Burkitt

My first job after my PhD was in the Genetics Department in the University of Newcastle upon Tyne. It was the quintessence of a Red Brick University - staffed and studented by ordinary people and integral to the local community.  The campus was on the very edge of the downtown shopping district which meant we could support the economy on our lunch-breaks.  But it cut the other way also, because every Thursday evening in term-time there was a Public Lecture in our biggest theatre.  The lectures could be, and were, about every topic under the sun and I made a point of going to them all - you never knew when it was going to be a blinder. It was all quite formal, with a Chair to introduce the session, and a vote of thanks afterwards.  One night, the speaker discarded the lectern and microphone and came forward to sit on a big mahogany desk at the front of the stage. As he swung his feet and asked for the next slide, he told us the story of his discoveries in East Africa and got starry-eyed and insistent about the importance of dietary fibre in the prevention of colon cancer - complete with pictures of a cross section through a flush-toilet containing "a floater" to indicate how we were to know if we had sufficient fibre in our diet.  It was the funniest, most engaging and most informative talk that year. His name was Denis Burkitt and he came from a family of evangelical christians in Enniskillen.

After WWII service in the RAMC,  his vocation insisted that he stop in Uganda to help the dispossessed.  One day he treated a small black child who had a tumour at the angle of the jaw.  The next day, looking out of the surgery window, he saw another child with a similar growth.  As he'd never seen such a condition in a child back home in the WEA, he was disturbed and intrigued. Not unlike William McBride noticing several limbless infants and eventually fingering thalidomide. As such tumours were untreatable at the time, it might have been more sensible to concentrate on diseases where his training could make a difference.  Burkitt on the contrary went up to head office in Kampala to dig out all the records of childhood cancers in the archives of the medical service of the colony. There were lots, but they weren't everywhere, so Burkitt went along the road to the Surveyors Office and got a map of the colony on which he marked each case with a cross.  A few sleepless nights and gnawing at the data and he twigged that the tumours were much more likely to happen in regions which had year-round hot and wet weather: regions where malaria was endemic. He assumed that he was dealing with a something that was transmitted along with the malarial parasites by the vector mosquitoes that hatched in large numbers where warm puddles were ever-available.  He was wrong, wrong almost right.

In 1961 he went to London on leave and gave a talk about his work at one of the medical schools.  This lit a fire under a young chap called Michael Epstein who came up to talk to him over a cup of tea afterwards.  Epstein was primed because he'd spent some time working with Rous Sacroma Virus which had been shown to cause cancer in chickens.  Epstein conceived the ambition of being the first to show a cancer-inducing virus in humans and arranged that Burkitt would air-freight samples of tumorous tissue from Kampala to London on a regular basis.  Nothing Epstein or his PhD student Yvonne Barr could do enabled them to isolate any sort of virus from these samples . . . until the day Heathrow was fog-bound and the Kampala flight was diverted to Manchester.  It was two days before the sample arrived at its destination and if looked 'off' - cloudy like it had a bacterial infection - and Epstein almost threw it away.  But a look down the microscope showed that the cloudiness was free-floating cancer cells and that was the first step in being able to see virus particles in the cells when viewed with a powerful electron microscope.  It's a type of herpes virus and now named EBV - Epstein-Barr Virus. Burkitt was wrong to believe that EBV is transmitted by mosquitoes because it turns out that we all (90-95% of adults) have EBV about our persons, but he was right about the malaria connexion. When the child's immune system is under siege from malaria, the EBV can multiply sufficiently to do its damage. It's like MRSA which at least 30% of us have ready to sneeze. That wasn't the end of the story, you can fill in the spaces here, en ook hier.  EBV is the cause of infectious mononucleosis (aka mono or glandular fever) in teenagers - if you haven't had it, you know lots of people who have.  It is also associated with a variety of auto-immune diseases including lupus.

Epstein didn't get a Nobel Prize (although it was a possibility) but he did become Sir Anthony Epstein CBE FRS (giving him parity of esteem with Jocelyn Bell Burnell) and nor did Denis Burkitt who is dead these least 20 years, so out of the running. Yvonne Barr seems, like Beatrix Potter, to have left science shortly after her one great contribution and married a bloke from Melbourne.

This is what makes science so fascinating.  It's never as simple as it seems at first sight.  Nature yields her secrets best to those who are observant, creative, all-the-hours hard-working, communicative, generous . . . and lucky.