Common Cold Unit

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The Common Cold Unit (CCU) or Common Cold Research Unit (CCRU) was a unit of the British Medical Research Council which undertook laboratory and epidemiological research on the common cold between 1946 and 1989 and produced 1,006 papers. [1] The unit studied etiology, epidemiology, prevention, and treatment of common colds. [2] It utilised Harvard Hospital, near Salisbury, a redundant Second World War-duration emergency infectious diseases field-hospital at Harnham Down.

Contents

Common colds account for a majority of all acute respiratory infections, [3] and the economic costs are substantial in terms of sick leave. [4] The public-facing side of the CCU involved continually recruiting human volunteers, by advertising. Volunteers were housed at the hospital, for typically ten-days while participating in common cold trials. Some degree of isolation from each other was enforced as well as restrictions on leaving the site.

Human coronaviruses, which are responsible for about 10% of common colds, were first isolated from volunteers at the unit in 1965. The unit closed in 1990. The site was later redeveloped and absorbed into the city of Salisbury, although there is memorial plaque referring to its former use as the Harvard Hospital.

History

Dr Kruse's 1914 findings

In 1914 at the Hygienic Institute, University of Leipzig, German bacteriologist Dr. Walther Kruse, showed that nasal secretions from people with colds could be filtrated to make them free from bacteria; and, that inoculation of those filtrated washes into the nose of other people could cause the same illness. [nb 1] [5] [6] It was the first direct evidence that colds were an infectious disease and that they were caused by something other than bacteria. [5] [nb 2]

Alphonse Dochez's 1920s / 1930s research

Dr Alphonse Dochez, a bacteriologist, at the Rockefeller Institute began to follow up the work that Dr. Walther Kruse started. [7]

Christopher Andrewes

Harvard Hospital site

The Harvard hospital was built, in the early 1940s, within an UK Emergency Hospital building programme. By July 1941, France had fallen and there was a fear of the spread of infectious diseases; and, this hospital was specifically set up to address that threat. It was to be the first Infectious Diseases hospital, of its type, in the United Kingdom. [8]

America was neutral at this time, as expressed in U.S. Neutrality Act. However, both the President of Harvard University and the Dean of their Medical school wished to provide direct medical assistance to the United Kingdom's Medical profession. In face-to-face discussions with the Chief Medical Officer, at the UK's Ministry of Health, Harvard University was prepared to offer a group of experts in bacteriology, epidemiology, nutrition, sanitation, medicine and surgery. [8] The Chief Medical Officer was concerned that a group of American medical experts would find it difficult to fit in to the English Public Health System, which was very different to the American system. It was decided they would supply the United Kingdom with a complete Infectious Diseases Unit, fully equipped and staffed. [8] It was to be sited close to Salisbury, as there was a lack of hospitals in this area capable of treating patients with Infectious Diseases. The hospital was also equipped with a mobile Infectious Diseases field-unit that could be moved around to carry out field tests anywhere in the United Kingdom. [8]

This was almost entirely provided by the joint efforts of Harvard University and the US Red Cross. It was decided that the American Red Cross had to have control of the hospital, so as to comply with the Neutrality Act. [8] The Ministry of Health (for England and Wales), however, bought the land from its existing owners; provided services, such as water, electricity and sewage; and, paid for the on-going costs, such as food, cooking, cleaning and laundry.

The hospital was scheduled to be ready for receiving patients by 22nd September 1941. It had fewer patient's beds than other emergency hospitals set up under emergency hospital-building programme, in this case only 125 beds, but hosted a fully-equipped emergency public health laboratory to handle infectious diseases. There was also on-site living accommodation and facilities for the American volunteer doctors, nurses and non-medical personnel; and, a decontamination unit. [8]

Statistics later showed that a majority of its patients were infectious troop casualties brought back from Europe, but there were, also, civilian patients. [8] When the US entered the War, the Red Cross and Harvard University pulled their staff out; and the Hospital was run by US Army personnel until 1945, when Red Cross and Harvard University donated the hospital back to the United Kingdom Public Health authorities. [5]

