After the isolation of A/New Jersey/76 (Hsw1N1) influenza virus from five soldiers at Fort Dix, New Jersey, case finding was initiated by obtaining specimens for viral isolation from 95 patients with acute respiratory disease and determining antibody to influenza A/Mayo Clinic/103/74 (Hsw1N1) antigen in paired sera from 74 soldiers who had been hospitalized with acute respiratory disease. Influenza A/New Jersey virus was not isolated, but serologic studies identified eight additional soldiers as A/New Jersey influenza patients. Development of heterotypic antibody to A/Mayo Clinic antigen following infection and/or immunization with influenza A (H3N2) strains was studied and was found to occur infrequently. One of the 13 identified patients had died, and postmortem findings were consistent with viral pneumonia. Four of the 12 surviving patients had radiologic evidence of pneumonia, but clinical syndromes in all 12 were similar to those described for other influenza A infections.
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Surprisingly, the 1977 "Russian flu" H1N1 pandemic influenza virus was genetically indistinguishable from strains that had circulated decades earlier but had gone extinct in 1957. This essay puts forward the most plausible chronology to explain the reemergence of the 1977 H1N1 pandemic virus: (1) in January-February 1976, a self-limited small outbreak of a swine H1N1 influenza virus occurred among Army personnel at Fort Dix, New Jersey; (2) in March 1976, the US launched a nationwide H1N1 swine influenza vaccine program; (3) other countries then also launched their own H1N1 R&D efforts; (4) a new H1N1 outbreak, genetically unrelated to the Fort Dix swine virus but indistinguishable from previously extinct H1N1 viruses, was detected early in 1977 in China; (5) the leading Chinese influenza virologist later disclosed that the Chinese military had conducted large H1N1 vaccine R&D studies in 1976. It is likely that the resurrected H1N1 influenza viruses were laboratory-stored strains that were unfrozen and studied as part of the emergency response to a perceived epidemic threat, and that accidentally escaped.
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