Polio Epidemic of the 1950s
Anyone who lived through the U.S. polio epidemic of the early 1950s has an understanding of this dreaded viral disease which can cause paralysis and death. They will also have a tremendous appreciation for the vaccines that finally brought it under control. Almost everyone at that time knew someone who had been touched by this infection, which can have sequelae ranging from a residual limp to confinement for years in an iron lung or even death. While there are still a few polio victims of the 1950s using iron lungs, this device has largely been replaced by positive pressure airway ventilators which allow for greater mobility. Because children were particularly targeted, this disease was also known as infantile paralysis. Back in the 1950s children were often warned to stay out of pools in the summertime or even to stay indoors away from other people altogether. Parents worried about every little complaint their children had that might possibly be an indication of polio, such as fever, sore throat or headache. There had been many polio epidemics throughout history, but the one that got everyone’s attention reached its peak in 1952 when there were 59,000 cases of paralytic polio reported in the United States, with outbreaks reported in every state. By the late 1950s, with help from money raised by the March of Dimes, vaccines were developed first by Jonas Salk (injectable) and then by Albert Sabin (oral) which virtually eradicated polio as a public health threat in the developed world.
The Polio Virus
Polio or poliomyelitis is caused by an enterovirus of serotypes 1, 2 or 3 which invades the brain and spinal cord. It occurs only in humans and is transmitted by the fecal-oral or respiratory routes. It can be transmitted through contaminated water or food or through direct contact with an infected individual. It is so contagious that if you lived in the same household with someone with polio it was very likely that you would become infected. An infected individual can shed the virus in their feces for weeks. Most poliovirus infections (95%) are asymptomatic, but 4 to 8% of patients will exhibit minor symptoms such as low grade fever, sore throat, fatigue, nausea, headache, stiff neck or pain in the limbs. Most of the time these symptoms resolve completely. Less than 1% of patients with polio will experience permanent paralysis, usually of the lower limbs and, of these, about 5 to 10% will die as a result of involvement of the respiratory muscles.
Efforts to Eradicate Polio Worldwide
There is no cure for polio, so immunization is the only way to protect yourself from this potentially serious infection. It was entirely because of the polio vaccination that the most feared disease of the 20th Century was eradicated from the United States by 1979. Unfortunately, polio still exists today in other parts of the world such as Africa and the Middle East. While much progress has been made in ridding the rest of the world of polio there are still a handful of countries that are considered to be endemic for this infection, but this is still a significant reduction from the 125 countries which reported cases in 1988. Several international health agencies are working together to completely eradicate polio from the world by 2018. While only the injectable inactivated poliovirus (IPV) vaccine is used in the United States now, the live oral poliovirus vaccine (OPV) will continue to be used in other parts of the world in the near future due to its ease of administration and low cost.
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A Stunning Success Story
The benefits provided by vaccinations are one of the most important achievements in public health during our lifetime. The eradication of polio from the United States is just one example of how vaccinations have benefited everyone in our country and we can all be proud of our wonderful health care system which has fostered innovations such as this. To keep this legacy of success going, infants and children should receive a dose of the inactivated poliovirus (IPV) vaccine at 2 months, four months, 6 to 18 months and at 4 to 6 years of age, for a total of four doses. For more information on the polio vaccine and other vaccinations, check out the Vaccine Education Center website sponsored by the Children’s Hospital of Philadelphia.