Thomas Henry Flewett
Encyclopedia
Dr Thomas Henry Flewett, MD
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...

, FRCPath
Royal College of Pathologists
The Royal College of Pathologists, founded in 1962, was established to co-ordinate this development and maintain the internationally renowned standards and reputation of British pathology. Today the College advises on a vast range of issues relating to pathology...

, FRCP
Royal College of Physicians
The Royal College of Physicians of London was founded in 1518 as the College of Physicians by royal charter of King Henry VIII in 1518 - the first medical institution in England to receive a royal charter...

 (29 June 1922 – 12 December 2006) was a founder member (and subsequently Fellow) of the Royal College of Pathologists
Royal College of Pathologists
The Royal College of Pathologists, founded in 1962, was established to co-ordinate this development and maintain the internationally renowned standards and reputation of British pathology. Today the College advises on a vast range of issues relating to pathology...

 and was elected (by distinction) a Fellow of the Royal College of Physicians of London
Royal College of Physicians
The Royal College of Physicians of London was founded in 1518 as the College of Physicians by royal charter of King Henry VIII in 1518 - the first medical institution in England to receive a royal charter...

 in 1978. He was chairman of the World Health Organisation (WHO) Steering Committee on Viral Diarrhoeal Diseases, 1990-3, and a member until 1996. His laboratory in Birmingham was a World Health Organisation Reference and Research Centre for Rotavirus Infections from 1980 until his retirement in 1987. He was an external examiner, visiting lecturer, and scientific journal editor. He was a member of the board of the Public Health Laboratory Service (now The Health Protection Agency
Health Protection Agency
The Health Protection Agency, or, in Welsh, Yr Asiantaeth Diogelu Iechyd is a statutory corporation. It is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards...

) from 1977 to 1983 and was Chairman of the Public Health Laboratory Service, Committee on Electron Microscopy from 1977 to 1987.

Flewett received his medical education at Queen's University, Belfast, where he graduated with honours at the end of the World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

 in 1945.

Childhood

Flewett was born in India, where his father, a graduate of Oxford University was a member of the Indian Forestry Service, that, in 1966, became the Indian Forest Service
Indian Forest Service
The Indian Forest Service is the Forestry service of India. It is one of the three All India Services of the Indian government, along with the Indian Administrative Service and Indian Police Service; its employees are recruited by the national government but serve under the state governments or...

 of the Indian Civil Service. His mother wrote in a birthday card to him "I was so pleased when the servants told me that I had given birth to a boy". He once described to Professor Margaret Thouless (virologist and wife of the physicist David Thouless
David Thouless
David James Thouless is a condensed matter physicist and Wolf Prize winner.Thouless earned his PhD at Cornell University under Hans Bethe. He was a professor of mathematical physics at Birmingham University in the United Kingdom before becoming a professor of physics at the University of...

) "a joyous childhood", often spent "riding on the backs of elephants". He was educated at Campbell College
Campbell College
Campbell College is a Voluntary Grammar school in Belfast, Northern Ireland. The College educates boys from ages 11–18. It is one of the eight Northern Irish schools represented on the Headmasters' and Headmistresses' Conference and is a member of the Independent Schools Council.The school occupies...

, Belfast.

Early years 1948–1956

Flewett's scientific interest in viruses began with his membership of the scientific staff of the National Institute for Medical Research
National Institute for Medical Research
The National Institute for Medical Research, commonly abbreviated to NIMR, is a medical research facility situated in Mill Hill, on the outskirts of London, England. It is mainly funded by the Medical Research Council, or MRC, and is its largest establishment and the only one designated as an...

 at Mill Hill, where he spent three years between 1948 and 1951 researching common cold viruses and exploring the effect of influenza viruses on cells in culture. This led to his first use of electron microscopy, in which he became a leading authority. In 1951 he moved as lecturer in bacteriology to Leeds University, where he was involved in the 1953 smallpox outbreak. This experience proved invaluable twenty-five years later when a laboratory-associated case of smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 at the Medical School of the University of Birmingham
University of Birmingham
The University of Birmingham is a British Redbrick university located in the city of Birmingham, England. It received its royal charter in 1900 as a successor to Birmingham Medical School and Mason Science College . Birmingham was the first Redbrick university to gain a charter and thus...

