Flu Hunter: Unlocking the secrets of a virus
By Robert G Webster
(University of Otago Press, $35)
Growing up on a Balclutha farm in the 1930s and 40s, one of Robert Webster's jobs was to put the family's Khaki Campbell ducks away at night.
Fond as Webster was of the ducks, he kept a more watchful eye on the destruction rabbits caused.
Had he known what he knows now, Webster might have been more guarded around ducks. Much of what we know now about the origins of influenza pandemics — outbreak of the flu — is because of Webster, a pioneering virologist and bird-flu expert.
In the 1960s and 70s, Webster and colleagues studied the link between bird and human flu viruses, showing that wild ducks are the ultimate reservoir of most influenza viruses.
But, when Webster left the University of Otago in 1957 with a BSc and MSc in microbiology and joined the New Zealand Department of Agriculture, he was most excited about pox viruses. He initially focused on the evocatively-named "Scabby Mouth", a serious threat to the health of sheep and goats.
Then Webster heard about Australian research into myxomatosis — a pox virus usually lethal to rabbits — so set off to do a PhD at the John Curtin Medical School with Professor Frank Fenner who was leading the studies. Some 56 years later and talking from his home in Memphis Tennessee, Webster, in calm and avuncular tones, describes his disappointment at what he found in Canberra.
"The day I arrived — and it was one of those 'never forget days' of life — I sat down with Professor Fenner, in front of his desk as a young student, and he said, 'you're going to work with influenza'."
What did he know about influenza?
"That I was less than thrilled… I was devastated. The pox viruses were the exciting thing; having grown up on a farm and knowing about the rabbit problem in New Zealand, I thought that would be a wonderful thing to work on. But it wasn't to be. That's what happens in life, so you make the most of it."
And make the most of it he did. His honours include membership of the National Academy of Sciences in the USA, a Fellow of the Royal Society of London and a Fellow of the Royal Society of New Zealand where, at his former university, the Webster Centre for Infectious Diseases is named after him and wife, Marjorie.
At 86, he still works in infectious diseases at St Jude Children's Research Hospital in the USA where he continues to publish research papers — more than 600 to date — mentor others and run influenza investigations and programmes around the world.
This year, we get a salient reminder of just how deadly the respiratory infection can be.
It's the centenary of the 1918 Influenza Pandemic dubbed the Spanish Flu because Spain, neutral during World War I, was not subject to the same reporting restrictions as most of the Western world meaning newspapers were free to report what a swathe the illness was cutting through the population.
Up to 500 million people were infected by the H1N1 strain of the influenza virus, which came in three waves. The first mild, the second ruinous and the third bringing a gradual reduction in severity. From the Arctic to the Pacific Islands and our own South Island, it killed between 50 — 100 million people globally — around 3 — 6 per cent of the world's population. In Samoa, the death toll reached around 8500, about 22 per cent of the population, after the New Zealand ship Talune docked and sick passengers were allowed to disembark.
In this country, in just two devastating months — from October — December, 1918 — we lost 8573, about half as many as the 16,500 New Zealanders killed during the entire four years of WWI. Maori were up to seven times more likely to die.
Public events and gatherings were cancelled, opening hours at businesses and public facilities restricted (or they closed because employees were too sick to staff them) and those who were well enough bravely volunteered to nurse the sick, check on family, friends and neighbours or, if they had a vehicle, deliver food and medicine or transport bodies for burial. Streets were disinfected; those who ventured out sprayed themselves with a solution of zinc sulphate, now known to offer no protection.
It's Webster's work, alongside collaborations with scientists around the globe, that will hopefully save the world from a flu pandemic as catastrophic as 1918. Now he's written a memoir, Flu Hunter: Unlocking the secrets of a virus. The title 'Flu Hunter' is a nod toward the moniker bestowed on him by the Smithsonian magazine in 2006.
The first chapter, devoted to the impact of that outbreak, offers provocative research and thoughts about how the 20th century might have been different if, for example, US President Woodrow Wilson, one of those negotiating the reparations and restrictions post-WWI Germany would face, hadn't become seriously ill with influenza. Wilson was a moderate who didn't want Germany brought to her knees; others, notably France, were less forgiving. But when he recovered from flu, Wilson gave in to all the French demands.
"Germany was beaten into the ground; extremists took charge — the Hitlers of the world — and that led to World War Two. The so-called bird flu, H5N1, we know gets to the brain experimentally of ferrets and mice so I suspect that Wilson was one of a genetically susceptible group of people who permitted the virus to travel to the brain."
What had Webster, born just 13 years after the pandemic, heard about it? Not a lot.
"No one in the family, to my knowledge, died in 1918 but I would be surprised if they didn't. I never dug into the family history to find out," he says. "I knew there'd been the 1918 influenza outbreak and, periodically, there were pandemics and probably the periodic pandemics… well, at that stage, no one really understood where they came from.
