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Minutes of society meetings
February 1957
Virus Infections Some Notes on Prophylaxis Facilities for Laboratory Diagnosis in England and Wales By F. O. MACCALLUM. B.SC., M.D.,
Director, Virus Reference Laboratory, Central Public Health Laboratory IRUS vaccines in most common use have been for X [ Protection against smallpox, rabies and yellow fever. V Altltough infection with glycerinated vaccinia pre-
in 1956 and there were probably insufficient paralytic cases in the age groups under study to be able to evaluate the vaccine. Living attenuated poliomyelitis virus vaccine has much to recommend it in the way of production and administration, when fully stable strains are available for all three types. In the work reported to date there has been a tendency for the viruses to interfere with one another if fed together, so several feedings will probably be necessary. The main doubt still lies with the permanence of the attenuation, but newer techniques for selecting pure lines of virus have provided strains which are currently under test and are likely to yield a satisfactory preparation in the near future. I n spite of the advances in technical methods there are still seve/'al common viruses which have been tamed only partly or not at all in the laboratory. No doubt they will receive more attention when poliomyelitis demands less attention. Measles virus can now be grown in certain tissue cultures, but not with the ease of poliomyelitis, and is not available yet for diagnostic purposes or epidemiological studies. I n view of the protection given by gamma globulin a vaccine is unnecessary at present. Varicella and zoster viruses have also been grown in cultures of human embryo tissue in one or two research laboratories in the U.S.A., but the procedure is not a simple one and is not available for use here at present. Rubella and hepatitis viruses have both been reported as cultured successfu!ly, but these reports await confirmation. No doubt success is not far off.
pared from the calf of sheep has been an effective and cheap method of protection against sraaUpox, it has certain drawbacks, and recent work has provided preparations which will withstand tropical temperatures. Efforts are c o n t i n u hag in the search for an effective inactivated virus vaccine for use in previously unvaccinated adults to try to avoid post-vaccil~al encephalitis, for use in pregnant women and for children with eczema. An attenuated rabies vi/'us vaccine prepared in fertile hen eggs has been used effectively in many thousands Of dogs and cattle in recent years and, more recently, in man. In combination with rabies immune serum it has aleady given promise of being more effective than the usual inactivated rabbit or sheep brain vaccine.
Influenza Vaccines Formolised influenza A and B virus vaccines have been shown to be effective in reducing the incidence of the disease, particularly in communities such as military establishments and boarding schools where the attack r a t e may be high. So m a n y other infections may be classed a s " influenza " in the general population that it may be difficult to demonstrate the effectiveness of the vaccine unless there is a very severe epidemic. Work on the use of living attenuated influenza viruses which might be easier to prepare and administer is being actively pursued in a number of countries. Some of the newly recognised adenoviruses have been -found t o cause respiratory infections, particularly among service recruits in winter time in the U.S.A. and Europe. Two apparently successful trials of a new vaccine containing several types of thesel ~viruses were carried out in the winter of 1955-6 in the U.S.A.~ Poliomyelitis vaccines have held the front page news for several years now, and work on' this continues. A very large amount of formolised virus vaccine of the Salk type has been used in the U.S.A. in 1955 and 1956, and the authorities are optimistic. Although there were many fewer cases of poliomyelitis notified in the U.S.A. this year than in the previous 4 years, the figures were higher than in 1947 in that country; and one must wait for several years to give .the final assessment. About two hundred thousand children under 10 years of age were injected in this country in 1956 ~with two doses of vaccine made in England, at an .interval of. a month between injections. The incidence of paralytic poliomyelitis was relatively low
Serum Prophylaxis It is now well recognised that gamma globulin prepared from pools of adult plasma can be used in the incubation period to prevent or attenuate an attack of measles in a very young child, or one in bad health from some other cause such as tuberculosis. Similar batches of gamma globulin are capable of producing a similar effect in infectious hepatitis and may be of value for nursing staff i n certain institutions where the disease is epidemic, or in adults who have no previous history of attack and are exposed to children in their family who have been infected at school. Unfortunately, the experimental work carried out in volunteers has shown that the gamma globulin fraction prepared from the serum of individuals convalescent from serum hepatitis does not have a protective effect against this disease. There is no risk from serum hepatitis from the gamma globulin itself.