, UK, led to the death of Janet Parker
Janet Parker
Janet Parker was the last known person to die from smallpox. She was a medical photographer and worked in the Anatomy Department of the University of Birmingham Medical School. Parker died after being accidentally exposed to a strain of smallpox virus that was grown in a research laboratory, on...

.

Regional Virus Laboratory, Birmingham, England 1956–1987

In 1956 Flewett was appointed consultant virologist to East Birmingham Hospital, where he established one of the first virus laboratories in England. His laboratory was close to an infectious diseases unit and this enabled him to provide confirmation of the clinical diagnosis of diseases that included poliomyelitis
Poliomyelitis
Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route...

, diarrhoea, smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 and AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

. He was a member of the senior management team of East Birmingham (now Heartlands) Hospital and helped to establish the regional immunology laboratory there.

Flewett's interests included influenza
Influenza
Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...

, coxsackie A and coxsackie B
Coxsackie B
Coxsackie B is the name of a group of six serotypes of pathogenic enteroviruses that trigger illness ranging from mild gastrointestinal distress to full-fledged pericarditis and myocarditis.-Geographic distribution:...

 viruses, the major and minor variants of smallpox virus, and hepatitis B virus
Hepatitis B virus
Hepatitis B is an infectious illness caused by hepatitis B virus which infects the liver of hominoidea, including humans, and causes an inflammation called hepatitis. Originally known as "serum hepatitis", the disease has caused epidemics in parts of Asia and Africa, and it is endemic in China...

. Although he discovered the cause of hand, foot and mouth disease
Hand, foot and mouth disease
Hand, foot and mouth disease is a human syndrome caused by intestinal viruses of the Picornaviridae family. The most common strains causing HFMD are Coxsackie A virus and Enterovirus 71 ....

, the work that gained him an international reputation began in the early 1970s with the discovery of viruses causing diarrhoea, particularly in infants and young children. Flewett named one of the then most frequent causes of death in infants in tropical countries, rotavirus
Rotavirus
Rotavirus is the most common cause of severe diarrhoea among infants and young children, and is one of several viruses that cause infections often called stomach flu, despite having no relation to influenza. It is a genus of double-stranded RNA virus in the family Reoviridae. By the age of five,...

es.

Norwalk virus had been discovered by Albert Kapikian
Albert Kapikian
Dr. Albert Kapikian is an Armenian-American virologist who developed the first licensed vaccine against rotavirus, the most common cause of severe diarrhea in infants. He was awarded the Sabin Gold Medal for his pioneering work on the vaccine.He is the 13th recipient of this recognition,awarded...

 using immune electron microscopy and Ruth Bishop and colleagues had seen different particles that they thought were viruses in gut biopsies by thin section electron microscopy. But the preparation of thin sections was too cumbersome for routine use, and Flewett and his co-workers showed that these viruses could be seen by electron microscopy directly in faeces. Flewett and his colleagues in his Birmingham laboratory had observed these viruses in the faeces of sick children before the publication of Ruth Bishop's paper but they failed to realise that they were the cause of the infection. The virus particles have a wheel-shaped appearance by electron microscopy, and it was Flewett who gave them the name "rotavirus," by which they have been known since. Flewett wrote: ‘At the South Wiltshire Virology Society I met Gerald Woode, then at Compton, in late 1973. He described a virus causing diarrhoea in calves. I realized we had much the same in children. We found his virus and ours were related – something new. We called them rotaviruses'

His original idea was to suggest the name “urbivirus” because of the structural similarity of rotavirus to orbivirus
Orbivirus
The genus Orbivirus is a member of the Reoviridae family. This genus currently contains 22 species and at least 130 different serotypes. Orbiviruses can infect and replicate within a wide range of arthropod and vertebrate hosts...

