{{Short description|British public health physician (1927–2008)}} {{Use dmy dates|date=August 2024}} {{Infobox medical person | honorific_prefix = | name = Spence Galbraith | honorific_suffix = | image = | image_size = | alt = | caption = | birth_name = Nicol Spence Galbraith | birth_date = {{birth date|1927|3|17|df=y}} | birth_place = Southborough, Kent | death_date = {{death date and age|2008|8|7|1927|3|17|df=y}} | death_place = | death_cause = | nationality = <!-- use only when necessary per WP:INFONAT --> | citizenship = <!-- use only when necessary per WP:INFONAT --> | education = *Tonbridge School *London University *Guy's Hospital *London School of Hygiene and Tropical Medicine | occupation = Epidemiologist | years_active = | known_for = *Founding the PHLS Communicable Disease Surveillance Centre (1977–1987) *Role in UK smallpox outbreak (1978) *Alerting of Infected blood products (1983) | relations = | website = | profession = Physician | field = Public health | work_institutions = *Lewisham Hospital *Guy's Hospital *Brook General Hospital *London School of Hygiene and Tropical Medicine *St Bartholomew's Hospital | specialism = | research_field = | notable_works = | prizes = *Freedom of the City of London (1976) *Jenner Medal of the Royal Society of Medicine (1991) *Pumphandle Lecture (1994) | child = | module2 = | signature = }} '''Nicol Spence Galbraith''' (17 March 1927 – 7 August 2008) was a British physician in public health and founding director of the Central Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC). The results of his efforts were demonstrated in 1978, when he represented the PHLS following the smallpox outbreak in Birmingham. Five years later, he warned the government of possible infected blood products.
In 1958, Galbraith joined the Epidemiological Research Laboratory of the Central PHLS, Colindale, which at the time was part of the Medical Research Council (MRC). After five years of working with vaccine trials, polio vaccine safety, and monitoring of foodborne disease, he was appointed deputy medical officer of health for Newham, East London, and in 1974 became the area medical officer. In 1976, he re-joined the PHLS and as director of the CDSC, set up teaching courses for NHS epidemiologists, and improved surveillance programmes in infectious disease.
In 1991, Galbraith was awarded the Jenner Medal of the Royal Society of Medicine, and in 1994, he delivered the John Snow Society's Pumphandle Lecture.
==Early life and education== Nicol Spence Galbraith was born in Southborough, Kent, on 17 March 1927, to Samuel Nicol Galbraith, the then medical officer of health for south west Kent.<ref name=RCP>{{cite web |title=Nicol Spence Galbraith {{!}} RCP Museum |url=https://history.rcplondon.ac.uk/inspiring-physicians/nicol-spence-galbraith |archive-url=https://web.archive.org/web/20220525221154/https://history.rcplondon.ac.uk/inspiring-physicians/nicol-spence-galbraith |archive-date=25 May 2022 |access-date=20 June 2024 |website=history.rcplondon.ac.uk}}</ref> He completed his early education at Tonbridge School, before gaining a place at London University to study medicine, and subsequently qualified in 1950 from Guy's Hospital.<ref name=RCP/><ref name=Bartlett2009>{{cite journal |last1=Bartlett |first1=Christopher |last2=Galbraith |first2=Sarah |title=Spence Galbraith |journal=BMJ |date=7 May 2009 |volume=338 |article-number=b1827 |doi=10.1136/bmj.b1827 |url=https://www.bmj.com/content/338/bmj.b1827 |language=en |issn=0959-8138|url-access=subscription}}</ref>
==Early career== Galbraith completed house officer posts at Lewisham Hospital and Guy's.<ref name=RCP/> In 1952, he enlisted with the Royal Army Medical Corps (RAMC) to do his National Service.<ref name=RCP/> The following year, he was posted to Egypt, where he served as deputy assistant director of army health, based at the Suez Canal zone.<ref name=RCP/><ref name=Bartlett2009/> There, he had to attend to a paratyphoid B fever outbreak.<ref name=RCP/><ref name=Bartlett2009/> In 1954, he gained the diploma in public health after completing studies at the London School of Hygiene and Tropical Medicine (LSHTM).<ref name=RCP/><ref name=TMD1974>{{cite book |title=The Medical Directory (A-Mac) |date=1974 |location=London |isbn=0-443-01204-0 |page=863 |edition=130th |last1=Sciences |first1=Elsevier Health }}</ref>
