Or do you say, `This one death is scary enough that we ought to really try to protect everybody and get--make a swine flu vaccine and give it out to the entire nation?' The decision was, I think, understandable. They said, `We can't take a chance, because if we guess wrong and the 1918 flu is back again, people are going to be dying rapidly. We'll have no way of protecting them.'

And so there was a decision to make an--an unprecedented campaign to immunize all Americans against swine flu. It turned out that it was kind of a campaign that didn't work too well. And President Ford, in order to try to encourage people to get the vac--the vaccine, was photographed getting his own flu shot.

Ms. KOLATA: Right.

Ms. KOLATA: It turned out that there was no swine flu epidemic. There—this guy got swine flu. No one knows where he got it from. He didn't have--it was totally unclear how he got it. A few other people seemed to have antibodies to a swine flu, indicating they might have gotten one and recovered, but nobody died, except for him. There were not--nobody was getting sick from this flu and so they had a vaccine against a flu strain that was not causing any sort of problem. And around the same time this--as everybody started getting immunized, people started saying, `The vaccine is actually killing people. It's making them sick.' And so this was--there was a lot of fear of this vaccine. And I think that's haunted people to this day. Because today, you still hear people say, `Oh, flu vaccines, they never get the right flu strain. And the vaccine is worse than the disease. And the vaccine can make you sick.' And I think a lot of that got started after 1976.

Ms. KOLATA: Yeah. Yeah.

Ms. KOLATA: There's a group of experts that are--there's a surveil—an international surveillance that goes on all the time. And what they look at is, they say, `What's the flu strain that's starting to become the predominant one at the end of the--end of the previous year?' And then, `What flu strains are appearing elsewhere in the world?' Because what happens is, the flu—what the flu does is every year it comes through a population and it kind of burns itself out. The 1918 one did that, too. And it infects everybody who could be infected and then it's--or who's--who's been exposed to it, and then it mutates. It just changes itself a little bit and then it comes back again and--and pe--and if it's--if people are vulnerable to it, it will infect them.

Ms. KOLATA: Well, there's some people who say that all--every major epidemic, every pandemic that's swept around the world in this century has--has begun in southern China. And there's a reason why they--they s--they think this is sort of the hot spot for flus. And that is that flu--in order to really, really sweep the world, you have to get a flu that's so different from anything you've seen that virtually everybody in the world is susceptible to it. And one way of doing that is to get a flu that--a flu that its genes have not been--or have not been seen by human beings really before.

And birds gets infected with flu all the time. They don't even get sick. It lives in their intestines. And bird flus are generally really different than ones that infect people. And pigs can be infected with both bird flus and human flus, and they can sort of a mixing bowl and come out with a new flu that has bird characteristics and--and human characteristics and can infect people.

Ms. KOLATA: I don't know. Can't answer that.

Ms. KOLATA: Well, no, it's not only pigs, but pigs are a--are a--are a ver--I--I can't tell you that it's only pigs. I wish I could. I think it's—I don't know.

Ms. KOLATA: Yeah.

Ms. KOLATA: Yeah. Yeah, long gone.

Ms. KOLATA: Yeah, when the pig's dead, the virus is dead.

Ms. KOLATA: Before you cook the pig, it's dead. You don't have to worry. And you have to--you have to get it into your lungs. If you eat the pig, you know, it's not going to get into your lungs. But anyway, it's dead.

So in--in southern China, what they do is they--they have this very clever way of growing rice, an ancient way. They grow the rice and they let loose ducks on their rice paddies. And the ducks only eat the weeds, they don't like the rice. And then when they harvest the rice, they--they put the ducks back in the rest--rest--among the rest of the farm animals, including the pigs. Now the pigs can now get the duck vir--the duck flu viruses. And the people that are very close to the pigs, the people can get the viruses from the pigs, and so you can end up with a new flu starting there that can then spread from there around the world.

