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NANCY ***: Arnold has done some studies that
are considered to be classics in the field of
influenza. They will remain
classics for decades to come.
DAVE JOHNSON: Prominent's not strong enough a word,
one of the truly seminal names in this important field of study.
ALLISON AIELLO: Arnold is the most well-respected and
I think renowned person in influenza today.
KEIJI FUKUDA: Arnold is the single greatest
influenza epidemiologist in our time.
SHARON KARDIA: He’s been responsible for saving
I don’t know how many hundreds of thousands or millions of
people's lives by doing just what he does.
NARRATOR: Each year, influenza kills between 250,000 and a half
million people.
Four major pandemics in the twentieth century claimed more than one hundred
million lives
the worst attack was the spanish flu in 1918.
In this century the most recent pandemic was the H1N1 swine flu in two
thousand nine.
Tracking the spread of flues projecting their next form and developing new
vaccines, falls to health organizations and experts around the world.
For 50 years, one of the most respected names at the heart of
influenza research
has been that of Doctor Arnold Monto,
of the University of Michigan's School of Public Health.
KARDIA: He really is one of the top world leaders in this arena.
It's not unusual for me to figure out what he's doing by reading the New
York Times, by reading the Washington Post, by listening to the BBC.
NARRATOR: Over the years, Montero has been a consultant to health ministries and
governments around the world,
advising them on policies for influenza
and other infectious diseases.
FUKUDA: And Arnold really has
an extremely
good ability to put things in perspective
so when you talk with Arnold, and you talk about the studies, what you really
do is get a sense the historical placement of the studies, a
contemporary importance of them
and then uh... some of the issues that come up.
JOHNSON: He's done that kind of research
that allows
for -- indeed promotes -- change.
He is
practicing public health with his research.
FUKUDA: One of the reasons why I think Arnold is so important
uh... is that he's not an academician. He works in an academic setting, but at
heart he's really a public health person. AIELLO: So he's always been thinking, I think, at
this global scale,
which is very helpful in terms of research and understanding
ways that we can prevent transmission of flu. KARDIA: His grace and style in articulating
what are the key
issues and what are the key findings for a world audience has been his biggest
signature.
Arnold is a wonder. He's got, basically,
the stamina and the energy of a 30- year-old, he is always flying to an international
conference meeting
and then buzzing right back to teach, to
give talks, to be interviewed, to then go work with the
CDC.
JOHNSON: Arnold has changed the face of a disease
and how we approach it . . .
particularly how we prevent
it.
MONTO: I grew up in Brooklyn,
New York, and
I went to Cornell undergraduate where I was a major in zoology
and did some studies in hibernating bats
to see what they
did
and what happened after they came out of hibernation.
And then I
went to medical school. I got so enamored with doing these kinds of studies, that I was
thinking, well maybe I'll get a Ph.D. in zoology.
And
my mother said, "Get your M.D. You can do whatever you want to do
after you get the M.D. degree."
and what I really wanted to do, and this was in the era of was called
at that time as the golden age of virology.
The golden age of virology was the explosion of identification of viruses
that were associated with various commen and not-so-common illnesses
because of the availability of cell culturing techniques.
So one of the
exciting areas to me was the respiratory viruses. I was actually a fellow
at Stanford in California. I was recruited to go to the Middle America Research Unit
which had the
double advantage of being in an interesting place, namely Panama,
and that's where I started doing community studies because we started
trying to figure out,
are these new respiratory virususes? Are they just in the temporate zone
or are they global?
It became natural
for me to come to Ann Arbor.
And I arrived in Ann Arbor,
was given
a laboratory,
which was also an office because Dr. Francis didn't believe
in having separate offices.
And I had
a bottle of distilled water
in the laboratory and nothing else.
NARRATOR: By the early
nineteen sixties,
Dr. Tommy Francis was already a giant in the world of public health.
He had been the first to identify influenza viruses and then invent a flu
vaccine.
He had run the successful field test on Jonas Salk's polio vaccine,
and designed a novel study on chronic diseases,
using the population of Tecumseh, Michigan.
