In 1918, about 50 million people, or one-fifth of the world’s population, became infected with the virus known as the “Spanish” flu, according to the Centers for Disease Control and Prevention (CDC).

“The 1918 Pandemic was the reason the military was so invested in getting a vaccine during World War II. They had seen what happened during World War I,” said Catherine Troisi, Ph.D., infectious disease epidemiologist and an associate professor at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health.

Developing an influenza vaccine took more than a decade. Clinical trials began in the 1930s and researchers worked closely with U.S. military officials during World War II. In 1945, the first flu vaccine was approved for military use in the U.S. The following year, the vaccine was approved for civilians.

Effective seasonal influenza virus vaccines have been available for a full 75 years. Influenza still causes widespread sickness and claims lives annually.

Featured on BBC Two’s ‘Trust Me, I’m a Doctor’, the history of the influenza virus and the development of a new type of influenza vaccine – a Universal Influenza Vaccine provided viewers with some useful and interesting insight. Unlike the current conventional vaccine, this new future vaccine would protect people over multiple seasons, and even in the event that a brand new flu virus appears, as happened in 2009.

We aim to develop a Universal Influenza Vaccine which means people do not need to be vaccinated each year and are prepared for the unexpected. In this blog, we’re going to be exploring the history of the vaccine – as well as a brief history of the virus itself – to set the scene.

The beginning of the flu

People queuing for flu jabs

The very first description of flu was described in the ‘Book of Epidemics’ by Hippocrates in 412 BC, where he very clearly outlined the virus’ symptoms. However, the virus’ first “official outbreak” was not described until 1580. This is when records may show the very first epidemic, fitting the full description of influenza as we describe it now. It may have resulted in the decimation of whole cities.

The term influenza originates from Italy in the 1400s; this was after the ‘Influence of the Stars’ epidemic raged across Europe, Asia and Africa. Over 31 potential outbreaks were recorded between 1404 – 1900, resulting in thousands of deaths.

In the last century, there were three influenza pandemics that occurred – the Spanish Influenza, Asian Influenza and Hong Kong Influenza. Spanish influenza, which probably originated in France, killed up to 100 million people – more than both World Wars combined!

But what caused the flu?

A group in London led by Wilson Smith, along with his colleagues Sir Christopher Andrewes and Sir Patrick Laidlaw, discovered the cause of flu. Nobody knew, until then, that it was a virus.

Soon after (in the 40s) another virus was also identified and named influenza B. This virus is also an important cause of disease in humans; this season (2017/18) this virus is significant, and is known this year as the “Japanese Flu”. Also this year, a variation of the influenza virus is causing significant problems across the world, and is known as “Aussie Flu”, or “H3N2”.

The History of the Vaccine

The discovery of the flu virus led to early testing of a simple “killed virus vaccine” in the thirties on British troops. Later, in the 1940s’, the first official vaccine was tested, and it was demonstrated that this simple killed virus vaccine was effective – and protected people against that strain/type of flu. However, the vaccine only protected against the strain/type of flu it “contained”, not any new flu that might appear.

The killed virus vaccine was “locked down” at the time it was made, and could only protect against the viruses that it was made from.

Flu Vaccine Timeline

1918

An Influenza A strain jumps from birds to humans, creating a pandemic that kills an estimated 50 million people worldwide. More World War I soldiers died from flu than were killed in battle. The episode stimulates influenza research.

1930s

Researchers isolate Influenza A and start the first clinical trials of flu vaccines.

1938

The first flu vaccine is developed and given to soldiers during World War II.

1940

Influenza B viruses—the main cause of seasonal epidemics—are discovered.

1940s

University of Michigan researchers Thomas Francis Jr., M.D., and Jonas Salk, M.D., develop the first inactivated flu vaccine with support from the U.S. Army. The U.S. military placed a high priority on influenza vaccine development following the flu deaths of about 1 in every 67 soldiers during the 1918-1919 pandemic, which coincided with the end of World War I.

1945

The first influenza vaccine is approved for military use in the United States. The whole-virus, inactivated bivalent vaccine, which offered protection against Influenza A and Influenza B, had been tested on military recruits and college students.

1946

The flu vaccine is approved for civilian use.

The Vaccine and the Future

The current conventional flu vaccine and its potential to protect people and save lives are constantly being developed, and work is far from complete. The effectiveness of the vaccine varies enormously each year, from just 3% up to 70%.

In 2009, the world saw the first outbreak of a Pandemic Influenza virus this century. Such new viruses occur when the virus juggles its genes with those of another virus in a different animal, and then humans are exposed to a virus never seen before.

Each year, however, the virus also changes slowly. Unlike a Pandemic Influenza virus that appears from nowhere, these yearly viruses are caused by slow and subtle changes. Because of these viruses that drift (known as antigenic drift to scientific geeks in the field) each year, we need to have a new vaccine.

The Aussie Flu

In 2018, with Aussie Flu, we have seen that influenza can catch us unprepared. We know that the virus has “drifted” slightly from that which is in the vaccine. The yearly vaccine is not perfect, it relies on a judgement that locks down the vaccine, but in the months that follow the virus can change.

In addition, we have had “Japanese Flu” – this was a B virus. In many countries, the yearly vaccine did not contain a killed virus that protected against that strain, hence we now read many reports of “Japanese Flu”.

The Aussie Flu had a major influenza outbreak in the northern hemisphere.  Healthcare systems in most countries were at a breaking point. This follows a southern hemisphere outbreak that, at least in Australia, has been reported as the worst ever.

We need a vaccine, a Universal Influenza Vaccine, not a vaccine locked to particular strains of the virus, that protects against the virus as it slowly mutates and drifts away from that used in the conventional vaccine each year. We also need a vaccine that protects against the unexpected Pandemic virus that can appear from nowhere, as it did with devastating consequences in 1918, and more recently in 2009 – when up to 1 million people are believed to have died.

Protecting the World Against the Flu

At FluCamp, we study viruses like the flu and the common cold in safe and controlled conditions, through the use of clinical trials. We hope that one day our work, with the help of our volunteers, will contribute to the development of a vaccine that protects against any influenza virus that might slowly develop or suddenly appear.

Healthy volunteers, like those we recruit, are at worst likely to end up in bed feeling rough, but what we learn from them has been, and very much is, invaluable.

To find out more about FluCamp and the work that we do, click here page for more information, or call us on 0207 756 1414.

References

Man nervous having a flu jab