At the infection front

Ninety-five years ago, the physician Rocha Lima discovered the origin of exanthematic typhus in Germanyanha

Fundo Rocha Lima, Centro de Memória do Instituto Biológico de São Paulo reproduções eduardo cesarRocha Lima in a German military uniform in 1914, at the start of the research into exanthematic typhus.Fundo Rocha Lima, Centro de Memória do Instituto Biológico de São Paulo reproduções eduardo cesar

During his early days in Berlin, Germany, the physician Henrique da Rocha Lima (1879-1956) found the climate “detestable” and the language, hard to understand; his only acquaintance had been devastated by the death of his father, and Lima himself was worried by the lack of news about his family. In that year, 1901, the new graduate found himself in Europe to improve his knowledge of microbiology, clinical surgery and pathologic anatomy. He began alternating years of studying his areas of specialization in German institutions with his work at IOC, the Oswaldo Cruz Institute, in Rio de Janeiro, until he established himself in Germany in 1909. When he returned to Brazil permanently in 1928, his days of malaise seem to have been rewarded: he had built a solid international career, the apex of which was the discovery of the cause of exanthematic typhus, in 1916. He was also a major promoter of exchange between the two countries’ scientists and was the administrator who consolidated the Biological Institute of São Paulo.

Rocha Lima spent only eight months at the Institute of Pathologic Anatomy at the University of Jena before moving to the Institute of Maritime and Tropical Diseases in Hamburg, thanks to an invitation from the Czech protozoologist Stanislas von Prowazek. Here, he continued studying the pathologic anatomy of yellow fever, as he did at the IOC. He also worked with Chagas’ Disease, researched the formation of nodules of the Peruvian wart and proved that what causes histoplasmosis, a lung infection, is a fungus rather than a protozoan.

During the First World War, Rocha Lima and Prowazek were assigned to the investigation of the exanthematic typhus epidemic that put the German troops at risk. The disease’s symptoms are similar to those of flu, but with skin eruptions (exanthemas). In less severe cases, the patient is cured, but when the disease affects the nervous system death is almost invariably the outcome. Associated with poverty and poor hygiene, typhus is highly infectious.

In 1909, Charles Nicolle, from the Pasteur Institute in Tunis, Tunisia, announced that transmission took place through body lice. In 1910, Howard Ricketts, from the University of Chicago, in the United States, carried out research in Mexico City that pointed to a bacillus-like microorganism as the pathological agent. Ricketts became infected, dying that very same year. Rocha Lima and Prowazek entered this race in 1914. One year later, Prowazek, having been contaminated, also died. The Brazilian became infected as well, but survived and carried on with the research. In 1916, in Berlin, Rocha Lima presented his results on the microorganism, which he named Ricketsia prowazek, in honor of Ricketts and Prowazek. He advocated that this was the true cause of exanthematic typhus, found in body lice.

“At that time, there were more than 30 pathogens put forth by other scientists struggling for priority,” says André Felipe Cândido da Silva, author of the doctoral thesis on the path of the Brazilian, which he defended in October, at Oswaldo Cruz House in Fiocruz, Rio de Janeiro. Rocha Lima stated also that at that time it was still impossible to determine whether this was indeed a bacteria or another type of microorganism. Years later, other research studies confirmed that R. prowazek was indeed what caused typhus and that it belonged to a new category of microorganisms, named rickettsia. “He always reaffirmed his priority in these discoveries that, to this day, are sometimes ascribed only to Ricketts,” Andre Felipe tells us.

The researcher returned to Brazil to become one of the leaders of the Biological Institute, set up in 1927, and he was important for its consolidation. One of the routines that he instituted became famous: the meetings held on Fridays, known as “sextaferinas” (roughly translatable as “Fridayers”) to discuss relevant scientific articles. These were also attended by researchers from other institutions. “In 1948, I was a medical student and I used to go to these meetings. The person who took me along was an important researcher, José Ribeiro do Valle, to hear the summaries and discussions on the most recent advances in our area,” says 84-year old Alda de Campos Lavras, a retired researcher from the Butantan Institute.

In São Paulo, Rocha Lima kept up his connections with Germany. During the Nazi period, he employed in the Biological Institute a number of persecuted German Jewish researchers and indicated others to foreign institutions. Even so, his admiration for German culture caused him to accept and receive, in 1938, from the hands of Adolf Hitler, the order of the German Eagle, Second Class, for his scientific contributions to the nation during the time he spent there.