Professor Natan Goldblum: The Pioneer Producer of the Inactivated Poliomyelitis Vaccine in Israel

A PANDEMIC OF POLIOMYELITIS struck Israel in the early 1950s and created an urgent need for immunization against the disease. By 1956, there were 5835 cases of poliomyelitis, 85% to 90% of whom were children aged 5 years and younger.¹ This pandemic began in part as a result of the massive immigration of Jews from post-war Europe and Middle Eastern and North African countries, which doubled the Israeli population within 3 years. It is possible that the virus was imported from these countries. In addition, the crowded, unsanitary conditions in the immigrant temporary camps facilitated the fast spread of the virus among the population.

Israeli health authorities were anxious to introduce immunization against the virus, particularly upon learning of Jonas Salk's success with the inactivated poliomyelitis vaccine (IPV) in the United States. The Israeli Ministry of Health decided to initiate local production of the vaccine on a semi-industrial scale and asked Natan Goldblum, director of the Ministry of Health's virology laboratory, and his colleagues to develop and produce the vaccine. Their operation was to be based on the methodology of Salk and the experience of Danish scientists, who had also been successful at duplicating Salk's work.^2,3

Work on the poliomyelitis vaccine began in the winter of 1955–1956 with the aim of immunizing the age groups most at risk—infants between 6 and 36 months—during the winter and spring of 1957. In 1955, Goldblum was sent to Salk's laboratory in Pittsburgh, Pennsylvania, to learn his methodology. He then returned to Israel and established his own laboratory to produce and check the efficiency and safety of the vaccine. As a result of the Cutter episode in the spring of 1955 in the United States, in which 94 persons tested positive for poliomyelitis after receiving a vaccine produced at Cutter Laboratories (166 close contacts of vaccinated persons also tested positive), changes in the production and testing of the vaccine were constantly introduced to produce an efficient, noninfectious (i.e., fully inactivated) vaccine, but Goldblum continued to adhere to the requirements of vaccine development enumerated by the United States Public Health Service.⁴

In 1957, Israel became the third country in the world (after the United States and Denmark) to produce the Salk vaccine independently when Goldblum and his colleagues prepared the vaccine at the Ministry of Health Central Virus Laboratories, at that time located in Jaffa, Israel. Children were then immunized with the new vaccine as part of the routine infant immunization program (together with Diphtheria-Pertussis-Tetanus); this initial campaign covered approximately 90% of those aged 1 year. The campaign was carried out through an extensive network of clinics and medical teams in rural settlements, Arab villages, and urban neighborhoods throughout the country.

Professor Natan Goldblum working in his laboratory, circa 1955. Source. Courtesy of Amiram Goldblum.

Almost immediately, the vaccinations had an impact. The number of poliomyelitis cases in Israel dropped from an annual average of 650 in 1952 to 1956 to 57 in 1957. The number of cases increased to 573 in 1958, but then decreased again, to 36 in 1959 and 38 in 1960. In 1961, however, another epidemic of poliomyelitis occurred, with 207 total cases reported. This outbreak consisted mostly of cases from the non-Jewish population, which because of its higher rates of unimmunized children, experienced attack rates as much as 10 times higher than those of the Jewish population. This experience led to the replacement of IPV with oral poliomyelitis vaccine (OPV) in Israel.⁵

In 1960 Goldblum accepted a position as an associate professor of virology and preventive medicine at the Hebrew University of Jerusalem. Over the next 30 years, he published about 50 papers on poliomyelitis. He taught medical students and conducted research on many different viral diseases, often supported by the National Institutes of Health in the United States. The World Health Organization also sent him on many missions to monitor infectious diseases around the world.

In 1974 Goldblum became vice-president of Hebrew University and chairperson of its Authority for Research and Development. In 1988 he received the Israel Prize for his contributions to public health, medicine, and science, and for his heroic efforts to prevent malaria, poliomyelitis, West-Nile fever, and other diseases.⁶