F.M. Kirby Foundation
Charles Henry Leach, II Foundation
The Reed Foundation
Adolph & Ruth Schnurmacher Foundation
The Starr Foundation
Edna Jean Offield, a friend and supporter of the VZV Research
Foundation since nearly its inception, passed away on March 31, 2001.
Mrs. Offield was Chairman of the Board, Director and Member of The
Offield Family Foundation. VZVRF wishes to express its sympathy to
her family, friends and fellow Board Members.
Thomas H. Weller, M.D., the Nobel Laureate who first isolated
the varicella-zoster virus, turned 85 on June 15, 2001. Happy Birthday,
Anne A. Gershon, M.D., VZVRF Scientific Advisory Board Chair,
will deliver the VZVRF Lecture at the 26th International Herpesvirus
Workshop (July 28-August 3) at the University of Regensburg in Germany.
Varicella-Zoster Virus: Virology and Clinical Management is
a comprehensive account of the biology and clinical features of the
varicella-zoster virus recently published by Cambridge University
Press. Edited by Dr. Gershon and Ann M. Arvin, M.D. of Stanford University,
the text is available for purchase by residents of the U.S. and Canada
by calling 800-872-7423 or visiting www.cup.org.
Outside the U.S. and Canada, the telephone number is +44 (0) 1223
326050; e-mail: firstname.lastname@example.org;
Herpes Zoster and Postherpetic Neuralgia presents up-to-date
information about all aspects of VZV, from basic science to new developments
in pain treatment. Published by Elsevier, the text is edited by C.
Peter N. Watson, MD, FRCP, and Dr. Gershon. Ordering information is
available to U.S. and Canadian residents by calling (212) 633-3730
or via email, email@example.com.
For outside the U.S. and Canada, visit the Elsevier website, www.elsevier.com.
Vol. V, No. 1 -- Spring/Summer
VZVRF Conference Highlights
Effect of VZV Virus on Immunocompromised
Letter from the Chairman
Allen & Jayne Meadows Speak Out on Shingles
Pays Tribute to Fellows & Foundations
2nd European Roundtable on Varicella Vaccination Convened
Planning for 2001 Conference Underway
Kirby Foundation Grant Launches Tissue Bank
David Braga Joins VZVRF Board
Chair of U.K. Subcommittee Named
VZVRF Conference Highlights Effect of VZV Virus on Immunocompromised
The impact and treatment of infections caused by the varicella-zoster
virus (VZV) - chickenpox, shingles and post-herpetic neuralgia (PHN)
- on immunocompromised patients due to HIV/AIDS infection, cancer,
transplantation and age was the focus of a scientific conference
on January 18, 2000 at The New York Academy of Medicine.
The "Conference on VZV & the Immunocompromised Patient"
attracted many of the nation's leading experts on VZV. It was sponsored
by the VZV Research Foundation in partnership with Columbia University
College of Physicians and Surgeons, which provided continuing medical
education credit (CME) to attendees. The conference was co-chaired
by Anne A. Gershon, M.D., professor of pediatrics at Columbia, and
Kathleen Foley, M.D., attending neurologist and Richard Payne, M.D.,
chief, Pain & Palliative Care Service at Memorial Sloan-Kettering
Participants heard 13 scientific presentations, including a review
of varicella vaccine trials involving immunocompromised patients
by Dr. Gershon. She noted that the vaccine has proven to be safe
and effective in certain immunocompromised children, specifically
in studies involving subjects with acute lymphoblastic leukemia,
those undergoing renal transplantation, and those with underlying
HIV infection who had relatively normal levels of CD4 helper T lymphocytes.
Dr. Gershon concluded that it is advantageous to immunize these
children because they may be protected against both varicella and
zoster. On the other hand, these children need to be monitored closely
after immunization and antiviral therapy used judiciously.
A presentation on the treatment of zoster among the immunocompromised
was made by Stephen K. Tyring, M.D., professor of microbiology at
the University of Texas Medical Branch at Galveston. Dr. Tyring
noted that these studies have found that the antiviral agents acyclovir,
famciclovir and valaciclovir all appear to be safe in the therapy
of immunocompromised individuals. However, while the efficacy of
acyclovir and famciclovir appears to be equivalent, the efficacy
of valaciclovir and its effectiveness relative to the other two
agents has yet to be determined.
