Cold wars: the fight against the common cold

N o infection of humans is more universal than the common cold. Yet despite centuries of invention by practitioners of folk medicine and decades of the dogged application of modern (although evolving) scientific methods, the decisive battles in the war against the common cold remain ahead. One should not conclude, however, from the lack of a sure-fire prophylactic method or a rapid and efficacious treatment that scientific progress has been meager. On the contrary, since the 1930s scientists have used creative laboratory and epidemiologic methods as well as innovative clinical trials to illuminate a highly complex battlefield filled with hundreds of different types of stealthy viral warriors. David Tyrrell and Michael Fielder paint a colorful picture of how science has sized up the common cold enemy in Cold Wars: the Fight against the Common Cold. Cold Wars presents this story largely through an informal, breezy expansion on the more than 40-year history of the British Medical Research Council's Common Cold Research Unit (Common Cold Unit [CCU] since 1960). One of the authors, David Tyrrell, was a key member of the CCU staff, from 1957 until its closure in 1990. Cold Wars is written for a general lay audience and, as such, it might leave the biologist or epidemiologist craving more technical detail. Although of necessity it touches on some technical aspects of virology and molecular biology, this book by no means intends to be a technically rigorous review of the relevant science. Rather it most effectively captures a flavor for the pursuit of science in all of its frustrations and joys, and highlights the internationally collaborative nature of the modern scientific enterprise. Cold Wars begins by a recollection of the centuries-old history of the medical and popular understanding of the common cold. The CCU, however, is the institutional thread that carries most of this saga. The CCU grew out of an effort by Harvard University and the American Red Cross to assist the British in the early days of World War II. Their efforts were focused on the establishment—atop Harnham Hill in Salisbury, England—of a prefabricated hospital shipped from the United States for the clinical care and public health management of communicable diseases. Although the demands for patient-care beds turned out to be minimal, the epidemiologic and laboratory capabilities were put to good use. With the American entry into World War II, management of this facility fell to the U.S. Army, which used it to support a variety of war-related needs. Subsequent to the war, the facilities were taken over by the British Medical Research Council, who appreciated its utility to isolate volunteers participating in experiments involving exposure to cold viruses. Over the more than 40 years of its existence, nearly 20,000 volunteers have participated in CCU studies. Some of the most interesting parts of Cold Wars involve descriptions of the recruitment of volunteers from all around Britain. For many volunteers, life in the friendly atmosphere of the CCU came to be seen as an idyllic country holiday experience, despite experimental exposures to cold viruses and rigorous isolation protocols designed to preclude exposure to confounding sources of respiratory infection. In fact, the CCU even acquired a rather exaggerated public reputation as a haven for honeymooners. Cold Wars is particularly inspiring when it describes the rewards of international cooperation, especially as facilitated through various World Health Organization initiatives, such as global influenza surveillance and collaborations that crossed the political boundaries of the Iron and Bamboo Curtains. The book traces, in a general fashion, the technical advances from using humans as cold virus detectors though tissue culture isolation methods and, more recently, the modern tools of molecular biology. It provides some interesting commentary on issues of research ethics and the role of psychology in symptom perception. Descriptions of ingenious experimental designs to illuminate aspects of viral transmission are also fascinating elements of the story. For the reader who would enjoy a taste of how the modern scientific enterprise has addressed this most universal of human plagues, Cold Wars is a smooth and generally pleasant read. Its organization is not particularly chronologic, which can at times make the story seem a bit disjointed, and the superficiality of the science presented may make a technically curious reader left wanting for details. The authors recognize this likelihood, however, and include a substantial list of additional recommended reading as an appendix. Though speculation is easy, the book begs one question and that is: Why the CCU was ultimately closed? Cold Wars highlights the value of unique institutions like the CCU and its potential to bring focused attention on a problem. Although the common cold is not likely to threaten international security or commerce, as does HIV or SARS (severe acute respiratory syndrome), the common cold remains an important source of lost productivity, personal suffering, and interpersonal annoyance. Hopefully Cold Wars will inspire a new generation of clinical researchers, epidemiologists, and virologists to take up where Tyrrell and his CCU colleagues left off and write the final chapters in the history of this war.