he DIVISION of BIOLOSICS STANDARDS Jiflj-stbtnljj Congress of % ®nitrtr Stotts of the fptst jfressura, Began and held at the City at Washington on Monday, the second day of December, one thousand nine hundred and one. AJN" ACT To regulate the sale of viruses, serums, toxins, and analogous products in the District of Columbia, to regulate interstate traffic in said articles, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That from and after six months after the promulgation of the regulations authorized by section four of this Act no person shall sell, barter, or exchange, or offer for sale, barter, or exchange in the District of Columbia, or send, cany, or bring for sale, barter, or exchange from any State, Territory, or the Distrust of Columbia into any State, Territory, or the District of Columbia, or from any foreign country into the United States, or from the United States into any foreign country, any virus, therapeutic serum, toxin, antitoxin, or analogous product applicable to the prevention and cure of diseases of man, unless (a) such virus, serum, toxin, antitoxin, or product has been propagated and prepared at an establishment holding an unsuspended and unrevoked licence, issued by the Secretary of the Treasury as hereinafter authorized, to propagate and prepare such virus, serum, toxin, antitoxin, or product for sale in the District of Columbia, or for sending, bringing, or carrying from place to place aforesaid; nor (b) unless each package of such virus, serum, toxin, antitoxin, or product is plainly marked with the proper name of the article contained therein, the name, address, and license number of the manufacturer, and the date beyond which the contents can not be expected beyond reasonable doubt to yield their specific resn**- n-*>mded, That the suspension ' - ’’ mat~ with the pro>«*ona o» this Act be, and the asms are hsrsoy, ispaaltl Speaker Bourn qf Representatives. fJ * -A llt g.M m jyuk AMUMM 4riWwlw» Wf OMW the DIVISION of BIOLOGICS STANDARDS “To apply our present knowledge to the im- provement of biologies now on the market, to find better ways of producing and testing these biologies, and to help in the develop- ment of new immunizing agents against the infectious diseases that, so far, have baf- fled science-these are the ultimate aims of those concerned with the control of biologies.” Director, Division of Biologies Standards For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 - Price 15 cents DBS staff works in two modern, interconnected buildings on the campus of the National Institutes of Health, at Bethesda, Maryland. The staff of approximately 300 includes more than 100 professional members- physicians, biochemists, virologists, biologists, and im- munologists. Although the research interests of the Di- vision cut across many disciplines, the work is organized into seven laboratories: Control Activities, Bacterial Prod- ucts, Biophysics and Biochemistry, Blood and Blood Products, Pathology, Viral Immunology, and Virology and Rickettsiology. BIOLOGICS REGULATION The DBS is responsible for establishing and maintain- ing standards of quality and safety of all biological prod- ucts that come within the jurisdiction of the Public Health Service. These products include all vaccines, antitoxins, therapeutic serums, allergenic products, and human blood for transfusion, as well as products prepared from human blood. Because many of these products are derived from liv- ing organisms, such as bacteria and viruses, and all by their nature are either potentially dangerous or ineffec- tive if improperly prepared and tested, close surveillance of production is essential. The development of realistic standards for these products and the exercise of proper control over them is effectively backed by a flexible re- search program. The standards for the production and testing of bio- logical products are set forth in regulations prescribed by DBS. As scientific knowledge advances, revisions are made in the regulations. Following determination by the DBS that the pre- scribed standards for safety, purity, and potency have been met, licenses for the manufacturing establishment and for the product are issued by the Department of Health, Education, and Welfare upon recommendation of the Surgeon General of the Public Health Service. Food and Drug Administration regulations require the monitoring of clinical trials of all investigational drugs. The Division therefore maintains surveillance of all ex- perimental biological materials under study for potential commercial use. CONTROL TESTING The safety, purity, and potency of all biologies must be established before licensing. Control tests range from relatively simple sterility tests to complex and costly potency determinations and safety tests. Once a product is licensed, continuing surveillance is maintained by inspection, review of manufacturing records of produc- tion