Men Against Measles

In the comic strips, measles is a joke. In much of the world the disease is treated lightly, partly from ignorance, partly because it is an almost certain incident of growing up. But measles is, in fact, all too often a killer or the cause of mental crippling. Last week Harvard's famed Virologist John F. Enders and 18 research colleagues, scattered from Colorado to Yugoslavia, reported dramatic progress in efforts to make a safe and sure vaccine against measles.

To date, 303 U.S. children have had the test vaccine; virtually all have responded by developing solid antibody protection against natural measles. Most have had a slight fever in the process, but none have become seriously ill. If wider-scale testing confirms these results, the vaccine may be licensed and generally available in about two years.

Threat to the Brain. The exact toll of measles illnesses and deaths is not known, the researchers note in the New England Journal of Medicine. In 1958 (most recent year for which full figures are available), 552 U.S. deaths were officially listed as caused by measles, as against 255 by poliomyelitis. Measles kills in many ways. The virus is sometimes the direct cause of fatal pneumonia, but more often it is the precursor of a bacterial infection. Measles also has a tendency to attack the middle ear, which may lead to permanent deafness (occasionally total) on both sides.

In its sharpest manifestation, the virus sets off an encephalitis (brain inflammation) so severe that it may cause death --or, worse, such sweeping damage that the victim survives only as an idiot or at the level of a vegetable. How many such cases there are is not known.

Though measles is a reportable disease throughout the U.S., fewer than a fourth of all cases are actually reported to health authorities. Women with several children usually call the doctor for the first one to come down with measles. They learn that he can do nothing to halt the disease, then they quietly apply his guidance in caring for the other children when they catch it--as they usually do, in quick succession. Since 95% of the population eventually gets measles, there are probably more than 3,000.000 U.S. cases a year. Up to 4,000 get encephalitis; best estimate is that 800 of these die (showing how woefully inadequate is the reporting of measles deaths); 2,000 survive with varying degrees of brain injury, and the rest pull through with no apparent permanent damage.

The Zinsser Influence. John Franklin Enders, 63, got interested in the viruses of polio and measles as the result of a series of fortunate fortuities. Son of a Hartford, Conn, banker who left $19 million, Enders had his B.A. ('19) from Yale and M.A. ('22) from Harvard, was well on the way to a Ph.D. and a teaching career in English when a friend exposed him to Harvard's late great Microbiologist Hans Zinsser, author of Rats, Lice and History. Enders switched to microbiology, took his Ph.D. in it ('30), settled down to teaching and research.

In 1948, while his lab was partly financed by a grant from the National Foundation, Enders took a flyer in polio virus culture. With Drs. Frederick Robbins and Thomas Weller, he found a way to grow the virus so that a safe vaccine could be made. For this work, on which the Salk and all later polio vaccines are based, the trio got a 1954 Nobel Prize. Harvard recognized Dr. Enders' greatness by naming him a full professor in 1956. Perpetual Fame. In 1953 Enders asked Dr. Thomas Peebles, assistant in his lab at Children's Hospital in Boston, whether he would like to take a crack at measles. Peebles would and did. First he needed some measles virus to work with. He thought he was getting it from measles-stricken students at the Fay School in nearby Southboro. But his first cultures turned up only cold-sore viruses or nothing at all. Then, from the blood and throat washings of David Edmonston, 11, son of a mathematician in Bethesda, Md., Peebles cultured what proved to be the virus of measles. If the vaccine based on this work fulfills the researchers' hopes, Edmonston, now a high school senior, will enjoy vicarious but perpetual fame in the annals of medicine.

From its isolation in 1954 until it could be attenuated for trial as a vaccine in monkeys, the Edmonston strain took almost four years of exquisitely refined laboratory techniques and testing. Dr. Enders put a series of assistants to work on it in turn. Each kept the virus growing while transplanting it from one tissue-culture pot to another. One grew it in cultures of cells from human kidneys. Another kept it going through 28 transplantations in cells of human amnion ("bag of waters"). A third got it to flourish in the amnion of fertilized hens' eggs. Dr. Samuel L. Katz took it from there, found that by this time the virus would multiply in chick-embryo cells growing in test tubes.

Drs. Enders and Katz soon found that in monkeys Edmonston virus causes a mild infection that provokes the subject to make antibodies against the measles virus. And antibody preparations from monkeys' blood provided the first sure test for the presence of measles virus.

Encouraging Tests. Dr. Katz began needle work on children. (Dr. Enders, no M.D., cannot give injections to human subjects.) The first dozen cases were encouraging enough for the Boston group to send vaccine to pediatric researchers in New York (Staten Island), Cleveland and Denver. Of the first 171 who had the vaccine injected just under the skin, 83% developed a fever that usually lasted less than three days. It was lower than the fever of ordinary measles, with a mean of 102.4DEG (rectal). About half the children developed a rash. Again it was milder than that of natural measles, and only 16% of the children ever got the severe spotting inside the mouth that characterizes the typical disease.

Will mothers be willing to have their children get a vaccine that provokes these reactions? The investigators think so. In fact, it would seem that the reactions are a good thing: they constitute evidence that the vaccination has taken. And despite high temperatures, the vaccinated children did not get sick enough to be kept in bed. They played games as usual. Most important, from the physicians' point of view, they did not develop the coughs, runny noses and stuffed-up heads of real measles--so often the forerunners of pneumonia. On the basis of early tests, neurologists believe that the vaccine, which has caused no encephalitis in monkeys, also protects the -human brain against viral invasion and damage.

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