* Abstract os an address delivered at a refresher course for school medical officers on September 21st, 1956. 95
Virus Iu[ections
PUBLIC HEALTH
R u b e l l a virus infection in the m o t h e r m a y result in passage o f the virus in the b l o o d stream to the foetus, and if this occurs in the first three to f o u r m o n t h s it sometimes results in cataract, deaf mutism, heart disease and mental retardation in the infant. G a m m a globulin is available for use in p r e g n a n t w o m a n contacts of rubella during the danger p e r i o d ,
T h e r e is little p r o o f that even g a m m a globulin prepared f r o m convalescent plasma is o f v a l u e in other virus diseases, such as varicelta, but it m a y reduce the chances of complications in mumps. T h e position in c h e m o t h e r a p y has r e m a i n e d unchanged for m a n y years. T h e o n l y viruses susceptible are those of th e psittacosis-lymphogranuloma v e n e r e u m group.
VIRUS DIAGNOSTIC LABORATORIES IN THE PUBLIC H E A L T H LABORATORY SERVICE (A.P.C.) ; psittacosis ; Q [ever ; strep.M.G. (atypical pneumonia) ; m u m p s ; and lymphocytic choriomeningitis are carried out at Bath, Birmingham, Bradford, Cambridge, Cardiff, Carlisle, C a r m a r t h e n , Chelmsford, Colindale, C o u n t y H a l l L o n d o n , Coventry, Exeter, Leeds, Leicester, Liverpool, Luton, Manchester, Newcastle, N o r t h a m p t o n , Nottingham, P l y m o u t h , Portsmouth, Salisbury, Stafford, Sheffield, Swansea, Winchester a n d Worcester.
T
H E n u m b e r of laboratories carrying out virus diagnostic w o r k is steadily expanding, as is the scope of the work. A l t h o u g h s o m e laboratories of the Public H e a l t h L a b o r a t o r y Service m a y not be included in the following list at this date all will be able to help in the collection of the correct type of specimen for any particular investigation. In addition to the isolation of influenza virus in eggs (because n o suitable tissue culture is yet available) and
Isolcttio.n of poliomyelitis and adeno.viruses~in tissue cultures is carried o u t at Bedford, Birmingham,
isolation of adeno~viruses, some Coxsackie viruses a n d poliomyelitis viruses in H e L a cell tissue cultures, bolation of variolct, vaccinict, cowpox, herpes simplex, psittacosis and lymphocytic choriomeningitis and other viruses in
Cambridge, Cardiff, Carlisle, Chelmsford, Colindale, C o u n t y H a l l L o n d o n , Exeter, G u i l d f o r d , Leicester, Leeds, Manchester, Nottingham, Plymouth, Portsmouth, Salisbury, Sheffield, Stafford and Winchester. Isolation o f influenza v&us in [ertile hen eggs is carried out at Birmingham, Cambridge, Cardiff, Carlisle, Colindale, Exeter, Leeds, Liverpool, Manchester, N o r t h a m p t o n , P o r t s m o u t h and Sheffield.
various animals and culture is carried out at Colindale and a small n u m b e r of other laboratories. Serological tests /or poliomyelitis m a y be available in a n u m b e r of laboratories in the c o m i n g year.
Serological tests [or influenza .4, B and C ; adenoviruses
Minutes of Society Meetings SPECIAL GENERAL MEETING Minutes of a special general meeting of the Society held in the Council Chamber, British Medical Association, Tavistock House South, Tavistock Square, W.C.I., on Friday, December 28th, 1956, at 9.30 a.m. Present : Dr. J. D. Kershaw, president, in the chair, and 12 members of the Society. In attendance : Sir Selwyn Selwyn-Clarke, medical secretary. 1. Approval of Minutes.--The minutes of the ordinary meeting of the Society held on October 19th, 1956, which had been published in the December issue of the Society's journal and circulated to all members, were taken as read and were approved, confirmed and signed by the president. 2. Special resolutions.--The special resolutions relating to the memorandum and articles of association of the Society which hgd been circulated to all members on December 1st, 1956, were then considered. On the motion of Dr. Chalke seconded by Sir Allen Daley it was resolved I. That the memorandum of association of the Society be amended as indicated in Resolution I circulated to members with the agenda for the meeting. II. That the articles of association of the Society be amended as indicated in Resolution 2 circulated to members with the agenda for the meeting. 3. Election of Fellows and Associates.--The president informed the meeting that the names of 18 applying for fellowship and six applying for- associateship of the Society had been circulated to all members of the Society with the pink circular in November and another 17 applying for fellowship with the December circular. On a motion from the chair these 41 candidates were duly elected as members of the Society. 4. Other business. On the motion of Dr. Btyth Brooke, members present at the meeting unanimously decided t o record their' good wishes" to the president for the coming year. There