. Ruth Bishop, who was the first to describe rotaviruses as a cause of gastroenteritis had suggested “duovirus” because these viruses replicate in the duodenum and, at the time, were thought to have a double protein outer coat. The early research papers from the 1970s use both names.

Flewett did much collaborative work on rotaviruses with others to establish the varieties of rotavirus which infect the young of virtually every species of animal. His research group were the first to describe the different serotype
Serotype
Serotype or serovar refers to distinct variations within a subspecies of bacteria or viruses. These microorganisms, viruses, or cells are classified together based on their cell surface antigens...

s of rotavirus. This work was important to the development of a rotavirus vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...

. He also identified two new species of adenoviruses (later called types 40 and 41), as well as confirming the presence of caliciviruses, astrovirus
Astrovirus
Astrovirus is a type of virus that was first discovered in 1975 using electron microscopes following an outbreak of diarrhoea in humans. In addition to humans, astroviruses have now been isolated from numerous mammalian animal species and from avian species such as ducks, chickens, and turkey...

es, and faecal coronavirus
Coronavirus
Coronaviruses are species in the genera of virus belonging to the subfamily Coronavirinae in the family Coronaviridae. Coronaviruses are enveloped viruses with a positive-sense single-stranded RNA genome and a helical symmetry. The genomic size of coronaviruses ranges from approximately 16 to 31...

es. He, along with H.G. Pereira also discovered picobirnavirus
Picobirnavirus
Picobirnavirus is a genus of dsRNA virus, which infect certain mammals. It may be implicated in gastroenteritis in animals and humans.The viruses have only been isolated from mammals to date.-Virology:...

es, and with other colleagues first described human Torovirus.

Birmingham smallpox tragedy

An account of the death from smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 of Janet Parker
Janet Parker
Janet Parker was the last known person to die from smallpox. She was a medical photographer and worked in the Anatomy Department of the University of Birmingham Medical School. Parker died after being accidentally exposed to a strain of smallpox virus that was grown in a research laboratory, on...

 in 1978 has been written. The diagnosis was made by Professor A. Geddes and the virus was identified by Flewett in his laboratory, at East Birmingham Hospital where she had been admitted. Before the diagnosis had been confirmed, a member of Flewett’s laboratory had collected lymph
Lymph
Lymph is considered a part of the interstitial fluid, the fluid which lies in the interstices of all body tissues. Interstitial fluid becomes lymph when it enters a lymph capillary...

 from Janet Parker’s vesicles and taken it across the grounds of the hospital for examination in the virus laboratory. Flewett recognised the danger of an outbreak occurring and immediately ordered his staff to fumigate the laboratory with formaldehyde
Formaldehyde
Formaldehyde is an organic compound with the formula CH2O. It is the simplest aldehyde, hence its systematic name methanal.Formaldehyde is a colorless gas with a characteristic pungent odor. It is an important precursor to many other chemical compounds, especially for polymers...

. The ward in which Janet Parker had been initially cared for was also fumigated. The building housing wards 33 and 34 were later demolished. Two members of Flewett’s team were subsequently quarantined but apart from Janet Parker’s mother, no further cases of smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 occurred. This tragedy led to the suicide of Professor Henry Bedson a friend and colleague of Flewett. Later, Flewett, with the contributions of other medical consultants established a trust fund for Bedson’s children.

WHO Reference and Research Laboratory 1980–1987

Flewett's work on rotaviruses brought him international recognition both as a virologist and an electron microscopist. He was one of the first western virologists to be invited to the Peoples' Republic of China (in 1983) to lecture. He was a judge for the King Faisal
King Faisal Foundation
The King Faisal Foundation was established in 1976 by the sons of King Faisal of Saudi Arabia. The Director-General is HRH Prince Khalid Al-Faisal...

