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Show fc 99 Altering the genes of viruses and bacteria so that they cannot produce disease but can stimulate antibodies. Isolating pieces of germs that can trigger immunity against the whole germ. Dr. Salk told PARADE: If there is a will to do so, there will be a way to develop vaccines. was slow This scientific know-hoin coming. In 1796, Edward Jenner, an English doctor, observed that milkmaids who caught cowpox from cows did not catch the deadly smallpox. Jenner got the idea that nibbing pus from the cows pox into peoples skin might somehow protect them from smallpox. Thus began vaccination, which comes from the Latin word for cow. vacca. Jenner didn't know it, but the pus contained the cowpox virus, now called vaccinia. (Like all viruses, vaccinia is a tiny germ, so small that 100,000 of them can fit onto the period at the end of this sentence.) And because this cowpox virus is a weak cousin to the smallpox virus, the cowpox antibodies stopped the smallpox germ. Much of vaccine technology today is based on Jenners principle --that is, using weak relatives or altered germs to fight more powerful viruses and bacteria. w yrV. t- ; u- - - However, most infections do not have such close relatives as do cowpox and smallpox, so scientists have to weaken strong viruses in the laboratory. The technique of injecting children with vaccines made from weakened viruses has reduced measles, mumps and rubella (German measles) to only a few thousand cases of each a year, the lowest levels in history. (The rubella vaccine is critical for any woman of childbearing age because, if she becomes pregnant, the virus can blind, deafen or retard her unborn child.) Despite these successes, vaccine science is not without controversy over the relative safety of live versus killed viruses and bacteria. Those who favor live vaccines point with pride to the success of the live Sabin polio vaccine (named for Dr. Albert Sabin), which practically wiped out polio. Made from thoroughly enfeebled viruses, it is touted today as one of the safest of the live vaccines. Nevertheless, it causes five to 10 cases of paralysis in the U.S. each year. Although it protects the vaccinated person from disease, the virus in the vaccine somehow regains its strength and may contaminate others. Dr. Salk and other proponents of his The Bower Of Vaccines t k L . V V -- a t V-- v JL ,fr . V Js' 1. - -, A ; Vaccines, r-- X i vs. and parental vigilance, have all but Miterated childhood diseases. Disease US. Cases in Peak Year (Before Modern Vaccine) Diphtheria Measles 206,999 481,530 Mumps 152,209 Polio Rubella Smallpox Tetanus Whooping cough 57,879 57.686 632,000 -- 601 .265,269 (1921) (1962) (1968) (1952) (1969) (1949) (1948) (1934) la 1982 (After Vaccine) 3 1697 5196 7 2283 0 81 1784 Latest year for which figures are available. Worldwide figure; actual unreported cases may be 10 to 50 times h'gher. 551 killed virus vaccine say that it is safer and just as potent as the live Sabin vaccine. They point to another vaccine, the DTP, a single vaccine that contains no living matter yet has all but obliteratd childhood diseases ed three diphtheria, tetanus and whooping cough, also called pertussis. (These three infections are caused by bacteria. Bacteria are perhaps a hundred times larger than viruses and, unlike viruses, they can reproduce outside cells. They do their damage by emitting poisons.) But even vaccines made from killed viruses and bactena are not without problems. From a controlled British study, it has been determined that the DTP vaccine causes brain damage in one child in 310,000. Nevertheless, without vaccination, the incidence of death by whooping cough increases by 19 times and the likelihood of brain damage quadruples. So, its advocates insist, taking the vaccine is much safer than not taking it. In response to the need for new vaccines and questions about existing ones the National Institute of Allergy and Infectious Diseases has set up a priority list of 10 inoculations against serious germ maladies. High on that list are fining a new, safer vaccine for whooping cough and w inning approval from the Food and Drug Administration for the chickenpox vaccine that already has saved Elena Jenkins. The institute also advocates a live vaccine for influenza, which kills 10,000 people a year. Several vaccines made from killed influenza virus already exist. They particularly benefit older, chronically ill people who have lung, heart and other health infirmities. But only 20 percent of this high-ris- k group takes the shots. If all such high-ris- k people were inoculated, says the Center for Disease Control in Atlanta, flu vaccines could save an additional 5000 lives in the U.S. But because the flu plays tricks on scientists, the influenza virus presents its own special problem. With each flu season, several different viruses may circulate in the population, so that the old vaccine doesn't work. Health officials hope that a live vaccine will be easier to manufacture and administer than a killed one. For one thing, if a new flu virus appears on the scene, scientists can quickly tailor-mak- e a vaccine to stop that epidemic. For another, the new vaccines may be sprayed into the nose. Researchers believe that people may be more willing to inhale a vaccine than to take shots. Older people are also reluctant to take vaccine shots for pneumonia, w hich kills 50,000 Americans a year. There is a pneumonia vaccine containing pieces of 23 different forms of killed pneumococcal bacteria. Dr. Maurice Hilleman of Merck & Co., Inc., the largest manufacturer of vaccines, says the injections could protect against 90 percent of pneu- long-feare- Vaccines On The Shelf & The Horizon NOW AVAILABLE Diphtheria: Altered diphtheria toxin Hepatitis B: Pieces of virus from blood Influenza: Killed virus vaccine; live vaccine coming Measles: live virus vaccine Mumps: Live virus vaccine Pneumonia: Mixture of killed pneumococcal bacteria Rabies: Killed virus vaccine Rubella: Live virus vaccine Whooping cough: Killed bacterium; new vaccine being tested BEING TESTED Chickenpox: Live virus vaccine Infant Diarrhea: Weakened live Rotavirus Mental Retardation: CMV live virus vaccine UNDER DEVELOPMENT Gonorrhea: Part of bacterium Hepatitis A: Live virus vaccine Herpes: Altered virus vaccine Malaria: Part of malaria parasite mococcal pneumonia. Pioneers in vaccine research are also developing inoculations to fight some of societys most virulent diseases. In 1982, Dr. Hilleman received FDA approval for his vaccine against hepatitis B, also known as serum hepatitis. He constructed a vaccine out of pieces rather than the whole hepatitis virus. This virus infection inflames the livers of 200,000 Americans a year. At risk are patients, medical personnel w ho handle blood, and homosexuals. Worse, one hepatitis victim in 50 dies from cirrhosis (or hardening) of the liver and 800 people a year contract cancer of the liver. In the world today, 170 million people are infected with hepatitis B. With this vaccine, says Dr. Hilleman, we could eradicate hepatitis in a few generations, just as we did smallpox. The technology is there." Also on the way is a vaccine against hepatitis A, known as infectious hepatitis, which you get from eating contaminated food. Scientists are also struggling with vaccines for gonorrhea and genital herpes. The herpes virus is a particular scourge because it stays in the body for life and intermittently flares up. Dr. Bernard Roizman of Chicago has altered the her-pe- s virus so that it does not linger in the blood-transfusi- FtBRUMY 12, 1984 PARADE MAGAZINE |