being no other business, the president thanked members for their attendance at an early hour and declared the meeting closed. ANNUAL GENERAL MEETING The Annual General Meeting of the Society for the 1954-5 session was held in the Council Room, B.M.A. House, Tavistock Square, W.C.1, on Friday, February 17th, 1956, at 12.50 p.m. The president, Dr. (;has. F. White, was in the chair and 30 members: were present. Minutes. The minutes of the previous meeting held on January 14th, 1955, were approved, confirmed and signed by the president. Annual Reports and Accounts.--The annual reports of the Council, the honorary treasurer and the editor of PUBLIC HEALTH for the 1954-5 session were received and adopted, together with the Balance Sheet at September 30th, 1954, and Income and Expenditure Account for the year ended September 30th, 1955. It was agreed that the financial affairs of the Society should be subjected to a detailed enquiry and a report submitted at the next Council meeting by the Executive Committee. Appointment of Auditors.--Messrs. Greene, Clements & Co., Chartered Accountants, 20 Bloomsbury Square, W.C.1, were reappointed as auditors. Election of 26 Members.--The following candidates, having been duly proposed and seconded, were elected to membership of the Society :--Drs. Bridget M. Bancroft, J. H. F. Brotherton, Catherine M. Counolly, Margaret M . Coughlan-Jones, Jessie S. Freeman, S. Freeman, Catriona M. Gourlay., Euphemia T. Guild, J. A. Hanraty, S. Hewitt, C. B. Higgie, Louise M. E. Hogg, G. B. Hopkins, A. C. Howard, J. W. Parsons, Steila M. B. Perry, M. Reilly, Elizabeth M. Sefton, F. Seymour; Esther E. Simpson, T. Stephens, R. B. Walker, Margaret Wigley, C. White, Elizabeth M. Jennings, Helen E.=Mair. Life Membership.---The following members were elected as life members of the Society "on the nomination of the Council and theii" branches : Drs. W. S. H. Campbell and C. A. Mason. 96
Virus Infections Some Notes on Prophylaxis Facilities for Laboratory Diagnosis in England and Wales By F. O. MACCALLUM. B.SC., M.D.,
Director, Virus Reference Laboratory, Central Public Health Laboratory IRUS vaccines in most common use have been for X [ Protection against smallpox, rabies and yellow fever. V Altltough infection with glycerinated vaccinia pre-
in 1956 and there were probably insufficient paralytic cases in the age groups under study to be able to evaluate the vaccine. Living attenuated poliomyelitis virus vaccine has much to recommend it in the way of production and administration, when fully stable strains are available for all three types. In the work reported to date there has been a tendency for the viruses to interfere with one another if fed together, so several feedings will probably be necessary. The main doubt still lies with the permanence of the attenuation, but newer techniques for selecting pure lines of virus have provided strains which are currently under test and are likely to yield a satisfactory preparation in the near future. I n spite of the advances in technical methods there are still seve/'al common viruses which have been tamed only partly or not at all in the laboratory. No doubt they will receive more attention when poliomyelitis demands less attention. Measles virus can now be grown in certain tissue cultures, but not with the ease of poliomyelitis, and is not available yet for diagnostic purposes or epidemiological studies. I n view of the protection given by gamma globulin a vaccine is unnecessary at present. Varicella and zoster viruses have also been grown in cultures of human embryo tissue in one or two research laboratories in the U.S.A., but the procedure is not a simple one and is not available for use here at present. Rubella and hepatitis viruses have both been reported as cultured successfu!ly, but these reports await confirmation. No doubt success is not far off.
pared from the calf of sheep has been an effective and cheap method of protection against sraaUpox, it has certain drawbacks, and recent work has provided preparations which will withstand tropical temperatures. Efforts are c o n t i n u hag in the search for an effective inactivated virus vaccine for use in previously unvaccinated adults to try to avoid post-vaccil~al encephalitis, for use in pregnant women and for children with eczema. An attenuated rabies vi/'us vaccine prepared in fertile hen eggs has been used effectively in many thousands Of dogs and cattle in recent years and, more recently, in man. In combination with rabies immune serum it has aleady given promise of being more effective than the usual inactivated rabbit or sheep brain vaccine.
