"Life in a germ-free world": Isolating life from the laboratory animal to the bubble boy

Bulletin of the History of Medicine

Volumn 86, Issue 2, 2012, Pages 237-275

  Kirk, Robert G W ^a  

^a UNIVERSITY OF MANCHESTER   (United Kingdom)

Author keywords

Bioethics; Bubble boy; Cross infection; Gnotobiotics; Laboratory animal; LOBUND

Indexed keywords

ANIMAL; ANIMAL HOUSING; ANIMAL HUSBANDRY; CROSS INFECTION; EXPERIMENTAL ANIMAL; GERMFREE ANIMAL; HISTORY; HUMAN; MEDICAL TECHNOLOGY; NOTE; PATIENT ISOLATOR; STANDARD;

ANIMAL HUSBANDRY; ANIMALS; ANIMALS, LABORATORY; BIOMEDICAL ENHANCEMENT; CROSS INFECTION; GERM-FREE LIFE; HISTORY, 19TH CENTURY; HISTORY, 20TH CENTURY; HOUSING, ANIMAL; HUMANS; PATIENT ISOLATORS;

EID: 84866667701     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.2012.0028     Document Type: Note

References (168)

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35. As already noted, the vocal interwar eugenicist Alexis Carrel devoted much of his scientific work to developing aseptic methods for the study of tissues and organs outside the body.
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47. For the LOBUND Institute's role in American biological warfare research, see Gerard James Fitzgerald, "From Prevention to Infection: Intramural Aerobiology, Biomedical Technology, and the Origins of Biological Warfare Research in the United States, 1910-1955" (Ph.D. diss., Carnegie Mellon University, 2003).
48. "Life Without Germs," Life Magazine, September 26, 1949, 107-13, 107.
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56. Ibid., 243.
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58. Indeed, Harlow's work was in part inspired by his observation that the introduction of isolation to prevent the spread of infection among his experimental monkeys detrimentally affected their learning capacity.
59. "Showcase Baby," Mechanix Illustrated, March 1947, 74.
60. B. F. Skinner, "Baby in a Box: Introducing the Mechanical Baby Tender," Ladies Home Journal, October 1945, 62, 30-31.
61. Subsequent letters (135-36, 138) attest to the popularity of the concept. Retrospectively, however, due to Skinner's association with operant conditioning, the "Baby Tender" has been confused with the "Skinner Box," leading some to erroneously relate it to the management of child psychology rather than their physical and microbial environment.
62. P. C. Trexler, "The Evolution of Gnotobiotic Technology," 4, ca. June 1984, in folder UDIS100/02, "LOBUND Laboratory Conference: Bubble Boy (6/84); International Symposium on Germfree Research 1972-1984," UND.
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64. Gould undertook extensive investigations of the antibiotic content of air in the hospital, pharmaceutical factory, and farm, in order to prove (a) bacteria traveling from patient to patient via the air was exposed to antibiotics for longer periods than conventional treatment allowed, thus explaining the inexplicably fast rise of resistant bacteria; (b) antibiotics themselves could travel by air, thus persons who worked in antibiotic heavy environments would be carriers of resistant bacteria.
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66. J. Anderson, "Greenhouses and Bodysuits: The Challenge to Knowledge in Early Hip Replacement Surgery 1960-1982," in Timmermann and Anderson, Devices and Designs (n. 13), 175-91.
67. J. Anderson, F. Neary, and John V. Pickstone, Surgeons, Manufacturers and Patients: A Transatlantic History of Total Hip Replacement (Basingstoke: Palgrave Macmillan, 2007), esp. 96-103.
68. J. Charnley, "Clean Air Operating Room Enclosures," Brit. Med. J. 5938 (1974): 224-25.
