Sarfraz Manzoor: Our long, hard battle to have a second child

One morning at breakfast our daughter, Laila, looked up from her cornflakes and said: “Why am I the only child in this family?”

We had always known we wanted more than one child. Laila was born in 2011, a year after Bridget and I married. I loved being a dad. Children are hope in human form and while parenthood was often challenging, it also gifted us an addictive joy.

Soon after Laila turned one, Bridget suggested we try for a second baby. We wanted another child because, to us, having only one made us feel as if our family were incomplete. We wanted Laila to have a sibling and felt we would be failing her if we did not give her the chance of being someone’s big sister.

Bridget got pregnant easily the first time, so we assumed she would do so again. To begin with, we did not pay much attention to the monthly disappointments. But, in time, I came to dread the sound of heavy footsteps as Bridget returned from the bathroom having spotted the blood that indicated her period was coming and a baby was not. She would curl back into bed with me and I would hear her quietly crying.

Sarfraz Manzoor with his daughter, Laila, when she was eight months old. Photograph: Graham Turner for the Guardian

We moved from trying and then struggling and then failing to fall pregnant. The more we tried, the less fun it became. Sex went from pleasure to duty, from spontaneous to scheduled. It did not matter if we had had a fierce row earlier in the evening – by the time we got to bed we would somehow need to kiss and make up. Meanwhile, friends’ pregnancies produced new siblings for Laila’s friends.

After more than a year of failure, we saw our doctor. No single factor appeared to explain why Bridget was not getting pregnant. It had never occurred to us that we might have fertility problems – we already had a baby – but having failed to conceive naturally, we were advised to consider IVF. The fact that we had Laila meant the NHS would not pay and that we would have to go private – at a cost of thousands of pounds. It would eat up my savings, and there was no guarantee of success, but we felt we had at least to try, so that Laila could have her longed-for younger sibling.

We agreed to start on IVF and a few days later two large cardboard boxes arrived at our home filled with drugs for Bridget. There were also fearsome-looking syringes for injecting drugs into her stomach. Meanwhile, I signed up for weekly acupuncture sessions that aimed to boost the mobility of my sperm, and started taking special sperm-enhancing vitamin tablets. The drugs worked: within a couple of months, Bridget had produced a cluster of eggs, two of which were then fertilised. On 26 June 2015, the two embryos were transferred into Bridget’s uterus.

We then had to wait two weeks for the all-important pregnancy test. We hardly slept the night before. That morning, with Laila still asleep in her bedroom, I pulled out a framed photograph of our wedding day. We stared at it. What we were going through was nothing compared with those having IVF who did not already have children. Whatever the result of the pregnancy test, we had a huge amount to be grateful for.

A blood test revealed that it was good news: Bridget was pregnant. We were elated: all that money and all the pills and needles had been worth it.

The following weekend, I headed off to the Latitude festival, while Bridget was booked in to have some blood tests. On the Sunday, I noticed a missed call from Bridget. She had heard from the clinic: her pregnancy hormones were not increasing as fast as was expected. It could be ominous or it could be nothing – the only way to know was to book in for a scan.

The scan revealed that there was a gestational sac – a first sign of early pregnancy – but in order to tell whether it was still growing, a follow-up scan was needed. At the second scan, the nurse said, “I can see the heart beating.”

Bridget burst into tears of happiness and we hugged each other as the nurse said we should book for a third scan to track the rate of the embryo’s growth. It felt like a formality. The scan was scheduled for 10 August, the day before Laila’s fourth birthday. It would, we thought, make a perfect pre-birthday present if she came with us and got a glimpse of her future sister or brother.

That summer morning, we walked into the room full of sunny confidence. I sat next to Laila holding her hand and Bridget lay on her back as the nurse examined her. She worked in silence, studying the cloudy images on the monitor. We had become used to the routine. The nurse completed her tests and then said, “I’m so sorry but it’s bad news: there is no heartbeat.”

I thought I had heard wrongly but Bridget understood. I was mute from shock – I could not believe what I had heard. Laila was wondering what had happened. “Are those happy tears, Mummy?” she asked.

When I recall the days after the news, what I most remember is Bridget and me weeping, sometimes together and at other times apart while trying to keep our distress from our daughter.

Bridget felt it was worth having one more attempt. She didn’t have the desire to keep going endlessly, failed round after failed round. It would be too hard on her body and mind, but she wanted to have one more try. The failed round of IVF had cost more than £12,000. We couldn’t afford a second cycle. It was then we had an unexpected stroke of good fortune: an uncle of Bridget’s generously offered to help to pay for a second round of IVF.

The whole business started again – the drugs and injections, the hope and the waiting.

One morning in mid-March the following year we did the pregnancy test and although the news was good, we could not allow ourselves to believe that success was inevitable. In the past, miscarriages had been something that happened to others, but they were now part of our story: we were too frightened to take anything for granted again.

I had a miscarriage. Why can’t we talk about losing a baby?

Even when blood tests confirmed the pregnancy and the scan revealed the tiny beating pulse of a heart, we could not allow ourselves to get too excited. Only when we went to the 12-week scan, which showed the embryo growing normally, did we feel safe enough to believe that our luck had changed.

It was a Saturday night and Bridget and I were at a friend’s wedding in the Devon countryside. She was 13 weeks pregnant and starting to show. The wedding disco had just begun and I was on the dancefloor. When I stepped outside the hall for some air, I saw Bridget. She had a stricken expression and I knew instantly that something had happened. “I’ve started bleeding,” she said.

Minutes later, she was sitting on the toilet in our hotel room, blood streaming between her legs. An ambulance crew advised us there was little point in being driven to A&E because they would not be able to confirm a miscarriage.

The next day we found ourselves in our local hospital as a sonographer smeared lubricating gel on Bridget’s belly. I am not sure we would have coped with a second miscarriage but, thankfully, the baby was fine – apparently the sort of bleeding Bridget had experienced was common but rarely discussed.

It was Sunday evening, 20 November, and Bridget was due to be induced the following day. She had been having minor contractions during the afternoon and by the evening they were becoming more intense. While we were having dinner, she said we should call for a taxi to take us to hospital. We reached the hospital at 9pm; an hour later, our son, whom we would later name Ezra Zakariya Manzoor, was born.

The following day, Bridget’s cousin brought Laila to the hospital. Bridget was in bed cradling our baby son when our daughter walked up to him. Bridget smiled broadly and said: “Laila – say hello to your little baby brother.”

