Wellcome Library, London
Spotlight
Historical Profile Sir Patrick Playfair Laidlaw British virologist who first isolated the influenza virus from human beings. Born in Glasgow, UK, on Sept 26, 1881, he died on March 19, 1940, aged 59 years. Described as a gentle, modest, generous man of science, Sir Patrick Playfair Laidlaw was part of the team of researchers who in 1933 discovered that a virus was the infective agent of human influenza, a deadly respiratory illness that had killed more than 50 million people only 15 years previously. The 1918 pandemic stands as the most deadly single event in recorded history, killing more people than did the Black Death bubonic plague (1347–51) or World War 1. While presenting Laidlaw with the Royal Medal in 1933, the President of the Royal Society, Sir Frederick Gowland Hopkins, stated that “both in its scientific and practical aspects, this is one of the most successful investigations in medical science”. Laidlaw studied medicine at St John’s College, Cambridge, and graduated from Guy’s Hospital, 682
London, where he received the Gold Medal in Medicine for showing distinguished promise. His next 4 years were spent at the Wellcome Physiological Research Laboratories at Herne Hill in south London, researching pharmacological actions of aminoacids under the directorship of Henry Hallett Dale, who described Laidlaw’s time there as one of “remarkable and varied fertility in research”. This was a happy time for Laidlaw— he would spend summers playing golf, and visit his beloved Scotland for fishing and sailing. In 1913, Laidlaw received the Sir William Dunn Lectureship in Pathology at Guy’s; however, this bright prospect was overshadowed by the start of World War 1. The war years were a bleak time for scientists in Britain, and few achievements could be made in research between 1914 and 1918. Unable to fight because of a childhood disability, for Laidlaw, this was also a time of isolation. In 1918–19, a deadly influenza swept through Britain. Influenza is a severe respiratory disease with a fast onset—some victims died within hours of their first symptoms, which included pneumonia, heliotrope cyanosis (a term coined during the 1918 flu pandemic to describe the blue discolouration of the skin caused by buildup of fluid in the lungs and subsequent suffocation), and sepsis. Little was known about the cause of influenza, and no effective prevention, vaccine, or treatments were available. There were suggestions that the pandemic was the result of German biological warfare, or that the war was a predisposing cause, related to mustard gas, smoke, cordite fumes, and filthy trenches, explains Carole Reeves, Senior Lecturer at the UCL Department of Science and Technology Studies (London, UK). “There was a paradox; Britain, with one of the most sophisticated public health systems of the period, mounted one of the least effective responses to the pandemic”, Reeves comments. Methods of prevention and treatment ranged from nasal douching and gauze masks to opium, alcohol, and turtle soup. “The most common preventive advice was for the public to ignore the epidemic and let expert medical professionals and public health authorities use science to deal with it”, she explains. “The pandemic was arguably the first major challenge to laboratory bacteriology and the new scientific medicine was unable to provide a convincing and widely acceptable frame for the disease.” During this crisis of confidence in the British medical profession, the National Institute for Medical Research (NIMR) launched an initiative in 1922 to create a programme of researchers in an unexplored area— infections caused by filterable or ultramicroscopic viruses. Laidlaw, then at the Medical Research Council (MRC) at Mill Hill, London, was chosen to join the team. This was the longest, last, and most important period in his life as a researcher, during which he was elected as a Fellow of the Royal Society in 1927. In 1933, an www.thelancet.com/respiratory Vol 1 November 2013
Spotlight
outbreak of typical, epidemic influenza presented a chance for Laidlaw to test the possibility that an infection could be caused by a filterable virus. “The work by Sir Patrick Laidlaw and his colleagues Wilson Smith, and later Sir Christopher Andrewes, on influenza can be classified as a key event in influenza research”, explains John McCauley, Director of the WHO Influenza Centre at the MRC. The discovery was made when ferrets they were working on to develop a distemper vaccine caught influenza from one of the scientists in the laboratory. At this time, the systematic study of virus diseases was at an early stage, and as McCauley explains: “Until this truly revolutionary work that enabled the team to show that the agent of influenza was a virus and, crucially in so doing, how it could be propagated, influenza research was largely observational.” The team’s breakthrough enabled definitive research to be done on the properties of the virus, the discovery of its now notorious antigenic variation, and the characterisation of the immune response to infection, which combined led to the rapid development of influenza vaccines. McCauley points out that the ferret model developed by Laidlaw for his work