"Flu is constantly mutating and varying and the idea at the time was, 'well, are these pandemics that occur just excessive amounts of variation?' but then there was a group of us who realised that there is flu in chicken and ducks and pigs in the world and maybe they came across and so that's where the interest came from."
Webster's team, made up of ex-trainees from St Jude's, isolated the "avian-adapted strain" of H5NI, which causes bird-flu, and were on the front lines of the fight to contain it when, in 1997, it appeared in humans in Hong Kong. Webster calls wild ducks "the Trojan horse" because they harbour, replicate and transmit the virus to other poultry by defecating in open water. They don't get sick but the other birds they infect — like chickens — are quick to succumb to H5 variants.
Occasionally, H5N1 infects humans and when it does, about 60 per cent of those who catch it die. If it were to mutate, allowing for easier transmission from human to human, we'd potentially face another pandemic.
Webster also asks if we're better prepared than we were 100 years ago to face that. Of that prospect, he remains measured and reassuring during conversation — in the way that experienced scientists bearing bad news do — but has a warning.
"Two groups of scientists looked at the question of, 'would the bird flu H5N1 ever learn how to transmit human to human?'. So, they set out and made changes in it so it would transmit ferret to ferret and they put in five changes in the spike on the surface of flu — those five changes actually exist in the world in different strains of H5N1 — and it did transmit.
"I describe it like a card game, that Mother Nature hasn't shuffled a perfect hand. If Mother Nature put all of those changes together in the virus herself, it would be a bloody disaster. It's a matter of luck, a matter of chance, as to whether or not we get one of these nasty ones."
It's when, not if, says Webster, who agrees we've become complacent about the flu because there hasn't been a recent pandemic. (It still kills about 500 New Zealanders annually with, according to a University of Otago study, Māori, Pacific Islanders, men and those living in poverty most at risk).
"It hasn't happened so, 20 years on, people are saying, 'it can't happen' but we know, scientifically, that it can. At the end of the book, I deal with the fact that we need new drugs; we need new vaccines and there's a big effort in the United States to do this. The funding for research is aimed at the universal vaccine for flu, which is theoretically possible and the first trials are going on, so, at the academic level, complacency hasn't set in at all."
Webster will spend part of this year travelling, as he has long done, to conferences around the world, some timed to coincide with 1918 centenary commemorations. He'll also check in on a research project in Bangladesh watching what happens with the viruses in the big live poultry markets.
"Live poultry markets really intrigue me," he confesses. "When we shut down the poultry markets in Hong Kong and they did the same thing in Shanghai, with the second bird flu, the spread to humans stopped. We're watching what's happening in probably the most densely populated country in the world and the markets in Bangladesh are absolutely loaded with H5N1.
"But, on the other hand, the H5N1 virus is not transmitting to humans and the impression we have is that the viruses is getting wimpier and wimpier and maybe we shouldn't worry so much but, you know, nature just has to change, to shuffle the right hand as it were…"
While the number of live poultry markets has greatly reduced in recent years In Hong Kong, Webster understands their appeal.
"My wife is an excellent cook but American chicken tastes of almost nothing," he says. "I have to agree with the elderly people in Hong Kong who say that live poultry tastes better so I still eat chicken but it's not my favourite food by any means. I'd much rather eat duck and that's even worse because that's where the real problem lies. Cooking kills it; it doesn't take much to kill flu."
Which is probably just as well because, as the live bird market example demonstrates, human behavior is harder to alter. If a flu pandemic were to start, would we batten down the hatches and stay away from work, school and the shopping malls? Give up our cars to transport the dead? Allow our nearest and dearest to be buried without the rituals we try to use to comfort ourselves around death?
"If it does happen, it would be all over the world in two days with aeroplane travel. We wouldn't have much time and if society fell apart, like 1918, people would probably do the same thing. They'd stay home. I mean, if the word got out that there was a killer flu strain circulating, would you go to work?"
Influenza 100 - Commemorating the 1918 Flu Pandemic features four historians relating accounts of what happened:
• "Why do we still need to know about the 1918 influenza pandemic?" with Geoffrey Rice, author of Black November;
• "The stories behind the names; who were the victims?" with Jason Reeve, Ancestry; "Lived experiences - remembering 1918-1920" with Auckland Libraries' Principal Oral History and Sound curator Sue Berman;
• The "Spanish Lady" and the Armed Forces - The "flu" and warfare in 1918" with military historian, Michael Wynd.
• Central Library, Wednesday, October 3 1 - 5:30pm; part of the Auckland Heritage Festival, bookings recommended.
Crusaders boss says cowbells will be melted down at the gate.