Sarfraz Manzoor: Our long, hard battle to have a second child

Germ warfare: the battle for the key to modern vaccines

On 9 October 1964, a baby girl was born at Philadelphia general hospital. She arrived early, when her mother was about 32 weeks pregnant. The baby weighed 3.2lb and was noted to be blue, floppy and not breathing. The only sign of life was her slow heartbeat. Nonetheless, she clung on, and her 17-year-old mother named her.

One month later, the baby was still in the hospital, and a doctor listening with a stethoscope heard a harsh heart murmur. A chest X-ray showed that she had a massively enlarged heart because a hole in the organ was preventing it from pumping blood efficiently. It also emerged that the baby had cataracts blinding both eyes. Later, other signs indicated that she was profoundly deaf.

The baby also suffered from recurring respiratory infections and had trouble gaining weight. A psychologist who assessed her in July 1965 judged the nine-month-old to be the size of a two- or three-month-old infant and at about that stage of development, too. She needed heart surgery if she was going to survive. Just before her first birthday, surgeons made an incision in her chest wall and repaired her heart. After the operation, she remained in hospital. The chronic respiratory infections continued. The baby was 16 months old and weighed just 11lb when she died of pneumonia on 18 February 1966.

The young mother had told the doctors that when she was one month pregnant, she had contracted German measles, also known as rubella.

The early 1960s marked a coming of age for the study of viruses such as the one that causes rubella – tiny infectious agents that invade cells and hijack their machinery in order to reproduce themselves. Biologists, with new tools in hand, were racing to capture viruses in throat swabs or urine or even snippets of organs from infected people and to grow them in lab dishes. Isolating a virus in the lab made it possible to make a vaccine against it. And making antiviral vaccines promised huge inroads against common childhood diseases such as measles, mumps and rubella, along with less common killers including hepatitis. The principle of vaccination is simple: if a person is injected with, or swallows, a tiny amount of a virus – either a killed virus or a weakened live virus – that person will develop antibodies against the virus. Then, if he or she is exposed in the future to the naturally occurring, disease-causing form of the virus, those antibodies will attack the invader and prevent it from causing disease.

But if the concept is simple, making effective vaccines is anything but. In the early 1960s, that reality was all too evident. In 1942, as many as 330,000 US servicemen were exposed to the hepatitis B virus in a yellow fever vaccine that was contaminated with blood plasma from infected donors (the plasma was used to stabilise the vaccine). Around 50,000 of the vaccinated servicemen contracted the liver disease and up to 150 died.

In 1955, a California-based company named Cutter Laboratories made a polio vaccine with the live, disease-causing virus in it. As a result, 192 people were paralysed – many of them children – and 10 died. Every senior US government employee involved in the Cutter incident lost his or her job, right up to the director of the National Institutes of Health (NIH) and the secretary for health, education and welfare.

Then, in the summer of 1961, Americans learned that cells used to manufacture the widely used Salk polio vaccine, harvested from monkey kidneys, harboured a virus named SV40. Tens of millions of American children had already received contaminated injections, and while the jury was still out on the tainted vaccine’s long-term health consequences, the risks were of great concern to regulators in the US and further afield.

It was against this backdrop that, on a drizzly June morning in 1962, a 34-year-old scientist named Leonard Hayflick went to work in his lab at the Wistar Institute of Anatomy and Biology – an elegant 1890s brownstone tucked in the heart of the University of Pennsylvania’s campus.

A serious, slight man with close-cropped dark hair, Hayflick was a product of working-class Philadelphia and hungry to make his name. He was in love with biology and had come to believe that he was extremely smart – a fact that was far from appreciated. Hayflick’s boss, the polio-vaccine pioneer Hilary Koprowski, saw him as a mere technician, hired to serve up bottles of lab-grown cells to the institute’s scientists.

The ambitious Hayflick was undeterred. That day, he planned to launch a group of human cells that would revolutionise vaccine-making. He was convinced that, compared with monkey cells, which were often laden with viruses, human cells would serve as cleaner, safer vehicles for producing antiviral vaccines.

Several days earlier, a woman living near Stockholm had had an abortion. The eight-inch-long female foetus was wrapped in a sterile green cloth and delivered to a yellow brick outbuilding on the grounds of the National Biological Laboratory in north-west Stockholm. The lungs were removed, packed in ice and flown to the Wistar Institute.

The Wistar Institute in Philadelphia. Photograph: The Wistar Institute

Hayflick had been waiting months for this opportunity. These lungs would be the source of the new cells he needed to make antiviral vaccines. Viruses can’t multiply outside living cells, and huge quantities of virus were needed to produce vaccines.

Now, at last, the lungs were here in his bustling second-floor lab, two purplish things floating in clear pink fluid in a glass bottle. They had been sent to Hayflick by a top virologist at the prestigious Karolinska Institute in Stockholm.

Hayflick knew that he was uniquely positioned to produce a long-lasting supply of these cells. He had spent the previous three years perfecting the procedure that would do it.

Hayflick took the lungs into a tiny room just off his lab – what passed for a “sterile” area in 1962. He picked up a pair of tweezers, dipped them in alcohol and passed them through the flame of a Bunsen burner. He waited for them to cool and then, gently, one at a time, lifted the organs and placed them on a petri dish. Each was no larger than his thumb above the knuckle. He began carefully slicing them into innumerable pieces, each smaller than a pinhead.

Hayflick nudged the minute pieces of tissue into a wide-mouthed glass flask. The translucent pink fluid was full of digestive enzymes from slaughtered pigs. These biological jackhammers broke up the “mortar” between the lung cells, separating millions upon millions of them. Later, he transferred those cells into several flat-sided glass bottles and poured a nutritious solution over them. Hayflick then loaded the bottles on to a tray, and carried them into an incubation room where the temperature was a cosy 36C. He laid the bottles on their sides on a wooden shelf and closed the door carefully behind him. There the cells began to divide. He already had a name for them: WI-38.

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The WI-38 cells that Hayflick launched that day were used to make vaccines that have been given to more than 300 million people – half of them preschool children in the US. A copycat group of cells, developed using the method that Hayflick pioneered, has been used to make an additional 6bn doses of various vaccines.

