Tdcj Board Meeting Minutes Medical Experiments 1977
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t ~.~ I I I ~ - _...., TEXAS DEPARTMENT OF CORRECTIONS Huntsville, Texas m I I I I AGENDA FOR REGULAR MEETING ) ~ OF THE TEXAS BOARD OF CORRECTIONS I I ~ .) J J., ~ McAllen, Texas 1U748 I~ I I I I I I I I, 'II :TEXAS BOARD OF ,CORRECTIONS ' , , May 16, 1977 ORDER OF' B~S r'N°ESS Call to Order Invocation Approval of Minutes I. INMATE AFFAIRS - Mr. Windham A. Activity Summary 1. 2. 3. 4. 5. Educational Programs Agency ,Reports Chaplaincy Program MedicaL Reports Release Programs B. 'Deaths ) C. ~ Statistical Reports 1. 2. 3. I I J ) '! 0.. Escapes E. Interviews with Inmates F. MUlti-Purp~se Buiiding at Retrieve G. Expenditure from E & R Funds for Folding Chairs at: Coffield H. Medical Research and Experimentation and Pharmaceutical Te~ting·protocols from Baylor College of Medicine I 1. .j Disciplinary Inmate Strength Received-Released ..' Comparison of Resistance to Wildtype Influenza A/Victoria Virus Following Vaccination with a LiveAttenuated Vaccine Candidate 1(;749 J .~ j WM .,CI3'::::::, . . .6. ... n ( !6#WJiM. h . .MR . .h \.~.3 '"r.: I .. : o.. :;.:;.:;:.d..;;,w.o,~w.wd.t. ';,.Jlh· ~ .0 • f [ 2. I. IL r Development of Rhinovirus Type 3 Chal1~ng~System for Normal Volunteers [' Amendment to Inmate Rules and Regulations PERSONNEL - Mr. Boyd rr B'. C. Training Academy r BUSINESS AND BUDGET - Mr. Montemayor A. Selected Budget Records B.' Industrial Budget Report IV. v;. c. Food Service D. Inmate Cost Per Day Report E. Livestock Report ~EGISLATION VII. iG750 m Re~ort ( CONSTRUCTION - Mr. Shield Progress Report B. Authorization for Construction Renovation INDUSTRIES - Mr~ Austin Progress Report VIII. r . Mr. McLaughlin A. LEGAL - Mr. MtLaughlin A. Tanya Tucker B. Phillips Petroleum Company ~, r Rcpo~ts AGRICULTURE - Mr. LaMantia Agricultural VI.. [ Out-of-State Travel '. Promotion Board A. III. (Cold-Adapted Recombinant) and That Following Natural Infection ~nd/or ~ p I~ " ." I I I I I I TEXAS DEPARTMENT OF CORRECTIONS w. J. E~tdle, Jr. Director Huntsville, Texas 77340 A. P. MANNING ASSISTANT DlI\I;CTOR III CHAttC& OF TRl::A.T.ld.ENT Apr i.l 25, 1977 TEXAS BOARD OF lJiREC'l'lONS Ja~es M. Windham Texas Board of Corrections P. ,0. Box 1272 Livingston, Texas 77351 -Mr. H. H. Co!tield ti,,,,.a - JI&4&I•. Tuao Dear Mr. Windha.m: r, Louis Austin, Jr, ."'tall' ~Iu. Tex.u Board approval is requested for the following i ~eIll.s : ter Boyd E ~I' aa, Tezu t Enclosed is the Activity Summary for Inmate Affairs for the months of February and March, 1977~ Would you please present this report at the next Board of Corrections meeting? • rk McLaughlin ~, A.clio. Tuu ~beTt J. ~b'" BacoD, H. D. Funds rema1nlng from the Retrieve MUlti-Purpose Building to be diverted as follows: $17,500 Enlarge visiting room area at Retrieve Unit $5,000 Wynne Unit Band BUilding (additional $14,'000 required is donated funds) .\Utoa, Tau l~d W. Shield [ber "' Ant.GDlo. 'JIu u • j ~ben Montemayor ,..,.h.p , Aatonla, Tau Expenditure of $6,000 out of E & R Funds to be used for folding chairs on the Coffield Unit. ~ i } V. T.IIMantia, ,t.,.w (0 .QM Jr. Will .1\%... i....Q.h....c...;,c.. .'i ... ,,'*. . .":' ., ;:;:; ;. . . ,H" .F.. ., . ya;;y@.(i:;,-".c...... ,Qi.Q.. t :m ..... l3.... d ..44t (W@6YS!i!4%6!,.i . ao . ...... li-If. .' / Mr. James M. Windham Boa'rd Agenda April 25, 1977 Page 2 • m r Medical Research and Experimentatlo~'~hd Pharmaceutical Testing Protocols from Baylor College of Medicine: 1. 2. Comparison of Resistance to Wild-Type Influenza A/Victoria Virus Following Vaccination with a Live-Attenuated Vaccine Candidate (Cold-Adapted Recombinant) and That Following Natural Infection. Development of Rhinovirus Type 3 Challenge System for Normal Volunteers. Very truly yours, , p.Man~ (7Y~ A. mwk Enclosures .[ R ~ ~ ~ Q ~ ~ ~ m t: I' I., 1{)754 [11 ~ / I I I I I I I I I -I I J J J J " M J 1 .! ;> . ~ j Activity Summary for Inmate Affairs April 25, 1977 Page 8 State Commission for the Blind Inmates Receiving Services Monies Expended Local Funds (Non-client Services) 366 $583.30 $595.40 Social Security Administration Inmates Receiving Services 109 Texas Veterans Affairs Commission Inmates ReceiVing Services 141 CHAPLAINCY Number of Church Services Inmate Attendance-Church Services Counseling Interviews . Death Messages Delivered Inmate Letters Written 653 "43,020 11,224 230 1,402 MEDICAL REPORTS General Hospital Report Patients Admitted Patients Discharged Out-Patients Treated Current Census 409 404 2,067 102 Unit Hospital Report (All Units) Medication Line Sick Call with Physician Sick Call with Medical Assistant Routin~ Transfers for Medical Attention Emergency Transfers for Medical Attention Emergency Transfers to Civilian Hospital ~ew Tnmates Processed 413,560 4,776 80,968 1,547 138 6Q 2 • 03~ , . .[ [ Activity Summary for Inmate Affairs April 25, 1977 Page 9 r t Treatment Center ~ Treatment in First Aid Sick Call with Medical Assistant Sick Call with physician Interviews with Psychiatrist Current Census : 0 r 59 3 281 293 I Operating Room Census General Surgery Local Surgery Oral Surgery Ophthalmolic Surgery ENT Clinic Plastic Procedures Podiatry Clinic Anesthetics Procedures - John Sealy Hospital Blood Transfusions Procedures - Huntsville Unit Hospital '/ 0 21 30 32 0 49 0 141 Laboratory Reports Hemotology Blood Chemistry Bacteriology Parasitology 'Urinalysis Serology Blood Bank Cerebrospinal Fluids Total Laboratory Reports (All Units) 2,430 3,604 426 12 2,602 810 8 0 9,892 Roentgenologist Reports General Head Extremities Electrocardiograms Electroencephalographs Total Reports ~ 30 43 [ r t ·r 'f"~' I~~ •.1 L ~ l'~ r L 1,154 199 518 166 22 6,803 1 I I' I .. f I I ~ I I I m Activity Summary for Inmate Affairs April 2~, 1977 Page 10 Special Clinics Report Ophthalmology Out-Patients Optometrist-Refractions Completed Total Reports \ 607 2,699 Oral Surgery Reports Total 136 Dental Procedures (All Uni ts) Total 10,964 Medical Reprieves Total I , 2,092 98 RELEASE PROGRAMS Pre-Release Programs' Inmates Completing Programs General Sessions Group Counseling Sessions Individual Counseling Sessions Outside Activities Speakers Participating Present Enrollment 345 136 8 SO 10 126 161 Work Release Programs (See Exhibit A) Inmates Employed Inmates Removed Inmates Currently Employed 38 8 30 Post-Release Program Inmates Enrolled Job Resources Developed ~nrolled Inmat~s Released Positive Termin3tions 1)2 17~ \. Comparison 'of· Resistance to Wild-Tipe Influenza A/Victo~ia Virus Following Vaccination with alive-Attenuated VaCClne Candidate (Cold-Adapted Recornbinant) and That Following Natural Infection 1. Title: 2. Principal Investigator and Associates: 3. Department Involved: 4. Granting Agency: 5. Period of Grant: June 26, 1974 - June 25, 1979 6. Location of Study:·· Baylor