Adventures in Science: Interview with Thomas M. Rivers

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Watson Davis: Our Adventures in Science guest today is Dr. Thomas M. Rivers, Medical Director of the National Foundation for Infantile Paralysis.

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Watson Davis: Dr. Rivers has been, up until 1955, director of the Rockefeller Institute Hospital, and I think you could call Dr. Rivers, Dr. Virus, because perhaps, as no-one else in the world, he has been at the forefront of this great investigation that's been underway against the virus diseases.

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Watson Davis: Not only Polio, but all viruses diseases. Dr. Rivers, we've made a real progress, great deal of progress in the past years, few years, against Polio. Won't you tell us just what that amounts to, in your opinion?

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Thomas M. Rivers: We certainly have made a great deal of progress. When we started in 1938, none of us had any idea that we would be as far ahead of the game as we are today.

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Thomas M. Rivers: I think it's remarkable that so much knowledge has been found and so much has been done to prevent the disease, and also to treat those who have been crippled by the disease.

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Watson Davis: Well Dr. Rivers, there's really not too much excuse for a person getting Polio these days, with the vaccine that's available, this vaccine is one of the great achievements of modern medicine.

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Watson Davis: Are most of the people in the country protected against Polio today? I should think they would be.

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Thomas M. Rivers: A lot of people are protected, but there's an amazing number who are not protected, and I'd like to give you a few figures.

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Watson Davis: I wish you would, Dr. Rivers.

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Thomas M. Rivers: There are 109 million people under 40 years of age. 64 million of these have had at least one shot of Polio Vaccine.

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Thomas M. Rivers: Only 34 million of these, however, have had all three shots. And it is necessary to have three shots, properly spaced, in order to get the full amount of protection.

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Thomas M. Rivers: That means, that 45 million people under 40 years of age have had no vaccine at all. And this is the sad part, 15 million of these are under 20 years of age. And that is a very susceptible group.

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Watson Davis: Well Dr. Rivers, you mentioned -- You didn't mention those over 40. Why is that? Are they less susceptible?

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Thomas M. Rivers: 98% of paralysis occurs in people 40 and under, years of age. And for public health reasons, one has to cut off and the cut off has been at 40. That doesn't meant that those over 40, if they wish it, shouldn't take it.

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Thomas M. Rivers: Because we do know of people, and I know of a doctor who was 55 years old, who contracted the disease. So those over 40 who want it, may take it.

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Watson Davis: But, actually, the very large number of people who haven't yet had the vaccine and, unlike the early days of the vaccine when parents were crying for it, it is available right now, isn't it?

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Thomas M. Rivers: There's a great abundance of it at the present time and people are not using it as they should.

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Watson Davis: Actually, some of the manufacturers, due to the expiration dates on the vaccine have had to destroy some.
Thomas M. Rivers: Correct.

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Watson Davis: Well that's a rather shocking thing, isn't it?

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Thomas M. Rivers: It is, it is.
Watson Davis: Well, under those circumstances, don't you think that during this month for the National Foundation's campaign, it'd be a wise thing for people to go to see their doctors and get these shots?

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Thomas M. Rivers: Well, the president's birthday is on the 30th of January. And I think that's a good date to remember, President Roosevelt's birthday is on the 30th of January.

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Thomas M. Rivers: And why don't all the people who have not received the vaccine make it a point to see the doctor before the 30th of January and get a shot.

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Watson Davis: Well that'd be a very good idea, Doctor, let's see if we can get that across.

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Watson Davis: And, of course, while we're talking about this campaign month, I think we ought to explain that while the vaccine has been developed and you supervised, I believe, the production of this for the Foundation under a committee, the Salk Vaccine Committee.

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Watson Davis: And you've been chairman of the Virus Research Committee of the national foundation since 1938, I believe, until you became medical director.

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Watson Davis: Well, under those circumstances, we ought to explain that there's a great deal to be done in this Polio field still. Even though there are this large number protected, a large number also unprotected.

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Watson Davis: And under those circumstances, this March of Dimes is a very proper thing to have and the money that's being raised will be used for patient care, and there are a lot of them that still need a lot of care.

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Watson Davis: Also, which is equally important, more important for the future, it'll be used for research. It's going to be -- There's a great deal to be done in research yet, isn't there?

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Thomas M. Rivers: A great deal to be done in research on Polio and, as you know, we will broaden our field and include other viruses in research.

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Watson Davis: What about, what are some of the other virus diseases, Dr. Rivers, some of those that will have to be tackled in the future.

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Thomas M. Rivers: Well the one that we are most interested in, at the moment, are the diseases of the respiratory tract. Many of which undoubtedly are caused by viruses.

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Thomas M. Rivers: And there's a big group of viruses been discovered recently known as the Adenoviruses, they come from the throat and some of those cause our common respiratory diseases and we've got to match up the virus with the disease.

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Thomas M. Rivers: In addition to that, there's a large group of viruses known as the Echoviruses and the Coxsackieviruses, which inhabit the intestinal tract, in a manner similar to the Polio viruses.

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Thomas M. Rivers: And these viruses may get into the bloodstream and also get into the central nervous system and cause an inflammation of the linings of the brain and cord, leading to what we know as Aseptic Meningitis.

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Thomas M. Rivers: Now, there's a large number of these viruses, and we've had epidemics abroad and we've had epidemics in this country.

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Thomas M. Rivers: Last summer, we had an epidemic of at least 100,000 cases in Milwaukee, 400,000 cases in St. Paul and Minneapolis. And Durham, North Carolina, they had an outbreak of Coxsackievirus B5. In Milwaukee and the Twin Cities, the outbreak was caused by Echo 9.

