George W. Comstock, 92, Dies; Leader in Fight Against TB
By LAWRENCE K. ALTMAN Published: July 18, 2007
Dr. George W. Comstock, an epidemiologist who made major contributions to the treatment and prevention of tuberculosis and was regarded by many peers as the world’s foremost expert on the disease, died Sunday at his home in Smithsburg, Md. He was 92 and had worked until last week. The cause was cancer of the prostate, said the Johns Hopkins Bloomberg School of Public Health in Baltimore, where Dr. Comstock taught for more than 40 years. Two sets of studies by Dr. Comstock in the 1940s and ’50s had a critical impact on the federal government’s response to tuberculosis. One set led public health officials to reject the tuberculosis vaccine known as BCG, which had been under consideration for routine use among American children.The second series of studies led the health profession to adopt the use of the drug isoniazid (INH) as a mainstay in treating tuberculosis, which mainly affects the lungs and remains a leading killer in the world today. Many BCG vaccines are used throughout the world. By the late 1940s, one such vaccine had been found effective in two trials in the United States. But the government wanted further research and dispatched a team led by Dr. Comstock to conduct studies among schoolchildren in Georgia and Alabama from 1947 to 1950. The studies found that the vaccine was largely ineffective. Public health officials then decided against routinely vaccinating children in the United States with BCG.
On receiving an award from the National Foundation for Infectious Diseases for his work, Dr. Comstock said he suspected he was the first person to be so honored for persuading people not to use a vaccine. Dr. Comstock attributed the discrepancies among the trials to variations in different strains of the BCG vaccine and a lack of standard manufacturing techniques. Later, genetics studies documented that there was no uniformity among BCG vaccines, said Dr. Richard E. Chaisson, a tuberculosis researcher at Johns Hopkins. In 1957, the United States Public Health Service sought a doctor to study tuberculosis patterns in Alaska, where one of every 30 natives was in a tuberculosis hospital. Dr. Comstock volunteered, saying he saw an opportunity to study preventive treatment. He conducted a controlled trial in 29 villages near Bethel, Alaska, where tuberculosis was rampant. Members of each household were given the drug INH or a placebo for a year, Dr. Chaisson said. The study showed the effectiveness of INH in preventing tuberculosis: after a year, INH produced a 70 percent decline in cases of the disease; a follow-up study five years later showed the drug’s benefit had been sustained.
In the trial, Dr. Comstock and his family took INH themselves to convince the participants of his belief in the therapy’s safety, Dr. Chaisson said. After the trial, Dr. Comstock returned and gave INH to those who had received the placebo.
The federal Centers for Disease Control and Prevention’s latest guidelines on INH therapy use Dr. Comstock’s data to this day. George Wills Comstock was born in Niagara Falls, N.Y., on Jan. 7, 1915, the son of George Frederick Comstock, a metallurgical engineer, and Ella Gardner Wills Comstock. He entered Antioch College planning to become a metallurgist. While working eventually on the vitamin deficiency disease pellagra, for the pharmaceutical company Eli Lilly, he developed an interest in nutritional diseases. He went on to earn a medical degree from Harvard Medical School in 1941 and a master’s degree and a doctorate in public health from the University of Michigan and Johns Hopkins, respectively. In medical school, Dr. Comstock, a thin, considerate man who stood about 6 feet 6 inches, rejected his parents’ wish that he study piano and instead bought a recorder, using money he had made by selling his blood for transfusions, a customary means of income for medical students in those days. Later, he took up the bassoon and played in symphony orchestras. He interned with the Public Health Service and later became chief of its tuberculosis epidemiologic studies. After he retired from the agency in 1962, he moved to Johns Hopkins. He was editor of the American Journal of Epidemiology from 1979 to 1988.
