Thursday, March 31, 2011

Waldemar Haffkine: Ending the Plague

Great Advances in Science

Alone of all religious and philosophic conceptions of man, the faith which binds together the Jews has not been harmed by the advance of research, but on the contrary has been vindicated in its profoundest tenets.
Waldemar Haffkine, in A Plea for Orthodoxy, 1916

Unlike tetanus or diphtheria, which were quickly neutralized by effective vaccines by the turn of the century, the immunological aspects of bubonic plague proved to be much more daunting.
Myron Echenberg, Journal of World History 13:2 (2002): 429

Waldemar Mordecai Wolff Haffkine [1860–1930]: The Haffkine Institute in Mumbai has this wonderful quote on its website: “The journey we make here upon the earth is so short. Before we know where we are, we are at the end, and called upon to answer an inner voice: ‘Have you finished the work you had to do?’ Happy are they who can think, yes, they have finished their work.”
Photo Credit & SourceElliot & Fry Photo co.; the National Library of Israel, Schwadron collection 
Source: Wikipedia

Waldemar Haffkine, a 19th century microbiologist,  invented the vaccines for the bubonic plague and cholera. He spent a good part of his life in India, where his discoveries greatly helped reduce the incidences of both infectious diseases. While other measures are now in place to prevent both plague and cholera, Haffkine's vaccines undoubtedly contributed greatly to the efforts to better humanity, thereby saving many millions of lives.

Small wonder, then, that Lord Joseph Lister of the United Kingdom called Haffkine “a savior of humanity.” Lister himself was no stranger to medical achievement, having made great contributions to humanity's betterment as a surgeon and pioneer of antiseptic surgery. Yet, many people in England, Canada and the United States would have a hard time not only knowing who Haffkine was, but also what his great contributions to science meant to the prevention of infectious diseases and epidemics.

Less than one hundred years ago, however, the audience was intimately familiar with the name of Haffkine, a point that Edythe Lutzker and Carol Jochnowitz made in an article for the American Society of Microbiology News published in 1987:
Writing in the 1920s and 1930s, Sinclair Lewis (in Arrowsmith) and A. J. Cronin (in The Citadel) mentioned his name as one with which their readers would be automatically familiar. It is hard today to find anyone in this country who has ever heard of him.
All the more reason that Haffkine deserves greater recognition.

The Early Years

Waldemar Mordecai Wolfe Haffkine, born Vladimir Aronovich Havkin, in Odessa, Russia, on March 15, 1860, was the fourth of five surviving children of Rosalie Landsberg and Aaron Havkin, a schoolmaster.The family was Jewish and of modest circumstances. Haffkine’s mother died just before his seventh birthday and his father was frequently absent on business. His childhood was therefore lonely. Haffkine never married.

Haffkine received most of his early education in Berdiansk, where he attended the local gymnasium (school)  and excelled academically. Afterward, he enrolled in the Department of Natural Sciences in Odessa Malorossiysky University and studied physics, mathematics and zoology. He supported his studies with small sums he earned as a tutor and graduated with a doctorate in science in 1884.

During his formative years studying, Haffkine came under the influence of Élie Metchnikoff, who was one of his professors and mentors. Metchnikoff left Russia for good in 1888, and joined the Pastuer Institute in Paris, where he worked the rest of his life. He won the Nobel Prize in Medicine in 1908 for his work on phagocytes, the body's white blood cells that protect it against infections.) Haffkine would also make his way to the Pasteur Institute and join his mentor there in 1889.

Haffkine, for a short time, was a member of Narodnaya Volya ("The People's Will'), but after the group turned to terrorism against public officials, including the assasination of Tsar Alexander II in March 1881 Haffkine left the revolutionary movement. He also was a member of the Jewish League for Self-Defense, which became more relevant after pogroms directed at the Jewish people became more pronounced in the 1880s. Haffkine was injured while defending a Jewish home during a pogrom. He was arrested but later released due to the intervention of Metchnikoff.

After graduation, Haffkine was offered a teaching position at the university, with the condition that he convert to Christianity and the Russian Orthodox Church, which given the importance that Judaism played in his life, he refused to do:  
Instead he accepted an appointment as kustos—assistant—in the Odessa Museum of Zoology, which he held until 1888. While there he wrote two articles that were published in the Annales des sciences naturelles of Paris, and he became a member of the Society of Naturalists of Odessa.
In 1888, Haffkine was allowed to emigrate to Switzerland and taught for one year at the University of Geneva under Moritz Schiff. A year later, he garnered a position at the Pasteur Institute in Paris, joining Metchnikoff. Haffkine was offered the only position open, a librarian, which he gladly accepted. In 1890, he became assistant director at the institute. His focus was on cholera, a deadly disease.
Haffkine in India: In 1894, Haffkine inoculated almost 25,000 people with his cholera vaccine, most who survived the disease. After contacting malaria, Haffkine returned to France to recuperate; he later reported his findings to the Royal College of Physicians in August 1895. After which,  Haffkine returned to India, in March 1896, and vaccinated an additional 30,000 people in seven months.
Source: http://www.hafftka.com/haffkine/haffkine.jpg
The Cholera Vaccine

By the time Haffkine had arrived at the Pasteur Institute, Robert Koch, a Prussian physician, had isolated the bacterium Vibrio cholerae as responsible for cholera, in 1883. Although the bacterium had been previously isolated by Italian anatomist Filippo Pacini in 1854, the prevailing view was that of miasma theory of disease, a Medieval-era theory related to poor air quality, and not the germ theory of diseases, which would take a few more decades to become the accepted scientific theory. Such were the conditions at the time.