And the reason--this is kind of interesting for 1918. It's not clear where the 1918 flu started, but there is at least one researcher, a guy named Kennedy Shortridge in Hong Kong, who is--is pretty--is--has this idea that it's—the 1918 flu actually started earlier in southern China. He says he has historical records to indicate that people in southern China were getting sick with something that looked like this flu and the Chinese laborers were sent to Europe to dig the trenches. So he thinks that southern China started the 1918 flu. Like he says, it started every other major pandemic in this century.

Ms. KOLATA: They did.

Ms. KOLATA: Well, I--I knew about it, but I didn't pay a lot of attention to it because I thought scientists were overreacting. I no longer think that. But at the time, what had happened was there were some--there was a flu in Hong Kong that seemed to be killing young people. They were getting really sick and they were dying.

Ms. KOLATA: Well, first there was one young boy who died. He got sick and he died. And it was very strange, because this doesn't normally happen. And there was a big investigation: What kind of flu did he have? It turned out that he had a bird flu. And that's really weird, because bird flus don't normally infect people. So immediately sort of the alarm bells go off. Is this a bird flu that's going to infect people and start--is this the beginning of a pandemic, because scientists always have 1918 on their mind.

When they--it turned out, though, that nobody else except for this boy seemed to be getting the flu--his family members didn't--didn't seem to be ex—be getting it. Nobody in his school. It was ju--this little kid. And no one knew, actually, where he got it. There was this big investigation and no one knew exactly how he got that bird flu. None of the hospital workers—because he died in the hospital--seemed to have been exposed. So scientists said, `OK, well, this was--we don't know what it was, but luckily it's going nowhere.' Then a few months later, people started showing up in the hospitals of Hong Kong--young people--dying of a flu. And it turned out to be a bird flu. And that was really terrifying, because it looked like something was happening in Hong Kong.

An international team of investigators, along with the very able investigators from Hong Kong, di--did an extensive investigation. And what they discovered was it seemed that there was a flu that was infecting chickens in Hong Kong and it was going from--jumping from chickens to people, which is really unusual, and it was dead--it could be deadly. It didn't seem to be spreading from person to person, but it was a flu that was even killing chickens, and they don't normally die of the flu. And so they--what they--the big fear was—was that if they leave this--if they don't do anything, that this flu would then infect a person and the person would also get a human flu, and in their lungs the two flus would merge and out would come a bird-type flu that could infect people and we'd have 1918 all over again.

In order to protect the world, the Hong Kong government ordered that every chicken in Hong Kong be killed. It was a huge number of chickens, over a million chickens, because in Hong Kong people like to buy their chickens at these markets where they're killed in front of your eyes, so you don't just go to a grocery store and buy a dead chicken. You buy a live chicken and see it killed. So they had these--they're called wet markets where all these chickens are in cages. And they ordered every single chicken killed. I think now that it was--at the time, I thought it was weird. Now I think it was a good idea.

Ms. KOLATA: We get it when somebody around us has it and they cough or sneeze.

Ms. KOLATA: No, they breathe it.

Ms. KOLATA: They usually breathe it in, or they get the virus on their hands and they touch their nose or mouth. It has to get into your lungs and usually you breathe it. And the reason you tend to get it in the winter they think is because, you know, you're inside more, there's more people that are coughing and sneezing, and it also lives longer in the air when the air's dry. So we get it in our winter, and in the Southern Hemisphere, they get it in their winter.

Ms. KOLATA: Well, you could barricade yourself somewhere, but...

Ms. KOLATA: You get it from the air. There's not much you can really do. You can stay away from people, wash your hands a lot. I don't know. Mainly, you need a flu shot.

Ms. KOLATA: I never had one till this year. When I wrote that book, I said, `Why was I so stupid?' And I had one and I made my whole family get them. We've all had them.

Ms. KOLATA: I have two children.

