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The paralysing fear: a polio epidemic in USA

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Polio, more properly known as poliomyelitis, was one of the most feared and studied diseases in the first half of the Twentieth Century (Sass, 1). This disease has paralyzed thousands in American history (Health Education Facts Sheet, 1). Polio struck its victims, mostly children under the age of three, as it appeared unpredictably bringing on a panic in the 1940s and 50s. Then, a break through occurred when Jonas Salk’s research established an effective vaccine to the poliovirus. Today, the fear of obtaining the poliovirus has been banished from children and parent’s nightmares (PICO, 3).

There are three viruses that can cause polio: type I, II, and III. The viral disease can range from a mild, sometimes unnoticed, infection to muscle paralysis and death. The viruses get into the body giving the host several symptoms like paralysis, fever, neck stiffness, nausea, and weakness in the muscle groups. There are three different kinds of the polio disease: spinal polio, non-paralytic polio, and paralytic polio (Diseases, 106).

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Spinal polio is the most common form of the poliovirus. It occurs when the polioviruses attack the nerve cells and begins to control the muscles of the legs, arms, trunk, diaphragm, abdomen, and pelvis (World Book Encyclopedia, 497).

The non-paralytic form of polio has many symptoms including nausea, headache, sore throat, back pain, neck pain, stiffness, moderate fever, vomiting, irritability, and sluggishness. The non-paralytic form changes the host’s reflex and elevates its fluid count. This form of the polio disease lasts about one week with back pain persisting for about two weeks. About 65% of known cases during the outbreak of polio were non-paralytic (What Are the Symptoms…,1).

Paralytic polio usually develops about five to seven days after the beginning of the fever. The symptoms are similar to non-paralytic polio with muscle weakness, loss of reflexes, extra sensitivity to touch, urine retention, constipation, and bloating. This causes the host to become paralyzed (Health Educations Facts Sheet, 1).

The poliovirus enters the host through contaminated drinking water or through contact with contaminated surfaces, such as unwashed hands. It spreads by close personal contact, usually from saliva or waste. The virus passes through the stomach into the intestines. Inside the intestines, cells are infected and the virus is duplicated. In most cases, this results in diarrhea or other minor symptoms. Unfortunately, that isn’t always the result. In some cases, approximately 1% of infections, the virus enters the nervous system and the bloodstream, causing the host to be paralyzed or even causing death. (PICO, 2)

The oldest polio outbreak incidence yet found has shown to be over 3,000 years old. This incidence is engraved on an Egyptian stele (PICO, 1). We do not know how or what started the poliovirus (Sass, 1). Regular epidemics of the polio disease began to occur in the 20th century, mainly in cities during the summer. (PICO, 1) The hot weather of late summer was the “polio season” which brought along many cases of paralytic polio. From the 1920s to the 1950s, the warmer months of the year were known as “nightmare summers of quarantine and contagion (PICO, 2).” The disease occurred 35 times more frequently in the month of August than in April, yet we do not know the reason for this seasonal irregularity (Sass, 1).

In 1894, the first major epidemic of polio hit the United States in Vermont, which consisted in 132 cases (The Polio History Pages, 1). The next reported epidemic hit New York in 1916. Although the total number of affected individuals is unknown, 9,000 cases were reported (Henderson, 2). In 1952, there were 57,600 Americans that had polio, the most recorded in a single year to date (Henderson, 1). By the time of the Great Depression, polio was the most feared disease in America. It hit people quickly and because it had no cure, many were crippled for life. (PICO, 2)

Before the 1950s, there was no treatment for the poliovirus. Two scientists, Jonas Salk and Albert Sabin, were searching for an effective vaccine. Taking different approaches, they each developed successful vaccines and brought the virus under control. When the Salk vaccine was introduced in 1955, the virus began to rapidly disappear and was removed throughout most of the industrialized world (PICO, 6). In 1955, there were two million infected children. This number drastically dropped within the next few years. In 1957, there were fewer than six thousand cases in the United States and by 1964, polio had almost disappeared with only 121 cases reported nationally (Sass, 2).

