In August this year Dr. Alvin Zipursky, a Canadian physician and researcher, died at the age of 90. He was renowned for improving children’s health in Canada and around the world and made research discoveries that were central to developing a life-saving treatment for a deadly disease called rhesus hemolytic disease, also known as Rh disease. Before a treatment was available, many Canadian women lost their babies to Rh disease, a condition that can develop in pregnancy when the mother and baby have incompatible blood types.
Dr. Zipursky’s research and a collaboration with Drs. Bruce Chown and John Bowman at the University of Manitoba in the early 1960s fed into the global pursuit, and eventual discovery, of a treatment for Rh disease. A Toronto Star profile of Dr. Zipursky from 2016 calls Rh disease “the biggest public health success story that many Canadians under 50 have likely never heard of—probably because they have had no occasion to worry about it.”
In Canada today, a widely available preventative treatment for pregnant women—an injectable drug called Rh immunoglobulin (known as WinRho in Canada)— has spared babies who once would have been killed or disabled by Rh disease. But in developing countries, the disease continues to be a problem. A 2013 study published by Dr. Zipursky and colleagues estimated that each year Rh disease kills 114,000 newborns and brain damages 75,000.
The lasting global impact of Dr. Zipursky’s achievements have been well described in other tributes (including this one in the Globe and Mail), but his personal influence on employees at Canadian Blood Services is less well known. Below, those with a special connection to Dr. Zipursky describe how his drive to eradicate Rh disease worldwide continues to inspire their work at Canadian Blood Services.
Introducing a test that identifies babies at risk and conserves drug supply
Although Dr. Zipursky’s early work was about detecting and treating Rh disease, his later work focused on public policy—that’s where our paths connected. He helped me by advocating for a test that could identify early on in a woman’s pregnancy which babies were at risk for Rh disease so that treatment with Rh immunoglobulin could be targeted to women who needed it.
Currently, all women with an RhD-negative blood type are considered to be at risk for having a baby with Rh disease and are routinely treated with Rh immunoglobulin, even if about 40% of them don’t actually need it because their baby’s blood type is compatible with their own. Today, a baby’s blood type is not identified during pregnancy, so it’s not possible to know if there is an incompatibility or not. The test Dr. Zipursky and I were pushing for is called “non-invasive perinatal testing”—using a sample of the mom’s blood, it’s possible to identify the blood types of both the mom and baby to figure out if there is an incompatibility, and therefore a need for treatment. I am still carrying on that work today.
Shortly after I started working at Canadian Blood Services in 2014, out of the blue I got an email from Dr. Zipursky. He had emailed Graham (Sher) and said, “Canada needs to get on board with non-invasive perinatal testing—what are you doing about this?” Graham told him to get in touch with me since I’d been working away for years to develop this test.
Subsequently, Dr. Zipursky would check in with me every 4-6 months, asking how he could help. I would suggest a name and he would send off an email championing funding that would change how we test prenatal patients in Canada. He’d basically tell a minister of health or anyone who could help, “What are you doing to eradicate Rh disease? Get on with it!”
Eradicating Rh disease worldwide
I never got to know Dr. Zipursky personally; I knew him mostly from his fame. I’ve always admired his work! Canadians should be so proud of his contributions.
Since I did my medical training in Mexico, I am painfully aware of the fact that Rh immunoglobulin is available but mostly in the developed world. There are still a lot of women who do not get Rh immunoglobulin when they’re supposed to get it, and they are still having babies that are affected by Rh disease. This should not be happening—this is a condition that is treatable and preventable.
In 2018, the 50th anniversary of the invention of Rh immunoglobulin was celebrated with a series of academic talks. During those celebrations, a realization hit the scientific community: Rh disease was not a problem of the past. It was still affecting thousands of women and babies in developing countries.
That’s how WIRhE was born, a non-profit organization I volunteer with. It’s a worldwide initiative—we need to develop the strategies needed to truly eradicate Rh disease worldwide. Dr. Zipursky was an honorary WIRhE member and did some of the early work in exploring the global toll of Rh disease.
My colleague Steven Spitalnik is the executive director of WIRhE and had the good fortune to know Dr. Zipursky. He described him to me as a wonderful human being who had completely inspired him. For me, I feel like he’s always behind me saying, “What have you done today to eradicate this disease?
The profound and simple pursuit of always acting in the interests of patients
I had the privilege of knowing and working with Dr. Zipursky during the time I was doing part of my hematology residency and fellowship training in Toronto, both at The Hospital for Sick Children and The Toronto Hospital. Not only was “Zip,” as we affectionately called him, one of the most gracious, kind and generous teachers and colleagues, he was revered by his patients, their families, and all who came into contact with him.
Early on in my professional career as a hematologist he imbued in me, as he did in countless trainees and practitioners, a profound and simple pursuit of acting—always and forever—in the interests of patients. Even when I moved into my administrative roles at Canadian Blood Services, Zip would periodically call me up and, as Gwen relays in her anecdote above, he would urge me to “get on and do it”—in this case develop and implement non-invasive prenatal testing.
His scientific legacy on our industry, both in Canada and internationally, is profound and far-reaching. But I will always remember Zip as the consummate human being, and a man filled with an enormous generosity of spirit. That, to me, is his true legacy.
To learn more about Rh disease and read the latest news from WIRhE, visit the WIRhE website.
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The opinions reflected in this post are those of the author and do not necessarily reflect the opinions of Canadian Blood Services nor do they reflect the views of Health Canada or any other funding agency.