Ms. KOLATA: Eighteen and 21. They're in college. And I said, `I want you to get a flu shot and I want you to call me and tell me you got it.' And they thought that was being totally ridiculous and then they each called, `Mom, we got our c--flu shots tonight.'

Ms. KOLATA: Yep, he got his.

Ms. KOLATA: He's a mathematician and he works for a non-profit society in Philadelphia--non-profit math society.

Ms. KOLATA: No, we live in Princeton, halfway between New York and Philadelphia.

Ms. KOLATA: It was, like, 1998.

Ms. KOLATA: My agent called me. I have one of these really aggressive agents.

Ms. KOLATA: John Brockland.

Ms. KOLATA: He called me and said, `Don't you think there's a book here in this flu stuff?,' which is what he typically does. And I said, `Well, I guess so. I think it might be kind of--it might be really interesting.' I didn't know the full story then, but I--I saw--I'd seen enough pieces of it just from doing reporting for The New York Times, where I--that made me--that made me think that there was actually a real story to tell, a story that would--would have a beginning, a middle and an s--and I was hoping an end, so that you would be able to read it like you were reading, I was hoping, a novel and not just like reading a textbook.

Ms. KOLATA: When I got a contract.

Ms. KOLATA: When Farrar Straus said they were going to publish it.

Ms. KOLATA: Oh. Oh, when Johan Hultin found the--the virus in Alaska, that was when I realized there was truly a story here, because when it happened was...

Ms. KOLATA: That was in 1950, I believe, or 1951, when he first went to Alaska.

Ms. KOLATA: OK, there's one--there's--there's two pictures of him.

Ms. KOLATA: That's the same year. That's the same...

Ms. KOLATA: That's in Alaska. It's in--it's in the Alaskan tundra. And below that, he's in his laboratory.

Ms. KOLATA: A mass grave, where almost every Eskimo adult in a--in a tiny village, in a little remote Lutheran mission, had died of the flu and they'd been buried all in one grave. And...

Ms. KOLATA: I think about 80.

Ms. KOLATA: Ninety percent of the adults. They had--all the kids were left orphaned.

Ms. KOLATA: 1918, that's right.

Ms. KOLATA: He's the pathologist. He was--he was a Swedish--he came to this country as a medical student, and he just was going to study for one year in Iowa, at the University of Iowa. And he came here and he--wh--he was a real adventurer, so he decided that what he would do, he and his wife, before he started school, he would travel to every state, every--all 50 states. So they got a--got a car and they started driving around and they ended up in Alaska. And while he was in Alaska, he met a paleontologist and he and his wife spent the summer with this paleontologist, sort of going around with him on his travels.

The next year in medical school, visiting virologists said, `There was this terrible tragedy in 1918, and the only way we're ever going to know what happened is if somebody could just find somebody that was buried in the permafrost where the ground never thaws and their lungs are still frozen and then maybe we could get the virus out and find out what it was.' So Johan Hultin said, `Oh, well, I know how to do this. I know this paleontologist. I can find out where the Eskimo villages were. I can get a map of the permafrost. I can find out where were their graves, where people might be in the permafrost. And I could go up there and actually find a flu victim.'

So he--he did do this. It was sort of an amazing adventure. He was still a so--young--this young student. He went to Alaska. He had three possible villages where he thought maybe he could find some bodies from the 1918 flu. It was like the three bears: the first one wasn't right, and then the next one wasn't right; the third village, the mass grave was exactly right, this little village called Brevig. He said to the Eskimos, `There was a terrible tragedy in 1918 and I'd like to--I'd like your permission to dig in this grave and to try to find some flu victims so that I can get that virus. We could make a vaccine and you will never have to suffer like this again.' They told him it was--that it was OK to do it. The story of how he did it is an adventure in itself, but he--he did manage to--to get some--some lung tissue still frozen from flu victims from 1918 and bring it back with him to Iowa where he tried to grow it, and that's what that second picture of him in a lab was.

