By EUGENE BINGHAM
Dr Alan Murphy pulled on his white lab coat determined for success in the battle against a deadly disease that was striking down children, causing schools to close and towns to be barricaded off.
Staring down the lens of his laboratory microscope, he was hunting for a breakthrough.
It was Auckland Hospital in the 1950s and the country was in the grip of polio. Waves of epidemics had killed or paralysed hundreds since the turn of the century. They were desperate times. Murphy, a pathologist, was searching for an important link that would help medical science to combat the disease.
The key was to find tissue or protein polio could grow on. If researchers could find an effective way to study the disease in a controlled laboratory environment, they could understand how it attacked the body and find ways of halting it.
Murphy was baffled. He was frustrated that more was known about the life history of the common flu than about polio, all because someone had discovered that the influenza virus could grow in hen eggs.
His experiments began with different types of tissue discarded during operations in the hospital's surgical wards.
Around the country, others in the medical fraternity watched his work with interest.
Five-yearly epidemics had struck since 1916, infecting an average of 800 people a time. In between, there were reported cases, too. Polio was not only causing epidemics, it was endemic.
The first recorded case of polio in New Zealand was a 6-month-old baby in 1887. In 1895, seven people were admitted to Wellington Hospital, but the first major outbreak occurred during World War I. By the 1950s, there had been seven epidemics - and another that struck New Zealand troops serving in the Middle East in 1941.
In 1947, Auckland Hospital was so short of beds that doctors had to restrict the number of cases being admitted to hospital. Large numbers of people carrying signs of the disease had to be turned away from the hospital doors.
Health officials fought as best they could to cope. Extraordinary measures were employed. During the 1947-48 epidemic, schools and Sunday schools were closed, and children's gatherings banned. Children were not allowed to travel between islands, go to public swimming pools or picture theatres.
And yet authorities seemed powerless to stop the spread. The New Zealand Medical Journal noted that one house-bound woman who lived in a rural area near Timaru had been infected in 1948, even though all but two of the other cases at the time were in the North Island. They looked to medical researchers for answers. In America, two men whose work would eventually earn them the right to have polio vaccines named after them - Albert Sabin and Jonas Salk - had begun a post-war race to defeat polio.
Besides these two brilliant men, others were feeding into the international body of work, including New Zealanders Alan Murphy, Professor John Miles and Professor John (Jock) Caughey.
In the early 1950s, Murphy began his experiments in Auckland. At first, he tried tonsils and other organs removed from patients in surgery. But there were problems with bacteria and the search went on for a better alternative.
In 1953, funded by money bequeathed to the hospital for research, Murphy knew he was on the brink of a breakthrough. During experiments in his Auckland laboratory, he began using stillborn human foetuses.
In today's climate, where we debate stem cell research and whether aborted foetuses should be used by scientists, Murphy's work would be controversial and ethically fraught, especially if it was conducted without the consent of the mothers - as was probably the case.
Medical ethicist Professor Donald Evans says the mother's consent would be crucial for ethical approval of human embryo research now. According to the Ministry of Health, research on human foetuses would be illegal under present legislation, although the ban is under review.
In 1954 Murphy's work was exciting research. He told a science congress of his efforts.
"Very little work along these lines seems to have been attempted overseas ... It does not seem to have been considered by the virologists as a practical proposition."
In a New Zealand Medical Journal article he set out how he used the foetal tissue. Muscle from the foetuses was minced into 1-2mm pieces. Four to six pieces were placed in a test tube and held in place with remnants of chick embryos. For nourishment, the foetal tissue was covered with a cocktail of horse serum, fluid from cow wombs and extracts of calf embryos.
Murphy wrote how after three to four days connective tissue, or fibroblasts, was visible under the microscope.
When polio extracts were added to the samples, the virus attacked the fibroblasts and destroyed them in three to five days. This destruction was the breakthrough he had sought.
He used the technique to figure out which of the three strains of polio virus were prevalent in New Zealand. In 1955, he tested blood samples from 100 children to see if they had antibodies to any of the viruses.
The next year, he used the technique to diagnose which of the viruses had attacked polio victims in the 1955-56 epidemic. It was during this research that Murphy realised how desperate the situation had become. His laboratory could not cope with the number of polio samples being forwarded to it and ran out of human foetal tissue. He turned to Auckland Zoo for help. With the permission of zoo authorities, he obtained monkey kidneys to continue his testing.
