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Notes and News

AIRBORNE TRANSMISSION OF VARIOLA VI[RUS

IN the aftermath of the incident in Birmingham last sum-mer, in which a photographer in the medical school died ofsmallpox, the Health and Safety Executive issued a summonsagainst the University of Birmingham for failing to protect thehealth of its ernployees. The case-which held up the publica-tion of the Shooter report on the incident-began on Oct. 22,and on Nov. 6 Birmingham magistrates dismissed the charges.The dead woman’s union, the Association of Supervisory,Technical and Managerial Staffs, may bring a civil action onbehalf of the family and of other technicians in the medicalschool. Brief daily accounts of the hearing, in the BirminghamPost, leave the impression that one factor in the magistrates’decision may have been the likelihood of airborne spread ofvirus from the smallpox laboratory, which the dead woman isnot thought to have visited. The possibility was, in effect, dis-counted in evidence from smallpox experts Prof. Alan Downie,Prof. K. R. Dumbell, and Prof. K. McCarthy. The Shooterteam (Prof. R. A. Shooter, Dr C. C. Booth, Sir David Evans,Mr J. R. MacDonald, Dr D. A. J. Tyrell, and Sir Robert Wil-liams) thought differently. Their report will be published "verysoon" by the Department of Health and Social Security, butonly if the H.S.E. decides not to appeal against the Birming-ham magistrates’ decision. Professor Shooter and his col-

leagues recognise that experts feel that "normal working con-ditions would not be likely to generate sufficient amounts ofairborne virus for infection to occur". However, in the Birm-ingham laboratory "procedures being employed were far fromsatisfactory"--e.g., the use of an aspirator outside the safetyhood to remove culture fluid from petri dishes. Smallpox virus"could have become airborne", and tests and observations hadsuggested one possible route from the virus laboratory to atelephone room that the smallpox victim had used. ProfessorShooter and his colleagues also expressed "deep concern at thefailure to follow agreed safety rules of the Department of Med-ical Microbiology". The world may be on the verge of beingofficially declared free of smallpox, but this does not make theissue of viral transmission merely academic. The courts, magis-trate or higher, are hardly likely to be able to decide the issue,and the scientific messages and organisational lessons in theShooter report apply to many pathogens other than variola.

DR SEMYON GLUZMAN

A PUBLIC meeting held in London on Nov. 11 was part ofthe campaign to secure freedom for victims of psychiatricabuse in the U.S.S.R. It was particularly associated with thename of Dr Semyon Gluzman’ and it was sponsored by:Amnesty International; Campaign Against Psychiatric Abuse(C.A.P.A.); South Place Ethical Society; The 35’s-Women’sCampaign for Soviet Jewry; and the Working Group on theInternment of Dissenters in Mental Hospital (secretary,Helena Abram, 13 Armitage Road, Golders Green, LondonNW11 8QT). The chairman was Mr Peter Cadogan (generalsecretary, South Place Ethical Society) and the meeting wasaddressed by: Dr David Clark (consultant psychiatrist,Fulbourn Hospital, Cambridge); Dr Marina Voikhanskayaformerly a psychiatrist in Leningrad); Mr Vladimir Bukovskywho wrote with Dr Gluzman A Manual on Psychiatry for Dis-sidents) ; Dr F. Weinberger (a Munich psychiatrist); Dr SidneyBloch (of the Department of Psychiatry, University of Oxford,and coauthor with Mr Peter Reddaway of Russia’s Political

1 Editorial. Dr Semyon Gluzman. Lancet 1979; ii: 946.

Hospitals2); and Mr David Markham (the actor and humanrights campaigner).

About 400 people attended the meeting and many signed astatement in support of a telegram urging the release of DrGluzman and others which had been sent to Mr Brezhnev, MrNikolai Shchelokov (U.S.S.R. Minister of Internal Affairs),and Academician G. V. Morozov (Serbsky Institute of Foren-sic Psychiatry, Moscow). The telegram was signed by Prof.Ralf Dahrendorf, Mr Joseph Grimond, Lord Janner, Prof.D. A. Pond, Lord Rawlinson, Lord Sainsbury, Prof. LeonardSchapiro, Lord Soper, and the Rt. Rev. A. M. Stockwood,Bishop of Southwark.The latest news bulletin of the Working Party on the Intern-

ment of Dissenters in Mental Hospitals includes names andaddresses of some of those interned and of Soviet officials, doc-

tors, and institutions to whom those who support the campaignmay care to write.