Today, it's sort of horrifying to think that someone was trying to grow the 1918 virus, but he hadn't really thought about--very carefully about the consequences. He was growing it in chicken eggs, which is to this day how they grow flu viruses. And he kept injecting chicken eggs with the lung tissue hoping to grow that virus. But nothing happened, so he concluded it was dead, but he never forgot that grave and the 1918 flu. And he always swore that one day, he would go back there, when science advanced enough, so he could do something with that tissue and he would try again to find--solve the mystery of the 1918 flu.

Ms. KOLATA: Right.

Ms. KOLATA: Right. Right.

Ms. KOLATA: He's a pathologist in the San Francisco area doing lots of other things--climbing all sorts of mountains around the world, still being an adventurer, but always thinking about this flu and always reading everything he could about influenza and molecular biology and wondering when would the time be right for him to go back again to Alaska and try to do something to find out about this virus?

Ms. KOLATA: Right, yeah.

Ms. KOLATA: Right.

Ms. KOLATA: Institute--Armed Forces Institute of Pathology.

Ms. KOLATA: No, he's not.

Ms. KOLATA: He's a civilian.

Ms. KOLATA: Yeah, he is. He got a MD, PhD degree, so he's both a medical doctor and also was trained as a PhD scientist. He--he had just--he just sort of stumbled into this kind of a career. He's a--he's a brilliant man who always asks the right questions, but he's an outsider to the flu field. And he got interested in influenza because he and--his lab had been asked--one of the things they do in the pathology lab there is they're--they're sort of con--they--they answer questions for other people in the military. And one of the questions he'd been asked was why were dolphins dying? So one of the military veterinarians said he thought that dolphins around the world were dying because they were infected with a measles-like virus. And he said to Taubenberger, `If--can you--if we give you decayed dolphin tissue and--can you pull out a measles' virus, if it's there?'

So Taubenberger's labs got so good at doing this, they actually did pull out a measles-like virus. And he said, `I wonder what else we could do with our--with our expertise?' And that's what led him to start looking for the 1918 flu virus in the lung tissues.

Ms. KOLATA: That's right.

Ms. KOLATA: But he hadn't gone there before for anything.

Ms. KOLATA: He never had gone there for things. That's right. He said...

Ms. KOLATA: Right.

Ms. KOLATA: Right. That's right. And then Johan Hultin saw Jeffrey Taubenberger's article in Science magazine, where Taubenberger says, `I have got this--this sample from the warehouse. I can start to pull out these genes.' And Hultin wrote him a letter and said, `If I--I think I could get you another sample. Would you be interested?' And he sort of carefully tried to explain who he was so Taubenberger wouldn't think he was crazy. And Taubenberger wrote back and said, `Well, yeah, of course, I'm really interested.' And Hultin said, `OK. Well, I can't do it this week, but I can probably go out there next week.' And the reason--he didn't want to say it at the time--the reason he didn't want to go out that week was he'd been working for 25 years building a replica of a 14th century Norwegian cabin in some mountain property he had and he was just about finished it, and he wanted to finish it up before he went to Alaska.

Ms. KOLATA: Now--he's in his 70s now. He was 71, I believe, when he went up there.

Ms. KOLATA: I think about half his age, when this story...

Ms. KOLATA: Oh, right.

Ms. KOLATA: You want to know the truth?

Ms. KOLATA: OK. I had wanted to put a picture of Kirsty Duncan in and the problem was that she kept writing these letters that indicated that in order to use the picture, she wanted to have some sort of control over what was said. And...

Ms. KOLATA: I mean, I can understand if she was worried about--you know, she's worried about would everything be right? Would it be the version she would want to be in there? But as a journalist, you can't let somebody control what's said in a book. I mean, I want to be absolutely accurate. I will check facts forever. I will check anything, but I can't tell you that you can write it for me.

Ms. KOLATA: Oh, she's got waist-long hair. She's very tiny.

Ms. KOLATA: She's about 5 feet tall, so she's really little. She's...