The study concluded that heart disease, cancer and other illnesses can be
prevented.
Monto would use Tecumseh
to prove another concept
known as Herd Immunity.
CHRIS VICTOR: The Tecumseh study was a great setting in 1968 for
the type of study that Arnold wanted to do, which was to look at what
happens if we vaccinate uh... on mass children in a community? What kind of a broader
impact on the community do we have by doing that? KARDIA: This was a concept that,
I think, many people may have known in their guts but had never really demonstrated,
which was, if you get vaccine to a large enough people, it doesn't have to be
everybody, you basically stop the infectious, sort of, traction of spread.
And so this whole concept of Herd Immunity
really then did push for people to do vaccinations as a routine.
VICTOR: We're implementing a very similar study
to the Tecumseh study that Arnold did back in 1968. And we're implementing
it in Senegal in Africa to look at the potential impacts in a tropical
population where children don't respond as well to vaccines because of
malnutrition and other issues. MONTO: And the tremendous advantages that was given to me by Dr.
Francis was he was well linked into
the National Institutes of Health,
the vaccine development community. And
he
gave me the opportunity to develop some of my ideas
then put them into effect in Tecumseh where we could study
what was going on in the community.
Tommy Francis died in 1969, the year that the Hong Kong flu
was tailing off.
The golden years of virology were passing, and the
technology in epidemiology was moving to new horizons.
Arnold Monto moved with the changes to the forefront,
from inactivated
to live-attenuated vaccines, antivirals, respiratory viruses, corona viruses, and
eventually
rotoviruses.
NANCY ***: Antivirals played a very important role in case management, in severe illness, and
in prevention,
and antiviruls weren't even on the horizon in the early days of Arnold's career. But
he clearly recognized the importance of antiviruls against influenza
in prevention and control.
JOHNSON: One of the things that he got involved in was this major study of the
effectiveness of influenza vaccine
in the elderly population.
I think his participation on that study, his leadership in that study,
helped to convince
the Medicare policy makers
to change and to make influenza vaccine a covered benefit. To me, that was
one way in which his work
had a profound effect uh... on our policies.
AIELLO: I had been contacted by Arnold
while I was off at a conference, and he put forth this
pretty -- what I thought was a pretty amazing proposal to do some collaborative
work looking act prevention measures to stop the transmission of
influenza
in dorms
here at the University of Michigan's
campus.
And so
the proposal
consisted of research looking at masks
and hand hygiene. That was really a large undertaking, and we were able
to recruit thousands of students to participate in this.
JIM KOOPMAN: The nature of science nowadays
is continually changing, and I think
for all of us, there are changes that are going to take place that are going to leave
a lot of us behind.
So it's hard to see exactly
what the legacy will be.
But maybe in a sense . . . the number of people that he's influences . . .
and changing the nature of that work,
there's a thread that carries on.
KARDIA: Tommy
Francis brought Arnold here as a young physician-scientist. His self-deprecating
style has, I think, gotten him in more doors
rather than kicked out of more doors uh... than
Tommy Francis would uh... have been in.
JOHNSON: For those of us who've had the privilege to know
Arnold a little bit more closely, we realized that that he's provided
great leadership. FUKUDA: I think it's that complete package, it's that context, it's that
historical
evolution
as well as being able to address the question very directly. I think that
uh... that's the kind of package that few others can bring. KARDIA: I think Arnold Monto's legacy is . . .
going to live on in the students that he trained. We already see that.
They have very much of the same
worldly view of the mission of improving
the whole world's health.
The Tommy Francis Professorship
is actually
one of the
longest-standing professorships in the department.
It's a --
only a small testimony
to Arnold's lifetime achievement but it really does represent what his contributions are, and I'm hoping
that he stays with this professorship
in its
spirit and legacy as long as we we can keep him here to actually bring
the next wave of Tommy Francises into the profession.
End (In 2010, Dr. Arnold S. Monto was named the Thomas Francis Jr. Collegiate Professor of Public Health.)