In 1958, after four years of house jobs at Brook General Hospital and the Lewisham Hospital, Galbraith joined the Epidemiological Research Laboratory of the Central Public Health Laboratory Service (PHLS), Colindale, which at the time was part of the Medical Research Council (MRC).<ref name=RCP/><ref name=Bartlett2009/> He remained there as an epidemiologist for five years.<ref name=Bartlett2009/> There, his work involved looking at vaccine trials, polio vaccine safety, and monitoring of foodborne disease.<ref name=RCP/> In 1963, he was appointed deputy medical officer of health for Newham, East London. The following year, he made his first call for a national epidemiological service that would be centrally co-ordinated.<ref name=Bartlett2009/> In 1974, he became the area medical officer of the City and East London Area Health Authority.<ref name=RCP/><ref name=Bartlett2009/>{{efn|A post created following the re-organisation of the NHS on 1 April 1974. Local authorities in health were abolished, and area health authorities introduced.<ref name=Jonas1975>{{cite journal |last1=Jonas |first1=Steven |last2=Banta |first2=David |title=The 1974 reorganization of the British National Health Service: An analysis |journal=Journal of Community Health |date=1 December 1975 |volume=1 |issue=2 |pages=91–105 |doi=10.1007/BF01319203 |pmid=819465 |url=https://link.springer.com/article/10.1007/BF01319203#:~:text=The%20Reorganization%20attacked%20one%20serious,administrative%20units%20with%20different%20boundaries. |language=en |issn=1573-3610|url-access=subscription }}</ref>}} During that time, he continued work on polio and BCG vaccines, and called for a centrally funded co-ordinated national epidemiological service, based on the American Centers for Disease Control and Prevention (CDC). He had previously first published on the case in 1968, in an article titled "Epidemiology and the Green Paper – a National Epidemiological Service".<ref name=RCP/><ref name=Kirchhelle2022>{{cite journal |last1=Kirchhelle |first1=Claas |title=Giants on Clay Feet—COVID-19, infection control and public health laboratory networks in England, the USA and (West-)Germany (1945–2020) |journal=Social History of Medicine |date=17 June 2022 |volume=35 |issue=3 |pages=703–748 |doi=10.1093/shm/hkac019 |pmid=36046218 |issn=0951-631X|pmc=9384317 }}</ref><ref>{{cite journal |last1=Galbraith |first1=N.S. |title=Epidemiology and the Green Paper – a National Epidemiological Service |journal=The Lancet |date=December 1968 |volume=292 |issue=7582 |pages=1339–1340 |doi=10.1016/S0140-6736(68)91831-X |pmid=4177402 |url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(68)91831-X/fulltext|url-access=subscription }}</ref>
==Later career== In 1976, Galbraith re-joined the PHLS after being asked to establish a national unit that could report and control communicable disease.<ref name=RCP/><ref name=Kirchhelle2022/> The following year, he became the founding director of the Communicable Disease Surveillance Centre (CDSC).<ref name="Lancaster2022"/> It consisted of Galbraith, one other medical officer and a secretary.<ref name="Lancaster2022"/> Administered by the Central Public Health Laboratory Service (PHLS), he chose the Broad Street pump as its logo.<ref name=Bartlett2009/><ref name=Stanwell2003>{{cite journal |last1=Stanwell-Smith |first1=Rosalind |title=Cholera, Chloroform, and the Science of Medicine: a Life of John Snow |journal=Journal of the Royal Society of Medicine |date=December 2003 |volume=96 |issue=12 |pages=612–613 |pmc=539667 |issn=0141-0768}}</ref> That year, he visited Alexander Langmuir at the CDC in Atlanta and subsequently began expanding the CDSC.<ref name=Kirchhelle2022/><ref name=Pollock2012>{{cite book |last1=Pollock |first1=George |title=An Epidemiological Odyssey: The Evolution of Communicable Disease Control |date=2012 |publisher=Springer |isbn=978-94-007-3997-0 |pages=67–68 |chapter-url=https://books.google.com/books?id=_y-NTs39QB0C&dq=Galbraith+smallpox+1978&pg=PA67 |language=en |chapter=6. A need for damage limitation}}</ref> As director of the CDSC, he set up teaching courses for NHS epidemiologists, and improved surveillance programmes in infectious disease.<ref name=RCP/> The weekly bulletin was his creation.<ref name=Pollock2003/> At the same time, he lectured at St Bartholomew's Hospital Medical School and at the LSHTM.<ref name=RCP/>