Ms. KOLATA: She's--I think now she's about 30 or so. She's very young. She's geographer.

Ms. KOLATA: She's lives in Windsor, Ontario. I think she recently got married. She used--she was living with her parents. She was mar--I think she recently got married for the second time. She's sort of in--intense looking, very intense--very, very intense-looking person.

Ms. KOLATA: Yes, and she's very--very passionate, extremely passionate.

Ms. KOLATA: She had the same idea as Johan Hultin. She wanted to find bodies in the permafrost.

Ms. KOLATA: She read a book called "America's Forgotten Pandemic" about the 1918 flu by a historian and she was just truly moved to tears, she says, by this story. And she said, `I'--she was a--she's a geographer.

Ms. KOLATA: She was living in Canada.

Ms. KOLATA: Yes, she is.

Ms. KOLATA: I don't know.

Ms. KOLATA: That's where she was working as a geographer.

Ms. KOLATA: And so she said, `I--I think I can find some bodies in the permafrost and get this virus and my primary concern is safety,' unlike Hultin, who was just going to go up there by himself and not tell anybody. If he found nothing, he was never going to tell a soul, because he didn't want the Eskimos to become sort of--part of a media circus. She decided that she wanted to make this an--something that everybody knew about, that they would all understand the urgency for doing this, and so that she could do this in the--in the safest manner possible, because she didn't want to unleash an e--an epidemic on the world.

Ms. KOLATA: You know, I've--I--you'd think I'd remember all these years, wouldn't you? She started it in the 1990s as well, but I can't remember the exact year that she started to search.

Ms. KOLATA: It wa--I think it was '97.

Ms. KOLATA: She knew that they--she--well, she didn't know about Johan Hultin. She knew that Jeffrey Taubenberger was onto something, while she was doing her story.

Ms. KOLATA: That's right, because she was trying to get money from the National Institutes of Health. And there was a big meeting and they were saying, `OK, so should we give'--she had found what she thought were the bodies of seven miners on a tiny remote island near the Arctic Circle off of Norway. And they...

Ms. KOLATA: Well, she had gone--she would--she'd been--with ha--it was sort of a coincidence. She had--she'd learned that that was a--an area of permafrost and then she started investigating to see if there might be any bodies there. And she found about these seven miners that had journeyed off from Norway to work in the winter in the mines on this little island, and they had gotten sick with the flu on this--on the boat on the way over and died practically as soon as they arrived. She learned that they were buried in marked graves and she learned that--and then she got permission to dig--from the Norwegian government to dig into those graves and try to get the--the miners' bodies, so she had to raise money. And she was raising money any--from the government, private industry.

Ms. KOLATA: Because she put together an international team and she was looking for money. And--and one of her team members was an American and s--he was an American virologist. So he was sort of, like, the lead person trying to ask for money from the National Institutes of Health.

Ms. KOLATA: I don't know. She got millions of--several million dollars. I think she got like a--she didn't get a lot from the ni--the n--NIH, something like a quarter million, but she got money from Merck, she got mo--money from the British. She got a bunch of money.

Ms. KOLATA: Well, but it wouldn't hurt to have some more samples. I mean, it's not like it's--it's--there's anything wrong with getting some more--but—but she didn't know about Johan Hultin when she was doing it, and Taubenberger tried to tell her, he said, that they had three samples. And she--at first, she said, `Well, his samples from the warehouse didn't count, because they were--they were soaked in formaldehyde and maybe something happened to the virus. What you need are some frozen samples,' so he tried to say that they had a frozen sample. And she doesn't think that she quite understood what he was trying to tell her, but she wanted to go ahead anyway. And she did go ahead.

Ms. KOLATA: To--he went back to Alaska--I'm sorry--and he did--he did dig into that grave again, he did get a sample, he sent--he divided it into four pieces that he--he didn't want it--he put it in a preservative, sent it to Jeffrey Taubenberger. He sent it--being Johan Hultin, everything is sort of done on a low-tech scale. So he decided this was a really precious sample of l--of lung tissue and he didn't want to just trust the mail, so he sent...

