Up the River Without a Paddle? the Theory That Polio-Vaccine Researchers Are Responsible for AIDS Is Leaky
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book reviews Up the river without a paddle? The theory that polio-vaccine researchers are responsible for AIDS is leaky. The River: A Journey Back to the den in 1995, with negative results. AP Source of HIV and AIDS Hooper rightly argues for more research by Edward Hooper on the earliest stages of the HIV-1 epidemic Penguin: 1999. 1,070 pp. £25 (hbk) in Africa and the West, with searches for John P. Moore archival tissues that could be analysed for HIV-1 sequences. Certainly, more knowl- as John F. Kennedy shot from the edge of the animal reservoirs for HIV-1 and grassy knoll by a Mafia hit man? Did HIV-2 would be useful, and might finally set- WHIV-1 enter humans via a contami- tle the issue of the origin of AIDS. But the nated oral polio vaccine (OPV) during need to address the past must be balanced mass vaccination campaigns in central against the more pressing requirement to Africa in the late 1950s? The second of these prevent HIV-1 spreading — by, ironically, theories, the ‘OPV–HIV’ hypothesis, is the the development of an effective vaccine. subject of this massive book by Edward Some of Hooper’s proposals are less valu- Hooper which has attracted considerable able. It would not, as he suggests, be informa- media attention. The BBC even issued a tive to try to reconstruct the route of contam- press release with the inflammatory title ination. Experiments along these lines were “Scientists started AIDS epidemic”. performed in 1993 by John Garrett and col- The River is, in many ways, superb. It is leagues in the United Kingdom. The results scholarly, thoroughly researched, well (if Exchanging one killer disease for another? were negative. Even so, Hooper dismisses densely) written and deserves, indeed them as perhaps not reproducing the condi- demands, to be taken seriously. It takes the phia- and Congo-based scientists deny that tions used for polio-vaccine preparation in OPV–HIV hypothesis way beyond its early polio vaccines were ever made from chimp the 1950s. But could the conditions of 40 manifestations in the magazine Rolling kidneys. years ago ever be reproduced well enough? Stone, and infinitely past the strange Internet Second, the supposedly PIV-contaminat- The scientist most criticized in The River discussions of Californian AIDS activists. ed vaccine was then used in the Congo in is Hilary Koprowski, formerly of the Wistar These conspiracy theorists have given the 1957–58, transmitting the virus that evolved Institute. Many of Koprowski’s actions and hypothesis a bad name — Hooper has into HIV-1. Although PIVs can spread orally, attitudes are presented in a very poor light. redressed the balance by presenting careful it is unlikely that kidney-cell cultures, even if The accuracy of this portrayal can perhaps and thorough research. His description of they did contain significant quantities of only be judged by those who know him. But the early days of the African and Western lymphocytes and macrophages, would pro- even if the OPV–HIV link were correct, nei- AIDS epidemics is marvellous, but it is his duce much virus and that enough of this ther Koprowski nor anyone else would be to support for the OPV–HIV hypothesis that could survive storage and shipment. blame. The risks of cross-species viral trans- will attract most attention. Finally, the theory has the infected mission were much less well understood 40 The problem is that, like the grassy knoll humans progressing to AIDS over the next years ago; one cannot condemn the past for theory, there is no smoking gun. Despite dili- 15–20 years, dying only around the time not following the standards of the present. At gent investigation, Hooper cannot prove when the disease first became visible in cen- worst, what Hooper argues happened would what he proposes and many of his arguments tral Africa in the mid-to-late 1970s. Again, have been a tragic accident. What is it about are highly speculative. Thus, a chain of this is possible, but not probable. The first AIDS that makes people seek a villain(s)? Do events is outlined in which each link is weak. authentic HIV-1 sequence, from the Congo we blame anyone for the Black Death? Or for The argument goes like this. First, sick chim- in 1959, has characteristics making it unlike- the influenza pandemic of 1919, a classic panzees housed at Camp Lindi in the Congo ly that a chimpanzee virus, such as SIVcpz, example of how animals are a reservoir for in 1957–58 for use in medical research might first crossed to man only a few years earlier. A human viruses? Of course not. But in the have carried a primate immunodeficiency few decades is a more reasonable estimate. AIDS epidemic, normal reasoning often gets virus (PIV). Yet PIVs are not