An update on the status of varicella vaccination in the United
States was presented by Karin Galil, M.D., M.P.H., medical epidemiologist
at the Centers for Disease Control and Prevention's (CDC) National
Immunization Program. Dr. Galil noted that approximately 20 million
doses of vaccine have been distributed in the U.S. since 1995, the
year of its licensure, with national vaccine coverage among children
19-35 months reaching 43 percent in 1998. The CDC's goal, by 2010,
is to reach a vaccine coverage of more than 90 percent among children
in this age group, and more than 95 percent among children at school
Myron J. Levin, M.D., professor of pediatrics and medicine, University
of Colorado Health Sciences Center, discussed clinical and laboratory
evidence in support of a vaccine to prevent herpes zoster. Specifically,
he noted that Phase I/II clinical trials candidate vaccines have
demonstrated that certain measures of VZV-specific T cell-mediated
immunity can be restored by immunization with live attenuated or
inactivated VZV vaccines. His presentation was followed by an update
on the Shingles Prevention Study by Michael N. Oxman, M.D.,
professor of medicine and pathology, at the University of California,
San Diego. The purpose of the study is to determine whether vaccination
with an investigational herpes zoster vaccine, which contains the
same live attenuated OKA/Merck VZV used to immunize children against
chickenpox, will decrease the incidence and/or severity of shingles
and its complications, including PHN, among older adults. Dr. Oxman
reported that 12,000 subjects have been enrolled in the study to
In his concluding remarks to the conference, VZVRF Chairman Richard
T. Perkin thanked the seven pharmaceutical companies whose financial
support made the meeting possible - Endo Pharmaceuticals Inc.,
Glaxo Wellcome Inc., Knoll Pharmaceutical Company, Merck & Co.,
Inc., Parke-Davis, Purdue Pharma L.P. and SmithKline Beecham.
He also expressed his hope that the conference will "spark
greater scientific exchange on the VZV virus' impact on the growing
immunocompromised population" and pledged to continue the dialogue
at the Foundation's "Fourth International Conference on VZV"
ENDO PHARMACEUTICALS INC.
GLAXO WELLCOME INC.
KNOLL PHARMACEUTICAL COMPANY
MERCK & CO., INC.
PURDUE PHARMA L.P.
Letter from the Chairman
I hope the year 2000 has treated you well thus far. At the VZV Research
Foundation, this year has been probably one of our busiest as we
launch several new and exciting initiatives that will lead us to
the year 2001, which marks not only the start of the "New Millennium,"
but also the 10th anniversary of our founding.
Our lead story highlights just one of the many ways in which we
have expanded our mandate. Our "Conference on VZV & the Immunocompromised
Patient" directed the scientific community's attention to the
plight of individuals afflicted with VZV infections, as well as
severely weakened immune systems as a result of HIV/AIDS infection,
cancer, transplantation and aging. We will continue fostering scientific
exchange on this important topic at the upcoming "Fourth International
Conference on VZV" that we are sponsoring in March 2001 in
An expanded area of interest is also evident in our establishment
of both a working group comprised of European scientists who are
meeting regularly to discuss the pros and cons of universal varicella
vaccination and in our selection of a leading British scientist
to assist us in establishing a presence in the United Kingdom. We
also increased the number of fellowships we awarded from three to
four and are establishing The VZVRF Sensory Tissue Bank (STB)
at Columbia University, made possible by The F.M. Kirby Foundation.
The purpose of the STB is to collect neurological tissue samples
and then make them available to researchers who are trying to unravel
the mysteries of PHN and develop more effective treatments for PHN
We also enhanced our public education efforts to include celebrities,
specifically Steve Allen and Jayne Meadows. We arranged for them
to appear on the Today Show to discuss shingles and to tape
both television and radio public service announcements. They were
We are even expanding our Board of Directors with the addition of
David Braga, who has already proven to be a true asset to our Foundation.
And, finally, I am delighted to inform you that we have chosen Salomon
Smith Barney as our investment managers.
Where do we go from here? With your continued interest and support,
we will continue to broaden our scientific research and public education
programs. Working together, I know that one day we will eradicate
VZV disease. Thank you for all your help to date.
Richard T. Perkin
Steve Allen & Jayne Meadows Speak Out on Shingles
VZVRF Chairman Richard T. Perkin on the set
with Jayne Meadows and Steve Allen
She had witnessed her own mother's painful episode of shingles,
but until she experienced it herself in 1999, Emmy Award-winning,
actress-comedienne Jayne Meadows didn't realize just how painful
it could be. Neither did her husband, Tonight Show creator
and host Steve Allen, whose mother also had shingles.
