April 29, 2009 -- In the center of the sprawling Atlanta campus of the Centers for Disease Control and Prevention sits Building 17, otherwise known as the infectious disease laboratory. Hop in the elevator and you'll quickly arrive at flu central.
Here, behind locked doors and a biohazard sign, are some of the most sophisticated labs in the world. This is where scientists routinely work with the flu virus.
Now, they're racing to unravel the make-up of this strain never seen before: a combination of swine, avian and human flu viruses.
Dr. Michael Shaw, the associate director for laboratory science in the CDC's influenza division and the point man overseeing the massive effort to understand this new public health threat, greets visitors sporting a container of hand sanitizer. Shaw, who holds a Ph.D. in molecular cell biology, has been working with influenza for more than 30 years, the last 16 of them at the CDC.
In normal times, Shaw has 100 researchers working in his labs. Now he has so many he can't count them all. The scientists are on 24-hour stand-by, waiting for flu samples. Many of the samples have come from Mexico, where the outbreak apparently began.
"We go into full crisis mode at that point, make arrangement with customs to let it get through as quickly as possible," Shaw said. "The airlines are notified, and in certain cases we can even send down a special airplane. So far we haven't had to resort to that from specimens coming from Mexico."
Shaw first became interested in studying flu viruses during another swine flu outbreak back in 1976. Then President Ford authorized a massive immunization program after soldiers at Fort Dix came down with a previously unknown swine flu. One soldier died, and 40 million Americans were immunized. The program was halted after the vaccine itself was blamed for more than two dozen deaths.
Shaw, then a graduate student at the University of Alabama at Birmingham, was one of those who received the vaccine. That propelled him, he said, into influenza research. He wryly noted that this latest outbreak "is like coming full circle."
Work on any samples that come to the CDC's infectious disease lab begin immediately after they are received.
"Regardless of the time -- day or night -- someone will be here to receive it and start the process, because clearly people want results as quickly as possible," Shaw said.
And initial results do come quickly, in as little as four hours. Confirmatory tests take 12 to 14 hours.
Testing Samples for H1N1 Flu, Developing a Vaccine
The incoming samples began as a trickle, but now it has turned into a daily flood, Shaw said.
"Right now it's approaching anywhere between 50 and 100, and it's increasing steadily," he explained. "They first starting coming in one and two, and the curve is just going up with no sign of abating."
This intensive activity is even evident in the hallways, which are stacked with boxes of extra supplies rushed in for the testing.
Researchers here aren't just confirming cases; they are also grappling with the more challenging task of unraveling the virus' make-up and preparing a strain suitable for developing a vaccine.
"The critical thing we need to find out is how much it's varying right now," Shaw explained. "Whenever a virus comes into a population it is going to start evolving fairly quickly, as it sort of adapts itself to a new host. That's going to be very important for selecting vaccine strain."
So far, researchers have seen very little variation, "which is kind of typical for an outbreak situation," Shaw said. That's because "a virus comes in and spreads very rapidly and it hasn't had a whole lot of time to change. That's what we are seeing in this case, which indicates to us that this is truly new."
When the virus samples first come in to the lab, they are handled by researchers wearing special protective clothing, face masks and double gloves. Shaw says the virus is "actually easily inactivated by detergents, soaps, alcohol. You wouldn't think so given how it is spread, but it is an easily inactivated virus."
Once inactivated, the samples are brought to a different lab, where scientists are studying the genetic make-up of the virus. They have found virtually no difference between the strain circulating in Mexico and the strain in the U.S. So the virus alone cannot explain the disparity in deaths.
"Something is different, we haven't figured out what yet," Shaw said. "It is not the virus, apparently, it is something else"
CDC scientists are also doing the critical initial work necessary for vaccine development, including trying to grow the virus. At first, that effort was not going well. "We were getting very, I won't say discouraged, but disappointed at first because it took several days before we could get one growing," Shaw said. "But now we're, we have over a dozen growing."
The scientists hope to have a key ingredient ready to send out to potential vaccine manufacturers in the next week. What's critical, Shaw said, is to find a strain that "looks typical of what's out there. That will give the most protection."
Any vaccine, though, will take months to make. The government said today one could be ready for testing by this fall.
U.S. government health officials have said for years now that it was inevitable that a potential pandemic flu virus would appear. Still, in many ways, this virus has caught them by surprise.
"The main thing it points out," said Shaw, "is regardless how we study what happened in the past, every new situation is truly new and different. This one was a total surprise coming out of Mexico. The assumption was it would come out of Asia, a larger population for variants to appear and of course we've been following the (Asian) avian influenza very carefully."
"This one just came out of nowhere."