Together these vaccines have protected people the world over from the gamut of viral illnesses: rubella, rabies, chickenpox, measles, polio, hepatitis A, shingles and adenovirus – a respiratory infection that flourishes in situations where people live in close quarters. (Every US military recruit – more than nine million of them since 1971 – is given an adenovirus vaccine made using WI-38 cells.) In the US, a vaccine made in WI-38 cells that is still given to young children has wiped out homegrown rubella. It was developed at the Wistar Institute by Hayflick’s colleague Stanley Plotkin, during a rubella epidemic that swept the country in 1964 and 1965.

The WI-38 cells Hayflick launched that day made vaccines that have been given to more than 300 million people

The WI-38 cells are still in use today partly because Hayflick made such a large initial stock of them: some 800 tiny, wine-bottle–shaped ampoules were frozen in the summer of 1962. When frozen, cells stop dividing, but then gamely begin replicating when they are thawed.Each glass vial that Hayflick froze contained between 1.5m and 2m cells. The cells in those vials had, on average, the capacity to divide about 40 more times. Early on, Hayflick determined that the newly derived cells in just one of his small glass lab bottles, if allowed to replicate until they died, would produce 20m tonnes of cells.In those 800 vials, he had created a supply of cells that for practical purposes was almost infinite.

In addition to their use in vaccine making, the WI-38 cells became the first normal cells available in virtually unlimited quantities to scientists probing the mysteries of cell biology. Because they were easily infected with human viruses, they became important to disease detectives tracking viruses in the 1960s, before more sophisticated technology came along.Biologists still reach for WI-38 cells when they need a normal cell to compare against a cancerous one, or to test the toxicity of new drugs. They are a workhorse of research into ageing, because they so reliably age and die in laboratory conditions. Original ampoules of WI-38 cells, and of polio vaccine made using them, are now part of the collection of the National Museum of American History.

But in the 1960s and 70s, a bitter feud broke out between Hayflick and the US government over who owned the cells.

Hayflick in the lab in the 1960s. Photograph: Supplied

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As the importance of the WI-38 cells grew,Hayflick was only too happy to promote them. “Human Cells Given Role in Vaccines,” the New York Times proclaimed after the scientist spoke at a vaccine conference in 1966. The article quoted Hayflick explaining that his cells were cheaper, cleaner and safer than the animal cells then used in vaccine manufacture.

As his profile rose, Hayflick ran out of patience with Koprowski. The disconnect between his contributions and his treatment by the Wistar Institute’s director had become too much to bear. Nine years after Koprowski hired him, Hayflick remained stuck as an associate member of the institute, in sharp contrast to many colleagues who had been made full members despite, to his mind, making contributions no greater than his own.

Hayflick began looking around. He applied for a position as a full professor of medical microbiology at Stanford University in Palo Alto, California. His application for the job was backed by a recommendation from a senior virologist who regarded his work as “reliable, trustworthy and original”. He was offered the post.

As Hayflick’s departure approached, there was probably only one thing that concerned Koprowski: the fate of the hundreds of ampoules of WI-38 cells that were still stored in liquid nitrogen in the Wistar Institute’s basement, under Hayflick’s watchful eye. Hayflick’s proprietary feelings about the cells were well known – he once described them as “like my children”.

Koprowski had designs on the cells from the beginning. Nancy Pleibel, a lab technician who worked for Hayflick, recalls that more than once Koprowski had turned up in the lab within a day or two of Hayflick leaving on a trip, smiling and asking her for an ampoule of WI-38 cells. Politely but firmly, she refused his requests, explaining that only her boss could hand out WI-38 ampoules. After a while, Koprowski stopped asking.

Minutes from meetings of the Wistar Institute’s board of managers in the early and mid-60s make clear that Koprowski tried repeatedly to cash in on Hayflick’s human diploid cells(defined as cells that carry the normal complement of 46 chromosomes). The institute sought payment not only from Norden, a Missouri company that was interested in using WI-38 to develop a rabies vaccine, but also from Pfizer for the use of Hayflick’s cells to make a measles vaccine, and from Wyeth, another Philadelphia-based drug manufacturer that by 1965 had used the WI-38 cells to make an adenovirus vaccine to protect US army recruits during basic training.

Koprowski’s attempts to turn a profit with the WI-38 cells were far from successful. By 1965, the board of managers had appointed “a special committee of lawyers and scientists to deal with problems” in selling the Hayflick cells to industry. The only backing that the institute landed, according to budget documents from 1965 to 1967, was $ 5,000 in each of those years from Norden.

Today it seems incredible that an institution like the Wistar, full of eminent scientists, was so at sea when it came to profiting from unique and desirable cells produced under its roof. But in that era living things, such as the WI-38 cells, could not be patented. It would take a landmark supreme court decision in 1980 to change that.

However, what could be patented was a method of using the cells to produce a novel vaccine. Koprowski had already applied, back in 1964, for such a patent for another, improved rabies vaccine that he was developing using the WI-38 cells. Soon the Wistar Institute would apply for a patent on a method of making a rubella vaccine with the WI-38s, devised by another of its scientists, Stanley Plotkin.

If and when the rabies and rubella vaccine patents were granted, Koprowski would need accessto at least some of the original ampoules of WI-38 frozen in the Wistar Institute basement.Vaccine companies would want original ampoules full of the youngest cells, which could be expanded into a nearly endless supply.

By the autumn of 1967, Hayflick vaguely suspected that Koprowski intended the WI-38 cells to serve something more thanthe good of mankind. Hayflick believed that his boss hoped to turn any vaccines made with the cells into sources of cash, boosting the Wistar Institute’s income and freeing him from fundraising duties that he detested and considered beneath him.

Transmission electron micrograph of Rubella virions. Photograph: Science Photo Library

Hayflick’s instincts were right. As 1967 drew to a close, a financial vice was tightening on Koprowski. While the Wistar Institute had remained solvent, it had never been flush with funds, especially after Koprowski blew through $ 271,506 to fund major renovations that were completed in 1959. By the mid-60s, his struggle to find cash not tied to specific grants was becoming desperate. Badly needed repairs to the roof and the air conditioning system were deferred.

