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Montage of images and link description. 	Influenza 1918
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*Latest Findings*

*February 1998*
The Molecular Pathology Division of the Armed Forces Institute of
Pathology (AFIP) identified material of the 1918 influenza from the
frozen remains of a Native Alaskan woman buried for nearly eighty years
in Brevig Mission, Alaska. This finding came from a group of samples
contributed to the AFIP by Johan V. Hultin, MD, a pathologist who
obtained permission to perform biopsies from the City Council of Brevig
Mission (formerly Teller Mission), Alaska. Brevig Mission lost
approximately eighty-five percent of its population to the flu during
one week in November 1918.

Doctor Hultin sent samples from four Breving Mission victims to the AFIP
in guanidinium thiocyanate, a solution that preserves genetic material
while inactivating any live organisms. One of the four victims' samples
yielded genetic material of the 1918 virus. The AFIP archives were the
source of the first case to provide a direct look at the virus, as
reported in the journal /Science/ in March 1997. Recently, another
positive case has been identified by screening formalin-fixed,
paraffin-embedded tissue samples from the AFIP archives. Both archival
cases were autopsies of US servicemen who died during the pandemic--the
first in Fort Jackson, SC, the second in Camp Upton, NY.

"We have now identified three cases: the Brevig Mission case and two
archival cases that represent the only known sources of genetic material
of the 1918 influenza virus," said Jeffery K.Taubenberger, MD, PhD,
chief of the institute's molecular pathology division and principal
investigator on the project.While the RNA, the genetic material of the
virus, is fragmented into tiny pieces in all three cases, molecular
techniques can be used to identify complete gene structures. All three
cases are from victims of the lethal fall wave of the pandemic.
Available records indicate that all three victims died within a week of
infection. "Analyses of three cases from geographically separated areas
will allow us to evaluate the genetic variability to the pandemic virus
strain," said Ann Reid, a molecular biologist at the institute.
Determining the genetic structure of the virus may shed light on the
exceptional lethality of the flu, and contribute to the understanding of
newly emerging influenza virus strains.

*February 1999*
A report released on February 15 by the Armed Forces Institute of
Pathology and published in the Proceedings of the National Academy of
Sciences, indicated that researchers have completely analyzed a critical
gene from the 1919 influenza virus and have determined that the virus
may have percolated for several years within humans, and perhaps pigs,
until it grew strong enough to become the world's worst influenza pandemic.

Ann Reid, a molecular biologist with the AFIP and the main author of the
study was quoted by the Associated Press as saying the gene probably
"was adapting in humans or in swine for maybe several years before it
broke out as a pandemic virus." Reid added, "We can't tell whether it
went from pigs into humans or from humans into pigs." Reid and her team
were studying lung tissue preserved from the autopsies of two soldiers
and an Alaskan woman who died from influenza. One of the soldiers had
been stationed at Fort Jackson, South Carolina and the other at Camp
Upton, New York. Through this investigation, Reid was able to map a gene
called the hemagglutinin, which is key to allowing the influenza virus
to take hold. Reid reported that the hemagglutinin closely resembles
mammal genes.

Reid's report indicates that the 1918 virus apparently evolved in
mammals, either humans or pigs, over a period of years before it matured
into a virus strong enough to kill millions. The study speculates that
the virus may have percolated in humans from as early as 1900. One
question left unanswered by the study is whether humans passed the virus
to pigs, or vice-versa. Despite that lingering mystery, Reid concluded
that the virus's long incubation period has implications for predicting
future outbreaks of influenza. Speaking to the Associated Press, Reid
said, "We may have to expand our concept of where pandemics come from."

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