This machine catches the flu.
I'm inside the Gesundheit II,
which is used to figure out how viruses like the flu spread.
This is part of the latest research to try to understand how we can stop the flu,
otherwise known as influenza.
Because in the past century,
tens of millions of people all around the world died from this virus,
and we still haven't fully figured out how to protect people from it once and for all.
So why haven't we gotten over the flu?
I'm Josh Frank.
This is Quartz.
Philadelphia's Mütter Museum is known for its impressively grisly array of anatomical specimens,
cataloging deformity and disease.
Dr. Jane. E. Boyd is a curator for the museum.
She's working on an exhibit about how the 1918 Spanish flu pandemic ravaged the city.
— Every single family every house every block every neighborhood was affected by this disease,
and people were dying left and right.
Undertaker's ran out of coffins.
Bodies started piling up in the morgues, started piling up in people's homes.
Dr. Boyd says most people today don't remember how bad the Spanish flu was.
— The 1918-19 pandemic has often been called 'The Forgotten Pandemic'.
It happened at the very tail end of World War I,
so it's often relegated to a sort of a footnote in history books.
There aren't any grand operas about the flu.
What is left is an enormous archive of death certificates.
and also this very pristine bedpan.
'Spit Spreads Death' will become a permanent exhibit at the museum
to remind people to take the flu seriously
because it's still a problem, today.
80,000 Americans died from the flu just last year.
— This is a big existential challenge to all of humanity,
that we know that there's always new influenza viruses appearing from time to time.
and we have to be ready for it.
That's why research on the flu is still so important.
— The right hand is for counting the number of coughs,
and the left one is for counting the sneezes.
The Gesundheit II is the first device of its kind.
You're the developer of this sampler.
— It was my idea, yeah.
Dr. Donald Milton works with a team of virologists
collecting breath samples from six students.
Here's how his machine works,
First you sit in a sealed chamber
and stick your head into this cone
kind of like putting your head into a gentle vacuum cleaner.
Then you breathe naturally for half an hour.
Whatever you exhale gets collected in the machine,
which is then analyzed for viruses.
The big question for Dr. Milton is,
— 'How do you know who gave it to you?'
— Yeah, sometimes, you got it from your house of mates
but sometimes you got it on the metro.
I've been working now for nearly 20 years to try to get at,
'Okay, how do we answer this question?'
This shows them headed out the classes.
One of them is going to a meal in south campus dining hall.
Dr. Milton also uses iPhone apps
to track six students, and their classmates
as they move around campus.
So this is when they're back in the dorm.
— Now they're back in the dorm room at night.
Just, kinda hanging out?
— Mm-hmm.
He's looking for clues about how the virus spreads
— Is it something that's in large ballistic droplets,
spray that you're within firing range of me,
and you could catch what I have?
Or are the people across the room in range
because it's tiny droplets that float in the air?
Have there been any findings or conclusions that have really surprised you?
Well I think some of the most surprising things have been that people shed virus into the air
even when they don't cough.
Dr. Milton says this is pretty much what we know.
But understanding how the flu spreads between people
is just part of a much larger puzzle
that scientists all over the world are tirelessly trying to solve.
The flu is a global problem.
And it's always flu season somewhere.
So virologists in different countries are in constant communication
about how the virus is changing.
This season the vaccine protects against strains
of the flu from Michigan and Colorado in the U.S.,
Singapore, and Phuket, Thailand.
Dr. Paul Offit is a specialist in infectious diseases.
He's part of a committee that predicts
which strains of the flu should go into the vaccine for Americans every year.
— The flu is a mystery in the sense that
we haven't figured out a way to get away from giving a yearly vaccine.
The surface of that virus changes enough from one year to the next
that you need to get an annual vaccine.
Today's vaccine offers protection,
but it doesn't always give complete immunity.
That's why you can get a flu shot and still get the flu.
Though, usually with less severe symptoms.
Last year the shot was only 40 percent effective at protecting people who got vaccinated.
— I think people think you know all right I'll take my chances.
So in a sense I mean, it's the degree to which people fear the virus,
that they understand the virus,
that they see that it can kill you, or your neighbor, or a loved one,
is the degree to which more people will get vaccinated.
The more people who get the flu shot the more it protects young children,
or people weak immune systems who can't get the vaccine themselves.
This is what's called herd immunity
Your doctor has probably already told you to get the flu shot.
But every year less than half of Americans actually go out and get vaccinated.
So here I am.
Could you imagine a scenario in which it is mandatory to get a flu vaccine?
— You know they can't pass a law to make us eat our broccoli, we think.
Dr. David Morens is an epidemiologist at the National Institutes of Health.
People nowadays, compared to a hundred years ago,
are much less likely to listen to public health and medical authorities
about the things you need to do to prevent influenza.
He says the online echo chamber doesn't help getting the right message to people either.
— We now in 2019
love to challenge authority and not do the things that authorities tell us we should do.
It says if in the Internet age authority has been democratized.
Authority can be anybody you want to listen to not anybody who knows anything.
Yeah, I guess, people weren't looking through YouTube videos in the 1919
about the dangers of vaccines.
I kind of think they were not.
From his perspective pandemics are actually a fact of life,
no matter where in the world we live.
— There will be new pandemics and new diseases in the future.
We don't know what they'll be,
but every time we stop and say,
'Well we've done a pretty good job, we got rid of most of those diseases,'
they come roaring back.
If younger people today are living in a world where they haven't seen much of that,
just wait, live a little longer,
they we'll see it.
Previous generations only had the memory of pandemics.
But our generations has more information at our fingertips than we know it to make of.
but if we only just asked our doctors
they'd probably say get the flu shot.