"In fact, it was Steve who first revealed publicly, on a television
talk show, that Jane had shingles and that the pain it was causing
had prevented her from appearing with him on that particular program,"
said VZVRF Chairman Richard T. Perkin. "I contacted the Allens to
determine whether they would be willing to use their celebrity status
to help us educate the public about shingles. Thankfully, they agreed."
The Foundation arranged for the Allens to appear on NBC's Today
Show on October 18 to discuss their personal experience with
shingles. "Jayne and Steve didn't miss a beat as they noted the
high incidence and potential severity of this illness, and, most
important, they identified the need to seek prompt medical attention
if one suspects shingles," said Mr. Perkin.
As Ms. Meadows recounted to Today Show host Matt Lauer, "I
was on the road in Alabama with my one-woman show, when I began
experiencing an itch and rash on the right side of my neck. I called
Steve immediately and asked him to make a doctor's appointment for
me. As soon as I landed at the airport back home, I headed to the
doctor's office. He diagnosed my condition as shingles and prescribed
antiviral treatment. I was very fortunate that we caught it early."
During the interview, the Allens urged viewers to log-on to the
Foundation's website or call an 800-number for a copy of the booklet,
"Shingles and PHN: Your Questions Answered." More than 8,000 telephone
calls were received within three days and the VZVRF website logged
nearly 3,000 visits on the day of the broadcast.
Following the interview, the Allens taped a 60-second public service
announcement (PSA) on which Ms. Meadows dispenses important facts
about shingles and PHN, while testing her husband's "VZV-IQ." Copies
of the PSA currently are being distributed to television and radio
stations across the country.
"To the best of our knowledge, the Allens are the first and only
celebrities to publicly discuss the impact of shingles on their
lives," said Mr. Perkin. "Their appearance on the Today Show
and in our public service announcements has significantly advanced
our efforts to inform the public that shingles is serious."
VZVRF Pays Tribute to Fellows & Foundations
Pictured (l.to r.): (back row) VZVRF Chairman Richard
T. Perkin and Secretary-Treasurer Mortimer Berkowitz III;
(front row) Chengjun Mo, Ph.D; VZVRF SAB Chair Anne A. Gershon,
M.D.; Karin Lottrup Petersen, M.D.;
Maddie Y. Hao, M.D.; Jorge A. Padilla, Ph.D. and VZVRF Board Members
Louis R. Gary and James S. Marcus.
The increasing role of the VZV Research Foundation in fostering
research on the prevention and management of VZV infections was
the recurring theme of remarks made at a luncheon on January 19,
2000, at New York's Union Club. The luncheon, which was sponsored
by VZVRF, honored the Foundation's four, 1999-2001 Post-Doctoral
Research Fellows, in addition to the underwriters of their studies.
Seventy-five guests were in attendance, including representatives
of foundations who support VZVRF research and education initiatives,
in addition to several members of the VZVRF Board of Directors and
Scientific Advisory Board.
Joined by their mentors, the following Fellows accepted commemorative
scrolls from VZVRF Chairman Richard T. Perkin, and outlined their
Dr. Maddie Y. Hao, of Columbia University College of
Physicians and Surgeons, who is studying "Envelopment, Intracellular
Transport, and Infectivity of Varicella Zoster Virus," essentially
finding an easier way to propagate and study VZV in vitro.
Among her goals are a better way to make vaccine. Dr. Hao received
her M.D. degree from Beijing University in 1990.
Dr. Chengjun Mo, a post-doctoral fellow in the Department
of Pediatrics, Stanford University, who is researching VZV glycoproteins,
in the hope of providing new information about the pathogenesis
of VZV. This data will be relevant for the design of vaccines
and, potentially, the development of antiviral drugs. A native
of China, Dr. Mo completed his earlier education there and went
on to earn his doctoral degree at Wayne State University in Detroit,
Dr. Jorge A. Padilla, a post-doctoral research fellow
in the Department of Pediatrics and Microbiology at the University
of Iowa, whose study, "Topography of gE on the varicella-zoster
virion," seeks to characterize the structural biology of VZV glycoprotein
gE. He will use standard molecular virology procedures, as well
as newer imaging methodologies he honed while earning his doctorate.
Dr. Padilla, a native of Mexico, was educated in Mexico City,
and completed his doctoral training at Okayama University, Japan.
Dr. Karin Lottrup Petersen, a post-doctoral fellow in
the Neurology Department of the University of California at San
Francisco Pain Clinical Research Center, who is attempting to
add to the understanding of the pain and neural dysfunction of
acute herpes zoster and PHN. She also is exploring opioid sensitivity
and underlying pain mechanisms in PHN. Dr. Petersen was born in
Copenhagen, Denmark and graduated from the University of Copenhagen
Medical School in 1996.
