Could SARS and the 1918 Influenza Pandemic be caused by the Same Virus?
James A. Marusek
11 May 2003
The quick answer to this question is they are not the same. The 1918 Influenza virus is an orthomyxovirus and SARS is a coronavirus. The gene sequencing of the 1918 Influenza virus is provided in http://www.pnas.org/cgi/content/full/97/12/6785. The gene sequencing of SARS is provided in http://www.rense.com/general37/knjown.htm. But there are three points to consider:
Those infected in the 1918 Influenza Pandemic shared similar symptoms with those infected today with SARS. As a result it may be fruitful to study the 1918 Pandemic in greater detail.
The 1918 Influenza Pandemic
The virus that caused the 1918 Influenza Pandemic infected between 20 to 40 percent of the world’s population and killed 20 million people in just four months. It has been called the most devastating epidemic in recorded world history. The virus that caused this pandemic was first nailed down in the year 2000. Even today it remains clouded in mystery, and is greatly feared.
One day in the spring of 1918, soldiers at Fort Riley, Kansas, burned tons of horse manure. A choking dust storm kicked up and swept over the prairie. The sky went black and all the soldiers at Fort Riley ran for cover. The storm raged for hours, then suddenly it stopped. Fort Riley was covered with a dense shroud of dirt and ash. The soldiers were ordered to clean up the mess. They worked long past midnight, sweeping, raking, shoveling, and coughing.
On Monday March 11, 1918 - two days after the dust storm - Private Albert Gitchell, a cook, reported to the camp hospital before breakfast. He had a fever, sore throat, and headache. The symptoms indicated just a normal flu, however by noon that same day the hospital had 107 cases reported. Within the next month, the hospital saw well over a thousand.
Many soldiers perished from influenza that spring. The cause of death was recorded as pneumonia in every case. The symptoms were highly unusual, including labored breathing, violent coughs, and projectile nosebleeds. Faces would turn an ashen blue. They often had high fevers, and their bodily functions were depressed. Autopsies revealed widespread bloody hemorrhage and swelling of the lungs. Patients literally suffocated from their bloody, fluid-filled lungs. Young, healthy men became sick and died within a matter of days, sometimes only hours.
Colonel Schreiner found evidence of Haemophilus influenzae, Pfeiffer's bacillus, in cultures taken from his patients. Pfeiffer's bacillus is the hemophilic bacterium widely believed to be the cause of influenza. Cultures also revealed a multitude of other bacteria. He could not figure out whether Pfeiffer's bacillus caused the deadly flu, or whether it was a mere incidental discovery.
Viruses are known to infect animals, birds and humans. The virus that infects horses is called the equine virus. In animals, scientists have seen a virus switch from being a diarrheal disease to a respiratory disease as the virus becomes lodged in different tissues and genetically evolves. Viruses also have the ability to cross over from animals to humans. Some animals can carry a virus but exhibit no symptoms, except that they are carriers. Animals (and humans) can develop immunity or partial immunity to viruses.
The following theory might explain how the initial 1918 infection occurred? Some of the horses in Kansas had become infected with an orthomyxovirus. Many of the soldiers came from cities where they did not have exposure to sick horses or other farm animals; therefore many did not have any built-in natural immunities to defend against this type of virus. The manure from the infected animals contained the orthomyxovirus. The storm blew the virus infected manure dust into the air. Over 100 soldiers were infected by breathing in this airborne dust into their lungs. Two days later after the incubation period expired, these soldiers began reporting to the medical hospital for treatment and the pandemic began to take root.
It is of interest to note that the published paper "Characterization of the 1918 "Spanish" influenza virus neuraminidase gene", uncovered a potential link back to horses. The amino acid residue 354 in the NA protein was coded "Asp". This position is normally occupied by "Gly". Three exceptions were found: A/Equine/Prague/1/56 (H7N7), A/Equine/Cornell/16/74 (H7N7), and A/Swine/England/191973/92 (H1N7). Two of these exceptions were from horses. The amino acid residue 354 was thought to possibly affect the virulence of the virus.
The mortality rate for the 1918 Influenza varied significantly by locality. This rate varied by the natural immunity or resistance within the population, by how effectively controls were put in place to contain the spread, and by path of exposure.
In the Alaskan settlement of Brevig Mission, 80% of the adult population perished. I suspect the Eskimos from that village had little natural immunity due to minimal contact with horses.
India suffered greatly the effects of the "Spanish Flu". Some estimate as many as 20 million individuals in India alone died during this pandemic, but their numbers were not counted. So why was it hit so hard? Perhaps it was the method they used in cooking. Back in the early 1900’s as well as today, millions of Indian housewives cook with dried cow dung because it is a plentiful cheap fuel. If the cattle became infected with the influenza from drinking contaminated water, it might provide another pathway for the influenza to spread.