 International Prize in 1983, which was awarded to Professor John S. Fordtran, Dr William B. Greenough III and Professor Michael Field, for their work on oral rehydration therapy
Oral rehydration therapy
Oral rehydration therapy is a simple treatment for dehydration associated with diarrhoea, particularly gastroenteritis or gastroenteropathy, such as that caused by cholera or rotavirus. ORT consists of a solution of salts and sugars which is taken by mouth...

 in reducing mortality and morbidity due to cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...

 and other acute infectious diarrhoeal diseases.
During these years he travelled widely as a World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

 consultant to most countries in which childhood diarrhoea is a major problem. He established The WHO Collaborating Centre for Reference and Research on Rotaviruses, (known as The WHO Lab), at his laboratory which was supported by The World Health Organisation from 1980 until his retirement in 1987. This laboratory was formerly a small tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

 bacteriology laboratory and the building was old and badly and in need of repair.
As well as continuing with basic research on the viruses that cause gastroenteritis, his laboratory produced reagents for the laboratory diagnosis of rotavirus infections based on monoclonal antibodies
Monoclonal antibodies
Monoclonal antibodies are monospecific antibodies that are the same because they are made by identical immune cells that are all clones of a unique parent cell....

 developed by his research team.
These reagents were sent regularly to numerous hospital laboratories throughout the developing world.
The WHO laboratory attracted many visiting scientists from many countries and his team of research scientists contributed to the development of a vaccine against rotavirus infections. His laboratory was active in the search for other, undiscovered causes of viral infections which Flewett called "the diagnostic gap", because many causes of gastroenteritis are still unknown.

Unfulfilled ambition—FRS

Shortly before his retirement Flewett wrote a private letter to Dr David Tyrell FRS, former director of the Common Cold Unit
Common Cold Unit
In Britain, the Common Cold Unit , also known as the Common Cold Research Unit , was set up by the civilian Medical Research Council in 1946 on the site of a former military hospital, the Harvard Hospital, at Harnham Down near Salisbury in Wiltshire...

, requesting support for admission to The Royal Society. Flewett had known David Tyrell for many years, (since his time at Mill Hill) and he hoped that the support of this prestigious Fellow would help him get elected. Tyrell replied saying that Flewett should make his own case for election which he, Tyrell, would read. Flewett was a modest man and only sent Tyrell a list of publications. Tyrell's response was not encouraging and Flewett—a man not used to failure—withdrew his request.

Hands on leader

There was little that was being done in his laboratory that he could not have done or had done himself. He was a hands-on leader of his laboratory. He could use and, in the case of the electron microscope, maintain, all the equipment. (He was a collector and restorer of antique clocks and kept one in his office along with an antique watch the hands of which were so radioactive, that he was forced to keep it in a lead-lined box). During the constant care and attention required by the Phillips electron microscope, which was made in 1960s and with which he first observed rotaviruses, he accidentally showered himself with concentrated nitric acid
Nitric acid
Nitric acid , also known as aqua fortis and spirit of nitre, is a highly corrosive and toxic strong acid.Colorless when pure, older samples tend to acquire a yellow cast due to the accumulation of oxides of nitrogen. If the solution contains more than 86% nitric acid, it is referred to as fuming...

 whilst cleaning the vacuum pump. He was later seen with a yellow streak on his face and hair and was heard complaining that he had "ruined a perfectly good necktie". In an earlier accident, a decade or so before, he breathed in fumes of osmium tetroxide, (used in electron microscopy) that left his sense of smell permanently impaired. Those colleagues who were ignorant of this were often amazed by Flewett’s tolerance of the bad odours associated with samples of faeces. Similarly, he was allergic to glutaraldehyde
Glutaraldehyde
Glutaraldehyde is an organic compound with the formula CH22. A pungent colorless oily liquid, glutaraldehyde is used to disinfect medical and dental equipment...

 and banned its use in any room which he often frequented.