===1978 smallpox outbreak in Birmingham=== {{main article|1978 smallpox outbreak in the United Kingdom}} The results of Galbraith's successful efforts as director of the CDSC were demonstrated in 1978, when he represented the PHLS following the smallpox outbreak in Birmingham, attending the initial meeting at Birmingham area Health Authority's headquarters along with Alasdair Geddes, Surinder S. Bakhshi, William Nicol, and Henry Bedson.<ref name=Commons1979>{{cite book|author=Great Britain. Parliament. House of Commons|url=https://books.google.com/books?id=Hjs6AQAAIAAJ|title=Parliamentary Papers, House of Commons and Command|publisher=H.M. Stationery Office|year=1979|pages=70–74}}</ref><ref name=Shooter1980>{{cite book |last1=Shooter |first1=R. A. |title=Report of the investigation into the cause of the 1978 Birmingham smallpox occurrence |date=22 July 1980 |publisher=Her Majesty's Stationery Office |location=London |url=https://www.nlm.nih.gov/nichsr/esmallpox/report_1978_london.pdf |archive-url=https://web.archive.org/web/20240531122546/https://www.nlm.nih.gov/nichsr/esmallpox/report_1978_london.pdf |archive-date=31 May 2024}}</ref> To assist at a local level, he transferred a few epidemiologists to Birmingham and confirmed that testing would be done at the Colindale laboratory.<ref name=Pollock2003>{{cite book |last1=Pollock |first1=George |title=Fevers and Cultures: Lessons for Surveillance, Prevention and Control |date=2003 |publisher=CRC Press |isbn=978-1-857-75583-1 |page=1994 |chapter-url=https://books.google.com/books?id=L_28EAAAQBAJ&dq=galbraith+1978+smallpox&pg=PA1994|chapter=3. Surveillance |language=en}}</ref><ref name=Commons1979/> In 1981, he was unsuccessful in his call for a local surveillance system that would include a clinical epidemiologist.<ref name="Lancaster2022">{{cite book |last1=Lancaster |first1=James |url=https://www.infectedbloodinquiry.org.uk/evidence/expg0000129-supplementary-report-structures-and-funding-communicable-disease-control |title=A supplementary report into structures and funding of the communicable disease control system by Dr James Lancaster and Professor Allyson Pollock – 15 Nov 2022 {{!}} Infected Blood Inquiry |last2=Allyson |first2=Pollock |author-link2=Allyson Pollock |date=2022 |archive-url=https://web.archive.org/web/20240624170030/https://www.infectedbloodinquiry.org.uk/sites/default/files/Completing%20Publication/Completing%20Publication/EXPG0000129%20-%20A%20supplementary%20report%20into%20structures%20and%20funding%20of%20the%20communicable%20disease%20control%20system%20by%20Dr%20James%20Lancaster%20and%20Professor%20Allyson%20Pollock%20-%2015%20Nov%202022.pdf |archive-date=24 June 2024}}</ref><ref name=Pollock2003/>
===Contaminated blood scandal=== {{Main article|Contaminated blood scandal in the United Kingdom}} On 9 May 1983, after reviewing literature revealing that 11 cases of AIDS in the United States, three in Spain, and one in Wales, were detected in people who had received American Factor VIII, Galbraith wrote to Ian Field of the UK Department of Health and Social Security, and suggested to withdraw products made in the US from blood donated after 1978:<ref name=Penrose/><ref name=Galbraith2008>{{cite web |title=Letter from N S Galbraith to Carol Grayson – 14 Apr 2008 {{!}} Infected Blood Inquiry |url=https://www.infectedbloodinquiry.org.uk/evidence/witn1055133-letter-n-s-galbraith-carol-grayson-14-apr-2008 |website=www.infectedbloodinquiry.org.uk |access-date=25 June 2024|archive-url=https://web.archive.org/web/20240625155746/https://www.infectedbloodinquiry.org.uk/sites/default/files/Docs%20Part%2019%202/Docs%20Part%2019/WITN1055133%20-%20Letter%20from%20N%20S%20Galbraith%20to%20Carol%20Grayson%20-%2014%20Apr%202008.pdf|archive-date=25 June 2024}}</ref>