In 1918, Dr. Joseph Goldberger successfully implemented and tested an immunization program for this deadly influenza. But he never connected the dots.
In 1918, most scientists believed that they knew the cause of influenza. They believed that the culprit was Pfeiffer’s bacillus, a rod-shaped bacterium. However, they still didn’t know as to why their vaccines were failing to stop it. In laboratories all over the world, medical researchers were making vaccines, which contained many bacterial agents including staphylococcus, streptococcus, pneumococcus, and many others. All the vaccines featured Pfeiffer’s bacillus. However, all the vaccines were proven useless.
In October, Dr. Joseph Goldberger, a U.S. Public Health Service researcher, decided to start a special program. He asked for volunteers from convicts at a naval prison in Massachusetts. If the prisoners completed the program, they would be pardoned of their crimes. Volunteers surprisingly came forward. They were about to be injected with Spanish influenza.
Goldberger’s goal was to prove that Pfeiffer’s bacillus caused Spanish influenza. The convicts were quarantines on Gallups Island in Boston Harbor. Each man inhaled a pure culture of Pfeiffer’s bacillus. Each was then inoculated with blood from flu patients. Nothing happened. No volunteer got sick. Goldberger then sprayed the convicts’ nostrils and eyes and swabbed their throats with broths of pure Pfeiffer’s bacillus. Again there was no result. Goldberger was baffled. He sent the volunteers to the influenza wards of Chelsea Naval Hospital. Each convict shook hands, talked with, and sat beside flu victims. They even leaned up close and let dying patients cough in their faces. Still, no volunteers got sick. None of Goldberger’s volunteers got sick. However, one of Goldberger colleagues, the doctor who ran the quarantine station, caught influenza and died.
The volunteers were immune to the Influenza virus before they paid a visit to the influenza wards of Chelsea Naval Hospital. The Pfeiffer’s bacillus was not the cause of the Spanish influenza. It was a secondary byproduct of the influenza. I believe the volunteers were immunized when they were injected with the blood from influenza patients. The blood contained live virus that was injected in the bloodstream of the volunteers. This virus produced antibodies in the blood that were able to effectively fight off the influenza when the volunteers were place in direct and immediate contact with individuals dying from the "Spanish Flu".
The SARS Pandemic
The first case of Severe Acute Respiratory Syndrome (SARS) was reported in Foshan City, China on November 16, 2002. Since that time, it has infected several thousand people and killed several hundred. The lethality rate of this virus is high, currently estimated at 15%. The infection usually begins with a fever greater than 100.4o F and body aches. Some people experience mild respiratory symptoms from the onset. After 2 to 7 days, patients can develop a dry, nonproductive cough, pneumonia, breathing difficulties and shortness of breath.
One of the biggest outbreaks of the SARS virus in Hong Kong was at the Amoy Gardens apartment complex. Several hundred people were infected at this location. The normal mode of transmission of this virus, droplets through sneezing and coughing, did not seem to apply in this case because; the individuals who lived in this complex did not have close personal contact with each other. But this particular apartment complex was known to have leaking sewer pipes and it was theorized the influenza could have been spread in this way. More recently doctors in Hong Kong have found active virus in the stool and urine of patients who were infected and later were thought to have recovered from SARS.
Why is the SARS virus so deadly? Generally pandemics begin when a virus is passed from animal/birds to humans. The mortality rate for those contracting the 1918 Influenza was 2.5%. The mortality rate for SARS is approximately 15%. In 1918, most individuals throughout the world lived in rural communities. Many had come in contact with infected farm animals and had developed built-in natural immunities or had these immunities passed down from their parents. This is not the case today where most individuals live in sterile city environments.
The spread of the virus is a function of how well the transmittal pathways are recognized and controlled and how well infected individuals are identified and isolated. With the SARS virus today, infected individuals are isolated quickly and individuals that came in contact with these infected individuals are identified and also placed into isolation. This has dramatically reduced the rapid spread of the influenza and in some cases produced total containment. In 1918, there was minimal control of infected individuals. World War I produced mass migration of soldiers that further fueled the spread of the Pandemic. Super-spreaders could contaminate whole communities. I also suspect the main transmittal mode of the virus in 1918 was water borne. Sanitation has improved significantly in the last century. Today, wastewater is treated prior to being discharge into lakes and rivers and this water is treated again before it is uptaked into city drinking water. In 1918, raw sewerage was dumped into rivers and lake. Generally drinking water was not treated and could contained small amounts of raw sewerage contaminated with a virus. Coronavirus is present in stool and urine of infected SARS patients long after they show full signs of recovery. Contaminated drinking water could quickly infect whole cities.