Ms. KOLATA: That's right.

Ms. KOLATA: Right. And...

Ms. KOLATA: ...back in the--in the grave site again getting another lung sample. He sent back it to Hultin, he s--and to Taubenberger. He divided it into four pieces. One was sent UPS, one Federal Express and I think the other one express mail. He actually used the mail, so he used--he sent it in four different ways. They all got to Taubenberger. Taubenberger found the—the viral genes in there and started working on them. Meanwhile, Kirsty Duncan, with her multimillion-dollar, huge expedition, went off to this island off the coast of Norway with the media in tow and film crews and...

Ms. KOLATA: I think there was like 10 camera crews. There were all sorts of documentaries being made. And she--it was--it was a--it was a very--it was a big media extravaganza.

Ms. KOLATA: Well...

Ms. KOLATA: ...there was a lot of controversy all along. People were—people were susp--people--scientists do get suspicious when there's a lot of media involvement. I mean, I'm part of the media, so it's--I hate to say this, but they do get suspicious when something seems to be sort of blown up like that. And all the talk about safety, safety, safety started to seem like almost hype to a lot of people.

And so what happened was there was a lot of animosity, and there were a lot of people that were angry with her. And Kirsty Duncan was--wa--is a very passionate, very emotional person. She dresses in a way that doesn't look like a scientist, wearing high heels and spandex and stuff, which I think also—I hate to say it, but I think that also sort of made people think she wasn't a serious person. I think, to her, this was--she was serious about trying to find this virus. I think she was genuinely moved by the stories, and I think she really hoped that she would be able to find a virus in these Norwegian miners.

Ms. KOLATA: He was.

Ms. KOLATA: Right.

Ms. KOLATA: And he already had that sample when he was on the committee with her, but he--the problem was that Hultin had told--and so he was hinting ar—he was saying, `We have another sample. We have another sample.' But he—Hultin had told the Eskimos that they were going to be the ones who determined when he made the announcement. He said he wasn't going to sort of spring the media and all the world on them; that they could decide how the--how to release this information. And so he was waiting for them to give him the go-ahead to say he went up there, he'd gotten the samples. There was this mass grave 'cause see he never announced it.

Ms. KOLATA: Yeah, he did. It cost him about $2,000.

Ms. KOLATA: That's right.

Ms. KOLATA: No, it took him--he just went up there immediately. The next week, he was up there with his pickax, sleeping on the floor of the one-room schoolhouse in a sl--on a--on an air mattress ready to dig in those graves. He got the permission of the Eskimos. And in 1951, he did it all by himself. This time they gave him a couple teen-agers to help him dig, which--which helped him a lot.

Ms. KOLATA: Right. They had--they had everything.

Ms. KOLATA: I didn't. I actually was on vacation when that happened. We did, but it was...

Ms. KOLATA: I think it was--was it '98? One of my colleagues was there, John Noble Wilford of The New York Times.

Ms. KOLATA: Yeah. Everybody went. I mean, everybody went there.

Ms. KOLATA: Well, they couldn't get near the grave...

Ms. KOLATA: ...because they said, `What if there's a virus?'

Ms. KOLATA: They were all sort of herded off in the distance. And they started to dig into this grave site, and she--every day, she would issue a press release. And what happened was it turned out the ground wasn't frozen. They had done elaborate radar work ahead of time, and they said, `The ground is frozen. It's permafrost. And we see the--we see the bodies, and it's going to be fine.' And when they started to dig, they found out that the miners were buried above the permafrost in ground that was not frozen.

So she said--she issued a press release that said, `We have succeeded. We've gotten soft tissue.' And people who were there told me that, actually, what she basically had was skeletons and that there was--that they took bone tissue, and they also took some tissue from brain, but there was bas--there was no lung there. And she--she now...