Character

Flewett was small of stature (5' 5") and very short-sighted. Throughout his adult life he wore thick-rimmed glasses and when asked to examine something small, he shifted these down his nose and peered over the lenses. He spoke in a crisp incisive manner using concise and rather staccato phrases and had an habitual cough—but he delivered his lectures and scientific presentations entirely from memory never using notes. This gave his public speaking a relaxed informality which he reinforced with numerous anecdotes about his famous and not so famous contemporaries. He rarely incorporated much raw scientific data into his lectures because he felt the spoken word to be an inappropriate forum for scientific discourse and much preferred the peer-reviewed scientific paper. He spoke fluent French but his accent lacked the nasal vowels of the language. Politics did not seem to interest him much but he was a supporter of Margaret Thatcher
Margaret Thatcher
Margaret Hilda Thatcher, Baroness Thatcher, was Prime Minister of the United Kingdom from 1979 to 1990...

 and once, one the eve of the British General Election
General election
In a parliamentary political system, a general election is an election in which all or most members of a given political body are chosen. The term is usually used to refer to elections held for a nation's primary legislative body, as distinguished from by-elections and local elections.The term...

 of 1983 said that he would retire if "Mrs. Thatcher did not get back in." He spoke even less about the politics of his native Northern Ireland, but on the morning following the Brighton hotel bombing
Brighton hotel bombing
The Brighton hotel bombing happened on 12 October 1984 at the Grand Hotel in Brighton, England. The bomb was planted by Provisional Irish Republican Army member Patrick Magee, with the intention of assassinating Prime Minister Margaret Thatcher and her cabinet who were staying at the hotel for the...

 of 1984 advocated the return of hanging
Capital punishment
Capital punishment, the death penalty, or execution is the sentence of death upon a person by the state as a punishment for an offence. Crimes that can result in a death penalty are known as capital crimes or capital offences. The term capital originates from the Latin capitalis, literally...

. He was, however, enraged by the portraits of Bonaparte
Bonaparte
The House of Bonaparte is an imperial and royal European dynasty founded by Napoleon I of France in 1804, a French military leader who rose to notability out of the French Revolution and transformed the French Republic into the First French Empire within five years of his coup d'état...

 in the Louvre
Louvre
The Musée du Louvre – in English, the Louvre Museum or simply the Louvre – is one of the world's largest museums, the most visited art museum in the world and a historic monument. A central landmark of Paris, it is located on the Right Bank of the Seine in the 1st arrondissement...

 proclaiming that "that man has so much blood on his hands".

He was difficult to work with—often rude, insensitive, distant and socially awkward. But, he ordered the removal of a book about Japanese war atrocities from the WHO laboratory library when a visiting scientist from Japan joined his team. His reasons being that "all this happened before he, (the visitor), was born". He enjoyed watching The Six Million Dollar Man and Doctor Who
Doctor Who
Doctor Who is a British science fiction television programme produced by the BBC. The programme depicts the adventures of a time-travelling humanoid alien known as the Doctor who explores the universe in a sentient time machine called the TARDIS that flies through time and space, whose exterior...

. He often read science fiction. He played golf
Golf
Golf is a precision club and ball sport, in which competing players use many types of clubs to hit balls into a series of holes on a golf course using the fewest number of strokes....

 for most of his adult life and won many trophies. For many years he drove an old Rover
Rover
-Leyland companies:* Rover Company , a British motorcycle and car manufacturing company, absorbed into Leyland Motor Corporation in 1967* Austin Rover Group , a mass-market car manufacturing subsidiary of Leyland...

 P car that rivalled the comfort luxury car manufacturers such as Rolls Royce
Rolls-Royce (car)
This a list of Rolls-Royce motor cars and includes vehicles produced by:*Rolls-Royce Limited *Rolls-Royce Motors , which was owned by Vickers between 1980 and 1998, and after that by Volkswagen...

 produced. He sold it in the early 1980s because " it drank too much petrol". Flewett suffered a severe stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...

in November 2006 and he died one month later. His body was cremated at Robin Hood Crematorium in Birmingham, England.

Legacy

Flewett was educated at a time when very little was known about viruses and viral illness and when there were no laboratory tests to aid or confirm a diagnosis. Flewett was a pioneer—today diagnostic virology laboratories, like the one he established in 1956, can be found throughout the world. It is impossible to estimate how many lives he helped to save. During his lifetime, Thomas Henry Flewett published over 120 scientific and medical articles and papers. He was a scientist, a doctor, a father and a grandfather. He left an estate valued at £815,846, mostly to his daughters and grandchildren.
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