Influenza Vaccines Formolised influenza A and B virus vaccines have been shown to be effective in reducing the incidence of the disease, particularly in communities such as military establishments and boarding schools where the attack r a t e may be high. So m a n y other infections may be classed a s " influenza " in the general population that it may be difficult to demonstrate the effectiveness of the vaccine unless there is a very severe epidemic. Work on the use of living attenuated influenza viruses which might be easier to prepare and administer is being actively pursued in a number of countries. Some of the newly recognised adenoviruses have been -found t o cause respiratory infections, particularly among service recruits in winter time in the U.S.A. and Europe. Two apparently successful trials of a new vaccine containing several types of thesel ~viruses were carried out in the winter of 1955-6 in the U.S.A.~ Poliomyelitis vaccines have held the front page news for several years now, and work on' this continues. A very large amount of formolised virus vaccine of the Salk type has been used in the U.S.A. in 1955 and 1956, and the authorities are optimistic. Although there were many fewer cases of poliomyelitis notified in the U.S.A. this year than in the previous 4 years, the figures were higher than in 1947 in that country; and one must wait for several years to give .the final assessment. About two hundred thousand children under 10 years of age were injected in this country in 1956 ~with two doses of vaccine made in England, at an .interval of. a month between injections. The incidence of paralytic poliomyelitis was relatively low
Serum Prophylaxis It is now well recognised that gamma globulin prepared from pools of adult plasma can be used in the incubation period to prevent or attenuate an attack of measles in a very young child, or one in bad health from some other cause such as tuberculosis. Similar batches of gamma globulin are capable of producing a similar effect in infectious hepatitis and may be of value for nursing staff i n certain institutions where the disease is epidemic, or in adults who have no previous history of attack and are exposed to children in their family who have been infected at school. Unfortunately, the experimental work carried out in volunteers has shown that the gamma globulin fraction prepared from the serum of individuals convalescent from serum hepatitis does not have a protective effect against this disease. There is no risk from serum hepatitis from the gamma globulin itself.
* Abstract os an address delivered at a refresher course for school medical officers on September 21st, 1956. 95
Virus Iu[ections
PUBLIC HEALTH
R u b e l l a virus infection in the m o t h e r m a y result in passage o f the virus in the b l o o d stream to the foetus, and if this occurs in the first three to f o u r m o n t h s it sometimes results in cataract, deaf mutism, heart disease and mental retardation in the infant. G a m m a globulin is available for use in p r e g n a n t w o m a n contacts of rubella during the danger p e r i o d ,
T h e r e is little p r o o f that even g a m m a globulin prepared f r o m convalescent plasma is o f v a l u e in other virus diseases, such as varicelta, but it m a y reduce the chances of complications in mumps. T h e position in c h e m o t h e r a p y has r e m a i n e d unchanged for m a n y years. T h e o n l y viruses susceptible are those of th e psittacosis-lymphogranuloma v e n e r e u m group.
VIRUS DIAGNOSTIC LABORATORIES IN THE PUBLIC H E A L T H LABORATORY SERVICE (A.P.C.) ; psittacosis ; Q [ever ; strep.M.G. (atypical pneumonia) ; m u m p s ; and lymphocytic choriomeningitis are carried out at Bath, Birmingham, Bradford, Cambridge, Cardiff, Carlisle, C a r m a r t h e n , Chelmsford, Colindale, C o u n t y H a l l L o n d o n , Coventry, Exeter, Leeds, Leicester, Liverpool, Luton, Manchester, Newcastle, N o r t h a m p t o n , Nottingham, P l y m o u t h , Portsmouth, Salisbury, Stafford, Sheffield, Swansea, Winchester a n d Worcester.
T
H E n u m b e r of laboratories carrying out virus diagnostic w o r k is steadily expanding, as is the scope of the work. A l t h o u g h s o m e laboratories of the Public H e a l t h L a b o r a t o r y Service m a y not be included in the following list at this date all will be able to help in the collection of the correct type of specimen for any particular investigation. In addition to the isolation of influenza virus in eggs (because n o suitable tissue culture is yet available) and
Isolcttio.n of poliomyelitis and adeno.viruses~in tissue cultures is carried o u t at Bedford, Birmingham,
isolation of adeno~viruses, some Coxsackie viruses a n d poliomyelitis viruses in H e L a cell tissue cultures, bolation of variolct, vaccinict, cowpox, herpes simplex, psittacosis and lymphocytic choriomeningitis and other viruses in
Cambridge, Cardiff, Carlisle, Chelmsford, Colindale, C o u n t y H a l l L o n d o n , Exeter, G u i l d f o r d , Leicester, Leeds, Manchester, Nottingham, Plymouth, Portsmouth, Salisbury, Sheffield, Stafford and Winchester. Isolation o f influenza v&us in [ertile hen eggs is carried out at Birmingham, Cambridge, Cardiff, Carlisle, Colindale, Exeter, Leeds, Liverpool, Manchester, N o r t h a m p t o n , P o r t s m o u t h and Sheffield.