Ms. KOLATA: Well, that's where the virus grows. And it's unheard of for the virus to grow in the brain. However, there's one--there's one strange thing about this virus. There are some people who thought at--who thought that maybe the 1918 flu virus had sparked an epidemic of Parkinson's disease. That's a degenerative brain disease where brain cells die. And so what--and then you might say, `Well, why would--how would you even know?' Well, there was a Parkinson's disease epidemic after 1918. In fact, when Oliver Sacks wrote his book "Awakenings" about people with Parkinson's disease, they were the—the people who supposedly got it after 1918.

And so--but still, if everybody's getting the flu and then everybody gets Parkinson's disease, so what? Why is there a cause and effect? There is one piece of information that was kind of interesting. In Samoa, there's one group of islands where they said, `We don't want this flu. No ships are going to dock here.' And they escaped the flu. And another group of islands where ships docked and they got the flu, the people who didn't get the flu didn't get Parkinson's disease. The islands where they did get this flu, they did have the epidemic. But nobody's ever heard of a flu virus getting into the brain. Flu viruses need an enzyme to clip one of their proteins, which is not found in the brain.

So as far as anybody has ever known or ever been able to show, a flu virus does not live outside the lungs. So if she did not get lung tissue, she should not be able to get a flu virus, period.

Ms. KOLATA: There were documentaries made, yeah.

Ms. KOLATA: No, no, no.

Ms. KOLATA: They showed the whole--in fact, "Nova" did a huge deal on this thing, but it didn't--it--it turned out to be--because it didn't work so well, it turned out to also include a lot of the Taubenberger stuff, too. In fact, they then...

Ms. KOLATA: ...they then--they then made it into a documentary. They were there from the very beginning with Kirsty Duncan. From the very beginning, when she started pulling her team together and saying, `Let's discuss this possibility, going to Norway,' she had the cameras rolling. But when it didn't work so well, they--the documentary became a documentary about the race with Taubenberger and his group with--and Hultin vs. Kirsty Duncan with an international team of experts and millions of dollars and the whole world was watching. And...

Ms. KOLATA: Well, it was very interesting to me that the most exciting work on the flu was being done by the outsiders, Hultin and Taubenberger, who were doing it in a very quiet, low-key way. And it was really interesting to me that you didn't need these elab--this elaborate and expensive apparatus to go dig into a grave site and ask whether you could get some frozen tissue.

Ms. KOLATA: John Oxford is a--he's a--a British virologist, and he was a member of Kirsty Duncan's team. And he began to exchange a lot of faxes with Kirsty Duncan that ha--was sort of disturbing his daughter because they sounded--her--her faxes to him and her phone calls to him sounded--they were so personal and so emotional. And--and, also, according to his--John Oxford's adult daughter, Esther Oxford, John Oxford's wife was also getting a little bit concerned. When Kirsty Duncan's marriage broke up, the first person she called was John Oxford.

John Oxford, by that time, had gotten her grants from the--from the British for her and--and paved the way for a lot of her work. He had a falling out with her, and he--I think he's still a member of the te--he is still a member of the team, but he no longer is--I--I--whatever their relationship is, and as far as I know--I have no reason to believe it's anything other than just letters, faxes, telephone calls. I--I don't believe it's anything else, but it's not what it used to be. There is sort of a chill in th--in their relationship.

Ms. KOLATA: Yes, I think so. I--every time I speak to--to scientists about the 1918 flu, I say, `Are we going to see another flu like this?' And they say, `Yes.' They say, `We just don't know when,' because there's no way of predicting what's going to happen when and how the flu virus is going to mutate. I think it's definitely important to try to understand how a flu virus can turn into such a killer, and if they--if they can't find out by looking at all eight genes of this virus, at the very least, they'll--they'll be able to do experiments that can say, `Maybe it'll take 100 changes to turn a flu virus into something, but what is it that it acts'--like, maybe there's no one change. Maybe there's hundreds of them. But they can say, `What does it do? What can you do to protect yourself? How do you stop this virus?'