College of Medicine Ramsey Unit of the Texas Department of 7. ,. Thomas R. Cate, M. O. Robert B. Couch, M. O. Julius A. Kasel, Ph. o. Howard R. Six~ Ph. O. W. Paul Glezen, M. D. Vernon Knight, M. D. Hicrobiology and Immunology NIH Contract AI 42528 Correclion~ Outline of Study: Background Information. Parenteral vaccination ''lith currently available inactivated influenza A virus vaccines provides 50-90% protection against infection with homologous virus (1). Estimates of the duration of protection against closely related influenza viruses have ranged from 3 years to more than 15 but less than 27 months (2). An additional problem is frequent antigenic variation of influenza A viruses necessitating yearly review and frequent updating of the vaccines. As a consequence, annual revaccination is recommended i~ order to obtain the greatest possible protection with inactivated influenza vaccines. . Occasionally troublesome but rarely serious reactions to inactivated influenza vaccines, such as headache, malaise and fever, have been reduced to an apparent minimum consistent \'/i·th retention of antigenicity by cu",-ent methods of manufacture. However, a much 1ess frequent but inore set-ious concomitant to vaccination \'1 it h ; nacti va ted i nfl uenza vacci nes came to 1i ght during the 1976 National Influenza Immunization Pl-o~ram, namely, the.GuillainBarre syndrome (3). ·This syndrome of uncertain pathogenesis is charactel';zcd by ascending paralysis and frequently follows mild respiratory illnesses by 2-3 \'/eeks. It normally Occurs at a monthly incidence of about-O.6 per millioll persons and carries a 5-10% mortality. Recipients of influenza vaccine in the fall of 1976 had a definitely increased incidence of Guillain-Barre sY~drpme, ~ppr?ximately 12-fold, 'i,ith the incre.3se being greatest 2-3 \'!<?ek<; af~er vacClnatlon and not persisting longer than 2 months after vaccination (4). ..1 I l .. ~" " I ~ ~ ) I I ,~ , i ~ I , \ Because of the association of inactivated influenza vaccine administration with Guillain-Barre syndrome, all .human stud.ie·s· involVing ,·influenza vaccination were suspended~ This suspension in~ludes trials that we and others (Drs. Brian ~1urp.hy, Myron Levine, and Gordon Dougla's) have been performing with live-attenuated influenza virus vaccine candidate strains administered intranasally. No complications have occurred during the latter trials, but the number of participants is low enough that it· is still possible that an attenuated influenza virus infection co~ld be associated with GuillainBarre syndrome if the monthly incidence is as low as the approximately one case per 140,000 observed following receipt of inactivated influenza vaccine. However, when one examines the question of whether Guillain-Barre syndrome occurs following natural influenza virus infection, the seasonal patterns of occurrence of the two do not over,lap, suggesting that there is no association (5, 6). A study comparing serological evidence of recent influenza infection in patients with Guillain-Barre syndrome and control subjects failed to find any difference in the two populations (7), and there is no ,correlation of deaths fro~ Guillain-Barre syndrome with influenza-pneumonia deaths over the past 10 years (see attached figure and reference 8). Jherefore~ if attenuated influenza virus infections behave like natural infe~tions appear to do in causing little predisposition to Guill~in-Barre syndrome, it could be argued that the increased incidence of the syndrome after receipt of inactivated influenza vaccines should provide added impetus to the development of live attenuated vaccines. Moreover, it is hoped that respiratory infection \"ith the latter vaccines will induce a more effective and durable immunity than that. foll,owing receipt of inactivated vaccine. '. . . . The protocol under which we were performing trials· wlth live attenuated influenza viruses, IIEvaluation of Recombinant ts.;.mutant·..Vaccines for Influenzii A/Victoria Virus ," was approved by Baylor College of Medicine {6/22/76}. the Texas Board of Corrections (7/12/76). and the National Institutes of Health (6/22/76) committees for review of human research; Studies performed under this protocol prior to the suspension involved a total of 55 volunteers and are summarized below. r I " Thirty-two men were inoculated intranasally with 8 x 10 4 TeIO SO of influenza vaccine candidate, A/V;ctoria/7S-ts-l[E), on 7/25/76. Two of those 32 men had high titers of naturally acquired antibody 'and have been excluded from further analysis. Of the remaining 30 men with both hemagglutination inhibiting (HAl) and antineuraminidase serum antibody titers of ~1:20 before inoculation, 15 shed ts-virus in their nasal secreti~ns, 18 developed an ).A-fold·rise in serum antibody titer (HAl and/or neutralizing) against influenza A/Victoria, and a total of 23 were infected based on one ~r both of these criteria. However, 10 of 30 men inoculated with the candidate vaccine virus also developed a respiratory illness, 4 with fever (~.lOOOF). On 9/19/76, 14 of the men who had rec~ived influenza A/Vic~oria-ts-l[Ej eight weeks preViously were challenged in~r&nasally with 8 x 10 TCrO So of wild-type influenza A/Victoria virus. Two of these men had had no eVl~ence of infection with the ts-virus~ botil \'J~re infected by the Wild-type virus 2 ,. . \ I t (no virus shedding. but.~4-fold rises i~ serum neutralizing antib~d~ titer) and both developed febrile ,respiratory lllnesses. Of the 12 remalnlng men who had'all sho\in evidence of infection with the ts-virus, 7 also developed infection with wild-type virus based on virus shedding (1 man) and/or an >4-fold rise in serum HAl or neutralizing antibody titer (7 men) ,and 3 developed respiratory 'illness, 2 with fever. Among 5 contro~ subjects for the wild-type virus challenge. 