Meningitis and Vaccines
An ‘Insider’s’ Story.
5th July 2021:
It has been a while since I last posted a blog as the last several months have been largely taken up with completing my forthcoming book, “Brain Fever: How Vaccines Prevent Meningitis and Other Deadly Diseases”. Due to be released this month and published by World Scientific Publishing1 my book is about a devastating disease – an infection of the linings (meninges) of the nervous system. It occurs when certain types of bacteria, which normally live harmlessly in our nose and throats, invade the blood, multiply and spread to the brain.
During my years as a medical student, trainee and ultimately a professor specialising in infections of childhood, caring for children with meningitis was among the most anxiety-provoking and challenging experiences of my professional life. When it first begins, meningitis is often no different from many other illnesses, perhaps seeming no worse than a mild case of “flu.” But as it progresses, the infection quickly becomes life threatening. It happens most often in the very young but can strike at any age and is fatal unless treatment is given promptly. Although antibiotics are lifesaving, even these powerful drugs fail to prevent a fatal outcome in around 5%. Among those who survive, around 10% suffer from lifelong brain damage such as deafness, impaired vision, paralysis and diminished mental functioning. As a paediatrician, I have been personally involved in looking after children with bacterial meningitis and have devoted many years to researching vaccines to prevent the disease.
Scientists, especially the medical profession, have a responsibility — one we have been failing to shoulder adequately for several years. — to help people understand what we are doing and why. It is the reason for writing a book that I hope will appeal to all who are curious about meningitis and what is involved in developing vaccines to prevent it: the complexity of the laboratory investigations, the role of universities in supporting medical science, the challenges of obtaining research funding and, inevitably, engagement with politicians. I hope what also comes across is the sense of collaboration involved in such work, and my admiration for the brilliant scientists I have worked with over the past fifty years. As we are learning from the Covid-19 pandemic, it is vaccines that we rely on to fight and overcome the devastation caused by virulent germs. But, if what is involved in developing a vaccine and how it works are not understood, trust in immunisation is compromised. The message is clear: no intervention in the history of medicine has conferred a greater public health benefit than immunisation.
My book, Brain Fever, begins with my boyhood dream to study medicine and traces my career from medical student, through to becoming Professor of Paediatrics at the University of Oxford and founding the Oxford Vaccine Group (OVG)2, now world-famous for its role in developing the Astra-Zeneca SARS-CoV2 vaccine. A combination of clinical practice and laboratory science over several decades was needed to unlock the secrets of meningitis. This was the basis of the several available vaccines, an historical breakthrough in public health.
Books often have heroes and villains, but few have as their central characters tiny single bacterial cells with their complex and fascinating biology. But, as I explain in my book, bacteria are just one of the different kinds of germs that cause infections. Not all infections are caused by bacteria; there are — in order of size (smallest to largest) — viruses, bacteria, fungi and parasites.
Sizes of different germs. 1μm (the size of a typical bacterium) is smaller than the width of a human hair. More than a thousand bacterial cells lined up abreast could fit within the full stop at the end of this sentence. The small size of bacteria (invisible to the naked eye) is important allowing them to live within and scavenge food from other life forms – mammals, fish, birds, insects, plants etc.
This kind of information is important – yet time and again reputable journalists write articles that confuse viruses with bacteria. Viruses are about one hundred times smaller than bacteria and are fundamentally different in their life-style.
I will be sharing more about Brain Fever in future blogs, starting with some thoughts about what is involved in writing a book and why I undertook to do it. There will be a Book Launch (virtual) that will take place on Thursday July 29 (5pm UK time)3 Register here to attend. Please note that all my royalties from book sales will be going to the UK Meningitis Charities (Meningitis Research Foundation and Meningitis Now). Until December 31, there is a generous discount of 30% – so the soft cover version of Brain Fever can be purchased for about £15.
Below are some commentaries from prominent scientists who have been kind enough to review my book.
‘……captures the drama of a detective novel, the cliff edge of a thriller in which scientists experience deep disappointments as well as moments of sheer joy. Moving from discovery science, through clinical medicine, to the politics of acceptance and global rollout of vaccines to all those who could benefit from them, this is an extraordinary story of how the impossible can become reality, and its release in 2021 could not be timelier or more prescient. Sir Jeremy Farrar. Director of UK Wellcome Trust.
“Brain Fever is a timely, compelling and vivid narrative of scientific endeavour that perfectly sets the stage for the ambitious World Health Organisation (2020) roadmap to defeat meningitis by 2030. Richard Moxon’s observations, by someone who was deeply involved in many of the key pieces of the puzzle, reveal his fascination with the remarkable people who worked tirelessly to understand and control meningitis and his own fight against the intriguing bacteria that cause the disease.” Sir Andrew Pollard. Professor of Paediatric Infection and Immunity, Director Oxford Vaccine Group, University of Oxford
“I picked up this book to have quick look and couldn’t put it down. Richard Moxon has written a fascinating account of bacterial meningitis, covering its history, microbiology and devastating clinical impact. He played a major part in the discovery of very successful vaccines that now protect our young people and he tells that story with great modesty while vividly conveying the excitement of that achievement.” Sir Andrew McMichael. Professor of Molecular Medicine and Former Director of the Weatherall Institute of Molecular Medicine, University of Oxford
“Part memoir, part scientific detective story, Richard Moxon writes with great elan to describe both the human and scientific sides of some of the greatest recent advances in the fight against infectious diseases. As hopefully we emerge from the Covid pandemic thanks to widespread vaccination, including one developed at an institute Moxon helped set up, there has never been a more important time to understand the interplay between humans and their pathogens.” Sir Charles Godfray CBE. Professor of Population Biology and Director of Oxford Martin School, University of Oxford
- Register here for the book launch: https://viewstripo.email/fd52706d-5cbb-4268-88f1-2232490e77441619518812962
Copyright Richard Moxon 05.07.21
Follow My Blog
Get new content delivered directly to your inbox.