In the autumn of 1967, when officials at the NIH’s National Cancer Institute (NCI) learned that Hayflick would be moving to Stanford, they decided to take the production, storage, study and distribution to researchers of human diploid cells out of his hands. The NCI had been paying the Wistar Institute hundreds of thousands of dollars for Hayflick to produce and distribute the cells since 1962, shortly after his paper announcing his human diploid cell strains to the world had sent demand soaring. The agency’s contract with the Wistar Institute had specified that the government would take ownership of the cells when the contract was terminated. Now, NIH officials set 1 January 1968 as the end date. The timing seemed right, and not only because of Hayflick’s impending move. The sense at the NCI was that the demand for the WI-38 cells had been sated. Those scientists who wanted them, it seemed, had them by now, more than five years after Hayflick had first produced them. They were being used widely and had already been cited in scores of papers.

On 18 January 1968, several men travelled to the Wistar Institute to sort out the physical disposition of the WI-38 cells now that the contract had ended. Koprowski summoned Hayflick to meet with them. Also present were senior scientists from the American Type Culture Collection (ATCC). This independent, nonprofit organisation was the country’s highest-profile cell bank, and was often where biologists turned when they needed a particular type of cell for an experiment. According to records, the assembled men agreed that all but 20 of the roughly 375 remaining original ampoules of WI-38 cells would be transferred to the ATCC, which would maintain them, deeply frozen, on behalf of the NIH. Hayflick would be permitted to take 10 ampoules with him to Stanford, and the Wistar Institute would also be allowed to keep 10.

The group also decided that any use of the 355 original ampoules being transferred to the ATCC – they were precious because the WI-38 cell populations in them had divided only eight times, and so could be expanded into untold billions of cells for vaccine making – “should be totally arrested”. By this, they meant that there was to be no more thawing of the ampoules, no more planting of these young cells into lab bottles, and no more splitting of those bottles over and over to generate multitudes of cells at higher doubling levels for scientists to use. Scientists could use the older cells that were already in circulation. The remaining 355 original ampoules needed to be kept safely frozen at the ATCC until such time as companies began winning US licences to make WI-38–based vaccines.

Some time during his last months at the Wistar Institute, Hayflick was working in one of the tiny “sterile” rooms that adjoined his lab. Plotkin squeezed through the door and pulled up the only chair. The two chatted for a while, then Plotkin showed Hayflick a document. It was a letter, on Wistar-headed paper, from Koprowski, written to a senior official at Burroughs Wellcome, the British pharmaceutical company. Koprowski was offering to provide to the company ample supplies of WI-38 cells, along with the recipe for making a vaccine with the cells and the virus itself, all in exchange for royalties.

‘To have the vultures descend on what I had struggled to give value to – most people would understand why I was upset’

Hayflick’s suspicions had been confirmed. He was profoundly upset. He had spent the previous decade deriving the cells and opened up a new, important field in the study of cellular ageing. He had derived enough WI-38 cells to serve vaccine makers into the distant future and worked as hard as was humanly possible to win acceptance of the cells for vaccine making. In the process of all of this, he had been ridiculed and been forced to struggle for respect and validation.

This letter signalled that not only was he not valued but that he was also being sidelined in major decision-making – and likely profit-making – connected to the WI-38 cells. As Hayflick said, “to have the vultures descend on what I had struggled so hard to give value to and [for them to] try to take it for their benefit – I think that an average person would understand why I was, to put it mildly, concerned”.

On or around 1 March – when, under the January agreement, the ampoules were to have been moved from the Wistar Institute to the ATCC – a specially outfitted station wagon arrived from Maryland, carrying the NIH project officer, Charles Boone, and John Shannon, the ATCC’s curator of cell lines. Hayflick turned them away, saying he wasn’t ready to hand over the cells because he had not prepared an inventory of them.

Not long after this, Hayflick, unobserved, visited the Wistar Institute’s basement. There he packed every single one of the remaining original WI-38 ampoules – 375 frozen vials: the largest stock of young WI-38 cells on earth – into one or more portable liquid-nitrogen refrigerators and departed the premises. He left nothing behind – not even the 10 ampoules that Koprowski’s institute had been promised in the January agreement.

Hilary Koprowski at work in his lab. Photograph: Yale Joel/The Life Picture Collection/Getty Images

Hayflick stored the frozen cells temporarily with a friend, a vaccinologist at the nearby Wyeth Laboratories who, from time to time, topped up the liquid nitrogen that kept the cells frozen. Hayflick says that he took the ampoules with the intention of keeping them only until the ownership of the cells could be properly sorted out. He believed that there were several potential stakeholders who might reasonably claim ownership: himself and his early collaborator at the Wistar Institute, the chromosome expert Paul Moorhead; the “estate” of the WI-38 foetus, by which he meant the WI-38 foetus’s parents; the Wistar Institute; and, just possibly, the NIH. But he was not going to be so naive as to leave the cells in the NIH’s possession while these matters were decided. If he did that, he was sure that he would never see them again.

In mid-1968, Hayflick left for his new job in California. Moving a family of seven 2,900 miles was no small undertaking. The Hayflicks split the travel. Ruth flew out to the San Francisco Bay Area with their two youngest daughters. Hayflick drove the three older children cross-country in their dark green Buick sedan. They drove west through Pittsburgh, stopped to see drag races in Joplin, Missouri, and then headed on to Arizona, where they gazed at the world’s best-preserved meteor crater and marvelled at the Grand Canyon. All along the way, some extra cargo travelled with them. Carefully strapped on the backseat beside his children was a liquid-nitrogen refrigerator stuffed with ampoules of WI-38.

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Hayflick’s flight with the cells would make him the target of a career-derailing investigation by the National Institutes of Health. Hayflick counter-sued – eventually, in 1981, settling with the government. He was allowed to keep six original ampoules of the cells, along with $ 90,000 that he had earned by charging researchers and companies for them after he left the Wistar Institute. A letter from supporters published in the journal Science, described the “happy outcome of Dr Hayflick’s courageous, sometimes lonely, emotionally damaging and professionally destructive ordeal”.

But just as the tug-of-war over ownership of the WI-38 cells peaked, profound changes occurred in attitudes and laws governing who could make money from biological inventions. In the space of a few years, biologists went from being expected to work only for their salaries and the greater good to being encouraged by universities and the government to commercialise their innovations for the benefit of the institutions, the US economy – and themselves.

Although the WI-38 cellswere launched long before these changes took place– and 18 years before the supreme court decreed that a living entity, such as a WI-38 cell, could be patented – a lot of money has been made from them. The drug company Merck, in particular, has made billions of dollars by using the WI-38 cells to make the rubella vaccine given to more than seven million American children each year. The Wistar Institute too enjoyed a handsome royalty stream from vaccines made by its scientists using the cells – including a much-improved rabies vaccine that replaced sometimes dangerous injections. Cell banks today charge several hundred dollars for a tiny vial of the cells.

