Here Is Where: Discovering America's Great Forgotten History (40 page)

Hilleman attended Montana State University, graduated first in his class, and won a full University of Chicago scholarship to earn his microbiology doctorate. The skinny, perpetually broke young student who had to get by on one meal a day made medical history at Chicago with his doctoral thesis. Hilleman discovered that chlamydia—which infects several million Americans a year and can make women infertile—wasn’t a virus, as most scientists believed, but a unique bacterium, and his research enabled doctors to treat the disease more effectively.

The New Jersey pharmaceutical company E. R. Squibb recognized Hilleman’s brilliance and hired him right out of school. For four years he worked on creating flu vaccines, and in 1948 he joined the team of scientists at the Walter Reed Army Medical Center in Washington, D.C., tasked with studying influenza and preventing future outbreaks.

Hilleman, almost single-handedly, did just that in the spring of
1957. On April 17 he read a short newspaper article about a nasty influenza bug racing through Hong Kong. As a precautionary measure, Hilleman cabled an Army medical post in Japan and told them to track down an infected U.S. soldier, collect a saliva specimen, and rush it to Washington. He regrew the sample and identified it as similar to the Asian flu strain that had swept the globe in 1889. Hilleman immediately alerted the World Health Organization, the U.S. Public Health Service, and the Army’s own Commission on Influenza about the potential threat, but all of them thought he was being hasty. In defiance of protocol, Hilleman issued a press release declaring that another pandemic was imminent and encouraged several vaccine manufacturers to get a jump on production. He also instructed them to advise their chicken farmers not to destroy their roosters at the end of hatching season, a standard practice Hilleman remembered from his Montana youth. Hundreds of thousands of additional eggs would be needed, he told them, to incubate millions of vaccine doses.

Critical time was lost when the health agencies initially dragged their feet, and seventy thousand Americans were killed by the Asian flu, but the numbers could have been dramatically higher were it not for Hilleman’s rapid response. “Many millions of persons, we can be certain, did not contract Asian flu because of the protection of the vaccine,” Surgeon General Leonard Burney later said. For his efforts Hilleman was awarded the Medal for Distinguished Public Service by the secretary of defense.

In 1957, Hilleman and his wife, Thelma, moved to Pennsylvania so he could accept a position heading up all virus and cell biology research at Merck. Thelma died of breast cancer in 1962, leaving a distraught Hilleman to care for their young daughter, Jeryl Lynn, by himself. On March 23, 1963, Hilleman’s little girl came down with epidemic parotitis. Better known as the mumps, the painful infection usually passes after a few weeks without inflicting any long-term harm, but in extreme cases the virus can cause deafness, diabetes, and brain damage.

After swabbing Jeryl Lynn’s throat, Hilleman returned to his lab
and injected the culture into chicken embryos. From this he produced the “Jeryl Lynn” mumps vaccine, which continues to be administered to this day. (There’s still no cure for the mumps, and the best “treatment” remains getting immunized and not coming down with it in the first place.)

Emboldened, Hilleman began tackling one vexing disease after another—but, thankfully, without relying on his daughter to be stricken with each one.

Next came measles, a virus that was killing and blinding tens of millions of children a year. In 1968, Hilleman invented a vaccine that, within the United States alone, brought the number of infections down from four million to approximately one hundred. He followed up with a three-in-one measles/mumps/rubella shot that has made the vaccinations less expensive and more accessible, especially to children in poorer nations.

During the mid-1970s, Hilleman pushed Merck to mass-produce vaccines for pneumonia and related illnesses. Since these could be treated with penicillin, other pharmaceutical companies deemed the research a waste of resources. But as Hilleman accurately predicted, the overuse of antibiotics made it necessary to expand the medical arsenal, and the pneumococcal vaccines were eventually put into wide use.

When Hilleman reached Merck’s mandatory retirement age of sixty-five in 1984, he refused to stop working. For him, Merck made an exception. By the time he died in April 2005, Hilleman had helped to develop more than forty vaccines, including for chicken pox;
Haemophilus influenzae
type b, or “Hib,” a bacterium that can lead to meningitis and paralysis; hepatitis A; and hepatitis B (with crucial assistance from Baruch Blumberg and Irving Millman), thereby cutting liver disease by 99 percent in some countries. His measles vaccine alone is estimated to have saved, at a minimum, more than 100 million lives over the past four decades.

After taking one last look at Hilleman’s childhood home, I walk back to Art and Nancy’s truck, climb in, and ask them why they think Hilleman has been so overlooked. Nancy mentions that, as far as Miles
City goes, Montana folks are reserved by nature, so his family wouldn’t have campaigned for any kind of tribute, lest it seem like they were bragging about one of their own.

“A lot of folks didn’t even know all that he had done until after he died,” Nancy adds. “He never boasted about it.”

According to his coworkers, Hilleman demonstrated that same reticence for self-promotion at Merck. He shied away from publicity whenever the company announced another of his breakthroughs, and he never named any of his vaccines after himself, which other scientists have done. (He did call the mumps vaccine “Jeryl Lynn” for his daughter, but he intentionally left off their last name.)

“You want to know why Hilleman’s not more popular?” Art pipes up from out of nowhere, just as we’re about to say our good-byes. “Nobody likes gettin’ those damn shots.”

Actually, I think he’s on to something. They may not hurt as much as they did in the old days, when the needles were bigger, but vaccinations are still an inconvenience. And when they work, which they overwhelmingly do, the result is—nothing. We can’t see or feel the payoff. No aches and pains have been alleviated, no inflammations relieved, no sores healed. It’s easy to take for granted something whose benefits can only be left to the imagination.

