In March 1961, Dr. Anthony Epstein, a pathologist at the Middlesex Hospital in London, almost missed a visiting doctor’s afternoon lecture for children with extremely large facial tumors in Uganda.
The doctor, Dr. Denis Burkitt, originally from Ireland, who called himself a bush surgeon, showed slides of bulbous tumors that appeared along the jaw line and appeared in tropical areas of Africa where rainfall was high. During his lecture, Dr. Burkitt mapped a veritable belt of pediatric cancer that stretched across equatorial Africa.
Despite Dr. Epstein’s initial reluctance to attend the talk—he sat in the back to make a quick escape—his enthusiasm grew the more Dr. Burkitt spoke. By the time the lecture was over, he knew he would be abandoning all of his ongoing projects to find the cause of the unusual malignancy. His PhD student, Yvonne Barr, soon joined him and, by 1964, their pioneering research had revealed the first virus capable of causing cancer in humans.
It shocked the scientific world with the announcement. Some doctors and scientists applauded the discovery. others refused to accept it.
Dr. Epstein died on February 6 at his home in London. He was 102. His death was confirmed by the University of Bristol, where Dr Epstein was professor of pathology from 1968 to 1985, and had also served as head of department for 15 years.
The pathogen that bore his and Dr. Barr’s name — the Epstein-Barr virus — belongs to the herpes family and is one of the most ubiquitous on the planet. An estimated 90 percent of the world’s adult population carries the virus, which is also known as EBV
“Having the foresight and being able to follow his case, with a bit of an admission, and identify the new virus was groundbreaking,” said Dr Darryl Hill, head of the School of Cellular and Molecular Medicine at the University of Bristol in England. in an email.
Studies since Dr. Epstein’s discovery have linked EBV, which is spread through close human contact, to several medical conditions, including multiple sclerosis and long-term Covid. As with other members of the herpes family, once you are infected with EBV, you are infected for life.
“Most people never know they’re infected,” Jeffrey Cohen, head of the Laboratory of Infectious Diseases at the National Institute of Allergy and Infectious Diseases, told The New York Times in 2022.
EBV is the cause of mononucleosis, the so-called kissing disease, which mainly affects teenagers and young adults with fever and swollen lymph nodes. EBV is also associated with Hodgkin’s lymphoma and a cancer of the nose and throat that is common in China.
The tumor affecting children in Africa, known as Burkitt’s lymphoma, has also been diagnosed in other tropical regions, including Brazil and New Guinea. Medical scientists believe that EBV causes childhood lymphomas in tropical areas because children in such areas often have weakened immunity from exposure to malaria parasites. The World Health Organization estimates that there are three to six cases of Burkitt’s lymphoma per 100,000 children per year in endemic areas.
When the 50th anniversary of the discovery of EBV was celebrated in 2014, Dr Epstein told a BBC interviewer what he was thinking as he listened to Dr Burkitt speak.
“I thought there must be some biological factor involved,” Dr. Epstein said. “I was working on cancer-causing chicken viruses. I had virus-causing tumors on the front of my head.’
The chicken virus he was referring to was the Rous sarcoma virus, which, when discovered in 1911 by Dr. Francis Peyton Rous, a pathologist at Rockefeller University in New York, was the first virus to cause cancer. Dr. Roos won the Nobel Prize in Physiology or Medicine in 1966. Although a Nobel prize eluded Drs. Epstein and Barr, their discovery had a lasting impact on science and medicine.
“We now know of several viruses and bacterial species that can cause certain types of cancer,” Dr. Hill said. “However, one could argue that the discovery of the Epstein-Barr virus paved the way for some cancers to be prevented by vaccination.”
Vaccines are available against the human papilloma virus, or HPV, which causes cervical and other cancers. The hepatitis B vaccine helps prevent liver cancer. But there is no vaccine against Epstein-Barr, although two vaccine candidates are in early-phase clinical research.
The discovery of EBV was not quick. Dr. Burkitt sent tumor biopsies to London from Kampala, Uganda, but Dr. Epstein could find no viruses in the first samples, according to Dr. Hill, who wrote a memoir of Dr. Epstein for the University of Bristol.
When another biopsy shipment was transferred from Heathrow Airport to another airport in Manchester, England, because of fog, the sample looked doomed, Dr. Hill said.
“By the time the sample reached Tony, it had turned cloudy – usually a sign of bacterial contamination which would send it to the bin. Tony did not throw it away but carefully examined it,” Dr. Hill wrote in his tribute.
“He discovered, to his surprise, that the turbidity was due to lymphoid tumor cells that had been shaken off the biopsy during transport and were now happily floating in suspension.” He continued, “Tony took advantage of this serendipitous finding to grow tumor-derived cell lines in culture. It showed that these remained alive indefinitely.”
By studying his new sample with a powerful electron microscope, Dr. Epstein was able to detect the distinct viral signature of a herpes virus. Dr. Hill called the discovery a eureka moment.
Drs. Epstein, Barr and Bert Achong, who prepared the samples for electron microscopy, announced the discovery in a scientific paper published in the March 1964 issue of the scientific journal The Lancet.
Dr Barr died aged 83 in 2016.
Michael Anthony Epstein was born on May 18, 1921 in London and studied at Trinity College, Cambridge University. He was a graduate of Middlesex Hospital Medical School, according to Wolfson College, University of Oxford.
After leaving the University of Bristol in 1985, Dr Epstein became a Fellow of Wolfson College and remained at the institution until his retirement in 2001. He was knighted by Queen Elizabeth II in 1991.
His marriage to Lizbeth Knight ended in divorce in the 1960s. Survivors include his longtime partner, Dr. Kathryn Ward, a virologist, two sons from his marriage, Michael and Simon Epstein, and a daughter, Susan Holmes.
He told the BBC in 2014 that one of his biggest wishes was to develop a vaccine against EBV. His wish may come true in the not-too-distant future if current research holds up.