and testing, and by testing samples of the product. Animals play an important role in control testing. Mice, guinea pigs, rabbits, and monkeys provide a variety of responses by which the safety, purity, and potency of these products can be evaluated. Safety tests in animals are performed to ensure the relative freedom from harmful effects to the recipient of the product. The guinea pig is used in safety tests for all vaccines, toxins, and toxoids. Closely allied to safety is the requirement of purity, or freedom from extraneous matter in the finished product. For example, to ensure freedom from fever-producing substances of bacterial origin for antitoxins, plasma, and other blood derivatives, a test dose of the product is in- jected into the ear veins of rabbits. Elevation of body temperature indicates the presence of impurities. To determine potency-the specific ability of a bio- logic to effect a specific result-a number of specialized tests are involved, including animal tests. In diphtheria and tetanus toxoid potency tests, the animal may serve to measure immune response to the product. The po- tency of typhoid vaccine is measured by immunizing mice; potency of smallpox vaccine is tested by the rabbit skin test. Approximately 35,000 control tests are conducted an- nually in DBS laboratories on samples of manufacturers’ products to ensure their safety, purity, and potency. If the DBS test results confirm those of the manufacturer, that particular batch of the product can be released for commercial use. The DBS tests serve as a basis for the annual release of some 4,000 production lots. 6 Some 180,000 mice, 3,500 rabbits, 2,000 monkeys, and 8,600 guinea pigs are used annually for control tests. The availability and use of viral and bacterial antigens has for many years protected millions of people against infectious diseases. Smallpox vaccination and the multi- ple antigen (diphtheria and tetanus toxoids and pertussis vaccine) are routinely given in this country to children of pre-school age. Travelers in areas of the world where typhoid fever, yellow fever, cholera, and typhus are preva- lent are immunized against these diseases. Despite the long-time use of these immunizing agents, there is always need for their improvement in the light of current scientific knowledge. DBS investigators continue to devise better methods of testing for viral, bacterial, and rickettsial antigens. It was, however, the advent of tissue-culture-produced virus vaccines which revolutionized biologies production. The first of these was the inactivated Salk polio vaccine, licensed in 1955. The development of the live, oral, Sabin poliovirus vaccine presented DBS with a new technical challenge. The monkey neurovirulence tests required for this vaccine involved extensive studies. More than 150 neurovirulence tests were made in more than 7,500 mon- keys during 1959-1961. These studies led to the estab- lishment of a standardized test system which assured the safety of the Sabin polio vaccine. Research, testing, and the development of standards in connection with measles vaccine represented another major concern for DBS, beginning soon after measles (rubeola) virus was isolated by Dr. John Enders in 1954 and continuing until the vaccine was licensed in 1963. Research is also directed toward the formulation of standards for new products. Advances in virology have led rapidly toward the development of viral vaccines for mumps, German measles, and some of the respiratory diseases. Studies are also conducted on diseases for which etiologic agents have not yet been isolated. Of increasing importance is the intensive study of the role that viruses may play in human malignancies. VIRAL . BACTERIAL RESEARCH TUMOR VIRUSES Many if not all animals harbor latent viruses, some of which may have a tumor-producing or “oncogenic” po- tential. This is of concern in biologies control since most virus vaccines are produced in animals or chick embryo tissue cultures or in embryonated eggs. One such virus, SV-40, found to be present in monkey kidney tissue culture, can cause tumors in hamsters. Another, avian leukosis virus, causes tumors in chickens. Since the role of these viruses in relation to human disease is unknown, the only position the Public Health Service can take is to require their exclusion from all licensed vaccines. Future vaccines will undoubtedly be produced in other tissue culture systems; therefore, DBS scientists are developing methods and special techniques to reveal potentially oncogenic viruses. These include animal in- oculation, electron microscopy, and histologic evaluation of tumor cells. For example, newborn hamsters have been found to be particularly susceptible to tumor induction by animal viruses and are used in demonstrating the tumor-producing capability of certain of these viruses. These studies are important for the entire field of cancer research, but are of special concern for vaccine safety. When an oncogenic virus is a contaminant of the vaccine, it can be eliminated by changing production techniques, but if the vaccine virus itself has an on- cogenic potential, the problem is infinitely more complex. It takes many months of study involving large numbers of animals to determine the possible effects of such viruses. 