The Fellows were each awarded a one-year, $50,000
research grant that runs through July 2000. The grants are renewable
for a second year, each totaling an additional $50,000, pending satisfactory
progress in the first year.
In his remarks, Mr. Perkin thanked the foundations whose generous
support had made the VZVRF 1999-2001 Fellowship Program possible,
including: The Achelis Foundation; The F.M. Kirby Foundation, Inc.;
The Mellen Foundation; The Reed Foundation, Inc.; St. Giles Foundation;
Adolph and Ruth Schnurmacher Foundation, Inc. and The Starr Foundation.
This luncheon was made possible through the generosity of the VZVRF
Board of Directors.
2nd European Roundtable on Varicella Vaccination Convened
As part of its ongoing efforts to forge international, scientific
exchange on VZV, the VZV Research Foundation has announced the formation
of the VZVRF European Working Group on Varicella Vaccination (EWGVV)
The primary objective of the EWGVV is to explore the desirability
and feasibility of universal vaccination again varicella (chickenpox)
Led by VZVRF International Committee Chair Bernard Rentier, Vice-Rector
of the University of Liege, Belgium, the group is comprised of 19
scientists representing the United States and ten European countries,
including: Austria; Belgium; Finland; France; Germany; Italy; Portugal;
Spain; Sweden and the United Kingdom.
On January 21-22, 2000, VZVRF Chairman Richard T. Perkin convened
the second meeting of EWGVV members at the University of Liege. Presentations
at the roundtable included: a review of the severity of varicella
by VZVRF Scientific Advisory Board Chair Anne A. Gershon, M.D., of
Columbia University College of Physicians & Surgeons (New York) and
an update on varicella vaccine coverage in the U.S. and vaccination
recommendations by Jane Seward, M.B.B.S., M.P.H., of the Centers for
Disease Control and Prevention (Atlanta).
Since the U.S. has the most significant, documented experience with
varicella vaccine, remarks by U.S. presenters were central to the
discussion. However, a number of European participants questioned
whether the American experience can be considered a transposable model
due to the many cultural differences and healthcare delivery systems
throughout Europe, which are largely driven by national policies.
Other barriers to universal varicella vaccination include the perception
that it is a mild childhood illness, in addition to questions concerning
whether sufficient coverage can be achieved and whether immunity will
wane over time. The existence of breakthrough cases and the cost of
vaccination are additional areas of concern.
Members of the EWGVV will reconvene in Berlin on June 18-20, 2000,
to continue the dialogue and review research they have conducted in
the interim concerning their countries' health policies on varicella
vaccination. This meeting will also feature a clinical workshop for
Berlin-based physicians on June 20.
The work of the EWGVV is made possible by an unrestricted, educational
grant from SmithKline Beecham Biologicals/Belgium
Planning For 2001 Conference Underway
La Jolla, California, is the site of the "Fourth International Conference
on Varicella, Herpes Zoster and Post-Herpetic Neuralgia," planned
for March 3-5, 2001 at the Hilton La Jolla Torrey Pines in La Jolla,
Calif. To date, five co-chairs have been selected and a preliminary
agenda has been adopted.
Five members of the VZVRF Scientific Advisory Board (SAB) have agreed
to chair the conference, including: SAB Chair Anne A. Gershon, M.D.,
professor of pediatrics at Columbia University College of Physicians
and Surgeons; Ann M. Arvin, M.D., professor of pediatrics and microbiology/immunology
at Stanford University; Robert W. Johnson, MB., BS., FRCA., consultant
anaesthesiologist at United Bristol Hospitals (U.K.); Bernard Rentier,
Ph.D., D.Sc., Vice-Rector of the University of Liege (Belgium); and
Stephen E. Straus, M.D., Chief, Laboratory of Clinical Investigations,
National Institute of Allergy and Infectious Diseases, NIH.
The conference will feature five sessions focusing on varicella, herpes
zoster, PHN and basic aspects of VZV, in addition to plenary addresses.
"Meet the Professor"sessions, a series of workshops for clinicians,
will be held, in addition to a public health forum at the conclusion
of the conference. A dinner commemorating the 10th anniversary of
VZVRF's founding is also planned.
Further conference updates will shortly be posted on the Foundation's
Kirby Foundation Grant Launches Tissue Bank
Research into the treatment of post-herpetic neuralgia, or PHN, a
painful, chronic complication of shingles, is at a critical juncture.
Drugs now used to treat PHN are ineffective for many patients, only
partly relieve pain, at best, and often have serious side-effects.
