The War on Mutant A

If Florence was in the grip of an epidemic of colds, coughs and fevers, astrologers . . . declared that it was caused by the influence of an unusual conjunction of planets. This sickness . . . came gradually to be known as "influenza." --Chronicles of a Florentine Family 1200-1470.

To combat new ravages by "the influence," a worldwide war is being waged this week in response to a call to arms from the Far East. Supreme headquarters is the World Health Organization in Geneva, which collects intelligence gleanings from around the globe, sends out captured specimens of the enemy virus to 46 nations. In more than a dozen laboratories-- including those of the U.S. Public Health Service and major American drug firms--virologists are at work, with techniques as fine and occult as those of cryptographers. Their purpose: to establish the virus' precise identity, pinpoint its strengths and weaknesses, prepare a defensive vaccine.

Such a determined counterattack against an influenza epidemic has only lately become possible--or been considered worthwhile. For centuries, while far deadlier pestilences were commonplace, the influence seemed unimportant, usually killed only the aged and already infirm (it was jocularly dubbed the "new acquaintance," "gentle correction" or even "jolly rant"). But as the ancient scourges were being brought under control, influenza occasionally became more lethal. Finally, in 1918-19, it erupted in a global pandemic, one of the worst disease disasters in history, which claimed at least 15 million dead--many of them, unaccountably, young adults in their prime. Still the cause of influenza was unknown.

ABC, but Not Simple. The first breakthrough came in 1933. when a virus, soon dubbed influenza type A, was convicted as the cause of one epidemic. It became clear that type A was likely to take the warpath every two years or so, with severe epidemics at four-to seven-year intervals. A vaccine could be prepared to give immunity lasting up to two years. In 1940 came the discovery of type B virus, and the realization that it belonged to a different immunologic family--vaccination against type A gave no immunity against B. and vice versa. Later came recognition of type C and a distant cousin, A-prime. A polyvalent vaccine gave limited protection against these. But there was another trouble: type A proved to be especially capable of mutation--changing its biological nature. Result: a vaccine effective against it in 1950 may be of no use against the 1957 crop.

The current outbreak apparently started in northern China in January; in February it swept through Shanghai; by March it was in Canton. Early in April, influenza jumped to Hong Kong, almost certainly carried by refugees from Red China. The disease was marked by three or four days of severe headache, fever (up to 104DEG), aching muscles, general malaise. Against complications--bronchitis, pneumonia, etc. --sulfas and antibiotics worked well. (Hong Kong's unemployed made a good thing of standing in the clinic lines for drugs, then when they neared the head of the line selling their places to the severely ill for $1.) In a month. Hong Kong had an estimated 500,000 cases, recorded 44 deaths. Meanwhile, by sea and air, carried in travelers' throats, the disease spread. Some of its steps:

P: Formosa: an estimated 2,000,000 cases since late April (victims included Foreign Minister George Yeh and Economics Minister Kiang Piao), 66 deaths.

P:Philippine Republic: about 1,600,000 cases since early May (victims included President Carlos Garcia); more than 1,200 deaths laid to flu and complications. U.S. military personnel had relatively few cases, no deaths.

P: Singapore and Malaya: 500,000 cases, ten deaths.

P: Indonesia: an estimated 10% to 20% of population affected; 43 known deaths.

P: Japan: an estimated 1,500,000 cases, five deaths. Introduction of the disease was officially blamed on U.S. Navymen, who supposedly spread it through hostesses in bars and nightclubs. With 155,000 children absent, 295 schools shut down tight; youngsters were encouraged to gargle with salt or even green tea.

P: India: 128,000 cases. 108 deaths, according to obviously low official figures. Authorities suspect that the disease arrived by S.S. Rajula at Madras on May 16, spread despite elaborate five-day quarantine. The Indian government, its office staffs depleted by 30%, closed swimming pools, all 25 cinemas in Delhi, and overcrowded eating houses. Even sadhu (holy men), believed to be in full control of body and soul, were seized with flu while conducting yagna (prayers chanted before a sacred fire).

P: Pakistan: also hit. though less severely than India; the flu is apparently spreading westward toward the Middle East.

New Vaccine. Early in the Hong Kong epidemic it was apparent that prior vaccination conferred no immunity against this flu. The virus must have undergone mutation. Throat washings were taken from victims in Hong Kong, Singapore and Japan, flown to W.H.O. in Geneva and to virus research laboratories in Australia, Britain, the U.S. There the material was injected into one of the fluid cavities in half-incubated hens' eggs. Within two days, the virus multiplied a millionfold. Withdrawn by needle, some was injected into other eggs to keep the production line going, some was subjected to delicate tests with human and animal blood to determine its type. The unanimous conclusion: it was type A, but of a new mutant strain that could be neutralized only by antibodies different from any produced in response to any previously known strain. So a new vaccine would have to be made.

U.S. Army virologists sent out virus samples to the six U.S. manufacturers already making polyvalent vaccine, within a few days got back a sample of specimen vaccine. Whether this one would meet U.S. standards was not yet certain, but manufacturers were confident that if they concentrated on a single-purpose vaccine against the new type A, and dropped their present polyvalent production, they could make 4,000,000 doses by August. This would be enough for all members of the U.S. armed forces and dependents overseas. Later, if necessary, they could add it to the polyvalent vaccine for civilians.

Will there be such a need? Nobody can yet be sure, but there is a better than even chance that the mutant type A virus will still be around in the fall (when the U.S. flu season usually starts) and that civilians should be vaccinated against it. In fact, mutant A is already lapping at the West Coast's shores.

Two by Sea. Fortnight ago, the U.S. military transport General Daniel I. Sultan docked at Fort Mason, Calif., out of Manila with ten cases of flu aboard. They were allowed to go home, after due warnings and notification to their local health departments. Last week the liner President Cleveland reached San Francisco with three cases still active out of 96 that had developed on board during a 20-day voyage from Manila by way of Hong Kong, Yokohama and Honolulu (the only fatality was a woman previously ailing).

In Europe, the first case was reported in Rotterdam. In Milan, the city's whole soccer team came down with the disease. In Rome, there was only one case, but the city's 1,800,000 were showing signs of panic. Many noble Romans refused to go outdoors. One man who had good reason to be careful was the Pope. He stepped up the alcohol swabs for his right hand, kissed more often than any other in the world, to four or five a day, lest some pilgrim infect him with Asian flu.

Short of inoculation with the new vaccine still in process of development, there is no preventive against Asian flu, no cure. The standard treatment is aspirin with codeine to ease the discomfort, alcohol rubs and ice bags to lower the temperature. Antibiotics and other modern miracle drugs are useless against influenza itself (as against all other true virus diseases), but of great value when bacterial invaders follow up the viral shock troops and cause complications in the lungs. Said Surgeon General Leroy Burney of the U.S. Public Health Service about the antibiotics: "You save them until you need them."

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