69. C. W. Howe, "Prevention and Control of Postoperative Wound Infections Owing to Staphylococcus Aureus," New Engl. J. Med. 255 (1956): 787-94.
70. C. W. Walter and R. B. Kundsin, "The Floor as a Reservoir of Hospital Infections," Surg. Gyn. Obstet. 111 (1960): 412.
71. R. Myles Gibson, "Application of Antibiotics (Polybactrin) in Surgical Practice, Using the Aerosol Technique," Brit. Med. J. 5083 (1958): 1326-27.
72. D. Hart, "Bactericidal Ultraviolet Radiation in the Operating Room: Twenty-Nine Year Study for Control of Infections," J. Amer. Med. Assoc. 172 (1960): 1019-28.
73. Letter, Philip C. Trexler to Mathew Maley (Shriners Hospital for Crippled Children, Cincinnati, Ohio), November 18, 1969, p. 1, Shriners Hospital Patient Isolation Unit Records, Archives Center, National Museum of American History, Smithsonian Institution, box 1, folder 4 (hereafter SHPI).
74. S. M. Levenson, P. C. Trexler, M. Laconte, and E. J. Pulaski, "Application of the Technology of the Germfree Laboratory to Special Problems of Patient Care," Amer. J. Surg. 107 (1964): 710-22, quotation on 710.
75. S. M. Levenson, P. C. Trexler, O. J. Malm, R. E. Horowitz, and W. H. Moncrief, "A Disposable Plastic Isolator for Operating in a Sterile Environment," Surg. Forum 11 (1960): 306-8, 307.
76. S. M. Levenson, P. C. Trexler, O. J. Malm, M. L. LaConte, R. E. Horowitz, and W. H. Moncrief, "A Plastic Isolator for Operating in a Sterile Environment," Amer. J. Surg. 104, no. 6 (1962): 891-99, quotation on 891.
77. U.S. Patent Office, number 3051164, filed August 17, 1959.
78. Levenson et al., "Plastic Isolator for Operating" (n. 62), 897.
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80. Levenson et al., "Application of the Technology" (n. 60), 721.
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82. Levenson et al., "Application of the Technology" (n. 60), 721.
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87. Charles River remains a global leader in the production and supply of laboratory animals. Snyder Laboratories was acquired by Zimmer (Warsaw, Ind.) in 1978.
88. A key innovation was Trexler's design of robust microbial-secure containers for the shipment of animals.
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92. U.S. Patent Office, no. 3265059, filed February 21, 1962. Details on the "Life Island" isolator can be found in box 1, folder 2, "Life Island (Mark V) Advertisements and Correspondence," SHPI.
93. For its popular representation, see "Life in a Life Island," Time, May 29, 1964, 52.
94. Cf. C. Timmermann and H. Valier, "Clinical Trials and the Reorganization of Medical Research in Post-Second World War Britain," Med. Hist. 52 (2008): 493-510.
95. For Betts, see Edward Boden, "Professor Alan Betts," The Independent, December 27, 2005, 47.
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103. As in the hospital, isolators on the farm were rivaled by pharmaceutical companies and feed manufacturers.
104. see Mark R. Finlay, "Hogs, Antibiotics and the Industrial Environments of Postwar Agriculture," in Industrializing Organisms: Introducing Evolutionary History, ed. Susan R. Schrepfer and Philip Scranton (London: Routledge, 2004), 237-60.
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107. O. Betts, "SPF Animals," in Intensive Livestock Farming ed. W. Blount (London: Heinemann, 1968), 508-13.
108. T. W. Heard and J. L. Jollins, "Observations on Closed Hysterectomy Founded Pig Heard," Vet. Rec. 81 (1967): 481-87.
109. J. Drummond, P. C. Trexler, G. B. Edwards, C. Hillidge, and J. E. Cox, "A Technique for the Production of Gnotobiotic Foals," Vet. Rec. 92 (1973): 555-57.