1 man was excluded from analysls because of high titers of naturally acquired antibody; the remaining 4 all shed virus and developed ~4-fold rises in HAl or neutralizing antibody. and 3 of the 4 developed respiratory illnesses, 2 with fever. { \ \. On 1/6/77, 18 additional men were inoculated intranasa1ly with 8 x 105 TC10SO of another live a~tenuate~ vaccine.candidate, an influenza A/Victoria/75-cold-adapted recombinant V1rus straln. Of, these men. 14 had initial serum neutralizing antibody titers of Sl:4 and 13 of them became infected as manifested by an ~4-fold rise in serum neutralizing antibody titer; two of the latter 13 men also shed virus and three developed mild, afebdle rhinitis. Of 4 'men who initially had serum neutralizing antibody titers of 1: 8 or 1: 16, none shed virus nor became i1 J. but one developed a rise in antibody tHel:" from '1: 16 to 1: 128. In sunmary, the data obtained in these studies suggests that the influenza A/Victoria/75-ts-l{E] vaccine can'didate strain retains the capacity to cause ill ness in about a thi rd of persons ,·,ith 10\'/ ti ters of both HAl and antineuraminidase antibody, and the resistance imparted by this vaccine candidate strain against challenqe with wild-type virus was less complete ,than anticipated. In contrast, illness caused by the A/Victoria/75-co1dadapted vaccine candidate strain was negligible and serum neutralizing antibody responses occurred with greater frequency than was observed with the ts-virus. Data,concerning th~ resistance of recipients of the cold~adapted recombinant to challenge ",lith wild-type virus and the resistance of men with natura lly-acqui red anti'body to a s imil ar cha 11 enge are needed to complete an evaluation of the efficacy of these t\'IO types of vaccine candidate strains. Purpose. To evaluate the protection against ",Ii'ld,,:,type influenz-a A/Victoria challenge afforded by previous intranasal infection with A/Victoria/75-cold adapted-recombinant vaccine candidate virus, and to compare 'these results with the protection afforded by previous naturally-acquired A/Victoria infection. Description of Study. Volunteers \'/ho \'tere previously vaccinated by means of intranasal inoculation with the influenza A/Victoria-cold-adapted~recombin ant virus and 25 additional men who are 18-40 years old and selected to have a range of naturally acquired serum neutl"alizing antibody to influenza A/Victoria~virus (up to 10 men having little or no detectable antibody) will be housed in the ll-Wing of Ramsey Unit I of the Texas Department of Corrections. ,Hter an initial history, physical examination, and laboratory evaluation (C8C, ~rinalysis, chest x-ray and electrocardiogram) to insure their good health, the men will be challenged intranasally \'Iith a <;imilar dllt;tion of 3 r t • 1 r I , ~ I \ ~.- I 9 m ~ g I I ~ ~ ~ J I J .. ~ the same wild type influenza A/Victoria virus used in previous. components of this· study. This virus pool, supplied through 'NIAID, was gro\·m in embryonated eggs and has. satisfied safety requirements of the Bureau' of Biologics. Federal Drug Administration. Volunteers will remain isolated in the II-Wing and will be examined at least daily by a physician for respiratory. illness for 8-14 days after inoculation. depending on the duration of any respiratory illnesses observed. Studies outlined on the attached protocol (appendix #1) will be performed to detect evidence of virus infection. Discomfort to Subjects. The discomforts associate~ with this project are those of venipunctures, nasal wash collections. and possible influenza illness. Experience with several hundred such intranasal influenza virus challenges indicates that any illness which occurs will generally be mild and last only 3-4 days; no pneumonia or serious complications of these artificially-induced infections have occurred. The possibility that a volunteer may develop Guillain-Barre syndrome is considered remote. 8. HUMAN SUBJECTS a) Subject population. Volunteers will be 18 to 40 year old male inmates of the Ramsey Unit, Texas Department of Corrections. Details of the selection process have been previously submitted. Volunteers must have no known allergy to chicken eggs or feathers. since the challenge virus was grown in embryonated eggs. Volunteers who complete the protocol will be offered $35. This level of remuneration is approximately equivalent to $4 for each blood specimen and $1 for each nasal wash specimen, the rate at which any volunteer who chooses to withdraw will be remunerated for specimens ~ollected prior to his withdrawal. " b) Discomfort and Potential Hazards. Some discomfort will be associated with obtaining blood and nasal wash specimens for virus isolation. Acute allergic reactions to the intranasal virus inocula are remotely pO$sible and all will be administered in the presence of a physician with ~mergency medications on hand if needed. Influenza illness may occur "in some volunteel's (see consent form). Volunteers will be seen at least daily by a physician. and all volunteers will have immediate access 24 hours a day to a medical aide who'will notify the responsible physician so that care can be given as indicated. If illness should be severe enough to warrant care beyond facilities in~ediately available, arrangements have be~n made for hospitalizing individuals for more definitive care. of virus to persons not par~ici -t:ir,g in the studies is a possibilbut minimal for several reasons. A! I subjects will be isolated during the period whrin they might be infectir~" Furthermore, the virus to be used in this study belongs to the Hon~ K0ng (H3M2) era which began in 1968; Spread Ity. '. -( ~ infection with a member of this subtype of influenza A virus has been almost universal among adults, and a large proportion have been infected with the particular strain to be used, influenza A/Victoria. : The level of immunity in the general population is sufficiently high to minimize any spread of the virus with which we will be working. Sick calls will be monitored, nevertheless, to make sure that there is no evidence of increased respiratory disease during the period of study, and appropriate diagnostic studies \'Ii11 be undertaken for any illnesses which do occur. f r The hazard of one of the volunteers developing Guill~in-[3arre syndrolile is considered remote. The volunteers and medical officers and dides at the Ramsey Uni t ",Ii 11 all be informed about the syndrome and they wi 11 a11 be a~ked to contact us if any suspicious signs or symptoms appear. In addition, the volunteers win be questioned ,about any suspicicus signs or symptoms at the time of the collection of the blood sample 1 month after inoculation and again 3 months after ihoculation. Any suspicious findings will be further evaluated and the volunteer will be aided in obtaining appropriate care. ~ ~ I ,f c) Method of Obt~ining Informed Consent. A general description of the study and the procedures to be performed will be given the volunteers verbally. Then, while they have the consent form (Appendix #2) in hand, the volunteers will be given a detailed explanation of what is to be done, including all known hazards, and they wi 11 be gi ven an opportunity to ask any questi ons they desire. It will be made clear that the volunteer can remove himself from" the study at any time, but that he may have to remain in isolation a few days' if he is potentially infectious for others. Volunteers will then be asked to sign the consent form for the study. r e c ) d) Protection against Hazards. Pr'otection against physical hazards has been outlined under section 8b above. Records concerning each volunteer's participation in this project will be maintained in a secure place in the Influenza Research Center. Any publication of results will not contain individual volunteers' identities. . e) Benefits to the Subjec~. Those subjects. who have sufficient" immunity to resist infection will obtain no direct benefit from these studies. 