10 DBS uses over 25,000 hamsters annually in its research and testing programs for oncogenicity. Electron microscopy is also a valuable aid in searching for and identifying extraneous virus particles in cell cultures used in the production of vaccines. BIOLOGICS STANDARDIZATION Since most biological products cannot be standard- ized by chemical or physical means, their strength or potency must be tested in relation to established stand- ards, or reference preparations. The official physical standards for biological products in the United States, provided by law and regulations, are those established by the National Institutes of Health. To ensure that biological products made by several manu- facturers will have uniform potency, the DBS provides manufacturers with these official standards. Their de- velopment depends on advanced knowledge in the fields of immunology, biology, virology, biochemistry, and medi- cine. More than 7,000 of the preparations prepared and tested are sent annually to manufacturers and others engaged in biologies standardization. DBS scientists are constantly working to improve these preparations by developing more accurate and economical laboratory tests. For example, complex bio- logical products are subjected to electrophoretic frac- tionation in order to identify the active components which will serve as more specific standards. DBS scien- tists are experimenting with stabilizers and freeze-drying techniques to develop better methods of preserving and storing biological products so that potency will be main- tained. Studies are being carried out to establish stand- ards of potency for new products pending licensing and for substances for which no suitable potency tests have been developed, such as allergenic products, poison ivy extracts, and certain bacterial vaccines. There are compelling reasons why biological stand- ards should be uniform throughout the world. This is best accomplished through international cooperation. DBS scientists serve on World Health Organization expert committees involved in the establishment of interna- tional standards, and assist other countries in establish- ing their own national standard preparations. BLOOD RESEARCH AND CONTROL Research in this field is designed to strengthen con- sol procedures for the manufacture and storage of blood and blood derivatives. During the past ten years, there has been a great in- crease in the use of such blood products as normal serum albumin, immune serum globulin, normal human Plasma, frozen single-donor plasma for coagulation de- fects, and sera for determining blood groups and types, as well as whole blood for transfusions. DBS scientists study the effects of freezing, thawing, ar>d drying of these various elements of blood; the effect °f storage conditions-temperature, time, light, and con- feiner materials-on the properties of whole plasma and fee separate plasma proteins. Of the estimated 5,000 blood banks in this country, 230 are operating under Federal license to ship human blood from one state to another for commercial use. These blood banks account for about 65 percent of the approximately 6,000,000 pints of blood collected an- nually. The remainder is collected by local blood banks for use within the community, and the medical proce- dures used are subject to local and state laws and regulations. Blood banks licensed under the biological products control provisions of the Public Health Service Act must comply with standards set by DBS. To assure continued compliance with these standards, every licensed blood bank is inspected annually by DBS personnel, and tests are performed on random samples of blood selected by the inspectors. INSPECTION To ensure continued compliance with Public Health Service regulations, specially trained members of the DBS scientific staff annually inspect every establishment licensed to manufacture biologies, as well as those ap- plying for license. * U. S. GOVERNMENT PRINTING OFFICE : 1968 O - 284-418 There are more than 200 establishment licenses and over 1,300 product licenses in effect, covering approximately 290 specific products. These include: Antitoxins Immune serum globulins Blood and blood derivatives Bacterial vaccines Toxoids Toxins Viral and rickettsial vaccines Diagnostic substances for skin tests Allergenic extracts Antivenins Poison ivy extracts Venoms photos: Roy Perry and Jerry Hecht THE NATIONAL INSTITUTES OF HEALTH PUBLIC HEALTH SERVICE U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service Publication No. 1 744