During the long battle for ownership of the WI-38 cells, Koprowski sent a Wistar scientist across the country to collect them from Hayflick’s Stanford lab. But Hayflick refused to part with them. A second emissary was more successful, returning with the 10 ampoules originally allocated to the institute. But later, while the NIH was still asserting its title to WI-38, Koprowski seems to have given up. Perhaps this was because Hayflick was now so far away. Maybe it was because, despite his propensity for it, Koprowski actually disliked direct conflict. Possibly, it was because several companies already appeared to have adequate supplies of the youngest WI-38 ampoules. On the other hand, though, it might have been because Koprowski had finally realised just how persistent, obdurate and dedicated Hayflick could be.

This is an adapted extract from The Vaccine Race by Meredith Wadman, published by Doubleday on 9 February in the UK and in the US by Viking.

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Germ warfare: the battle for the key to modern vaccines

Ginger’s life on the street: a battle with people’s disgust, illness … and the cold

For three days he hadn’t slept, at least not properly. The last time he remembered drifting off was before dawn on Tuesday. It was now 1:40pm on Friday, and Ginger was hunched in his sleeping bag on the freezing slab of north London pavement he called home. His resting place was outside a branch of HSBC, metres from Camden Town tube station. There might be more crowded locales in London but few are more frantic. Around him surged crowds of tourists and revellers starting the weekend early. A bunch of Italians took it in turns to take pictures of Ginger, red-eyed and weary, a very modern face of the capital. Others struggled to hide their pity; some looked plainly disgusted.

But it wasn’t the incessant tumult of Camden that had induced Ginger’s most recent bout of insomnia. “It’s the cold. You can’t sleep. You just lie there, freezing. Even when you turn numb, it’s still painful. And someone stole my gloves,” he shook his hands forcefully to mimic his shivers as the temperature fell to -3C last week.

Ginger said the best thing to kill the cold was heroin. “It’s the only thing that makes you feel warm, from the inside. But it’s been so cold, even that hasn’t worked.”

An articulate and incisive character, Ginger is one of Britain’s growing cohort of rough sleepers, among the 960 identified in London last year. Last week government figures showed that the number of rough sleepers in England had risen for the sixth year in a row, up 16% on the previous year, nearly double the number since 2010. Across the country 4,134 people were forced to sleep outside. Ginger describes it as a life of extremes, an existence that brings out the best and the worst of people. “Some people try to bully you, try to pick a fight, some spit at you or shout at you to get a job or get some benefits. Mostly they tend to stick their nose up at you.

“And then a lady will walk by and give you a helping of homemade stew that she’s made especially – that happened yesterday,” he smiles. Considering his profound fatigue, Ginger looks well, although he admits he feels “much older” than his 41 years. The average age of death for rough sleepers is 47. The lowest average life expectancy in the world is in west Africa’s Sierra Leone: 44.4 years.

Ginger, born in upper Clapton, east London, in March 1975, describes his life’s journey as a string of squandered opportunities, bad luck, bad decisions, substance abuse and ultimately the shocking murder of a loved one. His first setback occurred at the age of six and a half. Ginger’s mother walked out on him and his father. He has not spoken to her since. “She didn’t want anything to do with me.” His father, now 67, brought him up single handedly and, according to Ginger, remains supportive.

After leaving school aged 16, Ginger went to live with his uncle in the Irish city of Limerick. There, he fell in love with the outdoors. In the River Shannon he caught his first salmon. He went rabbit hunting in the fields below the Slieve Felim mountains. “I became a keen fisherman, I really took to the life.” But the lure of London drew him back and, aged 19, Ginger found work as a painter and decorator in Camden, making £50 a day cash in hand, a grand a month. “That was big money in those days,” he said. But his disposable income was invested disastrously. Ginger began drinking heavily in Camden pubs like the World’s End – opposite where he now sleeps – or the Camden Head. “The problem was that I was drinking with the wrong crowd.”

Cannabis use rapidly evolved into crack and heroin addiction. His job suffered, his income evaporated. In 2000 Ginger received his first custodial sentence for robbery. For the following eight years life became a blur of prison and heroin use. He served time in Pentonville, Wandsworth and Portland, among others. Amid the chaos, Ginger managed to maintain a seven-year-relationship. He and his partner had two daughters and a son between 2002 and 2006. The family lived in a two-bedroom flat in a yellow tower block behind Euston station. “I had everything I ever wanted. I thought I’d made it.”

But in 2008 the relationship broken down. Ginger went clean but he has not heard from his partner or children since. His loss prompted a period where he tried to build a new life, and Ginger is adamant he would have never ended up on Camden’s streets had it not been for the brutal murder of his Irish uncle in 2015. An intruder attacked and viciously beat the 74-year-old in his Limerick home. “I was asked to go to the funeral but had to say no. I couldn’t bear to see him in the open coffin. I wanted to remember him as he was,” said Ginger, still visibly grief-stricken. Heroin anaesthetised the pain. By the summer of 2016 Ginger had lost everything and was a rough sleeper. “Once you’re back on the heroin, it’s hard to get straight,” he said, describing his current heroin intake as “dabbling”.

Spice – synthetic cannabis – is the narcotic of choice among Camden’s rough sleepers now. “Everyone’s on it. It just knocks you out,” said Ginger. Last May the government made spice illegal, and the only people to benefit have been the dealers. Before then, Ginger could procure five grams for £25 from a local shop. Now dealers cut the substance and charge £10 for half a gram.

Camden could be a violent place for a rough sleeper, he said. He is wary of the surrounding streets, recounting a drunken night in 2003 when he got into a mindless squabble with a stranger in a nearby alley. They began fighting. Initially Ginger thought his assailant had punched him in the leg. “Then I realised I’d been stabbed. You live in fear that that can happen at any time.”

Ginger also admitted that he was a danger to himself. In 2008 he was taken to St Pancras hospital in handcuffs after a psychotic episode. Once there, he sliced himself open with a craft knife he had hidden in his pants. Yanking up his jacket, he reveals two parallel lines of knotted scar tissue 30cm long, running across his lower stomach. “It was the voices that told me to do it.” He was diagnosed as a paranoid schizophrenic and currently receives a fortnightly injection to control his condition. Research by charity St Mungo’s shows that four in 10 people who sleep rough have a mental health problem.