'Those volunteers who do become infected with the challenge virus should have long lasting protection against closely related viruses, a protection acquired with much less risk of serious illness than occurs ~Iith natural influenza virus infection. The major benefit of this study, hm·,ever, is a societal one of helping in the attempt to develop more efficacious means of orp"~,,,·:'· influenza disease. r:) I-- . I I ~ I I I I I I ~ f) Risk-Benefit Ratio. The major risk of this study consists of having influenza illness, but an illness generally much less severe than the ndtural influenza illness to which these men would have otherwise also been susceptible. The incidence of Guillain-Barre syndrome does not appear to be significantly increased by natural influenza illness and there is no reaso,n-to believe that it would be by artificial infection with wild-type virus. Thus, the relative risks of this study seem acceptable when plac~d against the possibil ity of furthering the development of more effective means for reducing the morbidity and mortality caused by naturally occurring influenza virus infection. Thomas R. Cate, 1'1. D.: Principal Investigator Robert B. Couch, N. D. Director, Influenza Research Center I J \ I 1 i ' / .. -_. _. (/') J~- i ~..L./u- ......;l-l.\.. II '- - .~ y ' --..:/:..-._-----Vernon Knight, M. D. Chairman. Dept. of Microbiology and Immunology 6 " ·l ~ f REFERENCES 1. f Leibovitz, A., Coultrip, R. L., Kilbourne. E. D., 'et al: Correlated studies of a recombinant influenza virus vaccine. IV. Protection against naturally occurring influenza in military trainees. J. Inf. Dis. f 124:481-487, 1971. I I 2. From the National Institutes of Health. Influenza Vaccines--Summary of Influenza Workshop V. J. Inf.:Dis. 129:750-77L 1974. 3. Gui1lain-Barre Syndrome--United States. Weekly Report£§.:401, 1976. 4. Center for Diseasc Control. Handout #4, January 7, 1977. (Note that components' of the handout are dated February 3-4, 1977.) , 5. McFarland, H. R., and Heller, G. L.: Guillain-Barre disease complex: A statement,of diagnostic criteria and analysis of 100 cases. Arch. Neural. ji:196, 1966. r 6. Wiederholt. \~. C.• l1ulder, D. '~., and Lambert, E. H.: The landry. Guillain-Barre-Strohl syndrome or polyradiculoneuropathy: Historical review, report an 97 patients, and present concepts. Mayo Clinic Proceedings 39:427, 1964. rlorbidity and r~ortality 7. Melnick, S. C., and Flewett, T.H.: Role of infection in the GuillainBarre syndrome. J. Neural. NCUl·osurg. Psychiat. 1l:395, 1964. 8. Data of Drs. L. Schonberger and Mathew lack. CDC. by Dr. Robert 11. Chanocl<. Kindly provided . f ,.7 r , 1 I 7 :MOIJTHL.Y rOTAL.S OF P\J~~MOIoJI~ AI-)[) II..\F~l\E.IJ"2.~ C€ATI1~ I~ TK~ lUJITED S"jJ\T~.s : \'1<:.'t- Ict-i~ , OcJ* CI'~~ Or~. l- Sc.1."" b /2 tot t r a... J M.tt.e~ 2qc.k "c./:k•. I I ". ; · I: • · ., . . I I I ., , I ,.... : . · J .' . . " .. .AlI(jb·g ~)u..,J ~\i . . 1-\ I l ' J\ . \ . 3:> , M4tJTHLV T"oTI\l.S of (;l,(l.l.l\lIJ C.B I ~"'U.~ h.t,~ ~.~~d ~. ~~r'; L i:le",TtiS (\(7.() . ~ c{o.r.t\o.:Mci... d,.."r"t...... «'(/"~"'$ ,ritt" T, ~ dClQ"", QIIClr«1il.c{ .2.'/.-3' d.••,. .;. .. . , !1 \1J ',A Y ~\ .4,J._+-,- .-, , <.~'f 31;.'1. ~S't) . .: ;::~: : ! Iq(.~_ ,q,.,\ ~. .,', ;i 1 . '.. I" I fi I .f r.~ r i1 11'\ ~ .1:11' ----r--------y..- .. \ (.(.t. ,,~ ··. 11 I ~ (,~ !"l'TI1€ I,(NITr./\ .liTAi"E'<.: ;01 .. I -;- -i---~·-··I l'.,-,! "ne \071 ---1----·-, "7.:t .'11\ s g iJ (/) ,V) r:: . ~ ~. l~ ~ (1) c.. ... -i ~ ,.. :; V'J tn 0 ::J :- c . ."" . . ::s CI ." ~. -i :J"' .,r: :E ~ c.. Q VI C .$ g . . . . 11) VI V1 5 . ." ."' .~ .(J') ~ ~. --i ~ C -i III 0. 0 : . tn VI s: ....-0 I'b C fi) ~ z< . f11 tJ') -l c; }> N N \0 00 ..... ...... 0 ~ !D 0) ~ 0\ V'I .z:,. W ..... N --I 10 0 ;:0 >< ~. csc Serology Blood Chemi stries __. -t :::r 0 :I PI rI'. ::0 n ,.... I)f >< Urinalysis Stool 0 & P Nose/Throat Bacteria Stools for Enteric Pathogens I " x EKG >< Chest X-Ray ID 3: .c Sinus X-Ray I I >< >< >< >< >< >< x x >< >< x >< Nasal wash (veal infus1( broth for virus) Throat swab >< Ana 1 swab >< . >< ( ~._L I >< >C >< x X >< I' T >< Nasal secretion (lactate Ringer's for antibody) Tube Clotted Blood F or Antibody I DOy'Of lOllege or Medicine DEPARTMENT OF MICROBIOLOGY AND IMMUNOLOGY. 113 100-4412 Inlluenla Resea,ch Cellie' • 113 190-4469 VOLUNTEER'S CONSENT FORM Influenza A/Victoria Virus Challenge I I I understand that I am consenting to have dropped into my nose a fluid which contains a live influenza virus. I understand that the virus was grown in chicken eggs and that 1 should not participate if I am allergic to chicken feathers or eggs. 1 understand that the virus in the nose drops may give me the flu. Though the flu caused by nose drops in studie$ like these is usually very mild. I understand that J may have such symptoms as a runny nose, headache. muscle aches. joint a::hes. bad feeling, fever and even pneumonia. I understand that no currently available medicines can cure the flu and that recovery depends primarily on my body's defenses and usually takes a few days to a week. I understand that I will be confined to the ll-Wing 'for the period of time when [ may be infectious for other persons (up to 2 weeks after the nosp. drops) and that I may not have visitors during this period. I I understand that blood samples of 15 ml (1 tablespoon) will be collected prior to the nose drops and Z times over the following month. I understand that nasal wash specimens will be collected daily over approximately a 2-week period and 3 times over the following 2 weeks. I. I und~rstand tha~ an illness consisting of progressive muscle weatnoss with pain or .funny sensations (Guf1lain-Barre syndrome) sometimes occurs one or two months following mild respiratory illnesses; the incidence of this illness is less than 1 case per month for every million people but about 1 person in 20 who develop it die of complications. I understand that there is no evidence .that influenza virus infection causes any increase in the frequency of this type of illness. HO\'lever. I understand that I should report to the doctor. the medical officers or the w~dical aides if J develop any unusual weakness. pains. numbness or tingling so that the cause can be investigated. J J I understand that these studies may help my body develop increased resistanc~ to a type of flu virus l'ihich may spread next fall and \',inter. I understand that I wil I receive $35 for comflleting these studies. I unde"stand that 1 may \':ithdraw from the stUdy at any time without affecting my right to be in future studies or my care. I understand that if I \.,i thdraw, I may have to rentain in isolation until r am no longer infectious for other persons, and that I will be paid $4 for each blood sample and $1 for each nasal wash sample collected up to the point 1 \1i thd ra",. I I I (-:ontinued on next page) i I ~ ., _\ J I i \ I j -. ------------_. ; .... .._ . H.... "sMr~~.