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Journal of the Royal Society of Medicine Journal of the Royal Society of Medicine http://jrs.sagepub.com/ An epidemiologist's journey from typhus to thalidomide, and from the Soviet Union to Seveso Marcus Klingberg J R Soc Med 2010 103: 418 DOI: 10.1258/jrsm.2010.10k037 The online version of this article can be found at: http://jrs.sagepub.com/content/103/10/418 Published by: http://www.sagepublications.com On behalf of: The Royal Society of Medicine Additional services and information for Journal of the Royal Society of Medicine can be found at: Email Alerts: http://jrs.sagepub.com/cgi/alerts Subscriptions: http://jrs.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav >> Version of Record - Oct 1, 2010 What is This? Downloaded from jrs.sagepub.com at The Royal Society of Medicine Library on October 14, 2014 FROM THE JAMES LIND LIBRARY An epidemiologist’s journey from typhus to thalidomide, and from the Soviet Union to Seveso Marcus Klingberg 12 rue Vavin, 75006 Paris, France E-mail: [email protected] DECLARATIONS Extraordinary circumstances led me to become We moved on, and eventually arranged for each of an epidemiologist.1,2 I was a 21-year-old medical the children to be returned to their parents, leaving Competing interests student in Warsaw in September 1939 when my me free to search for a medical school where I None declared father urged me and the rest of our family to ‘go could complete my undergraduate medical train- Funding east’ to escape the Nazi occupation of Poland. My ing. The medical school at Lvov was already full, mother objected, convinced that the British and partly because of the influx of Polish students who None French would come to our rescue. Although my had also fled from the Nazis. However, some Ethical approval father could not dissuade her, and was not pre- friends of mine in that part of Soviet-occupied Not applicable pared to leave her, he insisted that one of us ‘had to Poland had highly-placed contacts in Minsk, capi- survive’, so ordered me to leave for the Soviet tal of Soviet Byelorussia. They arranged for me to Guarantor Union. My parents and my brother remained in be admitted to the medical school there, and I MK Poland until they were deported to the Treblinka qualified in June 1941. It was a special committee extermination camp, where they perished in of the Ministry of Health which then decided that I Contributorship 1942. was to become an epidemiologist. I had never con- MK is the sole The medical school in Warsaw had been closed sidered this option (I had wanted to study internal contributor by the Nazis, and I was working in a home for medicine), partly because Jews were ineligible for Acknowledgements Jewish children with severe learning disabilities, government jobs in pre-war Poland. I am grateful to my mainly Down’s syndrome. The director of the On the day the Germans launched their offen- sive against the USSR on the 22 June 1941, I volun- friend, Iain home was a communist, and he came up with a plan. The mother of one of the children came from teered for the Red Army and was made a captain in Chalmers, who the area of Poland which had been occupied by the the Medical Corps. After being wounded in my encouraged me to Soviet Union. She obtained a permit for herself, her right leg on the Byelorussian front, I was sent to prepare this text; to own child and three other children to return there. Molotov – now renamed Perm – in the Urals, my daughter, Sylvia The director of the home suggested that I should where I was appointed head of an anti-epidemic Klingberg, for travel with them to help her look after four men- unit. The unit consisted of physicians, paramedics helping me to record tally disabled children during the journey. After (feldschers), nurses and disinfection personnel, these reminiscences; tutoring by my mother in how to recite for the and we had a small mobile laboratory for serologi- to Eva Alberman, German authorities the words written on the cal tests. Jan Chalmers, Judit Russian travel document, but fictitiously adding Druks and Richard my name, the six of us were authorized to leave Typhus in the Soviet Union Horton for German-occupied Poland and to remove our ‘Star commenting on of David’ armbands. In Perm, although we had to deal with outbreaks earlier drafts; and to A train conveyed us as far as the railhead at of typhoid fever, bacillary dysentery, scarlet fever, Bengt Källén for Małkinia. From there we had to walk for a few rubella and measles, our main concern was to pre- kilometres through a forest, crossing no man’s land vent or contain outbreaks of epidemic typhus. allowing me to make into Soviet territory at Zaremby Kos´cielne. It