But street life is not unswervingly bleak. Ginger’s survival relies on daily acts of unsolicited generosity. “Some people sit down for a chinwag and ask how I am. Others give me money, even 20p, for which I’m always grateful. People bring sandwiches or visit a local shop to buy me lunch, and local restaurants often bring leftover meals.”

Staff from the McDonald’s on Camden High Street bring over a quarterpounder with cheese, Ginger’s favourite. If not, there is the nearby soup kitchen which, in a sign of the times, can “become very crowded”.

Ginger talks fondly of his fellow rough sleepers, how they will defend each other if attacked or from new faces they don’t trust. In the past Ginger has befriended strangers and woken up without his shoelaces. Even so, rough sleeping is fundamentally wearying. Days begin around 5am, when the city starts waking up, and Ginger says he can only fully relax after 3am when Camden’s nightlife fades. His alternative “homes” – a doorway close to the American Apparel store across the high street and an alley behind the World’s End – are hardly more peaceful.

Ginger often thinks of the day he’ll be able to leave Camden’s streets. Like all rough sleepers his primary ambition is a permanent home. Without an address, securing a job and saving money is almost impossible.

But Ginger is also scared that he’ll never fully conquer the internal voices that he said prevented him from moving forward. “The medication is working in the sense that I can only hear mumbling. I can’t quite make out the voices but they are there, coming from behind my back. If they stop, I’ll be able to think more clearly.”

HOMELESSNESS FACTFILE

• Using a different methodology to the government figures, the Combined Homelessness and Information Network, found that 8,096 people slept rough at some point in London during 2015/16, an increase of 7% one the previous year.

• Of these, 5,276 people were new rough sleepers.

• 85% were male, with the proportion of women rising slightly over the last two years by 1%

• Many rough sleepers have pressing support needs: 43% have alcohol problems; 31% have drug addictions and 46% mental health issues. The proportion of rough sleepers with no support needs is around a quarter.

• A third of people seen rough sleeping in 2015/16 had served time in prison, while one in 10 had experience of the care system. Eight per cent had been in the armed forces.

• Where nationality was recorded, 3,271 people rough-sleeping were UK nationals – 41% of the total.

Ginger’s life on the street: a battle with people’s disgust, illness … and the cold

Egypt"s obesity battle: "No one cares about calories here"

Inside the neon palace that is Koshary Abou Tarek in downtown Cairo, the air smells of fried onions. Plates are heaped high with koshary, a traditional dish containing rice, macaroni and lentils topped with tomato sauce and onions – a filling mainstay across all Egyptian social classes.

An average serving at the restaurant costs the equivalent of £1.80, and contains an estimated 800 calories. The place is filled with families who are given a choice of sugary soft drinks as an accompaniment.

“We don’t measure the calories in the dish as no one here cares about that,” laughs the manager, Tarek Hosny. He elaborates on a prevailing theory that while koshary is all carbohydrates, these are somehow removed with the water they are cooked in.

Low to mid-income countries have some of the highest child obesity rates in the world and, Egypt ranks seventh with 32% of children obese, according to datafrom the World Obesity Federation. A diet heavy in meat, carbohydrates and sugar combined with few opportunities for exercise are taking a toll on the Arab world’s most populous country.

Nor is obesity bound by social class. Low-income families turn to rice and potato dishes to fill stomachs at the end of a long day. The wealthy, who can afford to eat meat with almost every meal, also have access to fast food, considered a luxury in the Middle East.

Koshary, a popular carb-dense dish, is served in a restaurant in Cairo. Photograph: Alamy

A survey by the World Health Organisation (WHO) covering 2011-12 found that 62.2% of Egyptian adults were overweight, and 31.3% of them were classed as obese.

“This is more than a health issue,” said Dr Randa Abou el Naga of the WHO in Egypt, who cites a lack of physical activity as the main driver of obesity.

“City planning is responsible,” she said. “There should be proper places for playing sports. Overcrowding in schools also means no sports classes; 75% of Egyptians aren’t doing any vigorous physical exercise.”

Naga said the Egyptian government could easily switch from subsidising sugar and oil to healthier options such as milk. Kiosks and corner shops throughout the country offer a range of sugary and salty snacks, a cheap option for children and their parents.

A Pizza Hut restaurant near the Giza pyramids in Cairo. Photograph: Alamy

“It might sound like a cliche, but Egyptians really love sugar. It’s an addiction,” said dietician Dr Sherine el Shimi. “They add sugar in their tea, and have five or six of these per day, each with two or three teaspoons of sugar in. If they just took out the sugar, their lives would be different.”

She said most if not all social gatherings revolve around food, and that social pressure to eat more was high. “Plus we also have delivery for everything,” Shimi said. For those who can afford it, a burger from one of Egypt’s growing number of burger chains can be delivered to your home within an hour.

“Fighting this starts in schools,” she said. “I know we’re not doing great economically right now, but nutrition classes and subsidising one fruit or vegetable per day per child would given them something they don’t get at home.”

Egypt"s obesity battle: "No one cares about calories here"

Widow of Falklands war veteran wins legal battle to save frozen embryos

The widow of a Falklands war veteran has won a high court declaration giving her a “last chance” to have her late husband’s child.

Samantha Jefferies, 42, from East Sussex, was forced to go to court after the shock discovery that the 10-year period for storing the frozen embryos the couple had created had been inexplicably amended to two years and had since expired.

Jefferies and her husband, Clive, had been undergoing fertility treatment when he died suddenly, aged 51, of a brain haemorrhage.

A judge has now declared that the amendment to the storage period was not valid and the embryos, instead of being allowed to perish, can still lawfully be stored and used.

The declaration was made by Sir James Munby, president of the family division of the high court, who said he would give his reasons later in writing.

Jefferies said the judge’s decision was “overwhelmingly fantastic – just brilliant, amazing”.

Jefferies, an occupational therapist, said she did not have a plan for using the embryos soon but added: “I would love to be a mum.”

She thanked the judge for Googling the history of her husband, who served in the Royal Army Medical Corps and was onboard the transport ship Sir Galahad when it was bombed in the Falklands in 1982, killing 48 men.

She told the court her husband was “a wonderful man”, adding: “I want my husband’s child.”

The Human Fertilisation and Embryology Authority supported her application on the grounds that the amendment to the MT form – used to record consent for embryo storage – had not been signed by Clive Jefferies.