-:;\1 ~ ,'.l-'~ 1__', • "_~" ,"': .. 1:0_~: / · ~r f "ppenOl x 2 page 2 ~ I understand that the Influenza Research Center at Baylor will retain a copy of this consefl't form \.,.ith my name and identifying number, as well as other records concerning' such things as any illness J may ~ave and laboratory evidence of virus infection. I understand that I may obtain copies of all my participation in thi~ study by writing to the address giving my name and the approximate date of the study. I publication of results of these studies will not give my information concerning on the head of this form, understand that any identity. The proposed study has been clearly explained to me and I understand the hazards involved. I have been given' the opportunity to ask any questions I may desire. I 5i gnature. _ Date Witness _ Identifying No. ------------------- I have carefully explained. the nature, demands, and foreseeable risks of the above study to the normal volunteer. Signature _ Date ------------- ~. l P, W r & ! ( , L (rr i [ [ ~." '. . .;. 'I I I I I I I I ," J I L l.A,....I~IUI , .- \...Ullt:::Itjv UJ I V Iv\..JI\.1l Iv OEPAATMHIT OF MlCMOOIOLOGV AND ;:/,I.IUNOLOGY· 713 ;UO·.\oH2 Influenza Research Cenle' • 71 J 790·44G~ .;.---- :. ~1 'r~t"'" April 11; 1977 Dr. Robert Chanock Lab. of Infectious Disease, NIAID National Institutes of Health Building 7. Room 301 Bethesda, Mary1and 20014 Dear Bob: Thanks for sendi ng me a copy of the proposed addC!ndum concern i 119 Guill a i nBarre syndrome \':hi ch you prepared for attacl)J;lent to protoeo 1s concerni ng study of £ recombinant vaccine candidates of the H3N2 subtype of influenza A virus. The suspension of studies concerning influen~a in hum~ns because of the increased incidence of Guillain-Barre syndrome following inactivated influenza vaccines caught us at a time \'IhC!n \'Ie had completed all of OUI· plannetl administrations of ts-recombinant viruses. The only component of the studies remaining to be donefrom the previ ous ly approved protocol slloioti tted from Baylol· \'Ias a \l/ild-type virus challenge of ·volunteers \'/ho recei\"f:~d the cOld-adapted recombinant. In addition, \ole \-Iould like to add a \'lild-type virus chiJllenge of men with natura.1ly acqui red anti body for compari son purposes. Enclosed is a copy of a protocol descl';bing \·/h ..: t i'le hope to do. I have incorporated some of your thoughts and infonlliltion cOllcer'ning Gui1lain-Barre syndrome. Even if your "generic" addendulII ;s approved and thel"eby reactivates all previously approved protocols concerning .t5..-viru~cs. \'Ie \',i11 still need approval of the enclosed protocol because it adds a further' wild-type virus challenge group (previous natural infection) for which we do not have previous approval. Best wishes. Sincerely yours,' __ -~-- CI·1... ~ Thomas R. Catc, 14. D. Associate Professor·of 'r'\icl'obiology Clnd :·ledicine TRC: 1 fs , cc: Or. John La Montagne Enclosure . I I / - ~~~TS~!~~OG~~:~~~~~? • ~ \ 71319044" ,I. • .: ~ - \ ~ f f ' ~"Cul:A,,,,,.,, Influenza Research Cenlcr· 7 \3 790-4469 t . April 11. 1977 r [ Dr. John La Montagne Development and Applications Branch NIAID, National Institutes of Health Westwood Building Bethesda, Maryland 20014 ~ I ! Dear John: Enclosed is the protocol which I spoke to you about on the phone. Also enclosed is a copy of a letter which I have mailed to Bob Chanock whjch explains why we need approval of this protocol even if Bobls "generic" addendum for ts-virus protocols is approved.", [ let me know if there are any questions I can help to clear up. Sincerely yours. C o/t:r'-'-- t ~-~ . Thomas R. Cate. ~1. D. Associate Professor of Microbiology and Medicine TRC: lfs . Enclosures , i t J I: I ,. { m" I.' o!) ~ 1. m 2. - Principal Investigator and Associates: ~ I ~ -Title: Development of Rhinovirus Type 3 Challenge System for Normal Vo.l unteers 3. Department: Microbiology 4. Granting Agency: 5. Period of Grant: 6. Location of Study: Immunology NIH-NIAIO Contract No. AI-32506 I , and Robert B. Couch, M. D. Stephen B. Greenberg, ~\. D. Thomas R. Cate, M. D. Maurice W. Harmon, Ph. D. The Methodist Hospital Gener~l Clinical Research Center Baylor College of Medicine Additional Information for Methodist GCRC: Duration of Study: 1 year Number of Subjects to be Hasp; ta 1i zed: ] 12-24 va l.unteers Duration of OcctJE.!I:.I_~f GCRC Bed by Each Subject: 10 days for students Ii. j 4 \veeks for p";sonel~s; Maximum Number of Patients to be Hospitalized at One Time: 12 I 7. Outline: Background Inforl~~tion: Rhinoviruses C\!lpear to be the cause of a significant proportion of acute resj1il~atory d·i~ease (ARD) in all age groups (1). l3ecau~of the reduced over~ll occurrence of ARD in adults, rhinoviruses assume a 9: .u~~· significance in this ag.e group. Although lO\1l~r re:;p"iriltory 'disease is ~cen in infants and children, these virll~e~ primarily pl'odllce a corn::lon cold syndrc::~,:. The major problems regarding prevention of rhinovirus i~fection5 ~rc the numerous serotypes carab 1e of produci n9 thr~ di se()~e, the llICK of a pl'ev~ 1ence of Pill~ticulal' serotype~) and the lack of a s'ignifi(~ant frequ:~ncy of hetl~rot'ypi\. antibody responses following infection. The latter two beli~fs have ~~~n recently chanenged by Fox (2). The5c beliefs, in cOll1bi!1i1tiun ,,"ith the rn;n1;;v:l protective effect produced when inactivated v\lccines \"!ere given by a pal'C:::lterCll route, provided the bu5is fJ:~ the prcvali:nt concept thut conLrol of t1~e c" cold is most likely to OCCUr' thl'ough the U511 of l'.l1tivil'als l"c1thl?r thiln If an antiviral is to be u~ed fOl~ pre'.,renti::lI1 (;1' t,'ealmmt of common colds, 'it \,'ou:d h<1'!t' to he very c:ol1v(,n;ent ClI1(; very st":fe. compouad specific Tat" rhi:.ovirus infection has -". """IPst! qwa,SUU ",,':M.. ... wad,);?.! kN.b .... ,_.5..,d ..t hi t 1&#&..t &.."... 3. t.. (Q5l$, been identified. '1i1cciilE~s. d:i::·~\'i:'.