Common Cold Unit

The Common Cold Unit (CCU) or Common Cold Research Unit (CCRU) was a unit of the British Medical Research Council which undertook laboratory and epidemiological research on the common cold between 1946 and 1989 and produced 1,006 papers.^[1] The unit studied etiology, epidemiology, prevention, and treatment of common colds.^[2] It utilised Harvard Hospital, near Salisbury, a redundant Second World War-duration emergency infectious diseases field-hospital at Harnham Down.^{[citation needed]}

Common colds account for a third of all acute respiratory infections and the economic costs are substantial in terms of sick leave. The public-facing side of the CCU involved continually recruiting human volunteers, by advertising. Volunteers were housed at the hospital, for typically ten-days while participating in common cold trials. Some degree of isolation from each other was enforced as well as restrictions on leaving the site.

Human coronaviruses, which are responsible for about 10% of common colds, were first isolated from volunteers at the unit in 1965. The unit closed in 1990. The site was later redeveloped and absorbed into the city of Salisbury, although there is memorial plaque referring to its former use as the Harvard Hospital.

History

Previous research and establishment

In 1914, German bacteriologist Dr. Walther Kruse showed that nasal secretions from people with colds could be filtrated to make them free from bacteria; and, that inoculation of those filtrated washes into the nose of other people caused the same illness.^[3] It was the first direct evidence that colds were an infectious disease and that they were caused by something other than bacteria.^[3]

Christopher Andrewes and David Tyrrell refined these experiments at the former Harvard Hospital site in Salisbury, England. Around 1946 it became the Common Cold Unit of the Medical Research Council.^[3] It was set up by the Medical Research Council after Dr. Andrewes promoted the idea of researches on volunteers and persuaded authorities to set up the research station.^[4][5]

Harvard Hospital site

The Harvard hospital was a redundant, Second World War-duration, emergency field-hospital and then a U.S. Army hospital at Harnham Down, near Salisbury, although as an Army hospital it still admitted civilian patients with infectious diseases.

It was built, in the early 1940s, within an Emergency Hospital building programme. By July 1941, France had fallen and there was a fear of the spread of infectious diseases; and, this hospital was specifically set up to address that threat. The hospital was entirely provided by Harvard University and the US Red Cross. They provided the funding, including its erection, equipping it and provided volunteer doctors and nurses.^[6] The majority its buildings were prefabricated buildings brought over from the USA by ship. ^[6][3][7] It had fewer beds than other emergency hospitals set up under the UKs emergency hospital-building programme, but contained a fully-equipped emergency public health laboratory to handle infectious diseases.

It was sited close to Salisbury, as there was a lack of suitable hospital facilities in this area. It was to look after troop casualties being brought back from Europe with infectious diseases.^[6] When the USA entered the War, the Red Cross and Harvard University pulled their staff out; and the Hospital was run by US Army personnel until 1945, when Red Cross and Harvard University donated the hospital back to the United Kingdom Public Health authorities.^[3]

Experiments

See also: Human subject research

Twenty to thirty volunteers were required every fortnight during Common Cold trial periods. The unit advertised in newspapers and magazines for volunteers, who were paid a small amount. A stay at the unit was presented in these advertisements as an unusual holiday opportunity.

Dr. Tyrrell, in 1992, when reflecting on the ethics of carrying out these trial on human subjects, makes the following points. ^{[citation needed]}

Volunteers were either infected with preparations of cold viruses, or they were used as a control group; and in this case the preparation given would be free of infection. Volunteers typically stayed for ten days and were housed in small groups of two or three, with each group strictly isolated from the others during the course of their stay. They were allowed to go out for walks in the countryside south of Salisbury, but residential areas were out of bounds.

As a screening test, no treatments were applied during the first five days. If, however, a volunteer presented symptoms of the Common Cold within these first five days they were considered ineligible to continue the trial; and, volunteers could be asked to leave if they broke the isolation rules.

Discoveries

The first coronavirus (B814) was found in washes from a boy with typical common cold symptoms in 1960 during the study led by virologist David Tyrrell at the Common Cold Unit. After washes were inoculated to volunteers and tested for known viruses none was found. Publication about first human coronavirus was published in The BMJ in 1965. Later virologist June Almeida imaged virus for the first time and group of eight virologists including June Almeida named it coronavirus in their publication in 1968.^[8]

