Professor Ruth Francis Bishop
12/05/1933 – 12/05/2022
Qualifications
AC BSc MSc PhD DSc DMedSc (Hon) FRACP (Hon)
Ruth Bishop’s name will forever be linked with the discovery of rotavirus in 1973 - one of the commonest causes of death from gastroenteritis in infants worldwide.
This virus was estimated to kill more than 500,000 children each year in the 1970’s. What set her apart, is that she and her colleagues not only discovered this lethal virus, but Ruth also contributed enormously to development of vaccines to prevent its serious effects. Rotavirus vaccination is recommended by the WHO for all children. Since 2008 every Australian child has received an oral rotavirus vaccine, and by the time of her death in 2022 it was included in the routine childhood immunisation schedule in more than 60 countries.
Her career
Ruth graduated BSc in 1954, MSc 1958, PhD 1961, DSc 1978, and was awarded and Honorary Doctorate of Medical Science in 2010, all from the University of Melbourne.
Her first job was in the Department of Surgery at the Royal Melbourne Hospital, working with Prof Maurice Ewing on gut bacteria. She was then a bacteriologist - not a virologist.
She went to Liverpool, UK with her obstetrician husband Geoff Bishop, and 3 young children from1962 to 1965, but still found time to be a Research Fellow in the Dept of Surgery at the Hospital where Geoff was working.
In 1968 Ruth was recruited by Prof Charlotte Anderson as Research Assistant in the Gastroenterology Research Unit, and so began her life-time association with the Royal Children’s Hospital. Prof Anderson was the 1st Paediatric Gastroenterologist in Australia, and one of the first world-wide. The Department of Gastroenterology, like others in the early days of sub-specialisation in child health, was a research department, partly funded by the RCH Research Foundation. Ruth assisted Charlo, as she was known, with her pioneering studies on chronic diarrhoea in children, including cystic fibrosis and coeliac disease, at a time when the difference between those conditions was unclear. Ruth became familiar with small bowel biopsy, which later proved to be the pivotal test leading to the discovery of Rotavirus.
Selected Appointments and Awards
Dr Bishop was a Research Assistant then Fellow in the RCH Dept of Gastroenterology 1968 – 2000, then Senior Principal Research Fellow in the MCRI. She was an NHMRC Principal Research Fellow, and Honorary Professorial Fellow in Dept of Paediatrics, University of Melbourne.
Other appointments included CEO of RCH Research Foundation, Secretary of the National Association of NHMRC Research Fellows, member of the NHMRC Regional Grants Committee, President of the Paediatric Research Society of Australia and Director of the Australian National Rotavirus Surveillance Centre.
Ruth was much better known overseas than in Australia. Dr Roger Glass from the Centre for Disease Control, Atlanta, labelled her ‘The Icon of Rotavirus’. She had many roles with WHO, including Chair of the Steering Committee on Viral Diarrhoeal Diseases, Chair of a Scientific Working Group on Immunology, Microbiology and Vaccine Development, Director of the WHO Regional Collaborating Rotavirus Laboratory, and Special Adviser to the WHO Vaccine Development Program. More recently she was a member of the Rotavirus Working Group for the Bill and Melinda Gates Children’s Vaccine Program. Bill Gates has published a statement that Ruth Bishop’s work was a catalyst for he and his wife Melinda to set up their Foundation.
In 2019 she was appointed Companion of the Order of Australia (AC), which replaced her AO (1996). She smiled when her staff called her Lady Bishop. Other awards included the University of Melbourne 1978 Selwyn Smith Prize for Clinical Research, the 1994 RCH Gold Medal, the Clunies-Ross National Science and Technology Award (1998) and an Honorary Fellowship of the Royal Australasian College of Physicians (2007). She was the first woman to be awarded the prestigious Florey Award (2013).
International awards include the Children’s Vaccine Initiative Pasteur Award presented in Geneva by Sir Gus Nossal, wearing his WHO hat. This honour was shared with Dr Kapikian and Dr Flores from NIH Washington, and Dr Glass from CDC Atlanta. In Bangkok she was presented with the Prince Mahidol Award for ‘outstanding achievements in medicine and public health worldwide’.
Ruth Bishop had very large numbers of publications (>>200) in prestigious journals, Lancet and NEJM being amongst them. She was also in great demand as a speaker in the international arena, in USA, Europe, Indonesia, Africa - and the Bunyip Country Women’s Association.
So how did the discovery of Rotavirus come about?