·s 1'1 .; ·r, . • • I ~[ ~ a natural body'substance produced in the course of virus infection and effective against a variety of viruses, is reasonable for consideration. Jackson and Douglas demonstrated that a small molecular weight interferon inducer when given topically ~ms capaJle of modifying artificially induced common colds (3, 4). Similarly, Merigan has indicated that exogenous interferon is effective against a rhinovirus challenge in adult volunteers (5). However, notable in the latter studies is that very large doses (14,000,000 units) were used and yet only a partial protective effect was obtained. In an attempt to ascertain the reasons for the apparent large dose required for prevention of rhinovirus common colds by interferon, Greenberg and Harmon have been systematically studying the effects of interferon in human nasal epithelial cell cultures and in adult volunteers (6, 7, 8). The tentative conclusions from those studies are that the difficulties with topical administration of interferon are a result of incomplete saturation of the nasopharyngeal mucosa with interferon and/or rapid mucociliary clearance. Studies are presently being conducted to attempt reduction of mucocil iary clearance as well as to improve delivery to the nasopharynx. Studies thus far on the interaction of interferon with nasal epithelial cell cultures have involved vesicular stomatitis virus as a challenge virus for the .culture systenl. Recently, rhinovirus type 3 has been shm'/Il to replicate .in the nasal epithelial cell culture~ and stud{es are ~nderway to ascertain the kinetics of interaction of interferon and this rhinovirus with nasal epithelial cells in culture. The eventual goal of these studies is to use the information being obtained on opt i ma 1 methods for de 11 very 0 fill tel"feron to th~ na scpha rynx of man \'1ith tha t on required dosage for d~veloprr.ent of and maintenance of an antiviral effect in specific numbers of nasal epithelial cells for design of experiments involving challenge of adult volunteers \·,ith rhinovirus type 3. For that purpose, a rhinovirus type 3 challenge system is re1~ired and the current proposal is for development of that challenge system. In earlier studies by us \·lith adult voluntee,·s challenged \·,ith l"hinoviruses, we have shown th~t intranasal and small pal·ticle aerosol inoculation produces a cornman cold syndrome in about 2/3 of individuals and lasts i.bout 2 to 3 days (g, 10, 11, 12). About lO:~ of indiv'icuals \-:ill d~vclop fevel· of 1 to 3 days dut·ation. The duration of virus shedding vilries bet'..,cen 9 l\nd 20 days although the n.ax;r.n:r.1 pel"iod of virus shedding is 3 to 4 dCty~ in associat.ion with the acute illness episode. \':chiwe expel"ienee "/ith rhinovit"us typC:!s 113, 14, 15, 16, and 17 and all hove proouced si;:iilar results in adult \'oltlllteer:i, Approximately 500 health.'! adult \'0llJ"lu~c:;rs hc:'.'e ~:,t'!~n studied bv us; no c<tscs of pneu'l:lon·ia occul·red and no unJ:ltiC.'ipu~.cd·C:(Jil:lJlicc:L.iOIl$ \':Ci'i;! nofcd. SiuIl'Jar studies hay!! been conduct(?rl by TYIT~ll) J~;d::;on, C\·:aHnc:·, ilnd Douglns \·:'ith similar re~.ults. f { [ ~ I ~ t t I t I (' { t r PurDflc;e of PI'('iect: To dEvrlop a 1·~I.'I'llci~IC;b1~ chcdlcl1r.(: system fOI" .;dult 'ml"nteel·s \·;ith I'hinovin:o; lype?'. The (;,;:11,,:,::;' :.:,,,t-';i:: \"ill 00. s:':)~('<:ll'~!1Uy uc;ed to evah 3te trc eHc:.:th·(Ii!:::·. 0' l"l!:;(;(iil", .:.::.:illl~u;rr:~ iJ1t~rr(:njll (,"PP1-ol/i:l1 '!lot rcqllc~L\?ci ill this p,-utocoi j for ·pl't. . . ::::lUU:1 of I-hino\'ir:;s C~J:.·:·01} 1_ •• _ . _ _--I ••• l col(j~;, - mo. <. ,. I Description of Study: Studies will invo'lvE?" no'rmal adult prisoner volunteers from the Texas Department of Corrections and students r~cruited from colleges in the Houston area. A volunteer inoculum has been prep~red from a naturally occurring isolate of rhinovirus type 3 (kindly supplied by Dr. J. Gwaltney) in Wl-38 human embryonic fibroblast tissue cultures and is currently being safety tested accord; ng to the attached protoco " for adventiti a 1 agents. m m Prisoner volunteers will be recruited by previously approved methods. Students \~ill be recruited from groups responding to campus newspaper and posted notices. In both cases the volunte~r groups will be met and a full explanation of the study will be given. After this, a candidate must indicate a desire to participate in the study before any further plans are made. A blood specimen will be obtained and only volunteers free of detectable serum antibody to rhinovirus type 3 will be eligible. Volunteers \'1;11 be brought to the General Clinical Research Center of The Methodist Hospital in groups of 6 to 12, depending upon available beds. All person's wjll receive a complete history and physical examination and d variety of, other tests designed to assess their state of normality. All IIhealthy ll volunteers will be given a full explanation of the study again and will ha've an'opportunity to withdraw. Those choosing to rem~;n must sign a written consent form (see attached). ~ , I I. . I i , , The initial study \'Iill consist of 6 voluntee'4s; two",'/jll be given , 100 50% tissue culture infectious doses (TCIO SO )' twd will 'be given 10 1C1050, and two will be given 1 TC1DSO by nasal drops. Sub'sequent studies, involving 6 to 12 volunteers, will be designed to determine the 50% human infectious dose for this virus pool. After inoculation t volunteers will be placed in isolation and -wi 11 remai n there for 5 to 7 days and each wi 11 be seen once or b'li ce daily by a physician. Specimens for virus cu1tures and nasal secretion and serum antibody assays will be obtained according to the attached protocol. Follow-up sera ",ill be obtai ned as necessat·y for those persons discharged from the GCRC before 1 month ~ost-inocu~ation. I Discomfort to Subjects: Some discomfort is associated with drawings of blood and nasal wasliTngs, although both of these procedures are commonly performed by us and the discomfOl'ts ill'e minimal. The only other discomfort associated \'Iith the investigation \";ould be respiratory illness if it occurs. Rhinovirus illness is always accompanied by nasal obstruction and/ol- nasal discharge. Other symptpms fre.quently present include SOt'e.thI4oat, he"adachc t and malaise. If fever occurs (10% of persons), some mya,lgias anc rlecrease in appetite" may be noted. An occasional individual develop!' nor.pl·o::' .:tive cough and the findings of tracheobronch'itis. Clouding of maxillarj' sinuses has been noted on follow-up sinus films in the past hut without the clinical findings of acute sinusitis. This clouding has always cleared after antihistamine and vasoconstrictor therapy, 8. d. ~ubj~_s..Lp'opul~.U.o~: The subject n:quirem.;nt is for nOl'IIlJl hettlU",j adults. ages lS-IW. 1';~lthods fOl' n:cl'witing p:-'isonel- volunteers tlnd ()bLi~ip~;'r infOI";'led consent have bcp.n previously l'E~vi.;'\';;'(; flnn 0rpl'oved, I:1 i:dcJ]~:u~ ." Drisc!lcrs, a number of studies ...,illin-;olvp. stucl.:nts, 3 '.~liI&&U6i t .'.i zit .I.n .J,d.. . xu d ..0. . .3.) IOW,b..(.(. iA it .. I(.h. : t ..&t..'.,,\.t . ..:;... &*.. ;;;;.661111., , ...,r::::w:;:iiMiW.6it"QM.J«.o,-,!,~,:;:iii"A""M..