In order to identify potential new treatments for PHN, scientists
need to better understand its causes. But to do this, they need to
study normal and affected autopsy human sensory tissue, although such
tissue is very difficult to obtain.
To help alleviate this problem, the VZV Research Foundation will shortly
be establishing the VZVRF Sensory Tissue Bank (STB)
University College of Physicians and Surgeons. Directed by SAB Chair
Anne A. Gershon, M.D., of Columbia University, the STB
work to secure human ganglia for study by researchers. Year 1 goals
include: formation of an STB
Scientific Advisory Board; liaison
with New York City-area hospitals' pathology departments; and the
securing of additional funding for Year 2 and beyond.
The seed money for the VZVRF Sensory Tissue Bank
by a generous research grant from The F.M. Kirby Foundation, Inc.
"This prestigious philanthropy has had a long history of support for
scientific research, and for the investigation of VZV infections,
in particular," said VZVRF Chairman Richard T. Perkin.
David J. Braga Joins VZVRF Board
VZVRF Chairman Richard T. Perkin has announced the addition of David
J. Braga of New York City to the Foundation's Board of Directors.
Mr. Braga is vice president, operations, of Commercial Capital Corporation,
one of the nation's leading, federally-licensed, small business lending
A Harvard College graduate, Mr. Braga's diverse background includes
extensive experience in property management and in the financial markets.
His previous public service includes two years of work with underprivileged
schoolchildren in Ohio as a member of Volunteers in Service to America
(VISTA) and three years as a board member of Lenox Hill Neighborhood
House. He also served for five years in the U.S. Marine Corps Reserve.
"Dick Perkin's offer to me to join the Board of the VZV Research Foundation
came at a time in my life when I was seriously considering how best
to return to public service," said Mr. Braga. "Working to improve
the lives of others in need is very important to me. And since several
members of my own family have suffered from shingles and PHN, I especially
welcome the opportunity to working with my fellow Board members as
we chart the course of the Foundation into the 21st Century."
Chair of U.K. Subcommittee Named
(l. to r.): Bernard Rentier, Ph.D., D.Sc., VZVRF International Committee
Chair, and Robert W. Johnson, MB., BS., FRCA., Chair, U.K. Subcommittee
As part of its efforts to establish a formal presence in the United
Kingdom, the VZV Research Foundation has named Robert W. Johnson,
MB., BS., FRCA., a leading British researcher on PHN, as chair of
its U.K. Subcommittee.
Dr. Johnson, a consultant anaesthesiologist and senior lecturer at
United Bristol Hospitals and the University of Bristol, has already
begun identifying scientists and clinicians from a broad array of
VZV-related specialties to serve on a U.K. Scientific Advisory Board.
"Advancing the cause of VZV research and education in Britain and
throughout Europe has long been an objective for the Foundation,"
said VZVRF Chair Richard T. Perkin. "In Bob Johnson, we have identified
an individual who enjoys the respect of his peers, and has the drive
required to help us become established in the U.K."
Vol. VI, No. 1 --Winter 1999
Landmark Shingles Prevention Study Underway
International Varicella Experts Urge
Palm Beach Conference Proceedings Published
"A Preeminent Virologist": Thomas H.
VZV Pioneer To Be Honored
Profile: Michael N. Oxman, M.D.
PHN Treatment Study Reported In JAMA
Landmark Shingles Prevention Study Underway
Can vaccination decrease the incidence and/or severity of herpes
zoster (shingles) and its complications in older adults?
Will vaccination protect against post-herpetic neuralgia (PHN)?
Finding answers to these critically-important questions is the goal
of the Shingles Prevention Study, a major study that has just been
launched involving 37,000 subjects, age 60 or older, who have not
yet had shingles.
According to the VZV Research Foundation, shingles afflicts more than
850,000 Americans each year and, in older adults, is often complicated
by post-herpetic neuralgia (PHN). PHN is characterized by pain that
persists for months or even years after the shingles rash has healed.
The double-blind, placebo-controlled, efficacy trial is being conducted
at 21 sites throughout the country by the Veterans Administration
Cooperative Studies Program with the collaboration of the National
Institute of Allergy and Infectious Diseases and Merck & Co., Inc.,
the vaccine's manufacturer. The study is being chaired by Michael
N. Oxman, M.D., professor of Medicine and Pathology at the University
of California, San Diego and a member of the VZVRF Scientific Advisory
Board (SAB). Several other SAB members are also involved, including
Myron J. Levin, M.D., of the University of Colorado, and Anne A. Gershon,
M.D. and Philip LaRussa, M.D., of Columbia University.