REPLACING DESIGNATED AREA ALLOWANCES

FOR thirty years the lynchpins of an N.H.S. policy encour-aging general practitioners to practise in underdoctored areashave been the power of statutory medical practices committeesto restrict entry into practices in areas of small average list sizeand the payment by the Health Departments of designatedarea allowances to those practising in areas of high list size(2500 or more). A working-party’ has concluded that simplearithmetic criteria for deciding what areas are "under-doc-tored" are too restrictive: "localities with comparatively lowaverage list sizes can be under-doctored ... and localities with

comparatively high lists may not always be actually as under-doctored as the list size would indicate". The present systemof designated area allowances is inequitable, when account istaken of the many factors that contribute to work-load; nor dothe allowances significantly improve the distribution of medi-cal manpower. However, no better formula can be devised, andthe designated area allowances, when phased out, should notbe replaced by another system of automatic payments by refer-ence to statistical criteria. Instead, the emphasis should shift,the working-party recommends, to extending and making moreflexible the initial practice allowances-i.e., providing help toyounger entrants in the early years. On detail, the working-party is imprecise, but it does suggest that the broader defini-tion of work-load to be used should be such that 25% of thepopulation would be defined as living in areas of heavy work-load.

University of London

Mr Denis F. Hawkins, reader in obstetric therapeutics in theInstitute of Obstetrics and Gynaecology at Hammersmith Hos-pital, has been appointed to the chair of obstetric therapeuticsat the Institute of Obstetrics and Gynaecology.He graduated in medicine from University College Hospital Medical

School, and studied pharmacology at University College London, andHarvard Medical School. After clinical posts at Hammersmith Hospi-tal and University College Hospital, he was appointed professor andchairman of obstetrics and gynxcology at Boston University School ofMedicine in 1965. In 1968 he became senior lecturer in the Instituteof Obstetrics and Gynaecology.

Royal College of Nursing Rejects TUC AffiliationMembers of the College have defeated by 3742 votes to 2849

a motion that it should seek affiliation to the Trades Union

Congress. A resolution to submit the motion to the annualgeneral meeting had been passed in April this year by theRCN’s Representative Body.1. Working Party on Under-doctored Areas (chairman, Mr R. Cattran): draft

report. Department of Health and Social Security, Nov. 15, 1979.2. Bloch S, Reddaway P. Russia’s Political Hospitals: the abuse of psychiatry

in the Soviet Union. London: Gollancz, 1977. See Birley J. L. T. Theclosed society and its enemies. Lancet 1977; ii: 184-86.

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Welsh National School of Medicine

Prof. Reginald Hall has been appointed to the School’schair of medicine.Professor Hall graduated from the University of Durham in 1956.

International Diary

Course entitled 4th Annual Review and Updating of the Immuno-logy and Practice of Allergy: San Diego Hotel, San Diego, Califor-nia, March 24-26, 1980 (Edith Bookstein, Office of Continuing Edu-cation, M-017, UCSD School of Medicine, La Jolla, California

92093).

Biological Council Symposium on Drug Receptors and theirEffectors: Middlesex Hospital Medical School, Cleveland Street, Lon-don Wl, March 31-April 1, 1980 (Mrs J. Kruger, c/o Department ofPharmacology, University College London, WC1E 6BT).

International Symposium on the Influence of Nutrition upon Navaland Maritime History: National Maritime Museum, Greenwich, Lon-don, April 17-18, 1980 (Conference Officer, National MaritimeMuseum, Greenwich, London SE 10 9NF).

14th World Congress on Rehabilitation: Winnipeg, Canada, June23-27, 1980 (International Department, Royal Association for Dis-ability and Rehabilitation, 25 Mortimer Street, London WIN 8AB).

International symposium on GABA and Glutamate as Transmit-ters: Cagliari, Italy, May 19-24, 1980. (Dr G. Di Chiara, Instituteof Pharmacology, Via Porcell 4, 09100 Cagliari).

7th international symposium on Drugs Affecting Lipid Metabo-lism: Milan, May 28-31, 1980. (Fondazione Giovanni Lorenzini, ViaMonte Napoleone 23, 20121 Milan).

lst international multidisciplinary conference on Traditional andAlternative Medicine: Amsterdam, July 7-12, 1980. (MedicinaAlternativa, P.O. Box 27131,1002 AG Amsterdam).

22nd British Congress of Obstetrics and Gynaecology: Edin-burgh, July 8-11, 1980. (Congress Office, Royal College of Obstetri-cians and Gynaecologists, 27 Sussex Place, Regent’s Park, LondonNW1 4RG).

Satellite symposium (in association with the World Conference onClinical Pharmacology and Therapeutics) on Therapeutic DrugMonitoring: University of Surrey, Guildford, England, Aug. 1-2,1980. (Prof. Vincent Marks, Dep. of Biochemistry, University of Sur-rey, Guildford, Surrey GU2 5XH).

Diary of the Week

Nov. 18 To 24

Sunday, 18thINSTITUTE OF LARYNGOLOGY AND OTOLOGY, Royal National Throat, Nose and

Ear Hospital, 300/332 Gray’s Inn Road, London WC1X 8EE10.15 A.M. Mr N. Shah: Problems of Deafness in Childhood.

