Reviewed by Margaret Sabine
Published by Angus & Robertson, Harper Collins Publishers, Australia, 1996, 266pp, ISBN 0 207 19041 0, RRP $16.95
'The AIDS epidemic began with the introduction of a monkey virus into humans via contaminated polio vaccine.' Science or science fiction? This horrific suggestion is explored in depth by Julian Cribb in The White Death.
Although AIDS (acquired immune deficiency syndrome) was first observed as a strange new illness among gay men in Los Angeles in 1979, its origin was traced to sub-Saharan Africa during the 1960s. It was a heterosexual disease. The first blood sample testing positive for HIV (human immunodeficiency virus) was collected from an individual in Zaire, in 1959.
The now generally accepted theory of the origin of AIDS is that a simian immunodeficiency virus (SIV) infecting an African monkey was transmitted to humans and learnt, or already knew, how to infect and cause disease in humans and thus became HIV. There is no agreement on how this species transfer occurred and numerous theories of varying degrees of credibility have been proposed—monkey bites, the eating of monkeys, bizarre sexual practices and so on.
It appears that two major strains of HIV arose initially in different parts of Africa at about the same time. HIV-1 and HIV-2 are not closely related genetically, whereas closer relatives exist in the SIVs of the non-human primates. There is much yet to be learnt. Probably there are more SIVs to be found, but let us hope no more HIVs.
Viruses, the ultimate parasites, multiply only in living cells so are grown in cell or tissue culture, chick embryos or animals. For vaccine production, polio virus is grown in monkey kidney cell cultures. The vaccines used today may consist of inactivated virulent virus treated so that the virus cannot grow or cause disease (Salk vaccine, administered by injection) or attenuated virus where the virus is weakened in disease-producing capacity but is still able to multiply (Sabin vaccine, which is swallowed on lumps of sugar or squirted into the mouth). An earlier experimental live vaccine was that of Hilary Koprowski. Salk, Sabin and Koprowski, all working in the USA in the 1950s, became intense scientific rivals.
In 1987, the revolutionary suggestion was broadcast on the radio by a San Antonio doctor, Eva Lee Snead, that the AIDS virus had entered the human race through a contaminated polio vaccine. Had a life-saving medical intervention caused this terrible disease of man?
The importance of screening vaccines for residual active virus or contaminating virus is obvious. However it was not always possible to screen effectively and even now methods are not fool-proof. SIVs were not discovered until 1985: they could not have been detected in the 1950s.
Snead’s suggestion of contamination was not outrageous. Polio vaccines supply some classic examples, e.g. the Cutter incident with Salk vaccine where inactivation of a batch of vaccine virus was incomplete; and the finding that some batches of various vaccines, primarily polio, were contaminated with a monkey virus of a different sort called SV40. It was long feared that SV40 might produce cancer in humans: the matter is still open.
Being a veterinary virologist familiar with the canine parvovirus story, I find the case plausible. Canine parvovirus disease resulted from feline parvovirus jumping the species barrier. This did not happen naturally between cats and dogs any more than SIV jumped naturally from monkeys to man, although both had plenty of opportunity to do so. In recent years the feline virus was grown in canine cell cultures. It is thought that the virus contaminated a canine virus vaccine which produced disease in dogs. The new disease spread rapidly throughout the world.
An ethics scholar from New York, Louis Pascal, had listened to Snead’s broadcast. He was struck with the idea that her theory was testable. Old stored samples of vaccine could be checked for the presence of virus. Antibody could be detected in stored serum. He carried out an in-depth study of the medical literature. He found that Koprowski's vaccine was given to 325,000 people in central and west Africa from 1957 to 1960. These areas of Africa have the highest incidence of AIDS today and the timing was right. Not unreasonably, Pascal thought the contaminated vaccine theory should be investigated. He recorded his ideas, canvassed many scientists and came up against a brick wall of non-cooperation. What followed provided the central theme of Cribb's book.
For fairly obvious reasons, the scientific establishment did not want to believe Pascal's assertions. The barrage of opposition was, however, most unscientific. Publication of Pascal's paper was refused by eminent scientific journals partly because it was not couched in standard form by a qualified scientist and sometimes for no given reason. In 1990 Brian Martin, Wollongong academic and WISENET member, entered the fray. His interest was not so much in the virology as in the suppression of dissent. He thought that Pascal’s arguments had not been refuted and demanded a full investigation. Martin saw that Pascal’s paper was published and circulated as a monograph, Science and Technology Analysis working paper no. 9 in 1991. Independently a freelance investigative journalist, Tom Curtis, published an article on this theory of the origin of AIDS in Rolling Stone in 1992.
There was some support for Pascal among the virologists but never to match the strength of the opposition. The requested investigations were not carried out.
The arguments for and against the view that AIDS began with a polio vaccine are neatly summarised in the book. Many questions are unanswered. Apart from the excellence of the main theme, there is much else of worth in the book. Not surprisingly, Julian Cribb’s lucid writing makes good reading for biologists and non-biologists alike. As well as a full account of the White Death (AIDS), the devastating effects of the Black Death, smallpox and influenza are chronicled. Included are up-to-date accounts of virus multiplication and the immune system. Other aspects of scientific ethics are disclosed, not the least the blithe use of mentally retarded children as 'volunteers' for experimentation.
An article by Leigh Dayton in the Sydney Morning Herald on 4 February 1998 was headlined 'First AIDS cases may have been before WWII' and stated that the work reported from a very recent letter to Nature largely refuted the polio vaccine theory. A summary, but unfortunately not the whole Nature letter, is currently available on the Internet. The original serum from Zaire collected in 1959 was re-examined. This case was authenticated as the oldest known HIV-1 infection and it was surmised that 'perhaps all major-group viruses may have evolved from a single introduction not long before 1959'.
Julian Cribb, in a letter to the Sydney Morning Herald (9 February 1998), denied that these findings refuted the polio vaccine theory but rather reinforced it. The serum was collected after the Koprowski vaccine trials. These words are his: 'There is a need for an open mind and objective, international scientific inquiry into this issue—because certain important vaccines are still grown in monkey kidneys and science is preparing to transplant animal organs, which may harbour unknown viruses, into people..'
I strongly recommend this book.
Margaret Sabine was the Associate Professor in Veterinary Virology at the University of Sydney. She has now retired.