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Race for a Remedy

Retired from the track, thoroughbred First Flight served as a "factory" to produce botulism antitoxin

"If a horse ever knew his value to the medical world, it was First Flight. He was a fractious, hot-blooded, pumped-up, macho horse," says George Lewis, who worked with First Flight for many years. Now retired, Lewis was a colonel in the U.S. Army Veterinary Corps when he worked with First Flight at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick, Maryland. Its mission is to develop medical countermeasures — vaccines, drugs and diagnostics — to protect American military personnel from biological warfare agents and endemic infectious diseases.

First Flight was not vicious or dangerous but had a mind of his own, says Lt. Col. Terry Besch, another veterinarian who worked with the horse for years.

"Woe to the technician who didn't have a way with horses," she says. First Flight would "lightly nip. A loud 'Hey!' and quick snap on the lead line by an experienced person" and First Flight cooperated again. He then stood nicely to be groomed or have his blood withdrawn and "gratefully accepted a pat and a carrot, then he was off to the fields to boss around the other horses," Besch says. He was almost always the dominant horse in the pasture, "proud and full of himself as if he knew he had some importance."

Using delicate and dangerous techniques, a research team under Lewis' direction produced small quantities of each of the seven toxin types and slightly changed them so that they would not be toxic to First Flight. Instead they would cause him to respond by producing antibodies that would neutralize botulinum toxin. Lewis injected these new products, called toxoids, into First Flight. Then, once the horse had developed antibodies, the actual toxin — in carefully titrated amounts — would be injected to further boost antibody production. It was this procedure that frightened and worried Lewis: if he miscalculated, the injections could kill the horse.

Time after time, as he approached First Flight, syringe in hand, Lewis prayed, "God, I hope I got it all right."

"I was attached to the horse and the project, and to the importance of what we were doing," Lewis continues. "We'd double- and triple-checked everything, but still I had doubts, concerns and fears. I knew there were 10 to 100 times the amount of antibody in him than was needed to neutralize the toxin" that he was about to inject into First Flight. Still, he spent a number of uneasy nights sleeping in the barn with the big, dark bay gelding, checking him every few hours for signs of botulism poisoning.

First Flight wasn't always a compliant patient. Lewis remembers one crisp fall day in a big field at Fort Detrick. "With fire in his eyes, he almost killed me."

First Flight had had enough of the discomfort from people sticking needles into him. The horse tolerated injections and bleedings on a regular basis, without tranquilizers. But on this day, First Flight fought medical research. He swung around quickly as Lewis swabbed his hip for yet another injection and double-kicked his rear legs.

A hoof whisked by each of Lewis' ears. "I stepped back, let him — and me — calm down and then immunized him," Lewis remembers.

In 1980 First Flight was transferred to the University of Minnesota Medical School, which had developed the best technology in the country for processing equine immunoglobulin. Under contract to the Army, researchers there collected some 1,600 liters of blood from First Flight over the course of the next decade — storing the hyperimmune plasma and returning the red blood cells, in saline, to the horse's circulatory system. In 1990, as trouble escalated in the Persian Gulf, the Army asked the Minnesota researchers to use the stored plasma to produce large quantities of botulinum antitoxin. The serum from First Flight thus became the sole source of the "heptavalent" botulinum antitoxin shipped in 1991 to Saudi Arabia to treat soldiers and civilians, a precaution in case Iraqi President Saddam Hussein unleashed biological weapons during the Gulf War.

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