Viral diseases are frequently the topic of apocalyptic movies. One of the most famous movies might be "Outbreak" with Dustin Hoffmann in the lead role. More recently however the BBC aired "Survivors" where an outbreak of a previously unknown strain of Influenza (designated as the "European Flu") depopulates not only the UK but -as we are told- the whole world almost overnight, leaving small pockets of people who are immune and and try to survive in a world without modern technology. As we follow the main characters we learn that the virus in question was genetically engineered by a pharmaceutical company and escaped the laboratory, probably with the knowledge of the government or at least part of the government. So, is the scenario accurate? We know from history that in 1918/1919 -just as the Great War ended- a worldwide Influenza pandemic caused more deaths than both World Wars combined. Native and isolated populations in Alaska were virtually wiped out within a short period of time, churches and other public places closed. The causative agent was isolated in 1997 by Jeffrey Taubenberger from bodies buried in the permafrost of Alaska and from archived specimens housed within the Armed Forces Institute for Pathology Institute. Research done on recombinant viruses derived from the genetic material isolated revealed potential mechanisms explaining the high mortality of patients infected with the virus (subsequently termed H1N1 A/South Carolina/1/18; A/New York/1/18 and A/Brevig Mission/1/18). Reports at the time described the features of the disease quite well. Patients who presented themselves with relativ mild symptoms would deteriorate within hours, with developing a fever and
cyanosis. Post-mortem analysis at the time revealed that the infection caused
severe damage to the lungs of the patient. Was the virus by itself the culprit?
There is evidence that the patients died from a secondary infection with
bacteria and indeed it is those infections, that make Influenza so dangerous
even today. How accurate is the TV series then? Unfortunately, the series
does imply that it is the virus which kills infected patients and subsequent
bacterial infections. On the other hand, the fictional virus does induce a
"Cytokine superstorm" akin to the virus isolated from victims, which
died in 1918.
Which leads me to the second example, a movie called
"Contagion" starring Kate Winslet, Matt Damon and Jude Law
(among others) from 2011. Here an unknown virus is causing an epidemic, which
leads to a breakdown of life as we know it. In contrast to the aforementioned
examples however this movie is quite accurate. It depicts the basic steps
necessary in the isolation of an unknown virus, including setbacks during
the isolation of a virus, basic epidemiology and moral dilemmas arising
when making vaccines available.
I enjoyed both the TV series and the movie. Both have their
merits. But from a scientific perspective I prefer "Contagion" since
it describes what science is about: trials, errors and the importance of basic
field work in tracing the origins of an unknown virus. My favourite scene
is therefore when of one the protagonist explains the Reed number.
Interestingly the infectious disease doctor didn't know what this number
means.
Further reading:
Watanabe T. and Kawaoka Y. (2011)
Pathogenesis of the 1918 Influenza Virus
PLOS Pathogen 7:e1001218
Reid et al. (1999)
Origins and evolution of the 1918 “Spanish” influenza virus hemagglutinin gene
PNAS 96:1651-1656
Taubenberger et al. (1997)
Initial genetic characterization of the 1918 “Spanish” Influenza virus
Science 275:1793-1796
Taubenberger et al. (2012)
Reconstruction of the 1918 influenza virus: unexpected rewards from the past
MBio 3:e002101-00212
Alfred W. Crosby
America’s forgotten pandemic
Cambridge University Press