various animals and culture is carried out at Colindale and a small n u m b e r of other laboratories. Serological tests /or poliomyelitis m a y be available in a n u m b e r of laboratories in the c o m i n g year.
Serological tests [or influenza .4, B and C ; adenoviruses
Minutes of Society Meetings SPECIAL GENERAL MEETING Minutes of a special general meeting of the Society held in the Council Chamber, British Medical Association, Tavistock House South, Tavistock Square, W.C.I., on Friday, December 28th, 1956, at 9.30 a.m. Present : Dr. J. D. Kershaw, president, in the chair, and 12 members of the Society. In attendance : Sir Selwyn Selwyn-Clarke, medical secretary. 1. Approval of Minutes.--The minutes of the ordinary meeting of the Society held on October 19th, 1956, which had been published in the December issue of the Society's journal and circulated to all members, were taken as read and were approved, confirmed and signed by the president. 2. Special resolutions.--The special resolutions relating to the memorandum and articles of association of the Society which hgd been circulated to all members on December 1st, 1956, were then considered. On the motion of Dr. Chalke seconded by Sir Allen Daley it was resolved I. That the memorandum of association of the Society be amended as indicated in Resolution I circulated to members with the agenda for the meeting. II. That the articles of association of the Society be amended as indicated in Resolution 2 circulated to members with the agenda for the meeting. 3. Election of Fellows and Associates.--The president informed the meeting that the names of 18 applying for fellowship and six applying for- associateship of the Society had been circulated to all members of the Society with the pink circular in November and another 17 applying for fellowship with the December circular. On a motion from the chair these 41 candidates were duly elected as members of the Society. 4. Other business. On the motion of Dr. Btyth Brooke, members present at the meeting unanimously decided t o record their' good wishes" to the president for the coming year. There
being no other business, the president thanked members for their attendance at an early hour and declared the meeting closed. ANNUAL GENERAL MEETING The Annual General Meeting of the Society for the 1954-5 session was held in the Council Room, B.M.A. House, Tavistock Square, W.C.1, on Friday, February 17th, 1956, at 12.50 p.m. The president, Dr. (;has. F. White, was in the chair and 30 members: were present. Minutes. The minutes of the previous meeting held on January 14th, 1955, were approved, confirmed and signed by the president. Annual Reports and Accounts.--The annual reports of the Council, the honorary treasurer and the editor of PUBLIC HEALTH for the 1954-5 session were received and adopted, together with the Balance Sheet at September 30th, 1954, and Income and Expenditure Account for the year ended September 30th, 1955. It was agreed that the financial affairs of the Society should be subjected to a detailed enquiry and a report submitted at the next Council meeting by the Executive Committee. Appointment of Auditors.--Messrs. Greene, Clements & Co., Chartered Accountants, 20 Bloomsbury Square, W.C.1, were reappointed as auditors. Election of 26 Members.--The following candidates, having been duly proposed and seconded, were elected to membership of the Society :--Drs. Bridget M. Bancroft, J. H. F. Brotherton, Catherine M. Counolly, Margaret M . Coughlan-Jones, Jessie S. Freeman, S. Freeman, Catriona M. Gourlay., Euphemia T. Guild, J. A. Hanraty, S. Hewitt, C. B. Higgie, Louise M. E. Hogg, G. B. Hopkins, A. C. Howard, J. W. Parsons, Steila M. B. Perry, M. Reilly, Elizabeth M. Sefton, F. Seymour; Esther E. Simpson, T. Stephens, R. B. Walker, Margaret Wigley, C. White, Elizabeth M. Jennings, Helen E.=Mair. Life Membership.---The following members were elected as life members of the Society "on the nomination of the Council and theii" branches : Drs. W. S. H. Campbell and C. A. Mason. 96