men in uniform. Virulence cannot as yet be tested in the lab. Could the Fort Dix swine flu be a comparable killer? No one at CDC knew any reason to suppose it was—contrast the 1920’s and the circumstances of the one death now—but still ….
The absence of surprise reflected expert views at that time about epidemic cycles and about the reappearance of particular types of viruses in people. It was widely thought—on rather scanty evidence—that antigenic shifts were likely about once a decade (interspersed with slighter changes, "drifts," each second or third year). There had been shifts in 1957 and in 1968, both followed by pandemics—Asian flu and Hong Kong flu respectively—and public health officials were expecting another by, say, 1978 or 1979. 1976 was close. The very day the Fort Dix cases were identified at CDC, the New York Times carried an Op Ed piece by Dr. Edwin D. Kilbourne, one of the country’s most respected influenza specialists, extolling cycles and affirming that pandemics occur every eleven years—another one of which, he warned, was surely coming soon:
Worldwide epidemics, or pandemics, of influenza have marked the end of every decade since the 1940’s—at intervals of exactly eleven years—1946, 1957, 1968. A perhaps simplistic reading of this immediate past tells us that 11 plus 1968 is 1979, and urgently suggests that those concerned with public health had best plan without further delay for an imminent natural disaster.2
Also, an influenza virus recycling theory was just then receiving attention, and this suggested swine-type as a likely next strain to appear. The idea was that the flu virus had a restricted antigenic repertoire and a limited number of possible forms, requiring repetition after a time period sufficient for a large new crop of vulnerable people to accumulate. The Asian flu of 1957 was thought to have resembled flu in the pandemic year of 1889. The Hong Kong flu of 1968 was thought to be like that of 1898. Swine flu, absent for 50 years, fit well enough, no surprise. The theory had been originally proposed by two doctors who wrote in 1973:
A logical sequel to the data presented and supported here would be the emergence in man of a swine-like virus about 1985-1991…. Regardless of one’s view as to the origin of recycling of human strains of influenza, the matter of being prepared to produce swine virus vaccine rapidly should receive consideration by epidemiologists. Man has never been able to intervene effectively to prevent morbidity and mortality accompanying the emergence of a major influenza variant, but the opportunity may come soon.3
Though some experts were skeptical about the regularity with which previous strains might be expected to reappear, no one doubted that a swine flu virus might well re-emerge in the human population.
On February 12, alerted by preliminary lab reports, Dr. David Sencer, CDC’s Director, asked a number of officials from outside his agency to join him there for a full lab report on February 14. The Army responded as did Goldfield from New Jersey. And from two other parts of CDC’s parent entity in HEW, the Public Health Service (PHS), Dr. Harry Meyer and Dr. John Seal came as a matter of course. Meyer was Director of the Bureau of Biologics (BoB) in the Food and Drug Administration; Seal was the Deputy