Which is why I thought it might be worthwhile to find a site associated with the world’s deadliest plague, a pandemic caused by a virus that scientists could neither cure nor restrain. Known as “Spanish influenza,” the disease is commonly thought to have kicked up first in Europe during World War I and then run riot across the globe, killing tens of millions of people in a matter of months.

Only in recent years has it come to light that a county doctor from Sublette, Kansas, treated the first documented victims of the Spanish flu in 1918, and they were most certainly not from Spain. They were his neighbors.

WHILE WALKING THROUGH
the airport in Liberal, Kansas, I notice a flyer pinned to the community bulletin board that cautions visitors to “please avoid the following acitivity” and, underneath, shows an adorable blond toddler kissing the wet, mud-splattered snout of a caged pig. Next to this tongue-in-cheek warning is a more somber government advisory about the swine-flu virus that recently swept through the country. Thankfully, the outbreak didn’t explode into the epidemic initially predicted (fewer people, in fact, died from this strain than from the regular seasonal flu), and after the threat petered out, there was a lot grumbling on radio call-in shows and cable news that the whole campaign needlessly frightened the public and wasted millions of dollars in unused vaccines. Pig farms, including those in this Kansas community, were hit hard financially because many consumers feared they could become ill by eating bacon or ham and stopped buying pork products altogether. Here in the airport, someone has apparently expressed frustration over the whole situation, having scrawled “Hogwash!” above the two swine-flu alerts.

But if health officials were overcautious, it wasn’t without reason; they knew full well what can happen when society is caught off-guard by a lethal, highly contagious influenza strain that, once unleashed, can’t be stopped by all the medicine in the world. Foremost in their minds was the Spanish flu of 1918, which killed more people than any pandemic in history. And it did so with unrelenting ferocity. Symptoms included fevers that spiked up to 104 degrees; excruciating muscle aches; vomiting; profuse bleeding from the nose, ears, and eyes; and coughing fits so violent and prolonged that even the strongest victims tore rib cartilage hacking up a red, frothy sputum that constantly filled their lungs. Those unable to fight the virus or its accompanying complications, such as pneumonia and tuberculosis, usually died within ten days. There were anecdotal reports that some people got sick in the morning and were dead by nightfall, while others languished in agony for more than two weeks. Oddly, the disease killed otherwise healthy young men and women at almost the same rate as infants and the elderly. This had never occurred before with an influenza strain. (Nor has it since.)

Other mysteries about the Spanish flu puzzled scientists for decades, including the simple question of where, on earth, it had started.

Spain would seem the obvious answer, but the country has been unfairly linked with the disease since May 1918. France, Great Britain, Germany, and other warring European nations had experienced outbreaks a month earlier, but their governments were censoring the media and prohibited news about a growing plague because it was too depressing. The Spanish press, unencumbered by such restrictions, covered it extensively, and so to the rest of the world the flu had apparently originated in Spain.

After the war, epidemiologists intent on locating the true epicenter focused initially on France’s west coast. From there, the disease had clearly expanded across Europe beginning in April 1918. But further investigation revealed that this was exactly when the first influx of American doughboys had disembarked en route to the Western Front, and many of the U.S. soldiers had been herded off crowded troopships already sick. The disease, it seemed, had come from the United States. Scientists backtracked the virus west to Fort Riley, Kansas, where in early March several soldiers at Camp Funston were hospitalized with the flu. More than five hundred of their fellow troops were bedridden within a week, and by the end of the month the number had jumped to eleven hundred. Private Albert Gitchell, admitted to the infirmary on March 4, is frequently cited as “patient zero.” But there are some minor disparities about this, too; according to some reports, his name might have been Mitchell, and he checked in sick on March 11, not a week earlier. Regardless, in 1998 a bronze historic marker was erected at Fort Riley stating that the “first recorded cases of what came to be the worldwide influenza epidemic were first reported here in March 1918.”

Now it appears that
this
information is off by a month and several hundred miles. A lengthy state-by-state account of the pandemic produced only a few years ago by the U.S. Department of Health and Human Services contains this small update:

That local physician was Dr. Loring Miner from Sublette, Kansas, the seat of Haskell County, and he was the first person in America to sound the alarm about what was later referred to as “the Spanish flu.” Miner appealed in writing to the U.S. Public Health Service for advice and assistance but received neither. The agency did, however, print in its spring 1918 issue (vol. 33, no. 14) of
Public Health Reports
Miner’s letter concerning “the occurrence of 18 cases of influenza of severe type … [in] Haskell, Kans.” This particular edition of
PHR
particularly caught my attention because its lead article was “PELLAGRA—Its Nature and Prevention” by Joseph Goldberger.

Miner’s
PHR
warning somehow went overlooked for almost ninety years, as did several February 1918 notices in a Haskell County newspaper listing the names of local residents sickened by influenza. Unknowingly, the paper also foreshadowed the epidemic’s expansion, mentioning Fort Riley servicemen home on leave and Haskell County citizens spending time with relatives at the Army post; “Ernest Elliott left Sublette,” one article stated, “to visit his brother at Funston,” and an earlier item had noted that Elliott’s young child was among those stricken with influenza. With an incubation period of one to three days, it leapt from host to host before carriers even knew they were sick themselves. And as the virus fanned out from town to town, state to state, country to country, it was growing stronger.