The Salk and Sabin vaccines are administered differently. The Salk vaccine, recommended in the United States, is an injection of a chemically killed virus, which “teaches” the immune system to recognize the virus and get rid of it. (Health Education Facts Sheets, 1) His vaccine was taken from the cells of infected monkeys (PICO, 5). Salk’s vaccine is administered in a series of three shots. It ensures immunity, but the host can still act as a carrier. Sabin’s vaccine, also made from monkey cells, is given orally. It contains live viruses of each of the three polio types. The live viruses replicate in the host’s intestines and induce immunity. It provides life-long immunity, and unlike Salk’s vaccine, it prevents the host from acting as a carrier (PICO, 5).

The Salk vaccine is recommended for children who have an immune problem or healthy children that are in contact with anyone who has an immune problem. Adults, who are at the increased risk of exposure to either the poliovirus or to a polio vaccine and have never been fully vaccinated, should be immunized with the Salk vaccine (Polio, 1).

The oral Sabin vaccine is recommended for most children because it is safe and gives excellent protection against polio. It is also recommended for regions where a polio outbreak needs to be contained because it helps to rapidly stop the person-to-person transmission of the virus. The Sabin vaccine should not be used if someone in the same household has an immune problem (Polio, 2).

Before there was a polio vaccine, an “iron lung” was used to treat polio patients. Philip Drinker invented it in the mid-1900s. The “iron lung” was used as an artificial respirator, and helped polio patients deal with their respiratory problems. The patient’s body was put into the metal tank that used air pressure changes to expand and contract the chest (The Gale Encyclopedia of Science, 243). A nurse from West Lane Hospital in Middlesborough wrote this letter to her friend explaining the “iron lung”:

The iron lungs were frightening contraptions and the patients were terrified of them. They were responsible for the patient’s health and safety should the iron lungs cease to function. The iron lung is a huge rigid coffin standing on four legs and attached to a large electric pump. All drinking, feeding, and physical care had to synchronize with the machine otherwise the patient might suffocate (Parker, 1).

There are about 1.63 million American polio survivors today (PPS Articles, 1). (Henderson, 2). My grandfather is one of them. He obtained the poliovirus when he was a child. He now has one leg that is shorter than the other, making him limp as he walks. He also has one arm that is skinnier than the other.

Many polio victims start to experience Post-Polio Syndrome. Like my grandfather, polio survivors have joint pain, muscular atrophy, fewer nerves, and become weaker at a faster rate (Dempsey, 2). Muscles must be gently exercised to prevent deformities and painful tightening of the limbs (Polio, 4). Physical therapy and exercise are now used to help with the pain of polio survivors (Dempsey, 2). Other treatment involves painkillers, for headaches and back pain, moist heat, to reduce muscle spasms, and corrective shoes and braces, to compensate for deformities (Treatment, 1).

Today the disease is on the verge of eradication (Stalking the Virus…, 1). Polio is no longer a threat to modernized countries. But there are still countries that are unable to vaccinate all of its citizens. America and the majority of Europe and Asia are polio free. But the problem still remains in most of Africa and nearly all of Southern Asia (Polio, 4).

Within the next ten years, polio should be dead throughout the world (Polio, 4). To ensure this, the world needs to do a few things. First, we need to ensure that every child born is routinely immunized against the poliovirus. This includes four doses of the oral polio vaccine within the first year of life. Second, National Immunization Days need to be held in every country in the world. Special organized campaigns need to be set up which would give each child under five years of age the polio vaccine. This would have to consist of two rounds, about one month apart, for three consecutive years. Having National Immunization Days would interrupt the transmission of the poliovirus. Third, there needs to be a system established to identify the suspect cases of polio. And lastly, once polio cases are defined in a region, there needs to be mop-up campaigns that go house-to-house and immunize that region (Stalking the Virus…, 1).

Thanks to the development of the polio vaccine, polio, one of the most feared and studied diseases in the first half of the Twentieth Century, is now extremely rare in the United States. Just within the past century, two brilliant scientists, Jonas Salk and Albert Sabin, developed the polio vaccine, which has all but eradicated the 3000-year old virus that has paralyzed thousands in American history. Parents and children no longer need to fear the “nightmare summers”.

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