Murphy and other researchers knew that if polio was going to be defeated, the world needed a successful vaccine. John Miles, a professor in microbiology at Otago University, was also publicly calling for a widespread vaccination campaign to stamp out the disease.
Miles, who had studied polio among Aboriginals in the Australian Outback, made a plea in a June 1956 New Zealand Medical Journal paper for the immunisation of children and adolescents as soon as a safe vaccine could be found.
Around this time, Salk had won approval for his vaccine, which immunised patients with a killed strain of the virus. Sabin, whose vaccine could immunise patients with the sip of a syrup containing a live strain of polio, was also competing for worldwide approval.
Authorities in New Zealand opted for the quick answer, Salk's vaccine, and began an immunisation programme. There was some public unease after problems in the United States, but small shipments of the serum arrived and primary school children lined up to be injected.
A trawl through Government documents held in the National Archives shows the lengths authorities went to in the early vaccination programmes - they were determined that as many people as possible, especially children, were vaccinated.
Child welfare agencies changed their policies so state wards could be immunised without their parents' consent. Officials even had the power to override parental objections.
"Immunisation against these diseases is a widely accepted practice and it is considered reasonable to proceed with it in the case of our wards ... " said a Government paper dealing with the change.
It was a similar attitude which led health authorities battling typhoid from the 1920s to allow for the immunisation of Maori children without their parents' consent, although Pakeha parents had to be asked first. In the 1950s, concerns that public health authorities jabbing Maori children without their parents' consent may be accused of assault led the Cabinet to secretly indemnify the nurses.
The ends, officials believed, justified the means. Mother state knew best.
Today's doctors and health officials could never dream of being able to get away with these vaccination programmes.
Take the meningitis vaccination studies under way in Auckland this year. Researchers believe they have found a way of immunising children against a particular strain of this deadly disease, but they are having to follow careful ethical and legal guidelines before they even contemplate a vaccination programme.
Public health director Colin Tukuitonga, who is responsible for immunisation, is a little envious of his predecessors' ability to vaccinate as many people as they could.
"In the old days, the doc knew best, he jabbed everyone he thought needed the good stuff and away we went."
He accepts and encourages the fact that people are more aware of their rights as patients, although he believes that people who rail against immunisation have it easy in some ways.
"Vaccination is a victim of its own success," he says. "It's meant diseases that were once common, devastating and deadly, people don't see any more. They become blase about the risks of measles and polio, and that has shaped a lot of the current attitudes to immunisation."
By the end of 1958 about 80 per cent of schoolchildren had been dosed, but polio continued to stalk the country. After another epidemic in 1961, including seven deaths, Miles argued for a rethink in the strategy. His efforts helped to convince authorities to switch to Sabin's live vaccine. While schoolchildren were initially targeted from August 1961, gradually it was made more widely available.
In September 1962 - 40 years ago this month - Sabin's syrupy sip of immunity was made available to the general population. The Department of Health estimated 80 per cent of the country was inoculated.
The results were dramatic and immediate. The following year, 1963, was the first year since records began that there were no reported cases of polio in New Zealand.
Murphy's dream of having polio defeated had come true. Whether his work or that of Miles, Caughey or other New Zealand researchers contributed directly to Sabin or Salk's success will never be known - the fiercely competitive nature of American medical research in the 1950s means the US was never likely to acknowledge any help along the way.
In the years since the battle was won, only a handful of cases of polio have been recorded - including one where a parent appeared to have caught the disease while changing the nappy of his three-month-old baby inoculated with the live virus. Cases such as this led the Ministry of Health to switch back this year to the inactivated or killed variety of vaccine.
Miles, who retired in 1979 and now lives near Wanaka, aged 89, remembers the defeat of polio as one of the highlights of his career.
"I would put it fairly well up the list," he says with a dose of understatement. "It was extremely satisfying - it gave us a great deal of pleasure."
As to whether Murphy ever celebrated the success in the polio war, it is impossible to say.
He moved to Australia many years ago where he still lives, but was unavailable for interviews.
All that is left of his role in one of New Zealand's most stunning public health victories is the research he published in medical journals.
Embryos used in polio battle
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