They have gained permission for the body of Sir Mark Sykes, 6th Baronet and owner of historic Sledmere House in Yorkshire, to be exhumed.
Sir Mark died aged 39 in a Paris hotel in 1919 from the Spanish flu virus while at the Versailles Peace Conference with his wife; he was an advisor to the Government on the Middle East.
His body was returned to Britain and buried in a lead-lined coffin because the disease was so virulent; it ultimately killed an estimated 50 million people worldwide.
Scientists have been searching for a sample of the virus for some time and are hoping the preservative qualities of the metal coffin may mean samples of his DNA may still be available.
It is possible that Sir Mark's genetic material could uncover new information about the H1N1 virus which killed him; this information could be useful in the task of developing drugs to fight modern forms of the disease such as the H5N1 bird flu currently doing the rounds.
Professor John Oxford, the Professor of Virology at St Bartholomew's and the Royal London Hospital is leading the project, and is encouraged that DNA samples could provide answers to very important questions regarding bird flu.
To dig up Sir Mark's body from the church in the Sledmere estate, the researchers needed permission from all of his living relatives as well as relatives of his wife Lady Edith.
The contents of Lady Edith's coffin will not be disturbed, but permission was needed to move it to reach that of her husband.
In the interests of science the families agreed to the exhumation and a special court in York granted permission for the exhumation.
Drs. Morens and Fauci also discuss the high number of deaths associated with the 1918 pandemic and the disease process, based on clinical and autopsy studies published between 1918 and 1922. Most pandemic deaths were associated with either an aggressive bronchopneumonia, in which bacteria could be cultivated from lung tissue at autopsy, or with a severe acute respiratory distress-like syndrome (ARDS) characterized by blue-grey facial discoloration and excessive fluid in the lungs. In neither case is it known whether most deaths were caused by a secondary bacterial infection or a primary viral infection. They propose that the many excess deaths that occurred during the 1918 influenza pandemic resulted from a disease process that began with a severe acute viral infection that spread down the respiratory tree causing severe tissue damage, which was often followed by secondary bacterial invasion. More definitive answers regarding the causes of deaths due to the "Spanish Flu" may require a comprehensive re-examination of the 1918 autopsy series, they note.
If a pandemic with similar characteristics were to occur in the near future, Drs. Morens and Fauci predict that the relative number of deaths would be substantially lower than that which occurred in 1918.
"Almost all 'then-versus now' comparisons in theory are encouraging," they write. "In 2007 public health is much more advanced, with better prevention knowledge, good influenza surveillance, more trained personnel at all levels, well-established prevention programs featuring annual vaccination with up-to-date influenza and pneumococcal vaccines, and a national and international prevention infrastructure." In addition, two classes of antiviral drugs are currently available, as well as antibiotics effective against bacteria that cause influenza-associated pneumonia.
The most difficult challenge in mitigating the effects of a severe pandemic today would be to ensure access to medical care and resources, they note. Hospitals, medical personnel and drug suppliers could be overwhelmed with huge demands for services, medicines and vaccines, a situation that would be exacerbated in less developed countries and impoverished regions.
Drs. Fauci and Morens conclude that the best hope for the future lies in developing and stockpiling more broadly protective influenza vaccines. In the meantime, prevention efforts should be directed towards logistical planning, increased surveillance, the development of medical countermeasures, an improved understanding of pandemic risks, and an aggressive and broad research agenda.
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