DISEASE SQUAD

Richard Rhodes’s new book, Deadly Feasts, is a breezy, immensely readable account of the effort to solve the riddle of the spongiform encephalopathies. More broadly, it is a splendid description of the process by which scientific knowledge is advanced. Embedded in this story are all the predictable components of complex endeavor: individual drive and institutional interest; lust for recognition and selfless dedication; serendipity and strategy; rivalry and cooperation; inspiration and painstaking work.

The interplay of personalities is fascinating. Towering above them all is Carleton Gajdusek, the National Institutes of Health research physician who led the assault on the mysterious New Guinean disease kuru, one of the two spongiform encephalopathies found in man. Gajdusek learned of kuru on a stopover in New Guinea in 1957 and trekked off into the highlands to begin what would become one of his several lifelong quests: to explain the causation of kuru and related diseases. Thirty years and a Nobel prize later, Gajdusek’s theories and the work of the lab he directed at NIH until 1996 remain state of the art. Yet the project’s advancement required the contributions of others very unlike him.

Clarence Gibbs is as rooted as the much-traveled Gajdusek is peripatetic: He still lives in the house his great-grandparents built in Washington, D.C. In the early 1960s, Gajdusek recruited Gibbs to take charge of the animal experiments that would show kuru to be an unconventional infectious disease transmissible to primates. Patricia Metz studied brain cells through a hugely powerful electron microscope in a Staten Island lab. For days and months and years on end, she searched directly for the agent of disease. “A jigsaw- puzzle aficionado, pragmatic and grounded and impatient with abstraction,” she eventually found minute formations she called “scrapie-associated fibrils. ” They are now accepted as the distinctive mark of the spongiform encephalopathies — though even today the nature of the disease agent, its remarkable resilience, and its means of propagation have not been fully elucidated.

Gadjusek, Gibbs, Merz, and others were engaged in a search for knowledge that is the central drama of Deadly Feasts: the sequence of forming and testing alternative explanations for phenomena; of pondering anomalies that cry out to be accounted for.

Gibbs, in charge of the experiments testing whether kuru could be transmitted to animals, oversaw a menagerie of 10,000 mice, 75 monkeys, and 7 crucial chimpanzees in a disused dairy barn he renovated at a federal wildlife research center. Kuru has an incubation period of years, so once the chimps had been carefully injected with a solution of kuru-diseased brain, it was a matter of waiting and watching. Gibbs chose never to study a human kuru patient so as to keep his observations of the animals uninfluenced by anything he had previously seen.

Eventually a chimp named Georgette exhibited changes. She began to withdraw, with a vacant look in her eyes. Sometimes she shivered. Her condition deteriorated steadily. Rhodes quotes from the lab assistant’s notes:

“14 July 65. Appears to have the ‘shakes.’ Trembles at frequent intervals. No sense of balance. Fell off stoop in cage. Moving around very slowly. Jaw hangs open constantly.

“15 July 65. Tremors continue. Fell off top of cage today.”

A few days later, another of the team, who had worked in New Guinea, summed up his observations with: “clinical impression — kuru.” Gajdusek was summoned home from New Guinea. He was impressed, but he still harbored doubts.

Georgette continued to decline. By October, when she was sacrificed, she had to be fed by hand and could no longer walk. A specialized neuropathologist named Elizabeth Beck was flown in from England for the autopsy. She took the brain back with her and three weeks later cabled NIH: Georgette’s pathology was indistinguishable from human kuru.

But, as always, human weakness and human tragedy complicated matters. A deep rivalry developed between Gajdusek’s lab and that of the ambitious Stanley Prusiner in San Francisco. It was discovered that some recipients of corneal transplants or of Human Growth Hormone harvested from cadavers had been infected with the spongiform encephalopathy known as Creutzfeldt-Jakob. And finally, Gajdusek’s career was derailed by his arrest in April 1996 for molesting an adopted son, to which he pleaded guilty in February.

In the 1980s, mad cow disease would present British politicians and regulators with the challenge of curbing a poorly understood epidemic and protecting human health from dangers more potential than known. Their policy choices should have been scrupulously informed by science; inevitably, they were also subject to economic and public-relations pressures. Rhodes’s account of the British authorities’ almost cavalier bungling of the crisis is the weakest part of his book. The winner of a Pulitzer prize for his justly acclaimed Making of the Atomic Bomb in 1986, he expresses a breathless anger at politicians, especially those of a conservative stripe, who did not invariably choose the most radical precautions when mad cow disease appeared. Rhodes appears to favor policies designed to eliminate all risk regardless of cost, including in this country, where mad cow disease has never been found.

Indeed, the book is marred by Rhodes’s taste for the sensational and his overstatement of the probable danger to man. The “deadly feasts” of the title are those by which some of these maladies were spread: ritual cannibalism in New Guinea, which was abandoned in the late 1950s, causing kuru to die out; and the feeding to cattle of protein supplements made from cattle remains, the “industrial cannibalism” that unwittingly fanned the epidemic in Britain before the government banned the practice in 1989. (Rhodes aficionados will detect here a minor theme of his work: He once wrote a novel about the Donner party, as well as an arresting childhood memoir of torture at the hands of a cruel stepmother, A Hole in the World, in which he recounted his stepmother’s “cannibalizing” his identity.) If indeed eating beef products has given the disease to humans, that becomes another deadly feast.

As for whether mad cow disease actually has infected humans through their food, mounting evidence strongly suggests that it has, though the rate of transmission across species is low. By the end of 1996, some 14 cases of a novel human spongiform encephalopathy had been confirmed in Britain and one in France. Given the long incubation period, the victims of this “new-variant Creutzfeldt-Jakob” were probably infected by beef products in the 1980s, before public-health countermeasures were in place.

The incidence of new-variant Creutzfeld-Jakob is expected to grow in the short term. Still, even worstcase estimates of where it could conceivably peak show Rhodes’s invocation of the Black Death — which wiped out one third of Europe in the 14th century — to be silly. The latest scientific update, by Paul Brown and Leon G. Epstein in the March 1997 issue of Neurology, stresses the lack of any suitable model for assessing the future but concludes: “Predictions of a huge epidemic . . . are probably not justified.”

If the threat is something short of apocalyptic, it is certainly real and demands to be more widely understood. For this, Rhodes’s book is a fine starting point, and his alarmism may usefully draw attention to the problem. As he notes, a coming thing in medicine is the transplantation of animal organs and tissues into human beings. Doctors and patients contemplating such transplants will need to guard against the clear risk that procedures intended as therapeutic may transmit a near-indestructible agent of fatal disease from animals to man.

Claudia Winkler is managing editor Of THE WEEKLY STANDARD.