on canine distemper virus and used for his investigations into influenza is still used for influenza research today. He also adds that although alternative laboratory animals, such as mice and guinea pig models, have been developed, none replicate the disease in human beings as well as the ferret model developed by Laidlaw. In 1935, Laidlaw received an Honour of Knighthood, and, 1 year later, became Deputy Director of the NIMR. His final years were spent quietly (he gave only two lectures that came to publication), but in varied collaborations in entirely different specialties. As Dale remarked: “Few men have given so freely of their knowledge and their ideas to assist the researches of others, and still fewer have been able to do so with effect over such a remarkable range of scientific problems.” Laidlaw will be remembered as a dedicated researcher who boosted scientific credibility at a time when many had lost faith in the medical community, and revolutionised our understanding of a deadly virus, saving millions of lives and paving the way for further developments in influenza research and treatment.
Natalie Harrison
Book Unpicking the politics of tobacco control in Oklahoma, USA In their new book, Heartland Tobacco War, Michael Givel and Andrew Spivak describe how, before 2001, the efforts of the tobacco industry in Oklahoma, USA, were largely triumphant. Progress in tobacco control occurred at a “glacial pace” between 1915 and the early 2000s. In their well researched book, the authors detail how—through retention of former state legislators with inside knowledge as lobbyists—the tobacco industry had “complete hegemony” in tobacco-related legislation. For example, Philip Morris, the cigarette manufacturer, was reported to have shortlists of the most and least friendly legislators and allied and adversary groups. In Tulsa, during 1987, as a result of lobbying by opponents of the legislation for second-hand smoke, the state passed legislation containing a preemption clause that prevented local governments from enacting stronger clean indoor air laws than had been passed by the state; so far, this clause has not been repealed. The tobacco lobby’s political hegemony, however, started to decline between 2001 and 2003. In June, 2001, the new health commissioner for Oklahoma, Leslie Beitsch took office. His intention was to vigorously advocate for new legislation to promote clean indoor air and to raise the tax on cigarettes. Heartland Tobacco War is an in-depth story of the drama behind political and public discourse on tobaccorelated legislation and an examination of how changes to www.thelancet.com/respiratory Vol 1 November 2013
state health policy occurred when Beitsch stood up to the tobacco industry. He achieved much in a short period in office. In October, 2001, Beitsch approved a voluntary and comprehensive tobacco cessation assistance programme for employees of the state’s health department. In January, 2002, his new policy to ban tobacco in all state health department buildings became effective. Progress in clean indoor air legislation also happened: on Sept 1, 2003, the development of the Senate Joint Resolution 21 became effective. This legislation meant a clean-indoor-air standard for most public areas and workplaces in the state. Beitsch’s campaign for clean indoor air was successful because it included promotion of the public interest and holding politicians publicly accountable for their pro-tobacco actions. Sadly, because of the worsening hostility directed towards Beitsch, he resigned in 2003. Despite his departure, the momentum from the clean indoor air bill led to the “first significant tobacco tax increase since the early 1980s” in Oklahoma in 2004. Givel and Spivak tell an interesting story that provides important lessons for the achievement of further progress in tobacco-control legislation in Oklahoma and other US states despite the tactics and resources used by the tobacco industry.
Heartland Tobacco War Michael S Givel, Andrew L Spivak. Lexington Books, 2013. Pp 121. US$60. ISBN 978-0-7391-7692-4.
