July 2010

Guest post by Robert D. Hicks, Ph.D.Director, Mütter Museum & Historical Medical LibraryWilliam Maul Measey Chair for the History of Medicine

As the recipient of a research grant, I recently had the opportunity to travel to Minneapolis to spend a week at The Bakken Museum. Founded in 1975 by electrical engineer Earl Bakken, a pioneer in medical devices including the first wearable, externally-worn, battery-powered pacemaker, the Bakken’s collection of artifacts and texts have promoted the study of electricity in medicine. The mission has expanded to embrace electricity in American life. The object collection features about 3000 artifacts dating to the 18th century, including electrostatic generators, batteries, various devices for physiological application, and other medical stimulators. The library’s collection of 11,000 books, journals, and manuscripts illuminates “the history of electricity and magnetism with a focus on their roles in the life sciences and medicine,” to quote the Bakken. Among its treasures is a primary source collection of trade ephemera including advertisements, catalogs, pamphlets, postcards, and circulars. “Ephemera” is libraryspeak for literature never intended for permanent use or retention. Last year’s catalogs usually end up in the trash bin. Historians are grateful for all of those people who do not toss out such stuff. My own research involved electro-medical devices during the Civil War, which I will apply to designing a future exhibit on Civil War medicine at the Mütter Museum. More

Guest post by Annie Brogran, Librarian, Historical Medical Library

I feel very fortunate that I have the privilege of getting to dig around the treasure trove that is the Historical Medical Library of The College of Physicians of Philadelphia for a living. The volumes and manuscript material in the library certainly provide an extensive lesson on the history of medicine, from Galen to Gross and beyond. Every so often, though, I come across an item, be it a letter or a note, which highlights an aspect of medicine that is not always apparent in the telling of the great moments of medical breakthroughs or reading through the minutes of a committee meeting. I refer, of course, to the human aspect, where disease and medicine may not be the main focus of a document, but we see how they affect people’s lives. More

This week The College of Physicians of Philadelphia is highlighting photographs from the History of Vaccines on its Facebook.

They’re posting a new picture and question daily. To learn the answer to each question, check back in at the end of the workday.

Today’s question and photograph (shown at left, from the historical photograph collection of the Mütter Museum) already have 27 responses.

Visit, comment, and LIKE at http://www.facebook.com/collegeofphysicians

Photograph property and copyright of the Mütter Museum of The College of Physicians of Philadelphia. May not be reproduced with permission of the College. See http://www.collphyphil.org/Imaging.htm for details. More

People in developed countries don’t tend to spend much time worrying about waterborne diseases. Modern water treatment systems have drastically improved the safety of public water supplies, and if people have even heard of parasitic diseases like Cryptosporidiosis (commonly called “crypto”) or Giardiasis, they tend to think of them merely as an unpleasant bout of diarrhea–uncomfortable and inconvenient, but nothing serious.

Parasitic diseases like Crypto and Giardiasis, however, as well as bacterial illnesses like Legionnaires’ disease, can cause severe infections that lead to hospitalization and death, even in developed nations. Recently, researchers from the Centers for Disease Control and Prevention analyzed the annual cost of hospitalizations for cases of Legionnaires’, Crypto and Giardiasis in the United States. Using insurance claim data from 2004-2007, the researchers determined that cases of hospitalization from the three diseases may cost more than half a billion dollars annually–including both costs paid by insurance companies and costs paid out-of-pocket by patients.

Among the three, Legionnaires’ was found to have the highest annual financial toll due to hospitalization, with the total cost estimated to be between $101 and $321 million. A single inpatient hospitalization for a case of Legionnaries’ averaged more than $34,000. More

Researchers have examined many possible approaches for vaccines against malaria, a parasitic illness spread by mosquitoes that affects hundreds of millions of people each year. One of the most promising approaches thus far has been a subunit vaccine: a vaccine candidate using this approach, RTS,S, is in late-stage clinical trials.

Researchers in Queensland, Australia have begun testing another approach, however: a vaccine that combines killed parasites with an adjuvant to boost immune response. The resulting vaccine was tested in mice, and was shown to provide long-lasting, cross-strain protection against malaria.

The group focused on developing a vaccine with the lowest possible dose of killed parasite that would still elicit a protective immune response. Their test vaccine induced a broadly reactive T cell response of the type usually generated by live, attenuated vaccines–yet with a safety profile more in line with a killed vaccine. More

HIV is a challenging target for vaccine researchers for many reasons, not the least of which is its lack of stability. The surface proteins of the virus frequently change, keeping the immune system from recognizing it–and keeping researchers from selecting a surface protein as a stable target for a vaccine.

At least one area on the surface of the virus, however, seems to remain fairly stable across all variants of HIV: a site located on the surface spikes the virus uses to bind to and infect immune cells. Now, two teams of researchers have found antibodies that attach to this site, preventing the virus from binding to immune cells, and have highlighted ways this discovery may lead to new advances in HIV vaccine designs.

The antibodies are found in the blood serum of many individuals infected with HIV. The researchers selected HIV-1 isolates encompassing all of the major circulating subtypes of the virus, and showed that these antibodies could bind to–and neutralize–more than 90% of them. That broad ability to neutralize so many variants of the virus is because of the stability of the binding site, which remains the same among nearly all strains. Therefore, a vaccine that could “train” the human immune system to generate similar antibodies could provide protection against the majority of circulating HIV variants. More

A post on the History of Vaccines blog earlier this month mentioned an outbreak of whooping cough in California, noting that at the time, four infants had already died from the disease. The death count has now reached five, all children less than three months of age, and the total number of confirmed cases reached 910 as of June 15th. The director of the California Department of Public Health declared in a statement that the outbreak is now an epidemic.

The most recent major outbreak of whooping cough was in 2005, when 3,182 cases were recorded in California. This year’s epidemic is on pace to surpass the number of cases from 2005. An outbreak has also been reported in Ohio, and Oregon public health officials have reportedly noted an unusually high number of cases there as well.

Whooping cough can be prevented by vaccination, but the first dose of the vaccine is not given until two months of age. Prior to that infants are highly susceptible to the disease, which is often spread by adults. A booster vaccine against whooping cough is available for adults as part of the Tdap (tetanus, diphtheria, pertussis) immunization, which can be substituted for one tetanus or Td vaccination between the ages of 19 and 64. The Advisory Committee on Immunization Practices (ACIP) recommends Tdap vaccination for adults who have contact with infants younger than 12 years of age. More