110. O. Betts and P. C. Trexler, "Development and Possible Uses for Gnotobiotic Farm Animals," Vet. Rec. 84 (1969): 630-32.
111. Virus from Monkeys," Brit. Med. J. 5605 (1968): 575-76.
112. "Work Stopped on Deadly Virus," The Times, February 11, 1970, 7, col. C.
113. Trexler, "Development of Gnotobiotics" (n. 68), 123.
114. "Application to the Department of Health and Social Security for Support to Finance Continuation of a Programme for Development of Hospital Isolators for Patients Suffering from Dangerous Infection," March 10, 1975, Medical Research Council Archive, National Archives, Kew, UK (hereafter NA), NA MH148/361.
115. For the NRDC, see S. T. Keith, "Inventions, Patents and Commercial Development from Governmentally Financed Research in Great Britain: The Origins of the National Research Development Corporation," Minerva 19 (1981): 92-122.
116. S. Spiers and P. C. Trexler, "The Use of a Plastic Isolator for the Prevention of Infection in Patients with Acute Leukaemia," J. Physiol. 231 (1973): 66P-67P.
117. Jennifer Stanton, ed., Innovations in Health and Medicine: Diffusion and Resistance in the Twentieth Century (London: Routledge, 2002), esp. 3.
118. "A Patient's Eye View of Life in an Isolator," June 1977, NA MH148/362.
119. R. T. D. Emond, B. Evans, E. T. W. Bowen, and G. Lloyd, "A Case of Ebola Virus Infection," Brit. Med. J. 2 (1977): 541-44.
120. J. G. P. Hutchinson, J. Gray, T. H. Flewett, R. T. D. Emond, B. Evans, and P. C. Trexler, "The Safety of the Trexler Isolator as Judged by Some Physical and Biological Criteria: A Report of Experimental Work at Two Centres," J. Hygiene (Cambridge) 81 (1978): 311-19.
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122. Department of Health and Social Security, Memorandum on Lassa Fever (London: HMSO, 1976).
123. "Evaluation of the Trexler Containment Isolator: Report of the Central Steering Committee," Appendix C, June 1977, p. 2, NA MH148/362.
124. J. McLauchlan, M. F. Pilcher, P. C. Trexler, and R. C. Whalley, "The Surgical Isolator," Brit. Med. J. 5903 (February 23, 1974): 322-24, 324.
125. P. C. Trexler, "An Isolator for the Maintenance of Aseptic Environments," Lancet 301 (January 13, 1973): 91-93.
126. See files NA MH148/362 and NA MH148/362.
127. R. T. D. Emond, "Hospitalisation of Patients Suspected of Highly Infectious Disease," in Ebola Virus Haemorrhagic Fever, ed. S. R. Pattyn (Amsterdam: Elsevier, 1978), 251-54, 251.
128. George Godber, Report of the Working Party on the Laboratory Use of Dangerous Pathogens, Cmnd 6054 (London: HMSO, 1975).
129. G. Helmick et al., "No Evidence for Increased Risk of Lassa Fever Infection in Hospital Staff," Lancet 8517 (November 22, 1986): 1202-5.
130. P. C. Trexler and A. M. Gilmour, "Use of Flexible Plastic Film Isolators in Performing Potentially Hazardous Necropsies," J. Clin. Path. 36 (1983): 527-29, 529.
131. S. M. Levenson, P. C. Trexler, and D. van der Waaij, "Nosocomial Infection: Pre-vention by Special Clean-Air, Ultraviolet Light, and Barrier (Isolator) Techniques," Curr. Problems Surg. 23 (1986): 458-558.
132. E. N. Thompson, "Thymic Lymphocytophthisis with Terminal Aplastic Anaemia," Proc. Roy. Soc. Med. 60 (1967): 895-97.
133. R. D. Barnes, M. Tuffrey, and R. Cook, "A 'Germfree' Human Isolator," Lancet 7543 (March 23, 1968): 622-23.
134. R. D. Barnes, D. V. I. Fairweather, J. Holliday, C. Keane, A. Piesowicz, J. F. Soothill, and M. Tuffrey, "A Germfree Infant," Lancet 293 (January 25, 1969): 168-71, 169.
135. R. D. Barnes, A. Bentovim, S. Hensman, and Alina T. Piesowicz, "Care and Observation of a Germ-Free Neonate," Arch. Dis. Childh. 44 (1969): 211-17.