(Q •••••• ( •• <&........3 . :..z.;".. %R&U • I r l~ . b. Potential risks: The only known risks of the study are the development of a convnon cold and the possibility of a complication. In our experience. artificially induced rhinovirus convnon colds 'have been mild, short term, self-limited nlnesses .. ~Ie have never encountered acute otitis media, clinical acute sin.usitis, or a primary viral or secondary bacterial pneumonia although each is possible. c. Consent procedures: Methods leading up to the obtaining of consent are described under "Description of Study." The consent form to be utilized is attached. Subjects wlll be permitted to read the consent form, a full verbal explanation \"ill be given by one of the investigators. and an questions' answered before the subjec~ signs the consent form. d. Protection against potential risks: An ,awareness of the possible complications by examining physicians, a complete reevaluatiQn after the illness episode is completed, and a statement to the subjects regarding the possible complications will be the methods used for detecting the potential risks. Treatment of any complication will be by accepted medical procedures. Records concerning each volunteer's participation in this project.\·,ill be maintained in a secure place. Any publication of results ,·lil1not contain individual volunteers' identiti~s~ Potential benefits: Prisoner volunteers will be paid 55 a day for the duration they al"e hospitaliz~d {a rate previously 'approved by the Texas Department of Corrections} and students will be paid $24 a day (a rate just established at the University of Houston fo,~ similar studies by others and based upon the supposition that a student could earn $3 per hour fOI' an 8 hour \'lOrk day ,'/et'e he not serving as a volunteer subject). An additional benefit is the obtaining of a cOli1plete assessment of health status. The potential henefit to society from the series of studies outlined under "Gackr.round" ;s the obtainin9 of a method for treatment of common colds. e. f. Risk-Benefit ratio: Although the risk of ilny hLlrm from rhinovi,"us challenge is low, tIle risk-benefit ratio of this ~tudy is still 10\'/ for the individuJl subject because he Qxperienc,es the risk of (;11 illn~ss (Ind poss"il)le cOll;plic;ations, \'/hereus his tangible benafit is prilililrily financial. The potential be/lcfit to society improves the risk-benefit ratio. Further information IJ fOi~ l r l 1 ~ , t 6 , i , l GCRC: Ql:l_!-'H' :! ne2..LI?!..J!.!..c_lr..q",tect,£D..d .E.:~9,~'~".:; ~I;"~ LP L r_l~~]_i ..!'.hl.~) ).q.!:f..5,',0.t.~_: ThE:. information ot.taincd fro;ii tilis sp::·r.:ifir. j.~r~lt\lcol i'/ill not be pun'd$h~bl(~ excc·;..t ill liubliciltions including more inf()rllli~~;(o;'1 (Ill rl",inov;rl:S:S. Tlr~ planned usc of the: data obtained in studic:\ \'/ith ill~:,:~d~~.. tJn Iii i1 I>~ plIl>lishi-l!Jle, \ \. 4 14, 4' I I I. I I I I .~ 9. ~ignptures Required: .--"_0'. Ja' . A~cJl . .s ...&\:-.<..:-L. r;--~ .... ,'. Robert B. Couch, M. D. ~ Princi~al In~estigator . J J I.. Vernon Kni'ght, M. D·. Chairman, Department' 'ofI.,. icrobiology and Immunology ' . I I I :.> .. .)- · ., ~ I , f REFERENCES { 1. 2. Gwaltney, J. N., Jr.: Medical Reviews: Bio1. Med. 48:17-45~ 1975. Rhinovir'uses. Fox, John P.:. Is a Rhinovirus Vaccine Possible? Yale J. rt Amer. J. Epid. 103: 345-354, 1976. 3. Panusarn, C., Stanley, E. Q:', Oirda, V., Rubenis. M., and Jackson, G. G.: Prevention of "llnes:i' .from rhinovirus infection by a topical interferon inducer. N. Eng" J.. Med. 291:57-61, 1974. 4. Douglas, R. G., J~"'Jnd Betts, R. F. Effect of induced interferon in experimental rhinovirus infections in volunteers. Infect. Immun. 2:506-510, 1974. . 5. Merigan, T. C., Reed, S. L, Hall, T. S., and Tyrrell, O. A.· J.: Inhibition of respiratory virus infection by locally applied. intel·feron. Lancet 1: 563-567, 1973.• 6. Johnson, P. L .• Greenbe.rg, .5. B., Harmon, N. H., Alford, B. R., and . Couch, R. 0.: . Recovery of apP'lied hUnJiin leukocyte intei'feron f"om the nasal mucosa of chimpanzees and humans. J. Clin. r4ici'o .1:106-107,1976. 7. Harmon, M. W., Greenberg,S. B., and Couch, R. a.: Effect of human nasal secretions on the anthiral activity of hum~n fi~roblast and leukocyte interferon •. Proc. Soc. Exp. B101. r'l~d. 152:598-602, 1976. B. Harmon, M. W., Greenberg, S. B., Johnson, P. E., and Couch, R. 0.: A Human Nasal Epithelial Cell Culture Systel1l: Evaluiltion of Response to Human Interferons. lnfec. J,,!!!!!!!,. (In Pre.s5) 9. Cate, 1. R., Couch, R. B., and Johnson, I~. r·L: Studies \'/ith in volunteers. J .. CHn. Invest. 43:56-67, 1~o4. rldnoviru$~$ 10. Douglas, R. G., Jr ... Couch, n. B., Cate, T. IL, Genme, P. J., and Knight, V.: Quantitative rhino·!it~us sll,:..; . ;in~ i't1'~~,;:nl;, in \'ol~:;1t('ers. Ar.t~R0V...~esp. D15. 2.i:159-167, ]96(. 11. COllch, R. B., Cate, T. R., DOllgl:ls, fl. ('lo, ,.11'" G::TO"~':, P. J" i~nd Knight, '1.: Effect of route of iIiOClil<,.: inn :)1) e>:rli:!ri;:i'~llt~il rc:-piratory vi:'1I1 dis(o;1se in vollJl1t':er~ z.1~·j ev;ejc::n,:'..' for rlll"bCii"i1C lrar.$n:i~'.;OIl. n~£t. L:. Rev . .~Q:517-529, [:O\l91aS, r.. ·:olulltec,~s. 1?6~. Pat:IO:l0ncsis of !'rl;110villJ;; (:01::::,:", cole', Ann, Ot,C,I1., ._r~hir.o\.. lS70. _ _ _. .•. _ __ _, _ _ :;IlC ._ •• ..;.~I"/!I:l. . __ . _ 7o:S<i _ • 1 G., J,'.: i;l tl:l!l'ilr. mal / I I ~- ~ , I 1 ~ ] I BOtJlor College of Medicine DEPARTMENT OF MICROBIOLOGY ANO IMMUNOLOGY· 713 79~:l72 Influenza ResearCh Cenler. 713 790·4469 VOLUNTEER'S CONSENT FORM Rhinovirus Type 3 Challenge I understand that I am consenting to have dropped into my nose a fluid which contains a live rhinovirus which came from a person \t/ith a com:non cold. I understand that I mayor may not II ca tch" the cold. If I "catch it, it mayor may not make me ill. If I develop an illness it may include nasal obstruction and discharge. sore throat, hoarseness, cough, and chest pain. I understand that fever may occur and I may develop headache. weakness, muscle aches and loss of appetite. I have been told that pneumonia may develop but that it is very unlikely. Fever usually lasts 2 to 4 days and symptoms from 7 to 10 days. I understand that other symptoms may occur a.nd that it is possible. but un1ikely,:that illhess will last .longer than 10 days. tl I understand that no currently available medicines can cure the cold and that recovery depends primarily on my body's defenses and usually takes a few days to a week. J understand that frequent nasal washings. throat swab and cough specimens, and b10ed drawings will be performed and used for tests. X-rays and oth~r tests will be performed as needed. J understand that the information gained from this study \'/il1be of no direct benefit to me but that the information gained may be of benefit to other peoplE'. I understand that I will receive $5 per day ($24 per day for .. students ) fOI' the clUI'atioll of my time in the hasp; tal, at the completion of the study .. Fer blood and nasal wash specimens obtained after leaving the hospi tal I wil i re'ceive $5 each time this is done. I understand the investigators will retain at Baylor.College.of "1edicine a copy of this consent form \'/ith my name and identifying number. as \'/e"ll ilS othel' records concerning such things as any illness I may have and labol'atory evidence of virus infection. I understand that I may obtain copies of all infol-mation concerning my participation in this study by 'f/riting to the address 011 the hp«d of this form. giving my name and the approximate date of the study. I understand that ilnV publication of results of these studies ,\-Ii11 not give -I:iy identity. ., The proposed study has been cleal"ly cxplc1inC'd to me a1,~1 I llndel'st\1nd'the hazat-ds involved. I have been given an opportunity to i)~k 2n)' questiuns I :lIi0ht dcsil'C and I understand that I have the ,-;ght to \-:1 thdl"ci'! fl"om the st\ liy at ullY time I may choose without prejudice to PIe. , ... I Si gnuture _ ._-----'------------- Oa te._---.