By Patrick P. Rowan
Up to the middle of the 20th century it sometimes happened that very young children became infected with the tuberculosis bacillus and the consequences were devastating.
These children had no immunity to the infection so they often developed severe infections affecting the brain or lungs. Acute tuberculous infection in children often developed into a fatal pneumonia while tuberculous meningitis, if not fatal, usually meant that the child was left in a permanently damaged mental state. Then an Irish doctor, Dr. Stopford Price, introduced BCG vaccine with the hope of preventing these infections. Her efforts were a huge success.
Dorothy Stopford was born in Dublin but her father died when she was young so the family had to sell out and move to England. Her father was descended from a long line of Church of Ireland clerics and her maternal grandfather, Dr. Evory Kennedy, had been Master of the Rotunda Hospital. Dorothy came from a Unionist family but while in England her aunt, an historian, introduced her to Irish history.
She was interested in art initially and passed an examination which qualified her for admission to the Royal College of Art. Then she decided to study medicine so she returned to Ireland to enrol in Trinity College. While she was a student there, she was very aware of the events of the 1916 Rising. The brutal treatment meted out to the leaders of the Rising influenced her into becoming a nationalist. Around this time she joined Cumann na mBan and she also met and married District Justice Liam Price.
When Dorothy qualified in medicine in 1921 she began work in Kilbrittain in County Cork as a dispensary medical officer. She treated IRA casualities and those injured during the Civil War where she favoured those on the Republican side. She didn’t stay long in County Cork but returned to Dublin to join the staff of St. Ultan’s Hospital which had been set up by Dr. Kathleen Lynn and her friend Madeleine Ffrench-Mullen in 1919. The infant mortality rate in Dublin in 1919 was 165 per thousand, so every sixth child could be expected to die before its first birthday.
This mortality rate covered rich as well as poor but a disproportionately large number of poor children died. Whole families, often of 10 or 12 people, were living in one room under very unhygienic conditions. Malnourished children suffered severely. On top of everything else infectious diseases took their toll and, of these, tuberculosis was the most dreaded. St. Ultan’s Hospital was established to help mothers whose infants needed extra care because of illness.
During the first half of the twentieth century, tuberculosis was rampant in Ireland. It was spread by coughing and spitting, so public transport carried warning signs ‘No spitting permitted.’
Young people who became infected with the tubercle bacillus usually suffered a mild reaction, which appeared like an influenza attack. The result was that they acquired a certain degree of immunity to further tuberculous infection but in some people, especially in infants and in very young children, they were unable to resist the infection and succumbed to tuberculous pneumonia or meningitis.
When Dr. Stopford began working in the voluntary unpaid position in St. Ultan’s Hospital, she began to study the effect that tuberculosis had on young children. In 1931, after a visit to Vienna to acquaint herself of how progress was being made in this regard, she began to use tuberculin, an extract of the tubercle bacillus, which helped to differentiate between those who had a tuberculous infection and those who were never infected.
She learned German to be able to keep in contact with new developments in the treatment of childhood tuberculosis. She was awarded a MD degree for her study of diagnosing TB in children.
As a result of her studies, she found that a vaccine against TB had been developed in the Pasteur Institute in Paris. This vaccine, named BCG, after the two physicians Calmette and Guerin who developed it, was in use since 1921. It is a live vaccine produced by the attenuation or weakening of the tubercle bacillus. It produces a degree of immunity in those who receive it and is especially effective in protecting babies and young children from the very severe types of tuberculous infections.
When Dr. Stopford Price began using BCG in St. Ultan’s Hospital, she was not hailed as a hero by the medical profession. In fact, many doctors were very sceptical initially, because there had been a catastrophe in Lubeck in Germany where 75 children given BCG had died, presumably because they were given a very virulent form of the vaccine.
Dorothy persisted and in 1948 she persuaded Dublin Corporation to introduce BCG vaccination in the city. The following year she was appointed Chairperson of the Irish National BCG Committee. Now, BCG is given in the form of an injection into the skin in infants as soon as possible after birth.
The use of BCG must have saved thousands of young children’s lives. It was often found that many teenagers and young adults, especially those from rural areas, had never been in contact with people suffering from tuberculosis and had no immunity to infection. When they went to work in towns and cities they were exposed to infection and developed the disease. This was often seen during WW1, when these people went to work in England and returned six or twelve months later suffering from a virulent form of the disease. Vaccination with BCG helped prevent this group of people picking up infection.
Dr. Price suffered a stroke in 1950, and in 1954 had a further stroke as a result of which she died. She was buried in St. Maelruen’s Cemetery in Tallaght.
As more beds became available in the new Children’s Hospital in Crumlin, St. Ultan’s was not needed any more so its doors were closed in 1975.