The primary hypothesis of the study is that immunization with live
attenuated Oka/Merck varicella-zoster vaccine will reduce significantly
the burden of illness due to shingles. The secondary hypothesis is
that immunization with live attenuated varicella-zoster vaccine will
protect against PHN.
Dr. Oxman notes that these hypotheses are based upon three key observations.
"First, there is a marked increase in the incidence and severity of
shingles and PHN in older persons, and this increase is correlated
with an age-dependent decline in their cellular immunity to the varicella-zoster
virus," he said. "Second, immunocompetent individuals rarely experience
more than one episode of shingles, and we think that this is because
an episode of shingles induces a substantial and prolonged increase
in cellular immunity to VZV. It seems as if one episode of shingles
immunizes against another attack. Third, several studies carried out
by Dr. Myron Levin and others have demonstrated that live attenuated
Oka/Merck varicella-zoster vaccine can induce a substantial and prolonged
boost in cellular immunity to VZV that is similar to that produced
by an episode of shingles. Therefore, we hope that the vaccine will
protect people the way that an episode of shingles does, but without
the associated pain and suffering."
Both the primary and secondary hypotheses will be tested by comparing:
(1) the total burden of illness due to shingles; and, (2) the incidence
of PHN, in vaccine and placebo recipients.
Veterans and their spouses, age 60 years of age or older, who have
never had shingles, are currently being enrolled in the study. Non-veterans
will also be enrolled. Each subject will receive vaccine or placebo
and then be followed for approximately four years. Subjects who subsequently
develop shingles will be asked to immediately contact their local
study site and to report to a Shingles Prevention Study clinic, where
they will be evaluated and offered state-of-the-art treatment without
The extent, severity and duration of the disease, as well as its impact
on their quality of life and daily activities, will be measured repeatedly
during the six-month period following the onset of their shingles
rash. Serial measurements of VZV-specific cellular immunity to VZV
will be obtained in a subset of vaccine and placebo recipients and
in all subjects who develop shingles. These measurements will make
it possible for researchers to verify the immunogenicity of the vaccine
and to compare the magnitude and durability of the immune response
induced by the vaccine to that induced by shingles.
To learn more about participation in this study, and the location
of study sites, please contact Heather Williams, R. N., national study
coordinator, at 619-552-8585, ext. 4638.
International Varicella Experts Urge Universal Vaccination
Medical experts from the United States and eight European countries
unanimously voted for universal vaccination against varicella (chickenpox),
a common childhood disease. The group was composed of 13 scientists
from: Austria, Belgium, Finland, France, Germany, Portugal, Spain,
Switzerland and the U.S.
The scientists met at the University of Li¸ge, Belgium on December
11-12, 1998 to review the status of varicella vaccination in each
country and develop a recommendation for Europe. The meeting, "Varicella
Vaccination of Healthy Children - A Challenge for Europe," was sponsored
by the VZV Research Foundation, through an educational grant from
SmithKline Beecham Biologicals/ Belgium. The U.S. has the most significant
documented experience with varicella vaccine. The vaccine was approved
in the U.S. in 1995 and has since resulted in an estimated coverage
of more than 30 percent, which is historically in keeping with the
acceptance rate of past U.S. vaccines.
The remarks by U.S. presenters (Dr. Anne Gershon, director of Pediatric
Infectious Diseases at Columbia University, New York, and Dr. Jane
Seward, chief, Varicella Activity of the Centers for Disease Control
and Prevention, Atlanta) were therefore central to the discussion.
According to Roundtable Chair and Vice-Rector of the University of
Li¸ge, Dr. Bernard Rentier, "The most important U.S. statistics
relate to the severity of varicella, namely, that it results in nearly
10,000 hospitalizations and nearly 100 deaths in the U.S. annually,
mostly among healthy children and adults."
In addition to the perception that varicella is a mild childhood illness,
other barriers to vaccination include questions about the vaccine's
duration of immunity and cost. Here again, the U.S. presenters provided
their perspective on these issues, citing: documented duration of
immunity in Japan (20 years) and the U.S. (10 years); and studies
relating to the vaccine as a cost-effective prevention.
"In the end, all participants agreed that varicella should be prevented,"
said Dr. Rentier. "Indeed, they agreed that vaccination against varicella
will prevent the spread of the disease, protect high-risk patients,
potentially prevent cases of herpes zoster, and alleviate the costs
involved in managing varicella patients."