Adapting the existing hospital facilities for Common Cold testing

The Harvard Hospital was constructed in 1941 as a complex of twenty-two standard-size prefabricated buildings. Ten of these buildings extended at right angles from a long central covered boardwalk and were used as hospital wards. The remaining six buildings, which connected to the main covered boardwalk, housed support services such as laboratories, administration, laundry facilities and a central kitchen. [9]

A further six buildings - comprising, two groups of three staggered buildings - located some distance from the main hospital complex, served as residential accommodation for the American doctors and medical personnel assigned to operate the hospital. [9] During its subsequent use as a United States Army hospital, additional structures were erected to support expanded medical operations and animal-testing.

Following the end of the Second World War, the American staff vacated the hospital. Although the facility remained structurally intact, it was left without medical personnel or patients. As a result, the site became available for reuse and was later adapted to serve as a Common Cold Unit, requiring only minimal structural modification. All the buildings had central heating; and were being used for storage at this time. [9]

The design and layout of the former hospital made it particularly suitable for this purpose. Its configuration allowed for the prevention or minimisation of cross-contamination, both between small groups of volunteers — typically consisting of two or three individuals within a total population of twenty to thirty volunteers at any given time — and between volunteers and the medical and support staff working at the unit.

This was achieved by modifying the six stand-alone - former American residential accommodation - buildings: by dividing each one into two halves. They were fitted out to provide, in total, twelve self-contained flats, each with an semi-enclosed entrance porch at one end. The six porches at one end of the buildings were linked by newly constructed semi-enclosed, covered, boardwalks; and, the six porches at the other end of the buildings were also linked by semi-enclosed, covered boardwalks. These boardwalks lead back to the central hospital covered boardwalk.

The porches had two uses: food cooked in the hospital kitchen could be delivered to each flat in insulated food containers and left in the porch for the volunteers to retrieve. The second use was to allow medical staff to dress up in protective coverings and a don a face mask before entering the flat so as to carry out the mandatory daily check on each volunteer: known as Matron's check.

Each fully-furnished flat had living accommodation for two or three people, so one flat could house a married couple, or two or three single people; there was a telephone, a sitting room, a small kitchen / dinner; and, room for Matron to carry out medical checks - in private - on a volunteer.

Creation of the Common Cold Unit

Around 1946, Medical Research Council agreed to fund a research project on the Common Cold, using human volunteers. A research station, known as the Common Cold Unit was set up using the buildings of the former Harvard Hospital site in Salisbury, England. [5] [10] [11] The Ministry of Health, as was the case in the Second World War, remained responsible for employing and paying the wages of the catering and maintence staff; and the Matron.

The initial aims of the Unit were to identify the viruses that caused the Common Cold, in humans; and, to learn how to propogate them in a laboratory, so that they could be studied.

Testing of human volunteers

Ethics

In 1992 Dr Tyrrell wrote, reflecting backwards on the ethics of carrying out trials on human subjects at the Common Cold Unit. In 1946, when the Unit started-up, the Nuremberg trial was current news; and later, in June 1964, the Helsinki Declaration was adopted in Helsinki, Finland. Both of these events would strongly influence what particular types of testing the Medical Research Council would allow the Unit to carry out on human subjects. [12]

As an example, he mentioned one particular suggestion as to how volunteers might be found: it was that Prisoners released on parole (requiring good conduct), or servicemen might, be recruited. However, it was decided that "being under strong discipline they could not be considered to volunteer freely"; and, so the suggestion was rejected. [12] However, it was decided that servicemen on paid leave could volunteer, if this was their own personal decision. [12]

The Volunteers' experience

Twenty to thirty volunteers were required every fortnight during Common Cold trial periods. The unit advertised in newspapers and magazines for volunteers, who were paid a small amount[ quantify ]. A stay at the unit was presented in these advertisements as an unusual holiday opportunity. [nb 3]