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Thomas M. Rivers: So, we have in our hands, a group of viruses that will produce infection of the respiratory tract, and produce embalmment in the central nervous system that we should study and see if we can arrive at some solution to how to handle them.

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Watson Davis: Well, this is really, in a sense, just as thrilling as the great attack that's been made on Polio, because it affects as many people, perhaps, and in the long run it'll be very important.

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Watson Davis: Course, this matter of disease seems very simple when you don't know too much about it. The minute you dig into it, Dr. Rivers, you do find it's quite complex and they've got large number of different kinds of viruses that are causing these illnesses.

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Watson Davis: And it seems to me, it must be one of the most exciting things in the world to do as you have -- To dig into and find out which viruses cause what and then look forward to making vaccines against them, just as you have with Polio.

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Thomas M. Rivers: That's correct.

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Watson Davis: Well, now, Dr. Rivers, what are some of the other problems? Do you think you can use the same methods on these diseases that you were mentioning, these virus diseases of the respiratory tract and so forth, that you've used against Polio?

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Thomas M. Rivers: As a matter of fact, the work on Polio led to the discovery of the Echoviruses and the Adenoviruses. Without the tissue culture methods that were developed by John Enders, we would not know that the Echoviruses and Adenoviruses existed.

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Watson Davis: That's one of the wonderful things about medical research is that one discovery rests upon another.

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Watson Davis: These things that happen are not isolated at all.

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Watson Davis: It isn't one man, one man's very important like Dr. Salk.

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Watson Davis: But after all, it's a long progression of research that really does the job and continued research.

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Watson Davis: Having research is over a long period.

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Thomas M. Rivers: That is very important and very true.

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Watson Davis: What are some of these other virus diseases that you foresee to may perhaps be conquered in the future, Dr. Rivers?

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Thomas M. Rivers: Well, of course, we have measles with us still.

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Watson Davis: That's a virus, is it?
Thomas M. Rivers: That's a virus disease.

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Thomas M. Rivers: They are working, the scientists are working on it and undoubtedly they will eventually come up with a vaccine.

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Watson Davis: You mentioned the common cold, you think we'll get something for that?

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Thomas M. Rivers: Eventually, we will. Whether it will be a vaccine, whether it will be a drug, I don't know.

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Thomas M. Rivers: Common colds are probably caused by more than one virus. That is a guess on my part.

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Thomas M. Rivers: It looks as though an attack of a common cold will not protect you for more than three or four months.

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Thomas M. Rivers: So a vaccine wouldn't be very good if the attack of the disease doesn't protect you.

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Thomas M. Rivers: My guess that common cold probably will be handled through drugs.

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Watson Davis: Something like the way we handled pneumonia and that sort of thing.
Thomas M. Rivers: Correct, correct.

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Watson Davis: Antibiotics or sulfur drug class of things.
Thomas M. Rivers: Correct.

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Watson Davis: Now what about, do you, what do you think is the next big disease field that we're likely to make an exciting conquest in?

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Thomas M. Rivers: Well, it's hard to give an answer to that because a breakthrough is likely to come anywhere at anytime unexpectedly.

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Thomas M. Rivers: But if one had to guess, allow me to guess, it may be in one of two fields.

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Thomas M. Rivers: First, I would like to say, that it would be an irrational, the field of rational pharmacology.

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Watson Davis: You better explain that Dr. Rivers.

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Thomas M. Rivers: Well, most of our pharmacological agents in the present time have been found and are used more or less empirically.

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Thomas M. Rivers: But over the years we have learned a great deal about what goes on in the human body in the way of chemistry.

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Thomas M. Rivers: And what takes place both in health and in disease.

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Thomas M. Rivers: And it seems to me that with all of this knowledge someone should be able to find drugs that would either help lagging by chemical reactions, or block adverse by chemical reactions.

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Watson Davis: Well, that's very, very hopeful and you mentioned two fields. What about the other one Dr. Rivers?

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Thomas M. Rivers: Well, the other one has to do with what is know as antigen antibody reactions.

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Thomas M. Rivers: Ordinarily, antibodies are considered substances that protect the body against injury.

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Thomas M. Rivers: But there are times when antibodies can be injurious because Hay Fever is an antigen antibody reaction.

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Thomas M. Rivers: Asthma is an antigen -- Is result of an antigen antibody reaction.

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Thomas M. Rivers: And there may be a number of other diseases.

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Thomas M. Rivers: Like Rheumatoid Arthritis, Acute Rheumatic Fever, Multiple Sclerosis that can be caused -- May be caused by peculiar and abnormal antigen antibody reactions.

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Thomas M. Rivers: The best example--

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Thomas M. Rivers: that show how this could be true is the reason why in this country and in England where

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Thomas M. Rivers: Acute Thyroiditis, that is an infection of the thyroid gland in the neck, is caused by an abnormal --

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antibody made by the person's own body against his own

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thyroid tissue.

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Watson Davis: Well thank you Dr. Rivers, this is a very, just one very

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quick question. Is Salk, is the Salk vaccine being

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used in Russia and other countries now?

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Thomas M. Rivers: Uh, certainly being used, made, made and used in South

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Africa and in Australia and to best of my knowledge, it is being used in Russia.

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Watson Davis: Well thank you very much. Our Adventures in Science guest today

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has been Dr. Thomas M. Rivers, the medical director of the National Foundation for Infantile Paralysis.

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