Farhat Yaqub 683
Spotlight
Historical Profile Sir Patrick Playfair Laidlaw British virologist who first isolated the influenza virus from human beings. Born in Glasgow, UK, on Sept 26, 1881, he died on March 19, 1940, aged 59 years. Described as a gentle, modest, generous man of science, Sir Patrick Playfair Laidlaw was part of the team of researchers who in 1933 discovered that a virus was the infective agent of human influenza, a deadly respiratory illness that had killed more than 50 million people only 15 years previously. The 1918 pandemic stands as the most deadly single event in recorded history, killing more people than did the Black Death bubonic plague (1347–51) or World War 1. While presenting Laidlaw with the Royal Medal in 1933, the President of the Royal Society, Sir Frederick Gowland Hopkins, stated that “both in its scientific and practical aspects, this is one of the most successful investigations in medical science”. Laidlaw studied medicine at St John’s College, Cambridge, and graduated from Guy’s Hospital, 682
London, where he received the Gold Medal in Medicine for showing distinguished promise. His next 4 years were spent at the Wellcome Physiological Research Laboratories at Herne Hill in south London, researching pharmacological actions of aminoacids under the directorship of Henry Hallett Dale, who described Laidlaw’s time there as one of “remarkable and varied fertility in research”. This was a happy time for Laidlaw— he would spend summers playing golf, and visit his beloved Scotland for fishing and sailing. In 1913, Laidlaw received the Sir William Dunn Lectureship in Pathology at Guy’s; however, this bright prospect was overshadowed by the start of World War 1. The war years were a bleak time for scientists in Britain, and few achievements could be made in research between 1914 and 1918. Unable to fight because of a childhood disability, for Laidlaw, this was also a time of isolation. In 1918–19, a deadly influenza swept through Britain. Influenza is a severe respiratory disease with a fast onset—some victims died within hours of their first symptoms, which included pneumonia, heliotrope cyanosis (a term coined during the 1918 flu pandemic to describe the blue discolouration of the skin caused by buildup of fluid in the lungs and subsequent suffocation), and sepsis. Little was known about the cause of influenza, and no effective prevention, vaccine, or treatments were available. There were suggestions that the pandemic was the result of German biological warfare, or that the war was a predisposing cause, related to mustard gas, smoke, cordite fumes, and filthy trenches, explains Carole Reeves, Senior Lecturer at the UCL Department of Science and Technology Studies (London, UK). “There was a paradox; Britain, with one of the most sophisticated public health systems of the period, mounted one of the least effective responses to the pandemic”, Reeves comments. Methods of prevention and treatment ranged from nasal douching and gauze masks to opium, alcohol, and turtle soup. “The most common preventive advice was for the public to ignore the epidemic and let expert medical professionals and public health authorities use science to deal with it”, she explains. “The pandemic was arguably the first major challenge to laboratory bacteriology and the new scientific medicine was unable to provide a convincing and widely acceptable frame for the disease.” During this crisis of confidence in the British medical profession, the National Institute for Medical Research (NIMR) launched an initiative in 1922 to create a programme of researchers in an unexplored area— infections caused by filterable or ultramicroscopic viruses. Laidlaw, then at the Medical Research Council (MRC) at Mill Hill, London, was chosen to join the team. This was the longest, last, and most important period in his life as a researcher, during which he was elected as a Fellow of the Royal Society in 1927. In 1933, an www.thelancet.com/respiratory Vol 1 November 2013
Spotlight
outbreak of typical, epidemic influenza presented a chance for Laidlaw to test the possibility that an infection could be caused by a filterable virus. “The work by Sir Patrick Laidlaw and his colleagues Wilson Smith, and later Sir Christopher Andrewes, on influenza can be classified as a key event in influenza research”, explains John McCauley, Director of the WHO Influenza Centre at the MRC. The discovery was made when ferrets they were working on to develop a distemper vaccine caught influenza from one of the scientists in the laboratory. At this time, the systematic study of virus diseases was at an early stage, and as McCauley explains: “Until this truly revolutionary work that enabled the team to show that the agent of influenza was a virus and, crucially in so doing, how it could be propagated, influenza research was largely observational.” The team’s breakthrough enabled definitive research to be done on the properties of the virus, the discovery of its now notorious antigenic variation, and the characterisation of the immune response to infection, which combined led to the rapid development of influenza vaccines. McCauley points out that the ferret model developed by Laidlaw for his work