Potential volunteers had to contact the Unit in advance - they could not just turn up; and, if accepted would be given a list of trial dates, written information on: the CCU; the facilities; the restrictions on (not) socialising / leaving the site; and the trial procedures, particularly what would happen to them. [nb 4] The arrival day was usually a Wednesday. With ten-day trials, this gave the Unit a few days to clean up and decontaminate the accommodation, ready for the next ten-day trial. UK non-local volunteers would usually be able to travel to and from the Unit by train; and would be collected at Salisbury railway station and taken to the Unit by road transport. [nb 5] Volunteers from overseas, however, did not receive compensation for their travel expenses.

Volunteers were either to be infected with preparations of cold viruses, or they were used as a control group. The control groups would be given a preparation that was free any of infection. Volunteers typically stayed for ten days and were housed in small groups of two or three, with each group strictly isolated from the others during the course of their stay. They were allowed to go out for walks in the countryside south of Salisbury, but residential areas were out of bounds.

As a screening test, no treatments were applied during the first five days. However, if a volunteer presented symptoms of the Common Cold within these first five days, they were considered ineligible to continue the trial. Volunteers could be asked to leave if they broke the isolation rules.

Discoveries

The first coronavirus (B814) was found in washes from a boy with typical common cold symptoms in 1960 during the study led by virologist David Tyrrell at the Common Cold Unit. After washes were inoculated to volunteers and tested for known viruses none was found. Publication about first human coronavirus was published in The BMJ in 1965. Later virologist June Almeida imaged virus for the first time and group of eight virologists including June Almeida named it coronavirus in their publication in 1968. [13]

Results

During the CCU's existence, thousands of volunteers participated in research in which they were inoculated with common cold viruses or were in a control group, [14] but no cure for the common cold was found. [15] Some compounds were active against rhinoviruses in vitro but did not demonstrate clinical efficiency. Interferons alpha and beta administered intranasally before infection effectively prevented infection with rhinoviruses, coronaviruses, influenza viruses, and respiratory syncytial virus, but they were not as effective during treatment and had local side effects so they have not been used in routine practice against these viruses. [15] Despite these dead ends, the findings made by the CCU improved the understanding of respiratory viruses, their lifecycles, and possible vaccines. [16]

Sources

Books

Journals, papers and newspapers

Web sites

Footnotes

  1. ↑ Andrewes (1965), Chapter 6, states that a sample of nasal secretion was taken from Kruse's assistant, who had a cold. It was diluted 15-fold with Saline solution; and the four out of the twelve staff given drops of this solution developed a cold between one and three days after receiving the drops.
  2. ↑ Note: During WW I Kruse served in the German medical Corps, it appears that Christopher Andrewes met him - lost citation, need to find it [Pyrotec].
  3. ↑ It appears that volunteers, when they left at the end of a trial were given these adverts to hand out to their friends, workmates, follow club members.
  4. ↑ It is not known if potential volunteer had to provide relevant medical information at this stage about, for example, any allergies, asthma, etc, or whether this information was sought during the first day at the CCU.
  5. ↑ It is not know for certain how this was administered. The volunteer may have received a Railway warrant which was to be presented at the volunteer's nearest railway station and exchanged for a return train ticket, or they bought their own return ticket and claimed the money back when the reached the CCU.

