plenty of new influenza cases, none was caused by the swine virus. On the other hand, that virus was isolated from a fifth soldier who had been sick in early February, and blood tests confirmed eight more old cases of swine flu, none of them fatal. Moreover, a sampling of antibody levels among recruits suggested that as many as 500 had been infected by swine flu. This implied human transmission on a scale that could not reasonably be viewed lightly. Around Fort Dix, however, in the civilian population—which was Goldfield’s territory for investigation—analysis of every case of flu reported, by a medical community on the alert, showed only Victoria. Elsewhere in New Jersey Goldfield’s inquiries turned up no swine flu. The Army’s inquiries turned up none at camps other than Fort Dix. The NIAID network of university researchers and the state epidemiologists in touch with CDC reported none untraceable to pigs. The World Health Organization, pressed by CDC, could learn of none abroad. One death, thirteen sick men and up to 500 recruits who evidently had caught and resisted the disease, all in one Army camp, were the only established instances of human-to-human swine flu found around the world as February turned into March, the last month of flu season in the Northern Hemisphere.


On March 10 the group that had met February 14 reassembled at CDC and under Sencer’s chairmanship reviewed their findings with the Advisory Committee on Immunization Practices (ACIP). That committee was in form a set of outside experts appointed by the Surgeon General, independently advising CDC; in fact it was almost a part of CDC, nominated, chaired and staffed at Sencer’s discretion. BoB deadlines now forced his pace. One ACIP function was to make vaccine recommendations for the next flu season available to manufacturers. The annual questions were: vaccine against what viruses, aimed at which population groups? For 1976 these questions had already been reviewed in a January ACIP meeting. The committee had recommended Victoria vaccine for the "high-risk groups" as then defined, some 40 million people over 65 in age or with certain chronic diseases. By March 10, the four active manufacturers had produced in bulk form about 20 million doses of Victoria vaccine for the civilian market. If Fort Dix meant a change or addition, now was the time to decide. Indeed for a regulatory body like the BoB, responsible for setting standards and for quality control, March was already late. Vaccine is grown in eggs; a vaccine against swine flu would require new supplies replacing those just used for Victoria vaccine. Then immunization trials would be needed if there were a new vaccine, also extensive testing. And what about the vaccine now in bulk? Whatever surveillance had turned up by now would have to suffice for some sort of decision.



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