BMI Healthcare Ltd, which runs the Sussex Downs Fertility Centre where the couple received treatment, also supported her and funded her legal costs.

The judge said BMI seemed to have acted “with sensitivity and compassion”.

Jefferies paid tribute to all those who had supported her “commonsense” application and said: “It has given me faith in the law.”

In court, Jenni Richards QC told the judge: “Samantha has brought this case because the embryos she is seeking to preserve represent her last chance of having the child of her husband they had both so dearly wanted.”

Three embryos were created from Jefferies’ eggs and her late husband’s sperm, with consent for them to be stored for 10 years from August 11 2013. Her husband also consented to their posthumous use.

The couple met in 1999 and married in December 2006 and always wanted to have children, the court heard.

After trying naturally for many years, they were referred in 2013 for NHS-funded IVF treatment, said Richards.

A number of amendments were made to Clive Jefferies’ consent form, including one specifying a reduction in the storage period from 10 years to two.

Most of the amendments were countersigned by Clive Jefferies, but the change to the storage period was not, said Richards.

Jefferies did not know who made the amendment and it came as a shock when she discovered it.

Richards said it was likely the amendment was made to reflect the clinic’s policy at the time, which was to only offer storage for the period for which the NHS would provide funding.

There was evidence that the clinic had asked couples to amend their forms to two years if they had chosen a longer period of storage.

Granting Jefferies a declaration that storage and use was lawful until August 11 2023, the judge said: “I am just so sorry that people like you should have no idea that this can end up in court because of mistakes made by other people who should have known better.”

Widow of Falklands war veteran wins legal battle to save frozen embryos

Jeremy Hunt has won a battle against junior doctors, but not the war

Junior doctors are used to managing crisis situations. Lifesaving treatments, long hours, dealing with dying patients, and coping with poor resources are all situations they would expect to wrestle with during their training. These young men and women want to cure the world – this is ingrained in their excellent and rigorous training, which might take anything up to 15 years.

So why is this important? You don’t have to live on Mars to know that the British Medical Association (BMA) – specifically, the junior doctors’ arm of it – and the government, namely health secretary Jeremy Hunt, are at odds.

It has become increasingly clear that Hunt has won the battle. Negotiations with the BMA have not just stalled, they have broken down because they failed to deliver the contract junior doctors felt was right for them and safe for patient care.

Hunt has a different view – not only does he think it is safe for patients, but he believes that it doesn’t discriminate against female doctors (over 60% of doctors are women), it offers a good work-life balance, and crucially it will deliver a seven-day service. His case is enhanced by the fact that junior doctors’ leaders endorsed the contract before consulting committee members. To some this is a matter of pay and conditions, while to others (not just within the BMA) it is a broader issue involving the current state of the NHS.

So is all well in the Hunt camp? Probably, insofar as the imposition of the contract is concerned. On the other hand, the BMA came to a rather desperate juncture. Its highest body, the council, backed the junior doctors’ committee’s demand to run an unprecedented series of five-day strikes. There was frustration, anger and even desperation at the inability of the government to see their viewpoint, fuelled no doubt by Hunt’s reappointment as health secretary.

In the cold light of day, the BMA realised that it would fall foul of the very reasons it was against the contract imposition – it had given trusts very little time to put together a contingency plan to safely cover the five days of the September strikes. It risked harm to patients, the very issue its 170,000 members feel is sacrosanct. The General Medical Council waded in, as did some of the medical royal colleges, ensuring the divisions in the senior medical fraternity were played out in the public and the media. A rapid climbdown by the BMA was inevitable, leading to an announcement that the September five-day strikes were off, further playing into Hunt’s hands.

To his credit, Hunt has not been gloating in this victory. He has adopted a dignified approach, welcoming the decision by the BMA but remaining steadfastly rooted in his conviction that the contract imposition would remain regardless. Last week, at Expo 2016 in Manchester he was very cordial, courteous and in consolatory mood. He expressed his wish to move forward.

Even BMA stalwarts might reluctantly agree that he is winning the battle. The imposition will proceed, without any further changes, unless he softens his approach.

However, Hunt should have no illusions. This is a hollow victory. Juniors are now a disaffected, angry, disillusioned and frustrated lot. These are the consultants and GPs of tomorrow, the very doctors the government needs to fulfil its plans for a round-the-clock, stellar NHS. Many feel that their professionalism and dreams have been thwarted by the government, and those who are really hacked off have emigrated.

The dispute is being played out against a background of an escalating funding crisis, trusts being unable to meet increasing demand and a warning that the health service will experience “pockets of meltdown” this winter. We could go on.

In the face of such adversity, the NHS is hardly able to deliver a five-day service, let alone the seven-day NHS Hunt dreams about. He has wrongly aligned his aspirations for a seven-day service to delivering the junior doctors’ contract. The BMA has repeatedly asked him to define his vision to enable a constructive dialogue on what is evidence-based, and what is achievable. What is clear is that both the BMA and Hunt require a highly motivated, energetic and engaged medical workforce to deliver the high-quality care needed to manage complex illnesses and meet rising demand.

The government is responsible for creating the conditions for safe working of our juniors and for providing and delivering safe services. Hunt must work hard to win the hearts and minds of junior doctors to achieve the ultimate goal of providing safe, high-quality services seven days a week. Theresa May should conduct her own appraisal of the state of the NHS and the problems it faces, and make her priority settling this dispute and finding more money for the health service.

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Jeremy Hunt has won a battle against junior doctors, but not the war

Acupuncture believed to support battle cancer by improving the immune technique and supporting remission!

A lot more and more individuals are in search of alternative cancer therapies.  Studies finished by the Survey Sampling Worldwide and The Investigation Intelligence Group report that two-thirds of people across the planet feel disrespected by their doctors.  They also report that unclear communication is a major cause for patient dissatisfaction.  One-fourth of individuals across the globe reported that their physicians really do not response inquiries, don’t involve them in treatment decisions and use health care terms with out explanation. (1)

Two-thirds of individuals close to the world feel disrespected by their doctors!