136. In addition to articles cited, see R. D. Barnes, D. V. I. Fairweather, E. O. R. Reynolds, M. Tuffrey, and J. Holliday, "A Technique for the Delivery of a Germfree Child," J. Obstet. Gyn. Brit. Commonwealth 75 (1968): 689-97.
137. "Raising a Germ-Free Baby," The Times, January 28, 1969, 6.
138. "Germ-Free Baby," Chemist and Druggist, August 10, 1968, 127.
139. Germfree Baby (thirty-five-minute film, Boehringer Ingelheim Ltd.), Wellcome Library for the History of Medicine, London, item BMA299.
140. See folder UDIS119/104, "Wilson, Raphael-Biology," and folder UDIS214/32, "Rev Raphael Wilson (formerly Br) re 'Bubble Boy' Case 1984," UND.
141. "The Bubble Boy's Lost Battle," Time, March 5, 1984, 51.
142. "Baby David: Alive, Well and Waiting," Sci. News 105 (May 25, 1974), 335.
143. Steve McVicker, "Bursting the Bubble," Houston News, April 10, 1997.
144. See Paediatr. Res. 11, pt. 1 (1977).
145. M. A. Murphy and J. B. Vogel, "Looking Out from the Isolator: David's Perception of the World," Dev. Behav. Pediatr. 6 (1985): 118-21.
146. For an account of David's life by his mother, see Kent Demaret, "David's Story: Victim of an Immune Deficiency That Condemned Him to Exist in a Sterile World, the Bubble Boy Lived a Full Life," People Weekly 22 (1984): 120-32.
147. "The Bubble Boy," People Weekly 22 (1984): 107-16.
148. "David, the Boy in the Bubble," Assoc. Gnotobiotics Newsl. (May 1984): 1-2.
149. R. J. Lawrence, "David the 'Bubble Boy' and the Boundaries of the Human," JAMA 253 (1985): 74-75.
150. "University of Notre Dame News, 8th June 1984," folder UDIS100/02, "LOBUND Laboratory Conference: Bubble Boy (6/84); International Symposium on Germfree Research 1972-1984," UND.
151. "Letter Morris Pollard (director, LOBUND Institute) to Francis Castellino, 16th March 1984," folder UDIS100/02, UND.
152. Trexler, "Evolution of Gnotobiotic Technology" (n. 52), 5.
153. Ibid., 4.
154. Schlich, Surgery, Science and Industry (n. 15), 35-41.
155. M. Berg, Rationalizing Medical Work Decision Support Techniques and Medical Practices (Cambridge, Mass.: MIT Press, 1997).
156. S. Sturdy and R. Cooter, "Science, Scientific Management, and the Transformation of Medicine in Britain, 1870-1950," Hist. Sci. 36 (1998): 421-66.
157. Sturdy and Cooter, "Science, Scientific Management" (n. 127).
158. "Life Island Isolation," ca. March 1967, 1, box 1, folder 2, SHPI.
159. Ibid., 7.
160. Stanley Joel Reiser, Medicine and the Reign of Technology (Cambridge: Cambridge University Press, 1978).
161. Hughes Evans, "Losing Touch: The Controversy over the Introduction of Blood Pressure Instruments into Medicine," Technol. Cult. 34 (1993): 784-807.
162. Sally Gadow, "Touch and Technology: Two Paradigms of Patient Care," J. Religion Health 23 (1984): 63-69.
163. Margarete Sandelowski, Devices and Desires: Gender, Technology and American Nursing (Chapel Hill: University of North Carolina Press, 2000).
164. "I. Purpose: To Provide a Contamination Free Environment for a Patient with Low Resistance to Infection," Life Island Instructions, p. 14, SHPI.
165. For the role of risk perception in medical innovation, see Thomas Schlich and Ulrich Tröhler, eds., The Risks of Medical Innovation Risk Perception and Assessment in Historical Context (London: Routledge, 2006).
166. "Evaluation of the Trexler Containment Isolator, Report of the Central Steering Group, June 1977," NA MH148/362.
167. Concerns regarding a return of infectious diseases, catalyzed by the fear of bioterrorism and potential flu pandemics, have refocused attention on microbial isolation as a means of containment.
168. see. Clin. Microbiol. Infect. 15 (2009): 8.