Infectious Diseases: A2-Hong Kong-68, or Whatever

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A plague was moving across the U.S. last week. Hundreds of thousands of Americans were sniffling, hacking, running low fevers and complaining that their bones ached. The vast majority of adults said they had "the flu," and many tried to show their medical sophistication by identifying it as "Hong Kong flu."

In most cases, the precise identity of the affliction and the microbe causing it was unknown. Cautious doctors described their patients' illnesses simply as "URD" or "URI" (for upper respiratory disease, or upper respiratory infection) and let it go at that. Whatever its nature, the illness was emptying schools and offices, stripping military installations of active-duty personnel, and decimating Broadway casts. Jane Morgan in the title role and eight other players in Mame had to yield their places to understudies. The cast of George Ml had five out. Playing the barber in Man of La Mancha, Leo Blum became so ill that he fell off the stage, and since his understudy was ill, the stage manager had to pinch-hit. At the Metropolitan Opera, John Alexander had to give up after two acts of La Sonnambula. And in Philharmonic Hall, Pianist Jose Echaniz could not even make it past intermission.

Out of China. The experience of other large cities was spotty. In Los Angeles, 15 members of the Rams' 40-man football squad gave up practice because of the flu. In Denver, the Hong Kong virus was blamed for a significant increase in the number of deaths due to influenza and pneumonia. Chicago and Detroit were holding their breaths.

Health officials and their laboratory experts, using ultrarefined microtechniques, began closing in on the culprit microbes. No doubt many of the illnesses were caused by assorted viruses that have no common names and produce indistinguishable illnesses. But it was almost certain that most of the symptoms resulted from the epidemic spread of influenza viruses. Of these, there are two main types, A and B. The B type appears to be stable and causes outbreaks of moderate severity every two to four years. On the other hand the A types are highly unstable and mutate unpredictably.

The best-documented mutation occurred in 1957, when a new and savage strain poured out of northern China and won deserved ill repute as "Asian A2." Whenever a virus mutates, pharmaceutical manufacturers have to in corporate the new strain into their vaccines because antibodies and therefore immunity against older strains are not as effective in combatting the successive mutants. That takes many months at best, and the makers lost the race to the virus in the winter of 1957-58.

Last July, another mutation erupted from China through Hong Kong and has been tagged A2-Hong Kong-68. This time the vaccine makers were able to work faster. In mid-November they announced Government approval and first shipments of a new, anti-Hong-Kong-flu vaccine, harvested from viruses grown in eggs, inactivated, then tested for potency and safety.