Charlotte Anderson who had recruited her, left for the Chair of Paediatrics in Birmingham, UK in 1968. Dr Rudge Townley who had returned from Boston, took over as Director of Gastroenterology. He had a particular concern about acute diarrhoea. There was a special ward for gastroenteritis at RCH, and numbers were such that overflow to Fairfield ID Hospital was needed at times. Dr Townley wanted to apply the new technology, as used in chronic diarrhoea, in acute diarrhoea. Ruth Bishop was Research Fellow in the new Clinical Dept of Gastroenterology. She agreed to apply her bacteriology skills to try to find the elusive cause. Dr Graeme Barnes joined the Gastro Dept in 1971, supported by an RCH Foundation scholarship. His supervisors were Dr Townley and Dr Ruth Bishop, and they explored during 1971 and 1972, possible causes of gastroenteritis. A lot of work by Ruth using her meticulous bacteriology skills, virtually excluded bacteria. However the site of pathology was shown to be the small bowel, not stomach or large bowel. The degree of damage in the duodenum was comparable to that seen in coeliac disease. The site of the lesion was clearly identified.
Ruth was not satisfied with the outcome of 2 year’s work. She was impressed with the severity of damage in the small bowel, and felt deeply that it was where the search should be focused. RCH did not have an electron microscope at that time, but she pursued her idea that there might be a virus causing the damage. She discussed her idea with Dr Ian Holmes at the Dept of Microbiology, University of Melbourne, then persuaded Rudge Townley to ask Dr Geoff Davidson, the next Gastroenterology Research Fellow, to do some more tests before he started his own planned research programme. Geoff sent 9 specimens to Ian Holmes.
BINGO!! Ian found a new virus in 6 of the 9.
Graeme Barnes came back through Melbourne in 1973 from UK on his way to a job in Dunedin, NZ.
“We think we’ve found it”, she told him.
Geoff Davidson never started his own project! He embarked on a prospective 15 month survey of all children admitted to RCH with gastroenteritis. He found that Rotavirus caused gastroenteritis in > 50 % of the 378 children admitted. Cases where the cause was known went up to 73 % in 1974, from only 12% in 1972. This finding was then rapidly confirmed in Birmingham, Washington and Toronto, once everyone knew what to look for.
Soon afterwards, Ruth met Dr Yati Soenarto in Indonesia, who has collaborated with the RCH Campus ever since. Her study in Yogyakarta reported in 1981, showed that rotavirus was also the most common cause of gastroenteritis in Indonesian children. It soon became clear that Rotavirus infection was the most common cause of severe dehydrating diarrhoea in children worldwide.
It was a virus: perhaps a vaccine could be developed, and in fact several very successful oral candidates have been. All give the 1st dose after 6 weeks of age – too late in some parts of the world.
After the discovery, Ruth worked with the next Research Fellow, Dr Don Cameron, and found that many healthy full-term newborns in Melbourne obstetric hospitals were excreting a unique strain of rotavirus, yet had no symptoms. Graeme Barnes returned to Melbourne in1975, and the team conducted a 3 year follow-up of infected neonates, versus those who were known not to be infected during the first weeks of life. It showed they were protected against the severe effects of community outbreaks of rotavirus. So it might be an ideal vaccine. This unique strain called RV3.BB, has been developed by Ruth’s team. It came from neonates with no symptoms, and has been successfully trialled giving the 1st dose at birth, in Melbourne, New Zealand, Indonesia and Malawi, by Prof Julie Bines who now leads the team. Given at birth is the best time for access to infants in some parts of the world. It is likely to be introduced into the Indonesian infant immunisation schedule in 2024, and probably elsewhere in Asia. This may help further reduce global gastroenteritis mortality, which has already fallen from more than 500,000 per year to 200,000 per year, using current rotavirus vaccines.
Throughout several decades Ruth trained a large number of scientists – national and international. They enjoyed a terrific relationship with their boss, and they regarded her as a real friend. Many influential international colleagues lined up at a conference in Melbourne in 2016, desperate to get their photo taken with ‘The Icon of Rotavirus’.
Ruth was a team player, always giving credit to her staff. They adored her.
Socially, Ruth and Geoff from time to time hosted the whole Department at their home in Kinane Street. On one memorable occasion Geoff popped a champagne cork, which went directly up and smashed a fluorescent light. Tiny slivers of glass and powder descended on a great smorgasbord. Ruth was only fazed for a moment. Emergency steaks were were procured from the freezer and the barbecue fired up. She always had another strategy available.
Ruth’s children and grandchildren will realise over time that she was one of the world’s really great scientists, who contributed immensely to the welfare of children around the world.
PS: The RCH no longer needs a special ward for children with gastroenteritis.
Adapted from a Eulogy presented by Graeme Barnes at Ruth Bishop’s Memorial Service on 24th May 2022.