Palm Beach Conference Proceedings Published
The proceedings of the "Third International Conference on the Varicella-Zoster
Virus," held in Palm Beach Gardens, Florida, March 9-11, 1997, were
published as a supplement to The Journal of Infectious Diseases in
November 1998. The conference was presented by the VZV Research Foundation
in partnership with Columbia University College of Physicians and
This supplement was edited by Anne A. Gershon, M.D., of Columbia University
and is dedicated to Michiaki Takahashi, M.D., D.M.Sc., developer of
the chickenpox vaccine. Dr. Takahashi was presented with the Foundation's
Scientific Achievement Award at the conference.
Publication of this supplement was underwritten by Merck & Co., Inc.
and the Richard Lounsbery Foundation. For information on obtaining
a copy of these proceedings, please refer to the section of this web
site entitled "How To Order VZVRF Publications".
"A Preeminent Virologist": Thomas H. Weller, M.D.
"In 1949, there appeared from a Boston research team a paper, modest
in size and wording, but with a sensational content. John Enders,
Thomas Weller and Frederick Robbins reported the successful cultivation
of the poliomyelitis virus in test-tube cultures of human tissues.
A new epoch in the history of virus research had started."
These remarks by Professor S. Gard of the Royal Caroline Institute
were followed by the presentation of the Nobel Prize in Physiology
or Medicine for 1954 to Drs. Enders, Weller and Robbins.
But, as a youth growing up in Ann Arbor, Michigan, Thomas Weller was
fascinated with natural history.
My father was very interested in nature, especially in birds. I
lived on the same block with the curator of fishes and the curator
of entomology and of reptiles. And I had a pet crow that would follow
me from tree to tree and then fly back home.
At the University of Michigan, he seemed to be heading in the direction
of medical zoology. In fact, he spent two summers at the University's
Biological Station working on the parasites of fish. But, in 1936,
although times were tough, his father agreed that he should go to
I looked at Penn, Johns Hopkins and Harvard. My reasons for choosing
Harvard included the fact that tuition was $400 per year, one or two
hundred less than Hopkins.
At Harvard, Thomas Weller became interested in general infectious
diseases. After learning that Dr. John F. Enders was working on tissue-culture
techniques as a means of studying the causes of infectious diseases,
he elected, as a fourth-year student, to do a research project with
In 1940, he earned his M.D. degree, and began his clinical training
at Children's Hospital in Boston. In 1942, he joined the Army Medical
Corps. Stationed in Puerto Rico for nearly three years, he gained
tremendous experience in the field of tropical diseases.
In 1947, I was able to return to the problem of growing viruses
in cultures of human tissues as Dr. Enders and I developed a laboratory
at Children's Hospital for virus research. In 1949, we reported the
isolation and growth of the poliomyelitis virus in tissue cultures.
I was successful in growing in cell cultures, mumps, Coxsackie, varicella,
cytomegalovirus, and rubella viruses. These findings popularized the
use of tissue cultures for the study of viruses and the field of virology
underwent a scientific explosion.1
In fact, Dr. Weller was the first scientist to isolate the virus responsible
for varicella and herpes zoster, and he obtained evidence that the
same virus was responsible for both infections.
The isolation of the varicella-zoster virus led to many other important
discoveries in VZV research, including Dr. Michiaki Takahashi's development
of the varicella vaccine.
Although my work in isolating and growing the poliomyelitis virus
in tissue cultures was the most significant contribution I have made
to medical science in terms of global impact, I am most proud of my
work with the varicella-zoster virus. It's something I planned to
do and worked for years to do. In fact, I obtained one of the first
strains of varicella virus from my older son.
Dr. Weller retired from the Harvard School of Public Health in 1985
as the Richard Pearson Strong Professor of Tropical Public Health.
He and his wife, Kathleen, have two sons and one daughter; a second
daughter is deceased.
Since we were married in 1945, my wife has been with me every step
of the way. She's polished every paper I've written. She's a good
As he continues working on his much-anticipated autobiography, Dr.
Weller is, no doubt, putting Mrs. Weller's editing skills to the test
Excerpted from "Infectious Diseases and Public
Health," by Thomas H. Weller, M.D., PEDIATRICS, Vol. 102, No. 1 ,
July 1998, Pp. 284-285.
VZV Pioneer Honored
In 1965, R. Edgar Hope-Simpson, M.D., a British general practitioner
from Cirencester with no formal training in research or epidemiology,
definitively concluded that zoster was caused by a reactivation of
latent varicella virus. That year, he also hypothesized that the increased
incidence and severity of shingles in older people is the result of
declining VZV immunity.
