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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

100 Years After the Great Pandemic

By Gary Evans, Medical Writer

One century ago this year, a terror struck a susceptible world. The 1918 influenza pandemic killed some 50 million people worldwide and disappeared in a little over a year.

Viruses were not yet discovered, so public health officials literally did not know what they were facing and certainly had few diagnostics to detect it. Doctors did not have today’s vaccines, antivirals, and antibiotics to treat bacterial co-infections.

Without such protections, the 1918 pandemic killed an estimated 675,000 people in the U.S., lowering the life expectancy by some 12 years in 1918 to age 37 for men and 42 for women, according to the CDC. As one author described it, the 1918 pandemic “killed more people in a year than the Black Death of the Middle Ages killed in a century; it killed more people in twenty-four weeks than AIDS … killed in twenty-four years.”1

The exact etiological agent would not be fully described until shortly after the turn of this century, when the CDC carefully resurrected the virus, using a molecular roadmap imprinted in the frozen lungs of victims buried in a remote Alaskan village.

With the help of researchers at the Armed Forces Institute of Pathology, Terrence Tumpey, PhD, a microbiologist and chief of immunology and pathogenesis in the CDC’s influenza division, successfully reconstructed the 1918 virus in 2004. He conducted several experiments with the live 1918 virus, which had a rare combination of high transmissibility and intense viral replication in the infected. Researchers then destroyed the resurrected virus.

“It was the CDC’s decision that they would do this, but I would be the only one working on it,” Tumpey tells Hospital Infection Control & Prevention. “If we ever wanted to work on it again, we could potentially do it. We would have to get approval again, but we could do it. We just decided we didn’t want it sitting in the freezer.”

Should this lethal combination recur in nature, the current flu vaccines would be effective against it, in part because the 2009 H1N1 influenza pandemic was a descendant of the 1918 strain. One of the last experiments done with the 1918 re-created virus showed that the HA component used in the 2009 vaccine conferred immunity, Tumpey said.

For more on this story, see the November 2018 issue of Hospital Infection Control & Prevention.


1. Barry JM. The Great Influenza: The Story of the Deadliest Pandemic in History. New York: Viking Books; 2004.