Medicine: 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 104°), 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: