The Worldwide Effort to Eradicate Polio

In the 1950s, when the weather began to turn warm and swimming pools to open, fear spread throughout the United States. Summer had the dubious name of “polio season,” and millions avoided public swimming pools and movie theaters to protect themselves and their children.

The panic was so widespread that insurance companies sold polio insurance for newborns because they were the most at risk of death from the disease.

Today, many people living in the United States have no concept of the fear that overwhelmed the nation, but in the 1950s the terror was valid. Polio is a highly contagious and crippling disease that radically altered the lives of thousands.

The Victims of Polio

 Between the 1940s and early 1950s, polio sickened and crippled 35,000 each year in the U.S. giving it the dubious reputation of being on the list of the most feared diseases in the twentieth century.

 In the year 1952, 60,000 children had become infected with the Poliomyelitis virus, and thousands were paralyzed. More than 3,000 children died in special hospital units equipped with iron lung machines to help keep victims alive.

The poliovirus is easily spread from person to person through the fecal-oral route but can also be spread by bathing or swimming in contaminated water or eating contaminated food.

Unfortunately for the smallest victims, the infection can be spread by contact with toys that have been handled by a child who has already been infected.

The child who is infected may not be showing signs yet, so often the spread of the disease in a nursery or other daycare situation was insidious striking down even young infants.

The Symptoms and Progression of Polio

Polio did not kill or cripple everyone who contracted it in the mid-20th century. Only 25% (1 in 4) people infected with Polio experienced flu-like symptoms making the transmission of the virus to others a greater risk. This mild infection has been given the name non-paralytic polio.

The mild symptoms that were experienced usually lasted only 2-5 days and then vanished on their own.

However, for some people, infection by the poliovirus was much more severe and affected their brains and spinal cords causing paralysis. This type of polio is called paralytic polio.

The paralysis brought on by the poliovirus is so severe that it could lead to permanent disability and even death. In fact, during the polio outbreak in the 1950s in the United States, 10 out 100 died because their diaphragms were paralyzed and made them unable to breathe.

Paralytic polio begins with the same flu-like symptoms as nonparalytic polio, but within a week other signs appear such as a loss of reflexes, severe pain, and weakness in the muscles, and loose/floppy limbs.

Many children and adults found themselves living with partial or total paralysis that can last a lifetime.

The Iron Lung

 No other treatment for polio is as iconic as the iron lung. It was invented in 1927 by Philip Drinker and Louis Agassiz Shaw at Harvard University.

The iron lung was powered by an electric motor with two vacuum cleaners that pumped air in and out of an airtight, cylindrical metal box. The changes in air pressure would force air into and out of the lungs enabling the person living inside to breathe.

The person lay inside the iron lung on a bed that slid inside and outside of the metal cylinder and had windows to allow attendants to adjust limbs or insert hot packs to ease the pain of cramping muscles.

It was extremely hard for those imprisoned in the iron lung to speak as the device breathed for them at least fifteen times per minute. Also, since the person was lying on their back 24/7 for at least two weeks, they could not see anything but what was right above them. That is why pictures of iron lungs in use have a mirror to allow the person some freedom to converse.

Although most people who entered an iron lung to keep them breathing were only there for a few weeks, there were a few exceptions.

Martha Lillard from Central Oklahoma is one of six polio survivors in the United States still living inside an iron lung. She has lived inside the bulky device for sixty-five years after entering it the first time when she was a five-year-old kindergarten student.

There exist on the internet pictures, like that I’ve posted here, of entire wards of children inside iron lungs, and some devices were large enough to hold several children at the same time.

 

 

 

 

 

It is understandable why so many parents were terrified by even the word polio.

 

The Salk Polio Vaccine

 The world received wonderful news on April 12, 1955, Dr. Jonas Salk announced the discovery of a polio vaccine that worked. Seemingly overnight, the horrifying epidemic of polio came to an end in the United States.

At that time, the prevailing belief among scientists was that a vaccine that was effective could only come from development from live viruses.

Dr. Salk went against this wisdom, he used dead polioviruses and injected them into the bloodstream tricking the patient’s immune system into producing antibodies to defend against the disease.

Dr. Jonas Salk Left

Many famous scientists scoffed at Dr. Salk’s approach calling it dangerous and doomed to failure. Dr. Albert Sabin, a virologist who was busy trying to develop an oral form of live virus vaccine called Dr. Salk “a mere kitchen chemist.”

However, in 1938 the National Foundation for Infantile Paralysis was founded by President, Franklin D. Roosevelt and co-founded by Lawyer Basil O’Connor to fight against polio and find a vaccine. Dubbed “The March of Dimes” by a national radio star, the organization, when word arrived of a possible vaccine by Dr. Salk, the March of Dimes through their full support behind the doctor.

After inoculating thousands of monkeys, Dr. Salk decided to give the vaccine to the children at two Pittsburgh institutions, himself and his family. Afterward, on March 26, 1953, Dr. Salk announced triumphantly that the first human trials of the vaccine and were safe.

In today’s medical climate, and for obvious reasons, the method used to test the vaccine initially would be considered unethical and illegal.

In April 1954, the most significant public clinical trial began in the United States, and in three months 1.8 million people had received the vaccine as “polio pioneers.”

Dr. Albert Sabin, who had been in competition with Dr. Salk for the creation of an effective polio vaccine, argued that the vaccine developed by Dr. Salk would create more cases of polio than it would prevent. However, the vaccine was given to thousands of volunteers.

April 12, 1955, the polio vaccine developed by Dr. Jonas Salk was declared “safe, potent and effective.” Later CBS newsman Edward R. Burrow interviewed Dr. Salk and asked him who owned the patent for the vaccine.

Dr. Salk’s answer can be torn apart by those who think his response was self-serving in that any patent served for the vaccine might have failed. However, it is this author’s opinion that Dr. Salk was giving away to the world something precious that he just did not want to become rich upon.

Dr. Jonas Salk answered Mr. Burrow stating, “There is no patent. Could you patent the sun?”

After Dr. Salk’s public statement on who owns the polio vaccine, the lawyers for the March of Dimes, who had been looking at the possibility of patenting the medicine for the foundation dropped the idea.

The world is a better place because a man who could have become enormously wealthy decided to give life to the world instead.

To this author, Dr. Salk is seen a hero.

The effort by Dr. Salk with the help of funds from The March of Dimes paid off enormously as the vaccine developed became the answer to the nightmare of a nation and a weary world.

Post-polio syndrome

Post-polio syndrome (PPS) is a condition that can strike an estimated 25-40% of those who were infected with the poliovirus and survived. In 1994-1995, there were estimated to be around 1 million polio survivors still alive in the United States with 443,000 reporting to have lived through paralytic polio.

PPS is not contagious and thus cannot be caught, and only a polio survivor may develop the disorder.

Post-polio syndrome seems to affect its victims in line with the severity of the first infection they experienced. People who had a mild case of nonparalytic polio will have a milder form of PPS while those who suffered the worst with paralytic polio may develop a more severe case.

The symptoms of post-polio syndrome occur several years after the first infection and are listed below:

  • Progressive muscle or joint weakness and pain
  • Fatigue
  • Muscle wasting (atrophy)
  • Breathing or swallowing problems
  • Sleep-related breathing disorders, such as sleep apnea
  • Decreased tolerance of cold temperatures

Complete Polio Eradication Remains a Worldwide Goal

 While there remains no cure for polio, the extensive use of the polio vaccine has almost ended the horror of the disease from humanity.

After the vaccine was developed in 1955, it was and continues to be given to people around the globe. The more affluent countries, such as the United States, eliminated polio almost entirely by the 1960s and 1970s.

By the 1980s large outbreaks occurred among the world’s population in 125 countries with over 350,000 cases documented.

To help curb the danger of polio to the people of poorer countries, the Global Polio Eradication Initiative (GPEI) was founded to fight polio by increasing vaccinations in affected areas.

Until 2016, worldwide cases of polio had been reduced by 99.99%. However, due to war and poverty the virus remains actively circulating in three countries, Afghanistan, Pakistan, and Nigeria.

A New Type of Polio?

 In 2013, a medical group in Texas observed a pattern of 1-4 cases of a polio-like illness. Then in October 2014, a report issued in Neurology Today, Dan Hurley stated there were outbreaks in California and Colorado and the possibility of 100 or more cases nationwide in the United States.

The criteria used to confirm cases of what was called acute flaccid myelitis (AFM) included MRI imaging and the elimination of diseases with similar symptoms such as traverse myelitis and Guillain-Barre Syndrome.

Through an online email list that doctors had subscribed to, more cases in Alabama and Kansas were suspected, with the largest cluster in Colorado with 29 cases. Three out of the four cases in Alabama involved the complete inability to move at least one limb.

By October 29, 2014, there were 88 confirmed cases in 29 states.

The similarities to polio both of onset and severity of symptoms to acute flaccid myelitis are striking.

The Signs and Symptoms of Acute Flaccid Myelitis

The onset of AFM usually involves symptoms akin to a harmless rhinovirus, with flu-like symptoms. However, after an incubation period (duration still unknown) the victim of acute flaccid myelitis there is a sudden onset of severe symptoms including:

  • Arm or leg weakness
  • Acute loss of muscle tone and reflexes
  • Facial droop/weakness
  • Difficulty moving the eyes
  • Drooping eyelids
  • Difficulty talking or slurred speech

In some cases, the person may experience numbness or tingling in the arms or legs and pain. They may also experience the inability to urinate and in the most severe cases of AFM, respiratory failure requiring ventilator support.

Sadly, most cases of acute flaccid myelitis are in children with adults rarely being affected.

Causes and Treatments of AFM

 When researchers have tested patients ill with acute flaccid myelitis, they have found no sign of the polio virus believed to have been eradicated in the United States several decades earlier. In fact, upon testing the spinal fluid of affected people, it was found to be clear of all known viral pathogens.

Whatever the virus is that is causing the illness to harm children, it is believed right now that the disorder may be an immune response to the pathogen. They think this because many of the affected children sometimes had a fever and/or respiratory illness before the polio-like symptoms began.

Right now, there is no specific treatment for acute flaccid myelitis, we can only treat the symptoms and then built the person back up with therapies afterward. Even the long-term effects of the illness are not understood, as it has only been known to exist a few years.

There is also no known way to prevent yourself or your family from contracting AFM. However, since it is most likely a virus hand washing and staying away from ill people may help.

A Few Parting Words About Polio

 The World Health Organization (WHO) in a publication about the polio virus outbreak in Niger reminds us that until polio is eradicated, polio-free countries will remain at risk of polio re-infection or re-emergence.

The most effective way to safeguard you and your family again the disease that terrified the world is to get everyone vaccinated.

Since 2000, the inactivated polio vaccine (IPV) is the only polio vaccine given in the United States. It is administered through a shot in either the arm or leg according to age. In other countries, the oral polio vaccine (OPV) is used.

The Centers for Disease Control (CDC) in the United States recommends that children receive four doses of the polio vaccine beginning at two months to the final dose being administered at 4 through 6 years of age.

With the world working in concert, polio, once the crippler of millions of children, will be eliminated from planet earth forever.

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Disclaimer: The opinions expressed in this post are the personal views of the author. They do not necessarily reflect the views of PatientNextDoor. Any omissions or errors are the author’s and PatientNextDoor does not assume any liability or responsibility for them.
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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