References

  1. ↑ Oransky, Ivan (18 June 2005). "David Tyrrell, Obituary". The Lancet. 365 (9477): 2084. doi:10.1016/S0140-6736(05)66722-0. PMID   16121448. S2CID   43188254. Archived from the original (PDF) on 28 August 2021.
  2. ↑ Halstead, Scott B. (9 April 2020). "An Urgent Need for "Common Cold Units" to Study COVID-19". The American Journal of Tropical Medicine and Hygiene. 102 (6): 1152–1153. doi:10.4269/ajtmh.20-0246. ISSN   0002-9637. PMC   7253108 . PMID   32274988.
  3. ↑ Tobin, Ellis H.; Thomas, Micah; Bomar, Paul A. (2025), "Upper Respiratory Tract Infections With Focus on The Common Cold", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   30422556 , retrieved 9 February 2026
  4. ↑ "The common cold coughs up $40 billion annual price tag". EurekAlert!. Retrieved 9 February 2026.
  5. 1 2 3 4 Lorber, Bennett (April 1996). "The common cold". Journal of General Internal Medicine. 11 (4): 229–236. doi:10.1007/BF02642480. ISSN   0884-8734. PMC   7089473 . PMID   8744881.
  6. ↑ Andrewes, Sir Christopher (1965). "Chapter 6: Early Research Work on Colds". The Common Cold. London: Weidenfeld and Nicolson.
  7. ↑ Eccles, Ronald; Weber, Olaf (2009). Common Cold. Birkhauser Advances in Infectious Diseases. Basel: Birkhauser. ISBN   978-3-7643-9894-1.
  8. 1 2 3 4 5 6 7 Dunn, C. L. (1952). "Chapter 14: The Provision of Medical Personnel". The Emergency Medical Services, Volume I: England and Wales. History of the Second World War: Medical Volumes. H.M.S.O and Longmans, Green and Co. pp. 393 - 394 & 435 - 437.
  9. 1 2 3 Andrewes, Sir Christopher (1965). "Chapter 7: The Common Cold Research Unit at Salisbury". The Common Cold. London: Weidenfeld and Nicolson.
  10. ↑ "Andrewes, Sir Christopher Howard (1896–1988), virologist" . Oxford Dictionary of National Biography (online ed.). Oxford University Press. 23 September 2004. doi:10.1093/ref:odnb/40059. ISBN   978-0-19-861412-8. Archived from the original on 18 September 2021. Retrieved 18 September 2021.(Subscription, Wikipedia Library access or UK public library membership required.)
  11. ↑ Tyrrell, D. A. (July 1987). "The common cold--my favourite infection. The eighteenth Majority Stephenson memorial lecture". The Journal of General Virology. 68 ( Pt 8) (8): 2053–2061. doi: 10.1099/0022-1317-68-8-2053 . ISSN   0022-1317. PMID   3039038.
  12. 1 2 3 Tyrrell, D A J (June 1992). "Mini Review: A view from the Common Cold Unit". Antiviral Res. 18 (2): 112–113. doi:10.1016/0166-3542(92)90032-Z. PMC   7133934 . PMID   1329647.
  13. ↑ Mahase, Elisabeth (16 April 2020). "Covid-19: Coronavirus was first described in The BMJ in 1965". BMJ (Clinical Research Ed.). 369 m1547. doi: 10.1136/bmj.m1547 . ISSN   1756-1833. PMID   32299810. Archived from the original (PDF) on 28 August 2021.
  14. ↑ Ellis, Harold (4 January 2003). "Cold Wars: The Fight against the Common Cold". BMJ: British Medical Journal. 326 (7379): 57. doi:10.1136/bmj.326.7379.57/a. ISSN   0959-8138. PMC   1124964 .
  15. 1 2 Snell, N. J. C. (March 2001). "New treatments for viral respiratory tract infections—opportunities and problems". Journal of Antimicrobial Chemotherapy. 47 (3): 251–259. doi:10.1093/jac/47.3.251. ISSN   0305-7453. PMC   7110210 . PMID   11222557.
  16. ↑ Lambkin-Williams, Rob; Noulin, Nicolas; Mann, Alex; Catchpole, Andrew; Gilbert, Anthony S. (22 June 2018). "The human viral challenge model: accelerating the evaluation of respiratory antivirals, vaccines and novel diagnostics". Respiratory Research. 19 (1): 123. doi: 10.1186/s12931-018-0784-1 . ISSN   1465-993X. PMC   6013893 . PMID   29929556.

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