Introduction
From the late 1800s to the early 1900s, European and American labs made major advances in disease prevention. They produced antitoxins for illnesses that had plagued mankind for centuries — such as tetanus and diphtheria — and improved the production of smallpox vaccine.
At the time, Canada did not have facilities to manufacture significant amounts of these life-saving medications.
To address this gap, Toronto physician Dr. John G. FitzGerald set up a small, backyard horse stable where he could produce diphtheria antitoxin.
From this tiny operation, FitzGerald made a proposal to the University of Toronto to establish a self-supporting, not-for-profit Antitoxin Laboratory. His proposal was accepted by the university in May 1914, and the Antitoxin Laboratory was born.
The lab underwent several name changes in the coming years; it was called Connaught Antitoxin Laboratories (1917-23), Connaught Laboratories (1923-1946), and Connaught Medical Research Laboratories (1946-72), before being privatized in 1972.
Over the next 58 years, it specialized in public health and preventative medicines — most notably antitoxins, vaccines, and insulin.
No matter its name, the history of Connaught Laboratories is the story of vaccination production in Canada. In 2002, a collection of materials from Connaught Medical Research Laboratories were entrusted to the Ingenium collection, many of which are featured in this story.
Smallpox
Smallpox was a potentially deadly, contagious disease caused by the variola virus. Victims were stricken with fever and fatigue, and soon broke out into a rash of red blisters.
Around 30 per cent of sufferers died, and many more were left blind and/or disfigured by scars.
Smallpox plagued humankind even before recorded history, though some scholars believe it originated in Northeastern Africa around 10,000 BCE. Along ancient trade routes, smallpox spread to Southeast Asia, China, and Europe, killing millions.
Smallpox first arrived in the Americas with the Spanish, devastating Indigenous communities. With no immunity to the virus, over 90 per cent of the Indigenous people in both North and South America died. In some areas—such as Cuba—there were virtually no Indigenous survivors.
In Africa and Asia, a technique known as variolation developed over centuries, where scabs from individuals suffering from the disease were used to inoculate healthy individuals, causing mild sickness followed by immunity. This technique was risky, however, as it could transfer other diseases to the healthy patient, or potentially cause a full-blown smallpox infection.
In 1716, a man from west Africa named Onesimus was enslaved to Puritan minister Cotton Mather in Boston. Onesimus shared the variolation technique against smallpox with Mather. This effective technique was eventually adopted widely in both the colonies and Western Europe.
Mather and physician Zabdiel Boylston experimented with the variolation technique in 1721, inoculating their families and those enslaved by them. They wrote about their work in a pamphlet, An Historical Account of the Small-pox Inoculated in New England.
Edward Jenner vaccinating a boy (painting). (1884/1884) by E.-E. HillemacherOriginal Source: Wellcome Collection
The first successful vaccine to combat smallpox spread was developed by Dr. Edward Jenner in 1796, building on the variolation technique demonstrated by Onesimus, and described in Boylston’s pamphlet.
His idea to derive the vaccine from cowpox — a related but less severe disease than smallpox — made his technique less risky to the patient.
In Canada, Dr. Alexander Stewart of Palmerston founded the Ontario Vaccine Farm in 1885, following a particularly deadly outbreak in Montreal that spread into eastern Ontario.
Smallpox vaccine production was transferred to the Antitoxin Laboratory in 1916, in order to keep up with demand due to the First World War.
Smallpox vaccine was produced by introducing calves to the vaccinia virus — a relative of smallpox — which caused reactions on their underbelly that were then pricked with points.
These points would then be poked into the forearm of the vaccine recipient to stimulate immunity.
Connaught produced a “glycerinated” vaccine (purified using glycerin and sterile water) rather than vaccine points, which was safer and had a longer shelf life.
Vaccination techniques
Prior to advances in the 1950s, smallpox vaccine could be delivered in two ways: scratch or puncture.
Scratch meant the administrator scratched the patient’s arm, and rubbed the vaccine into the scratch.
Puncture meant a drop of vaccine was placed on the skin, and a needle was used to puncture through it.
Later, a bifurcated (two tipped) needle dipped into a small amount of vaccine was used to puncture the skin several times, leaving a characteristic scar.
Smallpox is the only disease to have been declared eradicated by the WHO thanks to world-wide vaccination campaigns.
Diphtheria
Diphtheria, the deadly disease caused by the Corynebacterium diphtheriae bacteria, was the leading cause of death in Canadian children until the mid-1920s. It killed over 2,000 people each year.
Diphtheria produces a toxin in the body, resulting in a sticky coating on the throat and nasal tissues, making it impossible to breathe. Colloquially, it was known as “The Strangler.”
Like smallpox, diphtheria is spread through droplets in the air expelled by the infected person. Without access to effective treatments, patients were quarantined in their homes.
Diphtheria antitoxin, created in Germany in 1890, was the only effective treatment for diphtheria until a vaccine was developed in 1926. Supplies in Canada were low and the cost was out of reach for most Canadians before 1914.
Dr. FitzGerald founded the Antitoxin Laboratory in 1914 to produce diphtheria antitoxin in Canada, and sold it to Ontario’s board of health at cost.
The diphtheria vaccination was still in medical trials in January 1929, when a remote community in northern Alberta called Little Red River sent a frantic telegram to Edmonton: DIPHTHERIA. FEAR EPIDEMIC. SEND ANTITOXIN.
Famous World War I flying ace Wilfrid “Wop” May, along with business partner Vic Horner, made an historic and dangerous flight to deliver a supply of diphtheria antitoxin to treat those affected, along with the new toxoid vaccination for inoculating the community.
The outbreak was contained, and only one person died.
Tetanus
During the First World War, tetanus was a major concern for wounded soldiers. Tetanus bacteria live in soil, dust, and manure, and the soldiers were fighting on farmland that had been heavily fertilized with manure.
Ideally, any wounded soldier would have received a tetanus shot as part of their treatment to prevent this deadly infection. There was no domestic supply, so the Antitoxin Laboratory began producing tetanus antitoxin for Canadian troops in 1916.
Click here to go to Part 2: Influenza - Polio - Combined vaccines.
Ingenium would like to thank Dr. Christopher Rutty for his consultation on this project, and for work on the history of vaccination and disease in Canada.
For more resources, please consult:
History of Connaught Laboratories
A series of articles by Dr. Christopher Rutty on the history of Connaught Laboratories and Public Health in Canada
Vaccines and Immunization: Epidemics, Prevention and Canadian Innovation
Online Exhibit by Dr. Christopher Rutty for the Museum of Health Care.
The Spanish Flu and Canadian Influenza Vaccine Initiatives
By Dr. Christopher Rutty
History of Connaught
Part of the Insulin100: The Discover of Insulin project for Defining Moments Canada (Dr. Christopher Rutty).
Sanofi Pasteur: The Legacy Project
Timeline of vaccination research and development at the Connaught Lab, 1914 to the present (Dr. Christopher Rutty).