In 1888, during an epidemic, Haffkine had taken up cholera research. By the time he arrived in Paris, he produced an attenuated form of the bacterium by exposing it to blasts of hot air. A series of animal trials confirmed the efficacy of the inoculation. Then came the human trials, which he performed on himself:
Risking his own life, on July 18, 1892, Haffkine performed the first human test on himself. He injected himself with a dose of four times the strength that was later used, recorded his reactions, and determined that his vaccine was safe for human use.

On July 30 he reported his findings to the Biological Society of Paris. His success brought him congratulations from Koch, Roux, and Louis Pasteur (1822-1895).
Even though his discovery caused enthusiastic stir in the press, it was not widely accepted by his senior colleagues, including both Mechnikov and Pasteur, nor by European official medical Establishment in France, Germany and Russia.
That being the case, Haffkine decided that he needed to test the vaccine under real-life epidemic conditions. He offered the vaccine to his nation of birth, Russia, but they refused his offer. The fifth cholera pandemic (1891–1896) claimed more than 250,000 lives in Russia; and the sixth pandemic (1899—1923) in the first quarter of the twentieth century another 500,000 individuals. [see here for number of deaths due to outbreaks and pandemics.] The vaccine could have prevented some, if not a good many, deaths.

So, Haffkine went to India, arriving in March 1893. At first, Haffkine was met with suspicion by the locals, but eventually he won their trust, vaccinating almost 25,000 people, with great success. After contacting malaria, Haffkine returned to France, and dedicated his successes to Louis Pastueur, who had recently died (September 1895).

Cholera Still Prevalent

In seven pandemics beginning in 1817, cholera has killed millions of people worldwide, says a CBC report. It still affects three to five million people, resulting in between 100 000 and 120 000 deaths [source: WHO]. Cholera still exists in the world, and can make a home where poor sanitation exists.

Such is the case in Haiti, more than a year after an earthquake devastated the poor island nation of ten million inhabitants. Health officials from the Harvard Medical School predict that there will be 800,000 persons suffering from cholera in Haiti alone this year. (see article: VOA).

The problem can be boiled down to inaction, a point that one of the study's authors, Jason Andrews of Harvard Medical School, makes clearly:
Certainly, if more aggressive interventions were done, such as vaccinating a larger proportion of the population or a faster rollout of clean water, the impact of interventions could be greater. But what we found was by doing all three of these interventions, you could avert a substantial burden of cholera and a substantial burden of deaths over the coming year, and that's one of the main messages of my analysis.
And vaccinations, along with a clean water supply, ensures that a cholera epidemic can be averted.

The Plague Vaccine

Haffkine then turned his attention to the plague. In October 1896, an epidemic of bubonic plague struck Bombay (now Mumbai) and the government asked Haffkine to help. In 1894, Alexandre Yersin, a Swiss/French physician and bacteriologist from the Pasteur Institute, had isolated the bacteurium, Yersinia pestis, responsible for the plague. Humans are incidental hosts and are usually infected by the bite of rodent fleas.

The Plague, also linked to the bubonic plague, was feared, and many stories have been written about it, a testament to the fear it instilled in the hearts of humanity. It killed an estimated 200 million people through three major pandemics: the Plague of Justinian (541-542), which might have killed 100 million people in the eastern Roman Empire; Second Pandemic, or Black Death (1347-1351), a massive pandemic that hit Asia, Africa, Europe, killing as much as 75 million people and contributing to the destruction of the feudal system in Europe; and the Third Pandemic (1855-1959), which originated in China in 1855 and killed more than 12 million people in India and China alone. (Haffkine's vaccination efforts greatly kept the numbers lower than in previous outbreaks.)