There is an estimated 13,776,251 people living with cancer in the United States.(2)  Many of us have cancer and precancerous cells in our bodies.  Scientists feel that cancer thrives with the immune methods defenses cannot or don’t react correctly.  The high incident charge of cancer recurrence following traditional therapy, proves that the remedies fail to restore the immune method response.(3)

Following cancer treatment, the physique could acclimate to the presence of abnormal cells and the brain could even send messages that help the regrowth.(3)

Whether pairing option treatments with standard treatments or searching for a hundred percent option treatments, there is higher comprehending about the damages that conventional cancer treatment method causes.  More and a lot more people are in search of option therapies to assist enhance the immune program.(three)

Acupuncture located to enhance the bodies immune method in buy to battle cancer and continue to be in remission!

Dr. Wang Fuda of Greenville Study Clinic sees one hundred-200 sufferers per day.  Over 70 percent of his individuals have a cancer diagnosis.  Dr. Fuda is an acupuncturist that believes that acupuncture can retrain the body’s immune program to defeat cancer.  The therapy he offers is seldom acknowledged by local oncologists as the reason for recovery, nevertheless sufferers line up at Dr. Fuda’s clinic to share how acupuncture resulted in their cancer remission.(three)

Dr. Vivien Griffiths is an acupuncturist and coordinator of postgraduate research at Southern Cross University.  Dr. Griffiths is also a breast cancer survivor, who at first did not consider acupuncture as a primary treatment method. Following surgical treatment and chemotherapy, she then sought out an acupuncturist.(three)

Following surgical treatment, her acupuncturist utilised requirements and electrical stimulation on her surgical scar.  Within 12 hours the scar modified from blue to warm pink and her discomfort drastically decreased.  The improvement allowed her to participate in lymphatic drainage treatment and vigorous physiotherapy.(three)

Dr. Griffiths identified that acupuncture greatly enhanced her bodies ability to heal following breast cancer therapy and believes the acupuncture enhances the immune technique, enabling for remission!

Dr. Griffiths now believes that acupuncture is an crucial portion of publish cancer treatment method and can improve the immune program and enable for patient to continue to be in remission. Following breast cancer, Dr. Griffiths aisles utilizes herbal medication to assistance her immune overall health.(3)

“As a cancer patient, you receive a cancer diagnosis and a whirlwind of activity begins: constant tests, surgical treatment, chemotherapy, radiation,” she explained. “But as soon as the cancer is arrested, it’s a extended struggle to regain the overall health one had prior to the diagnosis. It appears as if obtaining a strong, healthier immune system is not perceived as ‘that important’ by typical medication. You are sent on your way and told to report back for a check out-up after a yr. You hold your breath hoping the cancer doesn’t return. When you get a very good result from your examine-up, you believe ‘Thank God, I’ve got yet another year.’ Your daily life depends on these phrases ‘in remission’ or ‘clear.’ Who or what is assisting cancer survivors to keep in that group?” (3)

Whilst Western medicine continues to fight cancer in laboratories, it is crucial to recognize that different medication is creating a difference.  Ultimately, men and women diagnosed with cancer want to join the list of cancer survivors.  In the vulnerability of this diagnosis, they also want to trust their supplier, be treated with respect and be a component of the therapy procedure.

Sources incorporated:

(one)  http://www.kevinmd.com/blog/2011/08/sufferers-flock-substitute-medication-suppliers.html

(2)  http://seer.cancer.gov/statfacts/html/all.html

(three)  http://www.acupuncturetoday.com/mpacms/at/post.php?id=28310

Acupuncture believed to support battle cancer by improving the immune technique and supporting remission!

Hackney council will take a walk on the wild side in battle towards obesity

Hackney has some great spots for kids to explore across the borough’s parks, canals, and woodland. Photograph: Graham Turner for the Guardian

Nowadays young children commit a great deal of time sat in front of TVs, iPads and different other screens. All across the United kingdom children are paying also significantly time indoors and not acquiring ample workout, and the borough of Hackney is no different.

When the responsibility for public overall health moved back to local government last yr, so also did the occupation of reducing childhood weight problems. As most mothers and fathers will tell you simply telling children to do something doesn’t usually perform, so Hackney council determined to do things differently – we approached the issue of getting individuals match with a bit of entertaining alternatively.

Specialists operating in behaviour change have been attempting to deliver the “entertaining concept” to bear on public well being for a whilst. They’ve had some notable successes, like obtaining folks to get the stairs by turning them into giant piano keys, and encouraging recycling with a bottle financial institution arcade. Adopting the easy principle that people are a lot more likely to do one thing if it is enjoyable seems like an clear way to get children lively.

I wasn’t the most active youngster, but I had mother and father who had been constantly insisting that I received out and about, and each and every school vacation they would take me on a loved ones caravan journey to the Lake District.

My dad would consider every trick to get me to stop complaining about getting bored, but he did not require to following I received a guide known as Rocky Rambler’s Wild Walks. It was the first Lake District strolling manual that place children in charge. In it, each and every a hundred metres of a stroll resembled a square on a board game and there have been colourful characters, larger than life landmarks and riddles along the way. There was no stopping me after that – I finished every single walk in the book with no so much as a grumble.

This is why I have set out to bring wild walks to Hackney. In terms of locations for youngsters to discover on foot Hackney has some great spots. There is adequate green room across our 56 parks to fit 450 football pitches, as effectively as canals, rivers and woodland.

My very first call was to Rocky Rambler’s creator, Colin Shelbourn, who kindly gave his permission for us to adapt the format and give it some east London flavour. The rest of the task fell into location when I stumbled across a brilliant nearby social enterprise referred to as Outside Men and women, and its director Cath Prisk, who knew Hackney like the back of her hand. She researched and wrote up the walks, with the support of her canine Charlie.

There were 3 criteria for every route. It had to consider a modest child about an hour (so about 2km) it had to commence in a single of the areas in Hackney with the highest charges of childhood obesity and it had to consider adventurers previous other public amenities kids could use to get lively, this kind of as journey playgrounds and parks. There necessary to be toilets along the route, and it necessary to be of interest to grownups too, helping mums and dads get to know their local community greater.

Encouraging youngsters to use neighborhood green spaces to get healthy is specifically the type of undertaking that has been created achievable by generating public wellness a neighborhood government duty. In Hackney, the person in charge of parks and leisure is the same particular person whose work it is to get residents more healthy. Parks are 1 of every regional authority’s most essential assets – but the challenge is to get residents utilizing them. By encouraging our younger residents to get their parents on a walk, Hackney’s Wild Walks aim to do just that.

The walks are offered to read on the internet here.

Kathryn Scott is public health communications manager at London Borough of Hackney

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Hackney council will take a walk on the wild side in battle towards obesity