<blockquote>I have reviewed the literature and come to the conclusion that all blood products made from blood donated in the USA after 1978 should be withdrawn from use until the risk of AIDS transmission by these products has been clarified.<ref name=Penrose>{{cite web |title=Preliminary Report Chapter 8: HIV and AIDS |url=https://www.penroseinquiry.org.uk/preliminary-report/chapter-8/ |website=www.penroseinquiry.org.uk |access-date=21 June 2024|archive-url=https://web.archive.org/web/20230419000652/https://www.penroseinquiry.org.uk/preliminary-report/chapter-8/|archive-date=19 April 2023}}</ref><ref name=Coombes2007>{{cite journal |last1=Coombes |first1=Rebecca |title=Bad blood |journal=BMJ (Clinical Research Ed.) |date=28 April 2007 |volume=334 |issue=7599 |pages=879–880 |doi=10.1136/bmj.39195.621528.59 |pmid=17463458 |issn=1756-1833|pmc=1857798 }}</ref></blockquote>
The paper Galbraith submitted on the matter was considered and rejected at a meeting of the biological sub-committee of the Committee on Safety of Medicines on 13 July 1983.<ref name=Penrose/>
===Other=== In 1986, Galbraith contributed to the founding of the British Paediatric Surveillance Unit, which functioned to detect new diseases in children.<ref name=Bartlett2009/> A vaccine advocate, he developed a way to examine risks of live polio vaccine, and was able to show the safety and efficacy of giving the BCG, diphtheria-tetanus, and oral polio vaccines at the same time.<ref name=Bartlett2009/> At the CDSC, he created an immunisation department for monitoring vaccine safety, efficacy, and coverage.<ref name=Bartlett2009/>
==Awards and honours== For his efforts as area medical officer in East London, Galbraith was made Freedom of the City of London in 1976.<ref name=RCP/> As president of the Epidemiology and Community Medicine Section of the Royal Society of Medicine (RSM), he delivered his presidential address in 1980.<ref name=RCP/><ref name=Galbraith1981>{{cite journal |last1=Galbraith |first1=N S |title=A National Public Health Service |journal=Journal of the Royal Society of Medicine |date=January 1981 |volume=74 |issue=1 |pages=16–21 |doi=10.1177/014107688107400105 |pmid=7007637 |pmc=1438324 |language=en |issn=0141-0768}}</ref> In 1991, he was awarded the RSM's Jenner Medal.<ref name=RCP/> In 1994, he delivered the John Snow Society's Pumphandle Lecture on the life of John Snow, titled "Dr John Snow – Early Life and Later Triumphs. An exploration of Snow's work from the epidemiological perspective".<ref name=Stanwell2003/><ref>{{cite web |date=9 September 1994 |title=1994 Dr Spence Galbraith: Dr John Snow – Early Life and Later Triumphs |url=https://johnsnowsociety.org/1994/09/09/1994-dr-spence-galbraith-dr-john-snow-early-life-and-later-triumphs/ |archive-url=https://web.archive.org/web/20240623131321/https://johnsnowsociety.org/1994/09/09/1994-dr-spence-galbraith-dr-john-snow-early-life-and-later-triumphs/ |archive-date=23 June 2024 |access-date=21 June 2024 |website=The John Snow Society}}</ref>
==Personal and family== Galbraith married Zina-Mary née Cullingworth Flood, in 1952. They had three daughters.<ref name=RCP/> At a young age, due to severe rheumatoid arthritis, he had two hip replacements.<ref name=Bartlett2009/>
==Death== Galbraith died on 7 August 2008, following a heart attack.<ref name=Bartlett2009/>