Ms. KOLATA: Oh. OK, there's two big differences. One is vaccine. In 1918, there were no vaccines. Now the big fear that everybody has is if they see a virus like this coming, and they have the six-month notice, which they are expecting to have to make a vaccine, that people will think that scientists are just crying wolf and will not ha--be vaccinated, and then...

Ms. KOLATA: Well, they're hoping to have--they're hoping--well, no, they may not.

Ms. KOLATA: Yeah, it has to start somewhere. Not everybody's going to get it. But--but if they have--if they can get vaccine going as fast as they can, that they--you could protect most of the world from the virus and sort of stop the pandemic from starting, if people believe the scientists this was--they had to have a vaccine.

The second big difference is antibiotics. A lot of people who died in 1918 died not--many of them died because of the flu itself, but then others got very ill from the flu, and while they were sick, bacteria came into their lungs and they died of bacterial infection. And people still do die of bacterial infections today when they get the flu, but we have antibiotics now, and we didn't have them then. And they'll make a huge difference in the death toll.

Ms. KOLATA: She's the--she heads the virology research at the Centers for Disease Control in Atlanta.

Ms. KOLATA: That's the nation--this is the--the national center where they look at thing--they're like the--the disease detectives.

Ms. KOLATA: It's like a--it's like the National Institutes of Health here. It's a campuslike thing, with--with these--with lots of big buildings.

Ms. KOLATA: The Na--the federal government.

Ms. KOLATA: Don't know, but I don't think it's enough.

Ms. KOLATA: I think it should be more, yeah.

Ms. KOLATA: That's right.

Ms. KOLATA: Well, she started to panic as soon as she heard that there was a bird flu killing kids. I mean, she was really scared. She got a call when she was on her vacation in Wyoming, and she was--and she was tossing and turning. She was really worried.

Ms. KOLATA: That's right, she was. But...

Ms. KOLATA: They worry that--that--you have to--you have to get at this thing fast, and you have to find out: What is it? How is it spreading? How easily is it spreading? Where is this virus? Is it only in Hong Kong? Is it elsewhere? How--should--what should you do? Should you--should you ask for vaccines to be made? Should you ask for another 1976-type thing to happen?

Ms. KOLATA: It is.

Ms. KOLATA: They are. They're the ones who look at AIDS, Ebola, everything you worry about.

Ms. KOLATA: Well, people would very quickly, almost overnight, die because their lungs would fill with fluid. You would have a young person who would start to feel sick and, within hours or a day or so, they would be gasping for breath. Their skin would be turning dark because they--their blood wasn't getting enough oxygen. One person said--described it as mahogany spots on the cheekbones, and then the color's--the dark color's starting to spread. We don't see that today. Today what you see is you feel very ill, and some people are dying, but nobody's getting sort of instant death as they were getting then.

Ms. KOLATA: Yeah. Yeah. That was what a--part of the--part of the reason I—I really enjoyed working on this book. Because the more I worked on it, it was like the story just kept getting better and better and growing and growing. Scientists and--and--and historians were extraordinarily generous with me, too. I mean, people were amazing. Ed Kilbourne, who's one of the people that I reference in this book a lot--he was a flu expert. He was there in 1976. I was calling him and e-mailing him constantly trying to get records from 1976. He was taking them down from his attic, and finally he sent me an e-mail saying, `I'm just going to keep all my files in my living room until you finish your book, Gina.'

But he was--people were willing to go through their old records, go through their old files, give me documents, try to reconstruct what had happened, how they had felt, what they said, why. They were so generous that I was just stunned. Johan Hultin was amazing, looking for old newspaper articles, old photographs, old documents. He would try to do anything he could to sort of help me reconstruct his story and go beyond just his memory of what had happened.

Ms. KOLATA: Thank you. Great.