Evening star. [volume] (Washington, D.C.) 1854-1972, 1955-08-28
TODAY IN MEDICINE
Cutter Report rogic,
Ironic and Mysterious
By JOHN MeKELWAY

BY JOHN McKELWAY
With the publication Of thu
long-awaited Cutter report last
week by the Public Health Serv-
ice, a chapter in the story Of
polio was finished. And while II
Is an ironic, tragic and even mys-
FERROUS chapter, it is still Just q
chapter. 1t is anybody's guess
whether q book on polio-that is
one with a final chaptsr-will
ever be completed.
The chapter is ironic in that
II the Cutter incident had liot
happened when it did. 1t might
have happened later on, and on
q much larger scale. In some
respects then, it was a good
thing.
It is tragic in that it took
about 70 cases Of polio and five
deaths to draw attention to the
need for revised safety standards
for the vaccine.
And it is mysterious in that nc
solid reason could be found to
explain, after months Of investi-
CATION, live virus in six lots OF
Cutter vaccine. That reason. al
though a number of good guesses
exist, may never officially be
found or stated.
Possible Elsewhere Earlier
The striking implication with
in the Cutter report, confirmed
by top public health officials, is
that what happened to Cutter
might have happened to any
other laboratory. If evidence
of negligence or contamination
had been found in the Cutter
laboratory. the reason for live
virus in its product could more
easily have been understood. But
as the Public Health Service
said: Nothing was found to in
dictate that the infective amounts
of live virus in Cutter vaccine
were attributable to contamina-
ton"
Cutter laboratories, like the
other five laboratories manufac-
turing Salk polio vaccine, used
approximately the same pro-
cedures in turning out "the an
swer" to polio. One of these
procedures was the process which
cooked" or inactivated the
three types Of live virus in the
vaccine in a bath Of formalde-
hyde.
The history Of the vaccine
shows all manufacturers had
trouble inactivating the three
viruses. The then used safety
tests turned up this fact-a fact
which was only made public
after the Cutter incident and the
institution of a sitter safety test.
But the then-uSed safety test. i'll
is believed, failed to pick up the
live virus that had survived the
cooking process in the Cutter
laboratory.
Same Test Used
It was a good test. but not
good enough: not sensitive
enough. as the Public Health
Service has stated. Yet all labora-
tories. before the Cutter incident.
were using the same test-andI
having the same trouble Cutter
was experiencing. The top scien-
ttf1c minds in the country agreed
1t was an adequate test.
It took the polio cases related
to Gutter vaccine to stop the
incubation program and give
science time to come up with a.
safety test which had salts
factory degree of sensitivity."
There are other significant de-
velopments tied to the Cutter re-
port. One is that scientists are
now going over the so-called
cooking" process with an eye
toward killing the virus with
something other than formalde-
hyde. Another investigation
seeksNto find a strain of the Type
I polio viruy different from that
used in the present Salk vaccine
the highly virulent strain
which the investigation isolated
from lots Of the Cutter vaccine.
In short, as one top official said
recently. you may not be able
to recognize the Salk vaccine in
q few years"
Ultimate Test in Human
But there is something some
what more significant between
the lines Of the Cutter report:
The best evidence that Cutter
vaccine caused polio was cpl
Neurological. This is a big word,
but what it means is that the
absolute, final safety" test Of
any new medicine is what
happens when the human
being gets 1t. Polio VIC
tins. when and where they
were paralyzed, were the best
evidence against Cutter vaccine.
It was the evidence used to stop
the polio program and the EVIL
dence used to say. as the recent
Cutter report said: 1T is con-
cluded that the development
of the disease in some Of these
patients was the result of the
presence, in infective amounts,
of live poliomylitis virus in some
distribution lots Of vaccine.
The strong evidence was not in
any laboratory or in any tissue
culture.
In many ways, the mass vac
cine inoculations staged in 1854
and in 1855 were large scale hui
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