Results

During the CCU's existence, thousands of volunteers participated in research in which they were inoculated with common cold viruses or were in a control group,^[9] but no cure for the common cold was found.^[10] Some compounds were active against rhinoviruses in vitro but did not demonstrate clinical efficiency. Interferons alpha and beta administered intranasally before infection effectively prevented infection with rhinoviruses, coronaviruses, influenza viruses, and respiratory syncytial virus, but they were not as effective during treatment and had local side effects so they have not been used in routine practice against these viruses.^[10] Despite these dead ends, the findings made by the CCU improved the understanding of respiratory viruses, their lifecycles, and possible vaccines.^[11]

Sources

• Tyrrell, D A J (June 1992). "A view from the Common Cold Unit". Antiviral Res. 18 (2): 105–125. doi:10.1016/0166-3542(92)90032-Z. PMC 7133934. PMID 1329647.
• Tyrrell, David; Michael Fielder (2002). Cold Wars: The Fight against the Common Cold. New York: Oxford University Press. ISBN 0-19-263285-X.
• Richmond, Caroline (June 2005). "Obituary: David Tyrrell". BMJ. 330 (7505): 1451. doi:10.1136/bmj.330.7505.1451. PMC 558394.
• "David Tyrrell obituary". The Times. London. 18 May 2005. Archived from the original on 10 March 2007. Retrieved 17 February 2008.
• "The Medical Research Council Common Cold Research Unit". Ministry of Defence. Archived from the original on 26 October 2012. Retrieved 17 February 2008.

References

1. Oransky, Ivan (18 June 2005). "David Tyrrell, Obituary". The Lancet. 365 (9477): 2084. doi:10.1016/S0140-6736(05)66722-0. PMID 16121448. S2CID 43188254. Archived from the original (PDF) on 28 August 2021.
2. Halstead, Scott B. (9 April 2020). "An Urgent Need for "Common Cold Units" to Study COVID-19". The American Journal of Tropical Medicine and Hygiene. 102 (6): 1152–1153. doi:10.4269/ajtmh.20-0246. ISSN 0002-9637. PMC 7253108. PMID 32274988.
3. Lorber, Bennett (April 1996). "The common cold". Journal of General Internal Medicine. 11 (4): 229–236. doi:10.1007/BF02642480. ISSN 0884-8734. PMC 7089473. PMID 8744881.
4. "Andrewes, Sir Christopher Howard (1896–1988), virologist". Oxford Dictionary of National Biography (online ed.). Oxford University Press. 23 September 2004. doi:10.1093/ref:odnb/40059. ISBN 978-0-19-861412-8. Archived from the original on 18 September 2021. Retrieved 18 September 2021. (Subscription, Wikipedia Library access or UK public library membership required.)
5. Tyrrell, D. A. (July 1987). "The common cold--my favourite infection. The eighteenth Majority Stephenson memorial lecture". The Journal of General Virology. 68 ( Pt 8) (8): 2053–2061. doi:10.1099/0022-1317-68-8-2053. ISSN 0022-1317. PMID 3039038.
6. Dunn, C. L. (1952). "Chapter 14:The Provision of Medical Personnel". The Emergency Medical Services, Volume I: England and Wales. History of the Second World War: Medical Volumes. H.M.S.O and Longmans, Green and Co. pp. 393 - 394 & 435 - 437.
7. Richmond, Caroline (June 2005). "Obituary: David Tyrrell". BMJ. 330 (7505): 1451. doi:10.1136/bmj.330.7505.1451. PMC 558394.
8. Mahase, Elisabeth (16 April 2020). "Covid-19: Coronavirus was first described in The BMJ in 1965". BMJ (Clinical Research Ed.). 369 m1547. doi:10.1136/bmj.m1547. ISSN 1756-1833. PMID 32299810. Archived from the original (PDF) on 28 August 2021.
9. Ellis, Harold (4 January 2003). "Cold Wars: The Fight against the Common Cold". BMJ: British Medical Journal. 326 (7379): 57. doi:10.1136/bmj.326.7379.57/a. ISSN 0959-8138. PMC 1124964.
10. Snell, N. J. C. (March 2001). "New treatments for viral respiratory tract infections—opportunities and problems". Journal of Antimicrobial Chemotherapy. 47 (3): 251–259. doi:10.1093/jac/47.3.251. ISSN 0305-7453. PMC 7110210. PMID 11222557.
11. Lambkin-Williams, Rob; Noulin, Nicolas; Mann, Alex; Catchpole, Andrew; Gilbert, Anthony S. (22 June 2018). "The human viral challenge model: accelerating the evaluation of respiratory antivirals, vaccines and novel diagnostics". Respiratory Research. 19 (1): 123. doi:10.1186/s12931-018-0784-1. ISSN 1465-993X. PMC 6013893. PMID 29929556.

External links

• History of the Common Cold Unit - a British Library oral history project

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