Tiny Invaders

The doctors could not tell what ailed the baby in a railroad flat on Manhattan's Eighth Avenue. She had an up & down fever and convulsions soon after birth, there was something wrong with her eyes and her head became enlarged. She died in a hospital at the age of one month. Pathologists Abner Wolf and David Cowen could not fix the cause of death, but they found some puzzling little organisms in the brain. They were protozoa, to be sure, but what kind? Not until two years later (1939), when the two doctors had a similar ease and were able to transmit the baby's disease to laboratory mice, could they be sure what it was: toxoplasmosis. The luckless youngster on Eighth Avenue, her illness posthumously diagnosed, was the first case in U.S. medical history.

Not So Rare. Last week experts in tropical medicine meeting in Galveston, Texas held a forum to tell all that they had learned about toxoplasmosis in the 15 years since the Manhattan baby's death. The main thing was that it is by no means as rare as doctors once thought. Though it escaped detection in animals until 1908, and in humans for almost another 20 years, hundreds of cases have now been recognized in the U.S. alone.

The commonest type of case is believed to be like the first U.S. record: the baby who gets the disease in the womb from a mother who has a smoldering, low-grade infection. The baby may be sick at birth, or not until a few weeks later. In either event, the tiny Toxoplasma invaders usually cause inflammation of the brain and spinal cord so severe that it is crippling if not fatal. (Later children of the same mother are believed to be safe because she develops antibodies.)

Mice & Men. Nobody knows how growing children and adults get the disease (mice are suspected of transmitting it), or why some victims get an acute infection while others have a milder form, often localized in the eyes. Pathologist Helenor Campbell Wilder presented positive data to the experts in Galveston: in 53 cases where a supposedly tuberculous eye had been removed, toxoplasmosis was found. Victims were 14 to 83 years old; some had had symptoms only a few weeks, others as long as 32 years.

No less elusive than the cause of toxoplasmosis is its cure. Antibiotics are almost useless. Sulfa drugs are being tried, and if they do any good, the improvement should be most obvious in acute cases. But because toxoplasmosis is hard to identify, the patient often does not get the treatment soon enough. Last week Microbiologist Don E. Eyles of the National Institutes of Health reported a hopeful new lead: Daraprim, which has already shown promise against the protozoa of malaria (TIME, Sept. 1), is effective against toxoplasmosis in mice when given with sulfadiazine. Now the trick is to extend the benefits from mice to men.

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