Lives of the fellows

Stephen Dyonis Elek

b.24 March 1914 d.21 January 1992
MRCS LRCP(1939) MB BS Lond(1940) MD(1943)DPH(1943) DCP(1945) PhD(1948) DSc(1958) MRCP(1960) MRCPath(1962) FRCPath(1963) FRCP(1971)

Stephen Elek was born in Budapest, Hungary, the son of Desiderius (Deszo) and Anna Elek. He was educated at the Lutheran High School and began his medical studies in Hungary. After coming to the UK he continued his studies at St George’s Hospital medical school, Hyde Park Corner, where he qualified in 1939. As a student, he was awarded the Webb prize in bacteriology. In 1940 he was appointed assistant bacteriologist in the pathology department. He held the Laking-Dakin fellowship in pathology, 1942-43, and also became clinical pathologist to the Maida Vale Hospital for Nervous Diseases, 1946-47. During the whole of his time at St George’s he pursued microbiological research energetically, obtaining a PhD and being appointed a consultant bacteriologist in 1948. He was later awarded a DSc on the basis of his published work. In 1956, with a Fulbright fellowship, he worked on tissue culture with John Hanks at Harvard Medical School, USA. On his return to St George’s in 1957, he was appointed to the chair of medical microbiology, to be the first head of the new department. This was the consummation of a change for which he had worked hard - the independence of microbiology. With the same inspiration, ten years later, he was able - with Tom Parker - to persuade the Pathological Society to split its Journal of Pathology and Bacteriology into two separate journals in 1968: the Journal of Pathology and the Journal of Medical Microbiology. He was the senior editor of the latter which soon became a successful journal of high repute.

Stephen considered himself primarily to be an immunologist and his other major heart’s desire was the establishment of immunology as a discipline at St George’s; this was not achieved until 1978, five years after his retirement. To mark the occasion, he endowed an undergraduate Elek prize in the subject.

In 1953 Stephen Elek had foreseen that departmental expansion was essential: he recruited Leslie Butler to provide expertise in bacteriological chemistry and, later, bacterial genetics and also Harold Stern who was destined to go to the USA for a year to equip himself for the setting up of a clinical virus laboratory - one of the earliest to be established in Britain. Later, in 1966, he persuaded the Public Health Laboratory Service to establish a Public Health Laboratory, directed by Douglas Fleck, to join the Tooting section of the St George s microbiology department. This was only the second instance of the integration of a PHLS Laboratory with a medical school - the first was at Cambridge - and it has been a most fruitful association. In 1984, Stephen’s personal qualities, his international reputation and the benefits he conferred on the school, were acknowledged by the naming of the new microbiology laboratories at Tooting as ‘The Stephen Elek Laboratories’.

Stephen had a considerable private income and chose to retire early, in 1973, foreseeing without relish the increased bureaucracy that would result in 1974 from the first of the several reorganizations experienced in the NHS.

Among his more notable researches in immunology and microbiology was his early work on the serological reactions of staphylococcus aureus and diphtheria toxins, with Emmanuel Levy, the first valuable outcome of this being the ‘Elek plate’, a test for the identification of virulent diphtheria bacilli which obviated any further need for the use of animals for the purpose. This was a special example of his ‘right-angle double-diffusion in gel’ method for the analysis of antigen and antibody mixtures. In 1954, with Dick Hilson, a similar approach was applied to pairs of antibiotics diffusing at right angles into nutrient agar inoculated with bacteria, with later sampling which detected whether there was increased or decreased bacterial action in the area of interaction - synergism or antagonism.

Elek was always ready to recruit human volunteers - members of his department and students - to investigate problems of pathogenicity in which animal inoculation was unhelpful. In 1955 he showed that at least a million stap.aureus are needed to cause a purulent lesion after intradermal injection into human skin, though as few as 200 were effective if incorporated into a suture knotted tightly in the skin; a finding significant for the subject of surgical infection. In 1957, the suggestion that certain strains of clostridium perfringens (welchii) could cause diarrhoea was tested by him in volunteers and found to be true.

In collaboration with colleagues at Harvard in 1956, he succeeded in obtaining limited growth inside macrophages of the bacilli that cause rat leprosy. These bacteria, which could not then be cultured in vitro, were used as a model for the related human leprosy bacilli, which can still be grown only in animals. This was the start of his interest - with Hilson - in leprosy, which has continued in his department up to now. Meanwhile, his interest in staph.aureus, then known as pyogenes, had continued and in 1959 his book Staphylococcus pyogenes and its relations to disease, Edinburgh & London, Livingstone, was published. This book was recognized as authoritative and, together with the immunological studies already mentioned, led to his name and that of St George’s becoming known throughout the world of microbiology.

That same year, by the use of the newly established virus laboratory, Elek, Stern, Millar and Anderson recognized a new disease: presumed bacterial whitlows on the fingers of nurses in the neurosurgical unit were shown to be examples of primary herpes simplex virus infection contracted from the saliva of unconscious patients receiving mouth toilet, preventable by the wearing of gloves by the nurses. Stephen Elek’s later areas of work were on 'resistotyping’ and in virology. Resistotyping was a method he devised for distinguishing between different strains of a bacterial species for epidemiological purposes; genetically unrelated strains showed different patterns of inhibition (resistotypes) by a set of several chosen inhibitors eg. metal salts, organic chemicals. The method was independent of immunology or bacteriophages and was found to be valid by testing it on species for which there were recognized trying systems. In the virus field, with Stern, he studied the natural history of cytomegalovirus infection which had only recently been recognized as a cause of neonatal congenital abnormalities.

Stephen had strong artistic sensibilities, except for music since he was tone deaf, and was himself a most accomplished sculptor. A favourite recreation was to model busts of friends and colleagues; they combined the highest artistic content with instant recognition of the subject. His bronze head ‘Dr Anthony Feiling’ - senior neurologist at St George’s [Munk's Roll, Vol.VI, p.173] - was accepted for the Royal Academy’s Summer Exhibition of 1950. He had a lively sense of humour and specialized in jokes about Hungarians - either to their credit or their detriment. In committee he could occasionally be ‘a bit Hungarian’ (as we might put it) but his colleagues, whether retired or still at St George's, treasure affectionate memories of a very vivacious and gifted friend.

Stephen married Sarah Joanna Hall in 1947; there are three daughters and several grandchildren. He was deeply interested in all of them and a very proud grandfather.

G R F Hilton

[The Times, 14 Feb 1992;The Independent, 30 Jan 1992; The Daily Telegraph, 31 Jan 1992]

(Volume IX, page 150)

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