Dr. Comstock founded the Johns Hopkins Training Center for Public Health Research and Prevention in Hagerstown, Md., where for 30 years he oversaw community-based research studies on cancer, heart disease and an eye disease known as histoplasmosis. The center was renamed for Dr. Comstock in 2005. He was a lifelong advocate of public health efforts and expressed disappointment in later years that more doctors were not devoting their services to it. In an interview in 2003, Dr. Comstock said that members of medical school faculties had little contact with public health departments. Dr. Comstock was preceded in death by his first wife, of 60 years, Margaret Karr Comstock, and his sister, Ruth Comstock Dunlap. He is survived by his wife, the former Emma Lou Davis; two sons, Dr. Gordon Frederick Comstock of Arcade, N.Y., and Dr. Lloyd Karr Comstock of Chapel Hill, N.C.; a daughter, Martha Wills Comstock Williams of Marietta, Ga.; five grandchildren; one great-granddaughter; two stepchildren, Jonathan Davis and Anna Davis; and two step-grandchildren
By LAWRENCE K. ALTMAN Published: July 18, 2007
Dr. George W. Comstock, an epidemiologist who made major contributions to the treatment and prevention of tuberculosis and was regarded by many peers as the world’s foremost expert on the disease, died Sunday at his home in Smithsburg, Md. He was 92 and had worked until last week. The cause was cancer of the prostate, said the Johns Hopkins Bloomberg School of Public Health in Baltimore, where Dr. Comstock taught for more than 40 years. Two sets of studies by Dr. Comstock in the 1940s and ’50s had a critical impact on the federal government’s response to tuberculosis. One set led public health officials to reject the tuberculosis vaccine known as BCG, which had been under consideration for routine use among American children.The second series of studies led the health profession to adopt the use of the drug isoniazid (INH) as a mainstay in treating tuberculosis, which mainly affects the lungs and remains a leading killer in the world today. Many BCG vaccines are used throughout the world. By the late 1940s, one such vaccine had been found effective in two trials in the United States. But the government wanted further research and dispatched a team led by Dr. Comstock to conduct studies among schoolchildren in Georgia and Alabama from 1947 to 1950. The studies found that the vaccine was largely ineffective. Public health officials then decided against routinely vaccinating children in the United States with BCG.
On receiving an award from the National Foundation for Infectious Diseases for his work, Dr. Comstock said he suspected he was the first person to be so honored for persuading people not to use a vaccine. Dr. Comstock attributed the discrepancies among the trials to variations in different strains of the BCG vaccine and a lack of standard manufacturing techniques. Later, genetics studies documented that there was no uniformity among BCG vaccines, said Dr. Richard E. Chaisson, a tuberculosis researcher at Johns Hopkins. In 1957, the United States Public Health Service sought a doctor to study tuberculosis patterns in Alaska, where one of every 30 natives was in a tuberculosis hospital. Dr. Comstock volunteered, saying he saw an opportunity to study preventive treatment. He conducted a controlled trial in 29 villages near Bethel, Alaska, where tuberculosis was rampant. Members of each household were given the drug INH or a placebo for a year, Dr. Chaisson said. The study showed the effectiveness of INH in preventing tuberculosis: after a year, INH produced a 70 percent decline in cases of the disease; a follow-up study five years later showed the drug’s benefit had been sustained.
In the trial, Dr. Comstock and his family took INH themselves to convince the participants of his belief in the therapy’s safety, Dr. Chaisson said. After the trial, Dr. Comstock returned and gave INH to those who had received the placebo.
The federal Centers for Disease Control and Prevention’s latest guidelines on INH therapy use Dr. Comstock’s data to this day. George Wills Comstock was born in Niagara Falls, N.Y., on Jan. 7, 1915, the son of George Frederick Comstock, a metallurgical engineer, and Ella Gardner Wills Comstock. He entered Antioch College planning to become a metallurgist. While working eventually on the vitamin deficiency disease pellagra, for the pharmaceutical company Eli Lilly, he developed an interest in nutritional diseases. He went on to earn a medical degree from Harvard Medical School in 1941 and a master’s degree and a doctorate in public health from the University of Michigan and Johns Hopkins, respectively. In medical school, Dr. Comstock, a thin, considerate man who stood about 6 feet 6 inches, rejected his parents’ wish that he study piano and instead bought a recorder, using money he had made by selling his blood for transfusions, a customary means of income for medical students in those days. Later, he took up the bassoon and played in symphony orchestras. He interned with the Public Health Service and later became chief of its tuberculosis epidemiologic studies. After he retired from the agency in 1962, he moved to Johns Hopkins. He was editor of the American Journal of Epidemiology from 1979 to 1988.
Dr. Comstock founded the Johns Hopkins Training Center for Public Health Research and Prevention in Hagerstown, Md., where for 30 years he oversaw community-based research studies on cancer, heart disease and an eye disease known as histoplasmosis. The center was renamed for Dr. Comstock in 2005. He was a lifelong advocate of public health efforts and expressed disappointment in later years that more doctors were not devoting their services to it. In an interview in 2003, Dr. Comstock said that members of medical school faculties had little contact with public health departments. Dr. Comstock was preceded in death by his first wife, of 60 years, Margaret Karr Comstock, and his sister, Ruth Comstock Dunlap. He is survived by his wife, the former Emma Lou Davis; two sons, Dr. Gordon Frederick Comstock of Arcade, N.Y., and Dr. Lloyd Karr Comstock of Chapel Hill, N.C.; a daughter, Martha Wills Comstock Williams of Marietta, Ga.; five grandchildren; one great-granddaughter; two stepchildren, Jonathan Davis and Anna Davis; and two step-grandchildren
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