==Selected publications== ===Articles=== *{{cite journal |last1=Galbraith |first1=N.S. |title=Epidemiology and the Green Paper – a National Epidemiological Service |journal=The Lancet |date=December 1968 |volume=292 |issue=7582 |pages=1339–1340 |doi=10.1016/S0140-6736(68)91831-X |pmid=4177402 |url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(68)91831-X/fulltext|url-access=subscription }} *{{cite journal |last1=Galbraith |first1=N. S. |title=Salmonella Infection in a Meat Products Factory: The Role of the Medical Officer of Health |journal=Journal of Applied Bacteriology |date=April 1967 |volume=30 |issue=1 |pages=148–158 |doi=10.1111/j.1365-2672.1967.tb00284.x |pmid=6045099 |url=https://enviromicro-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2672.1967.tb00284.x |language=en |issn=0021-8847|url-access=subscription }} *{{cite journal |last1=Galbraith |first1=N. S. |last2=Young |first2=Susan E. J. |title=Communicable disease control: the development of a laboratory associated national epidemiological service in England and Wales |journal=Journal of Public Health |date=May 1980 |volume=2 |issue=2 |pages=135–143 |doi=10.1093/oxfordjournals.pubmed.a043298 |pmid=7398237 |url=https://academic.oup.com/jpubhealth/article-abstract/2/2/135/1612941?redirectedFrom=fulltext|url-access=subscription }} *{{cite journal |last1=Galbraith |first1=N S |title=A National Public Health Service |journal=Journal of the Royal Society of Medicine |date=January 1981 |volume=74 |issue=1 |pages=16–21 |doi=10.1177/014107688107400105 |pmid=7007637 |pmc=1438324 |language=en |issn=0141-0768}} *{{cite journal |last1=Galbraith |first1=N. S. |last2=Forbes |first2=P. |last3=Clifford |first3=C. |title=Communicable disease associated with milk and dairy products in England and Wales 1951–80. |journal=British Medical Journal (Clin Res Ed) |date=12 June 1982 |volume=284 |issue=6331 |pages=1761–1765 |doi=10.1136/bmj.284.6331.1761 |pmid=6805699 |url=https://www.bmj.com/content/284/6331/1761.short |language=en |issn=0007-1447|pmc=1498668 }} *{{cite journal |last1=Galbraith |first1=N. S. |last2=Barrett |first2=Nicola J. |last3=Stanwell-Smith |first3=Rosalind |title=Water and Disease After Croydon: A Review of Water-borne and Water-associated Disease in the UK 1937–86 |journal=Water and Environment Journal |date=August 1987 |volume=1 |issue=1 |pages=7–21 |doi=10.1111/j.1747-6593.1987.tb01184.x |bibcode=1987WaEnJ...1....7G |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1747-6593.1987.tb01184.x |language=en |issn=1747-6585|url-access=subscription }} *{{cite journal |last1=Galbraith |first1=N. S. |title=CDSC: From Cox to Acheson |journal=Community Medicine |date=1989 |volume=11 |issue=3 |pages=187–199 |doi=10.1093/oxfordjournals.pubmed.a042467 |jstor=45156808 |pmid=2691191 |issn=0142-2456}} *{{cite journal|title=Quarterly Communicable Disease Review January to March 1991: From the PHLS Communicable Disease Surveillance Centre|url=https://academic.oup.com/jpubhealth/article-abstract/13/3/219/1537106?redirectedFrom=fulltext&login=false |volume=13 |issue=3|page=219 |journal=Journal of Public Health|year=1991|author=Galbraith, N. S.|doi=10.1093/oxfordjournals.pubmed.a042622 |url-access=subscription}}
===Books=== *{{cite book |title=Infection |date=1982 |publisher=Grant McIntyre |location=London}} *{{cite book |title=Dr John Snow: his early years |date=2002 |publisher=The Royal Institute of Public Health |location=London}}
==Notes== {{notelist}}
==References== {{Reflist}}
==Further reading== *[https://www.bmj.com/content/suppl/2009/05/07/bmj.b1827.DC1/galbraith0409long.pdf "N. S. Galbraith". ''British Medical Journal''] *{{cite journal |title=Quarterly Communicable Disease Review January to March 1991 |journal=Journal of Public Health |date=August 1991 |volume=13 |issue=3 |pages=219–225 |doi=10.1093/oxfordjournals.pubmed.a042622 |url=https://academic.oup.com/jpubhealth/article-abstract/13/3/219/1537106?redirectedFrom=fulltext|url-access=subscription }}
{{Authority control}}
{{DEFAULTSORT:Galbraith, Nicol Spence}} Category:1927 births Category:2008 deaths Category:British epidemiologists Category:British medical researchers Category:People educated at Tonbridge School Category:Recipients of the Jenner Medal of the Royal Society of Medicine Category:People from Southborough, Kent Category:British academic administrators Category:British medical writers Category:Public Health England Category:Administrators in the National Health Service Category:Fellows of the Faculty of Public Health Category:21st-century British medical doctors Category:Vaccination advocates Category:Alumni of the University of London Category:Royal Army Medical Corps officers