Monday, 19thROYAL COLLEGE OF SURGEONS OF ENGLAND, Lincoln’s Inn Fields, London WC2A

3PN el4.30 P.M. Dr E. Katchburian: Cells and Biomineralization. (Arnott demon-

stration.)INSTITUTE OF DERMATOLOGY, St. John’s Hospital for Diseases of the Skin, Lisle

Street, Leicester Square, London WC2H 7BJ4.30 P.M. Prof. M. W. Greaves: The Pharmacology of Normal Skin.

Tuesday, 20thINSTITUTE OF DERMATOLOGY, .

4.30 P.M. Dr R. Dawber: Hair Physiology.INSTITUTE OF NEUROLOGY, The National Hospital, Queen Square, London

WC1N 3BG5.30 P.M. Prof. Dr J. Droogleever Fortuyn (Groningen): Posture, Ventilation

and Well-being.

Wednesday, 21stINSTITUTE OF NEUROLOGY,

6 P.M. Dr E. J. Thompson: A Defect in Duchenne Myogenesis.7 P.M. Dr M. Baraitser: Carrier Detection in Duchenne Muscular Dystrophy.

INSTITUTE OF ORTHOPEDICS, Royal National Orthopoedic Hospital, 234 GreatPortland Street, London Wl 1

6 P.M. Mr A. J. Partridge: Cerclage.7 P.M. Mr J. A. Fox: Traumatic Vascular Surgery.

INSTITUTE OF PSYCHIATRY, de Crespigny Park, Denmark Hill, London SE55.30 P.M. Dr S. Crown: The Dangers of Psychotherapy.

ROYAL FREE HOSPITAL SCHOOL OF MEDICINE, Pond Street, London NW3 2QG5 P.M. Dr 0. James: Pharmacokinetics and the Liver.

CLINICAL RESEARCH CENTRE, Northwick Park Hospital, Watford Road, Harrow,Middlesex HA13UJ

1 P.M. Dr M. Piper: Geriatric Case Presentation.JOHN RADCLIFFE HOSPITAL, Headington, Oxford OX3 9DU

5 P.M. Prof. K. D. Bagshawe: What Can We Do With Tumour Markers?THE MEDICO-CHIRURGICAL SOCIETY OF EDINBURGH,

8 P.M. (Royal College of Physicians, 9 Queen Street, Edinburgh), Dr K. Little:Accident and Emergency.

ROYAL MEDICAL SOCIETY Students’ Centre, Bristo Street, Edinburgh EH8 9AL8.00 P.M. Mr P. Steptoe: The Establishment of Human Pregnancies by

Embryos Grown in Vitro.

Thursday, 22ndROYAL COLLEGE OF SURGEONS OF ENGLAND,

4.30 P.M. Prof. H. N. Whitfield: The Diagnosis of Pelvi-uretenc JunctionObstruction. (Huntenan Lecture.)

ST. MARY’S MEDICAL SCHOOL, Norfolk Place, London W2 1PG5.15 P.M. Prof. P. Mollison: Rh-Haonolytic Disaese-A Disappearing Prob-

lem.MANCHESTER MEDICAL SOCIETY,

4.30 P.M. (Stopford Building, Medical School), Dr D. A. Robinson: The Re-gion’s Germs-1979.

Friday, 23rdROYAL COLLEGE OF RADIOLOGISTS,

4.30 P.t. (66 Portland Place, London WIN 4AD), Dr R. 0. Murray: Reflec-tions on the Diagnosis and Treatment of Bone Tumours. (44thSkinner Lecture.)

UNIVERSITY OF LIVERPOOL,’5 P.M. (Royal Liverpool Hospital, Daulby Street, Liverpool L7 8XP), Mr

C. E. Ackroyd: Indications and Techniques for Internal Fixation.

Saturday, 24thUNIVERSITY OF LIVERPOOL,

9 A.M. (Royal Liverpool Hospital, Daulby Street, Liverpool L7 8XP), MrC. E. Ackroyd: Safety Belts and R.T.A.’s.

NUFFIELD ORTHOPEDIC CENTRE, Oxford8.30 A.M. Dr G. Ardran: Dose Problems in Radiology.9.30 A.M. Dr B. Shepstone: Bone and Joint Scintigraphy.

Corrections

Long-term Continuous Subcutaneous Insulin Infusion in Diabetic:at Home.-Dr J. C. Pickup and his colleagues inform us that DJE. M. Kohner’s name was omitted from the list of authors of their article (Oct. 27,p.870).

Incidence and Significance of Antibodies to Delta Antigen in Hepa;titis B Virus Infection.-In this article by Dr Mario Rizzetto and col-leagues (Nov. 10, p. 986), the fourth sentence under reagents shoulcread "Reference antiserum to HBsAg/adw (guineapig) was obtained... and not "Reference antiserum to HBsAg/adw PI ..." This ha!been corrected in the North American edition.