known to cause One can sense Hooper’s frustration that, discarded. disease in chimps, and even if these animals despite all his work, he cannot prove his cen- There are lessons to be learned from The were somehow infected with a pathogenic tral point. He states “it could have happened River. One critical point is best made by a PIV, one could argue that any transmission this way”, but can any of the complex Philadelphia polio-vaccine researcher of the to humans occurred by a more conventional sequence of events ever be proven? Hooper 1950s, who said “even though procedures route such as via blood during butchery pro- outlines a series of investigations, some of [like vaccination] are very laudable and nec- cedures, or from biting or scratching during which are worthwhile. If additional records of essary, you do in fact have to make every pos- handling. Instead, Hooper suggests that “it polio-vaccine production exist, they should sible effort to ensure that all safety proce- could be that [kidneys from these chimps] be released. And if frozen samples of the rele- dures are satisfied”. The theoretical and actu- ended up at the Wistar” — a laboratory in vant vaccine stocks still exist in American or al dangers of cross-species viral transmission Philadelphia where polio vaccines were European institutions, these should be tested are now clear, so absurdities such as baboon manufactured — where they contaminated for the presence of possible HIV-1 precursor liver transplants into AIDS patients simply vaccines with a PIV. viruses. If the air of suspicion can be cleared, must be avoided in future. There can be few Chimp kidneys were shipped from Lindi then it should be. But any such tests would excuses today for meddling with viruses in to Philadelphia in 1958 and 1959. But they have to be most carefully designed, executed such a potentially lethal manner. went to an institute doing hepatitis research, and interpreted, and it is notable that some My biggest concern over this book is that not to the Wistar, and the surviving Philadel- frozen vaccine stocks were analysed in Swe- it could reinforce public distrust of science NATURE | VOL 401 | 23 SEPTEMBER 1999 | www.nature.com © 1999 Macmillan Magazines Ltd 325 book reviews and scientists. It is a dangerous policy to ly seen in popular books. The result is an His insights on the lunar terrain were hammer science for unproven — and proba- adventure story told by the explorers — the sophisticated and greatly furthered our bly unprovable — events. Eventually the Magellans of the mid-twentieth century. understanding of the geology of the Taurus- public may turn to those who believe that sci- Although the dialogue becomes tedious at Littrow valley. This mission demonstrated ence is bad for society. That really would be a times, filled with NASA jargon, it does reflect the great potential of future field geology tragedy. science in the making. expeditions to the Moon. So, while respecting Hooper’s scholar- Each of the Apollo missions added much The Apollo astronauts were extraordi- ship and thoroughness, I am not convinced to our understanding of the Moon. The first nary men in extraordinary times. All but one by his central argument. At most, I turn to large rock brought back by Apollo 11 ruled were military officers and test pilots. As the Scottish legal verdict of ‘Not Proven’. But out the ‘cold Moon’ theory, which proposed revealed by Harland, they struggled to find an outright acquittal for the polio-vaccine that the maria, or dark plains, were the result appropriate terminology and samples with researchers of the 1950s would be sounder, of melting following meteor impacts. geological significance, even with NASA’s pending the discovery of solid, and not just Instead, episodic volcanism produced the extensive training. Schmitt’s lucid technical circumstantial, evidence to the contrary. maria. Apollo 12 carried equipment for the conversations with geologists in the ‘back Instead, I believe that HIV-1 and HIV-2 first science experiments on the lunar sur- room’ at Houston were in striking contrast crossed to humans from chimpanzees and face. The lunar laser-ranging retroreflectors to those of earlier Apollo missions. However, sooty mangabeys, respectively, probably on this and subsequent missions established one marvels even today at the amazing range when PIV-infected animals were butchered that the Moon is moving away from the of tasks performed by these Apollo astro- for human consumption. Oh, and I also Earth at a rate of 3.8 cm per year. Apollo 12 nauts — piloting an advanced-technology believe that Kennedy was shot by Lee Harvey also discovered the enigmatic KREEP (abun- lander using a computer far less capable than Oswald from the sixth floor of the Texas dance of potassium, phosphorus and rare- today’s home PC; their expert photography Book Repository.