For these and many other contributions to the field of VZV research,
the VZV Research Foundation presented its fourth Scientific Achievement
Award to Dr. Hope-Simpson on February 12, 1999, at a luncheon in Cheltenham,
This event was underwritten by SmithKline Beecham Pharmaceuticals,
Glaxo Wellcome plc and Pharmacia & Upjohn, Ltd.
Profile: Michael N. Oxman, M.D.
Dr. Michael N. Oxman entered Harvard College in 1958, intending to
become a theoretical physicist. Late in his sophomore year, however,
he realized that he wanted to do something with more direct, human
contact. So, after graduating with honors in Physics, he went on to
Harvard Medical School, graduating with honors in 1963.
Thirty-five years later, in 1998, Dr. Oxman formally launched a major
Veterans Administration Cooperative Study-the Shingles Prevention
Study -to determine whether a live, attenuated varicella-zoster vaccine
can decrease the likelihood and/or severity of shingles and PHN.
Dr. Oxman, a member of the VZV Research Foundation's Scientific Advisory
Board, credits Dr. R.E. Hope-Simpson's landmark 1965 paper on herpes
zoster as a major inspiration for this study. "It was all there in
a paper written nearly 35 years ago by Dr. Hope-Simpson, in which
he hypothesized that individuals develop shingles as they age because
their immunity to the virus is weakening, and they very rarely develop
shingles more than once because their first episode boosts their immunity,
effectively immunizing them against a subsequent attack."
Dr. Oxman cites the late Nobel Laureate, Dr. John F. Enders, with
whom he enjoyed a close association, as helping to point him in the
direction of virology and infectious diseases. "Dr. Enders was a hands-on
researcher who was driven by curiosity, not ambition. He was also
a warm and nurturing mentor. Even when I did research in his laboratory
as a medical student, he treated me like a colleague."
After housestaff training on the Harvard Medical Service at Boston
City Hospital, Dr. Oxman spent three years at the National Institute
of Allergy and Infectious Diseases with another mentor, Dr. Wallace
P. Rowe, whom he calls "a virologist's virologist." He then returned
to Dr. Enders' lab in Boston, where he became director of the Virology
Laboratory at Children's Hospital Medical Center and associate professor
of Microbiology and Molecular Genetics at Harvard Medical School.
Following Dr. Enders' retirement in 1976, Dr. Oxman moved west to
become a professor of Medicine and Pathology at the University of
California, San Diego, where he works and teaches today.
"I was and continue to be attracted to the educational philosophy
of the school, which recognizes the importance of basic science to
clinical medicine and, in its training of medical students and physicians,
attempts to fuse the science and the art of medicine," said Dr. Oxman.
Dr. Myron Levin, of the University of Colorado, has collaborated with
Dr. Oxman since 1967. In an interview with VZV Focus, he gave this
assessment of his long-time colleague. "Dr. Oxman has a unique way
of getting to the heart of a problem and showing the way to others
as they attempt to find solutions," said Dr. Levin. "Many important
scientists around the country regularly call upon him for his perspective
so that they can be sure they're on the right track. In so doing,
Dr. Oxman has contributed greatly to the way a generation of American
scientists think. That's a lasting contribution to science."
PHN Treatment Study Reported In JAMA
The anticonvulsant drug gabapentin has been found to be "effective
in the treatment of pain and sleep interference associated with post-herpetic
neuralgia (PHN). Mood and quality of life also improve with gabapentin
These are the findings of a study designed to determine the safety
and efficacy of gabapentin in reducing the pain associated with PHN,
the often-painful aftermath of shingles, as reported in the December
2, 1998 issue of the Journal of the American Medical Association (JAMA).
Gabapentin (Neurontin) is manufactured by Parke-Davis, sponsor of
the study. Parke-Davis is a division of Warner-Lambert Company.
The multi-center, randomized, double-blind, placebo-controlled trial
took place between August 1996 and July 1997. It involved 229 subjects
at sixteen U.S. outpatient clinical centers.
The authors of the study included Michael C. Rowbotham, M.D., associate
professor of Clinical Neurology and Anesthesia at the University of
California, San Francisco, School of Medicine. Dr. Rowbotham is a
member of the VZV Research Foundation's Scientific Advisory Board.
In an editor's note concerning this study, which appeared in JAMA
on December 9, 1998, David Cooper, M.D., a contributing editor, wrote
that "these data suggest that gabapentin may be useful in the treatment
of post-herpetic neuralgia (PHN)." He also stated that shingles afflicts
over one million individuals each year, of whom 10 to 15 percent,
or 100,000 to 150,000 shingles sufferers, develop PHN