was a For example, in 1942 we were confronted with an available his Friday evening, and when we spotted candles outbreak in a kolkhoz (collective farm). We went reflections on the alight within a house, we asked the Jewish family from house to house, looking for typhus-stricken work of there for something to drink; but we were refused. people, grouped them together in a temporary 418 J R Soc Med 2010: 103: 418–423. DOI 10.1258/jrsm.2010.10k037 Downloaded from jrs.sagepub.com at The Royal Society of Medicine Library on October 14, 2014 An epidemiologist’s journey from typhus to thalidomide, and from the Soviet Union to Seveso the International hospital set up in a requisitioned school, and The next step was to meet the director general of Clearinghouse. disinfected their clothes and home belongings, and the new coalmine, a high-ranking man in his late Additional material the garments of those who had been in contact forties. He listened politely as I described the epi- for this article is with sick people, whom we kept under obser- demiological situation and asked him why he had available from the vation. Prevention of typhus was very important not prepared accommodation and other facilities James Lind Library because, in those pre-antibiotic days, only sympto- before the arrival of tens of thousands of workers. website (www. matic treatments were available for people who Did he not understand that without adequate contracted the disease. living facilities and basic sanitary arrangements, jameslindlibrary.org), In our attempts to trace the source of the epi- outbreaks of communicable diseases were to be where it was demic, we looked for information everywhere: expected? originally published among the relatives and neighbours of infected The director general said he agreed with me, but people, teachers, local authority officials, party asked whether I realized that the Soviet Union activists and police officers. Since we lacked note- would be unable to fight the fascists without coal paper, we used the wallpaper in our office to draw for the country’s industry in general, and for mili- a map of the farm, and to get a picture of the tary industry in particular. ‘Before I left Moscow,’ disease’s evolution: the location of the index case, he said, ‘I was summoned to the Kremlin and in- and the dates of the first symptoms for the subse- structed personally by comrade Stalin to produce quent cases. We traced the outbreak of the epi- coal in very great quantities and to start the enter- demic to the house in which a recently released prise immediately. This was an order! And for your prisoner had first stayed. We then identified other information, I am obliged to report daily to com- households where he had stayed, and had infected rade Molotov how much coal we have produced. other families. As the man had already left the Now, please tell me what I can do. If I do not kolkhoz, we had to discover his whereabouts. The achieve the production target I shall be tried and local militia made clear that searching for him on face a death sentence. I may choose to be sent to foot was completely unrealistic, so, although I had one of the punitive battalions on the front line. If never previously ridden a horse, I was persuaded I survive there I shall be a hero; but as you may to accompany them horseback. We eventually know, the chances of survival there are almost found him and burned his clothes. zero. And by the way, if the outbreak of epidemic Another example illustrates the problems that typhus spreads and there are many fatal cases, I confronted us. One day, a coded telegram arrived will be blamed for that as well.’ After this very sad notifying us of an outbreak of epidemic typhus conversation, the director general invited me for a in one of the new coalmining locations. By 1942 dinner of caviar, different kinds of sausages and the huge coal fields in the Ukraine were under meats and vodka. We were alone apart from a German occupation, and the Soviet government young woman who served us. He did not pressure had started to explore new coal fields in the east of me to write a dishonest report. the country, including the Urals. After our anti- I stayed at the coalmine with my unit for some epidemic unit’s arrival there, I went first to meet weeks. We tried our best to prevent further spread the local chief medical officer. The outbreak was of the outbreak, but our efforts were only partly putting at risk tens of thousand of workers who successful. After returning to Perm, I prepared a had been brought there from the Caucasian Soviet report, and, as far as I know, the regional authori- Republics to create new coal mines.
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