--.--- --._ ..---- - - 1 d~l1t i Iyi TIS ';0 • l)l)\·r~ 1 have cClreful1y expl.::ined tlll~ nature, st'.:fj/ to tt,e not-il/ul '1.)luilteer. : -.-~-'-_._- .. (je.:l~n(i~.. _-_._-------_.- .. _--_._. -----_ ..--_.. D.' Ie SAFETY TEST PROCEDURE Test Primarily Designed for Volume and Method of Inoculation T;iiv91J~o;btc i3r~t~ Bacteria I Fungi 1 ml per tube S,: bo~ :~'~~ljd Li qui d Fungi 1 mI per tube Test Units Observation Period 3 tubes' 15 days 3 :tubes, 15 days Number of ",' l3r~t~: !'/i~dificcJ T: s :~;e C~l tl~rC: Cor, ttl mj na li h9 viruses: Adcnoviruses / Hcrpf!S ~nd RS viruses '•• 1 ..• , . . , _ / I L,~ , ... ,... "~. I ' t.:. I\. I- 0.2 m] per tube I + serum 1 tuue, virus alone 4 lubes virus 1 tube I 5 crum a lone 28 days with subpass as necessary 2 tubes, lIni nocu ILlted - I Adcnoviruses, Pi cr~r.(1 viruses PicCillll Vini!i CS I terpe 5 vi:'lJSCS ': ,". J ~ •• • - "" I : <II ..... , • !."')1I' :/ :,: .'n o ' j '\ .1.1.".) I .... - ..~,'' , . , .....' ..I; i .!.....~ c'l. , ••,., 1"1 'I \.. J I I j ..., •~ ." ~ ( . .) I:: , ....... : Sirn~,i:~ virus 40 . ~. ••• •• - '(. '-0' . ._ I 2 r I I a . i :; :' ~.: \' ; I :H.' y .". : .," '.: ~. : '3 .. 1 ", Rl:bc:!u viruS J xv 6 tubes, virus ;-serum 1 tube, virus ulone 1 lube, senlin alone 4 tubes / un j nocu fated w: , " .... t.· • ! ~ .. TEXAS DEPARTMENT OF CORRECTIONS W. J. Estelle, Jr. Director Huntsville, Texas 77340 ~AUL B. iN TE:tA~ NEWTON April 14, 1977 ASSI&'1'ANT DI1\ECT01l CBAltGIl BOARD OF CORRECTIONS H. H. Coffield Cbl....... Roekd:al.. Tau varnes M. Windham 'V1c.. Cbalnn~" 1.lvlnpto... Teso T. Louis Austin, Ir. or AGlUCUL'rtTU Mr. Joe V. LaMantia, Jr. 115 Houston McAllen, Texas 78501 Dear Mr. LaMantia: Since our last meeting, we have made a considerable amount of progress on the 1977 crop. During the last three or four years, we have tooled up with larger tractors and equipment. This factor has enabled us to prepare land more rapidly, and in spite of the setback we experienced due to four months of wet weather, we are in relatively good shape. About a week ago, we had some light rains. Had we have gotten two inches, our planting on lower units would, with the exception of soybeans, be complete. OUTSIDE SALES Le~ter Boyd ),felDbor VUllO'" TellU Beets Dogs Hogs Van DeWalle &Sons 20.975 Tons $120/Ton Baylor College of Medicine 5 ea. $ 50 ea. Baylor College of Medicine 2 ea. 78.3t lb. POULTRY PRODUCTION Composite Poultry Report for February .5... Annlo. Tau Ave. No. Hens in Production -------------------------. B ~1 DAve. No. Eggs per day to Food Service Dept. - --------RohertJ. acon,u .• p 1 ou try Sl aug h tere d - BrOl'1 ers ----------------------- $2,517.00 250.00 92.39 Mark McLaughlin 'Member '!.l.mb·, l/""Il~n. Tn... Fr~d ·N. Shield Mfm~, ~-;." Antoft'''. 0 f pauL try slaug h tere d 'ln 1b s. -------- 1wo additional broiler houses on Eastham are being completed and will be 1"eady for delivery of broiler chicks by Hny 2, 1977. T~a •• HIIbcn Montemayor :1f':J\bC'r 0~:l A n~r.fo. °rf' •• ' Jr." V. LaMantIa. Jr. ,·..,,,ber !#'(AH~a. 0 resse d ' ht we~g 51,917 33,978 6,471 23,735 TeJ'1S '!\·/o additional broi ler houses on Coffield are being completed and will ready for de 1i very of broiler chicks by May 16, 1977 and .June 16, 1977. ,e ~ .. '!,' i~ \ TEXAS DEPARTMENT OF CORRECTIONS Authorization for Construction and/or Remodeling Job No. :_.....Z_4-'-Z-'-ZWlZ. _ Proposed Project: John Sealy Location: Date Unit_;.;.".:.,:.a::..;.:.....- Estimated Cost: Materials Issued:~~-~Z7L- __ _ H~ital Projec~t~ Dept. _ _ Property No.---!n.!.l.~a!-:.. _ (Remodeling Only) Source of Funds: _ ~Z~-~4~)0~7~0~5~0~B~4~3_ _ Appropriation Pr0<J:'!:am---__ 03 Other _ ~ $69,000 Total Justification for Project: 05 Activity r T~o~i~n~s~u~r_e~a~d~e~q~u~a~te~m~e~d~i~c~a~l~a~t~t~e~n~t~i~on~~rs~_ received by an increasing inmate population. [ f t I r t r Plans by: Construction Div. Project Proposed By: Drawing No.: Construction Superintendent Assigned: A-3 t 99 4-19-77 ~~~~~~~~ Mr. Treatment 0 j v. Paul Guidry Assistant Director for Construction Approved:,jIJC~~~~;,c~~C""'.c...~sst. Dirc,::"tor for another Division: Treatment Approved :_-"';;;;;.-J~-f-,)t-'"'Y---' Approved: ____Pg .. Board of Corrections Budget Line Item Specifically Authorizes Project? ]yes Jno Required Approval: $1000 or Less - Assi~;tant Director for Construction $/.500 or Less Director & Assistant Director for Construction Ah~ve $2500 Distribution: .') (] () 0 8 - Bcnrd vf Corrections or Budget Line Item 1st Copy' Business Divinion 2nd ~0PY Director J l"d CO~'1 Ccnst r 1lcticn Di viRion :i til copy Cons t ruction SUr?e rin tendent :) toll c'o[.l,! ';/arf}house ~C802 , , r ~" ~ C;::I'::t:minaUng viruses . .:~nd baclerin: Adult r·.'1icc Ncurohopic. viruses " · 4 0.03 mile. ,20 nn!ma I 5, yirus alone {lCM I etc.) COX'S(1C ki cvirusas o.01 ml"IC' and 'SC S . ..-. 28 days .8 animals, saline ·'O.lmII0 6 xlO Herpes viruses 16 animals, virus alone 28 days 2 animtlls 28 d"ys and 2 drops on seari fi ed cornea r''':r'c''' i,,; .1' I '.~ rv1 ycobacterium tuber- Ir)'lns :,J culosis 1 mf IP 7 3.animnls -- rJ1ycoplilsma S[l. a .1 ml . per plate . 4 plates (2 anaerobically, 2 aerobically) , .l.CI~J!lcr;~~ wjth Echovirus Type 11 elt 28 days .... L i.J • . , . ' ,." .... ~'r., .. ~r.'···'· __ ""lnl:";" If''l... ....: t.. "'l~ w·. 7 '-'1 , ,1 (\ ..r:,':1 2P rl .:J... ays .~ .' Lt'::::' C:~2 ;: cc;!trcls tl!d 2 .J """'" ~ . ,.: ....... L. """ \... , '.) I •• : I ~ " ...,. ' L """'I'C' ·• _~J •• ~ , ~Jin:5 plus serum with Echovirus Type 11 at 14 days Iy 1r",- .. :- ...... ' t'.• • .' '_; •• ~. itC' ; p,!1t~::'?r'Jll1 fo~ rhinovirus type 3 used only in Hep-4, HEK t HI-38, and RhMK tests. 1· , .... ~~~~~~"~~~"'~c=a.~~~',,,,, 28 days ,>, \ ' INVESTIGATOR R.B. Couch, M.D. Date Day xx Prl:. X X X X X X X X Tues. 1 , Wed. 3 Thurs. 4 Fri. 5 Sal. 6 Sun. 7 Mall. 8 C.~~-+~9-t---t--t--1I-+--f-+-+--4-{--4--+--l--4--:I-.t--J-4--4---l~ Tues. Wed. 10 ~~-+--1--I-4--4--l·-t-t-+--+--t--~-1--+--t--4--4-l'-·1-_l-.-l-1 11 I Fri. Sal. t ! 1 J ) J 1 1 1 1~ ,.