on canine distemper virus and used for his investigations into influenza is still used for influenza research today. He also adds that although alternative laboratory animals, such as mice and guinea pig models, have been developed, none replicate the disease in human beings as well as the ferret model developed by Laidlaw. In 1935, Laidlaw received an Honour of Knighthood, and, 1 year later, became Deputy Director of the NIMR. His final years were spent quietly (he gave only two lectures that came to publication), but in varied collaborations in entirely different specialties. As Dale remarked: “Few men have given so freely of their knowledge and their ideas to assist the researches of others, and still fewer have been able to do so with effect over such a remarkable range of scientific problems.” Laidlaw will be remembered as a dedicated researcher who boosted scientific credibility at a time when many had lost faith in the medical community, and revolutionised our understanding of a deadly virus, saving millions of lives and paving the way for further developments in influenza research and treatment.
Natalie Harrison
Book Unpicking the politics of tobacco control in Oklahoma, USA In their new book, Heartland Tobacco War, Michael Givel and Andrew Spivak describe how, before 2001, the efforts of the tobacco industry in Oklahoma, USA, were largely triumphant. Progress in tobacco control occurred at a “glacial pace” between 1915 and the early 2000s. In their well researched book, the authors detail how—through retention of former state legislators with inside knowledge as lobbyists—the tobacco industry had “complete hegemony” in tobacco-related legislation. For example, Philip Morris, the cigarette manufacturer, was reported to have shortlists of the most and least friendly legislators and allied and adversary groups. In Tulsa, during 1987, as a result of lobbying by opponents of the legislation for second-hand smoke, the state passed legislation containing a preemption clause that prevented local governments from enacting stronger clean indoor air laws than had been passed by the state; so far, this clause has not been repealed. The tobacco lobby’s political hegemony, however, started to decline between 2001 and 2003. In June, 2001, the new health commissioner for Oklahoma, Leslie Beitsch took office. His intention was to vigorously advocate for new legislation to promote clean indoor air and to raise the tax on cigarettes. Heartland Tobacco War is an in-depth story of the drama behind political and public discourse on tobaccorelated legislation and an examination of how changes to www.thelancet.com/respiratory Vol 1 November 2013
state health policy occurred when Beitsch stood up to the tobacco industry. He achieved much in a short period in office. In October, 2001, Beitsch approved a voluntary and comprehensive tobacco cessation assistance programme for employees of the state’s health department. In January, 2002, his new policy to ban tobacco in all state health department buildings became effective. Progress in clean indoor air legislation also happened: on Sept 1, 2003, the development of the Senate Joint Resolution 21 became effective. This legislation meant a clean-indoor-air standard for most public areas and workplaces in the state. Beitsch’s campaign for clean indoor air was successful because it included promotion of the public interest and holding politicians publicly accountable for their pro-tobacco actions. Sadly, because of the worsening hostility directed towards Beitsch, he resigned in 2003. Despite his departure, the momentum from the clean indoor air bill led to the “first significant tobacco tax increase since the early 1980s” in Oklahoma in 2004. Givel and Spivak tell an interesting story that provides important lessons for the achievement of further progress in tobacco-control legislation in Oklahoma and other US states despite the tactics and resources used by the tobacco industry.
Heartland Tobacco War Michael S Givel, Andrew L Spivak. Lexington Books, 2013. Pp 121. US$60. ISBN 978-0-7391-7692-4.
Farhat Yaqub 683
