Call for Caution

The very means that man uses to conquer or prevent disease have a way of turning on him unless he uses caution.

Last week, in the A.M.A. Journal, doctors warned of two invaluable aids to medicine that need to be handled with great care.

Monkey Danger. Thousands of lives have been saved with polio vaccines made from virus grown in cells from monkeys' kidneys. But monkeys harbor a mysterious "monkey virus B," which is nearly always fatal in man. At least 18 lab workers, write Drs. Frances M. Love and Erwin Jungherr of Lederle Laboratories, have become infected with "monkey B"--and many other cases have gone undiagnosed.

Monkeys carry the virus without showing any ill effects. But in a case described by Physician Love and Veterinarian Jungherr. a 24-year-old lab worker came down with a bewildering variety of symptoms after going to work as a monkey handler, developed a polio-like stiffness of the neck and died. The autopsy showed that monkey virus B had spread through his lungs, heart, spinal cord and brain.

Virus B belongs to the herpes family, and the victim may have been infected by saliva--a monkey's spit may be as bad as its bite. Lederle now allows only specially trained personnel, following rigid rules, to be near its temperamental monkeys.

Chancy Shots. In similar danger is the do-it-yourselfer who has gashed himself with a dirty hack saw. Since too few people ever have a tetanus booster, and fewer can remember when, his doctor often recommends a shot of antitoxin, designed for emergency use on nonvaccinated patients.

This, says Milwaukee's Dr. H. William Bardenwerper, is probably the chanciest thing the doctor could do. Of 2,000,000 tetanus antitoxin shots given annually in the U.S., an estimated 300,000 to 600,000 result in serum sickness, some in severe, possibly crippling serum neuritis. Antitoxin may cause 20 or more deaths a year.

The risk is nearly always needless, says Dr. Bardenwerper. Although tetanus (lockjaw) itself can be deadly, it can best be guarded against with a toxoid shot, which is made from killed tetanus bacteria and, unlike the antitoxin, contains no animal protein and virtually never causes serious reactions. The public, complains Dr. Bardenwerper, has had too little prodding from doctors on the importance of vaccination with tetanus toxoid, and still less on the need for booster shots every four or five years. Even if the patient has had no recent shots, there is generally no need for antitoxin: before tetanus can develop, there is usually time to start building up active immunity with the toxoid.

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