The Black Death: Burning of the Jews, 1349. As was common during the Medieval Age in Europe, Jews were often blamed and killed for various diseases and plagues. To avoid such horrible libels and the resulting tragedies, both on the Jews in particular and humanity in general, drove Haffkine's search for a vaccine for the plague.
SourceWikipedia: A History of the Jewish People by H.H. Ben-Sasson, ed. (Harvard University Press, Cambridge, 1976) p.564-565

The Development & Human Trial 

After arriving in India, the British authorities gave Haffkine a tiny research space in the corridor of the Grant Medical College in Bombay. On January 10, 1897, Haflkine again became a human test subject, the first to test the efficacy of the vaccine he had developed. He gave himself a dosage four times greater than what he would normally use, as he did with the cholera vaccine. He experienced a painful week of fever, and then announced his findings to the authorities, Edythe Lutzker and Carol Jochnowitz said in an excellent article on Haffkine:
Two weeks later, when plague struck the Byculla Jail, he put his vaccine to a controlled test. (The British had originally regarded prison trials as morally impermissible, but had relented in the face of a virulent cholera epidemic in 1894.) There were 154 volunteers, 3 of whom were found to have been suffering from plague at the time of inoculation; those three died. Two more volunteers developed plague but recovered. Of the 170 controls, 12 caught plague; 6 of them died.
In the next five years, from 1897 to 1902, Haffkine met continued resistance from the British authorities on many fronts, and rarely supplied him the manpower and equipment he needed to produce increasing dosages of the plague vaccine. This despite Haffkine's position as Director of the Plague Laboratory in Bombay (now called Haffkine Institute). But Haffkine persisted despite the animosity and jealously shown by British officials toward what they considered an "upstart" and his new ways.

In what has been called The Little Dreyfus Affair, an allusion to Haffkine's Jewish background, in 1902 Haffkine was falsely accused of administering an unsafe vaccine when nineteen Punjabi villagers died of tetanus. After having been relieved of his position. Haffkine returned to England to clear his good name. It took four years, but it came together when eminent scientists from Britain, including Ronald Ross, the Nobel laureate, signed a letter in Haffkine's defense that was published in the (London) Sunday Times in July 1907. The letter declared that the case against Haffkine was “not only not proven, but distinctly disproven.”

That was enough for the Indian government to reverse its earlier findings. Haffkine's good name remained untarnished. He returned to Calcutta, India, where he remained for eight years at a reduced salary and position, a humbling experience for such an eminent scientist.

Even so, his contribution was great. By the turn of the century, the number of persons inoculated with Hafflkine's vaccine in India alone reached four million.  The World Heath Organization considered the pandemic active until 1959, when deaths dropped to 200 per year.

In a very interesting article in The New York Times titled "Europe's Plagues Came From China, Study Finds" (October 31, 2010), scientists have determined that all three major plagues have their origins in China.

The Latter Years


In 1915 Haffkine reached compulsory retirement age of fifty-five and left India to spend some time in London and then in Boulogne-sur-Seine, a suburb of Paris. Although he occasionally wrote for medical journals, he devoted a great part of his time to Jewish affairs, which is evident in an article he wrote for The Menorah Journal: April 1916, titled A Plea for Orthodoxy.

As the title intimates, the article lays out the appeal of traditional ways. In such traditions steeped in history, Haffkine found not only community and comfort, but the "only possible foundation of an orderly and prosperous life." For Haffkine, that order came from the Commandments given at Mount Sinai. The reach and depth of the Commandments was open to all humanity.

Some honors came his way, some before and some after his death. Queen Victoria made Haffkine a Companion of the Indian Empire, the Tata Institute of Science in Bangalore elected him to its Court of Visitors, the Plague Research Institute that he founded in Bombay (now Mumbai) was renamed in his honour in 1925, and still bears the name Haffkine Institute. In commemoration of the centennial of his birth, Haffkine Park was planted in Israel in the 1960s.

Haffkine moved to Lausanne, Switzerland in 1928, and in 1929, he created the Haffkine Foundation, which still exists, for fostering religious, scientific, and vocational education in Eastern European yeshivas, or Jewish religious schools. To the foundation, he bequeathed his personal fortune of $500.000.

In his rented room in Lausanne, Switzerland, on the evening of October 25, 1930, Waldemar Haffkine died from the heart condition he had been suffering for 10 years. He was seventy. In an obituary in Science magazine (Vol 73: 1881), published a few months later, on January 16, 1931, the writer, F. G. Benedict, said:
As a scientist, Haffkine was meticulously careful and accurate in his work and well as ingenious in his methods. As a man his character would be summed up in the following words, a quotation from a letter received by the writer from Dr. M. Archer, Bex, Switzerland, who attended the funeral: "Great was his scientific work in that he literally saved millions of lives but equally great was the personal character of the man and, most particularly, his modesty and humility. He never asked for help from any man but he was always ready to help."
Those are words worthy of a man who did his utmost to help better the human condition of all people. On a personal note, for Haffkine, a practicing Jew, ending the plague, the biological disease, was important on two fronts: to alleviate the suffering of all humanity, which he was successful; and to end the plague of hatred that has often been directed at the Jewish people. It's a virulent strain, and that work still continues.

2 comments:

  1. Immunization combines science with nature. Our own bodies produce the antibodies they were designed to create in order to keep us healthy. Science and nature were meant to work together.
    But what about the poor bacteria?

    ReplyDelete
  2. Thank you for your comments. it's true that the human body carries a lot of bacteria, most of it rendered harmless by the body's immune system. Some bacteria are beneficial, but a few species of bacteria are pathogenic and cause infectious diseases, such as cholera and bubonic plague. The vaccines help our bodies immune system.

    ReplyDelete

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