Christina Marsalona
HIS 398
Professor Sellers
11-20-18
The Public Health’s Effect on Polio
Poliomyelitis, also called infantile paralysis or polio is an acute, infectious disease that has a drastic impact on our history. It was described as early as the late 1700’s, and recorded as an outbreak in 1894 in the US. Many people only know polio as the disease we receive a vaccine for when we were younger or how one of our US presidents had the disease. However, many do not know how our public health system, the creation of vaccinations and immunizations have impacted our country and public health in regards to polio. There were many attempts to control the disease, and they could all be considered influential in regards to the fight against polio and the advancements of our medical technology. All of this has led up to today’s time, where the disease almost seemed unheard of for a while, but-with a recent polio-like virus that has been affecting children in the United States with 127 reported cases in 22 states in 2018, the disease might not be as vanquished as we thought. This essay will address the advancements of the battle against polio in our country over time, as well as our public health’s various efforts that progressed as time passed, in order to make polio something that people do not have to worry about.
To begin, the history of this debilitating disease must be explained. Through this history we are able to see all the efforts that were put into effect by our public health system. In 1789, there was the first clinical description of the disease described by a British physician named Michael Underwood. Most people understood this disease as something that made people’s limbs withered and limp. Almost 100 years later in 1840, Jacob Heine describes the various of clinical characteristics of polio, including the involvement that it has in the spinal cord. The virus is spread quickly among people by contact with infected secretions from the mouth or nose or from contact with infected wastes. It will usually enter the body when the person comes into contact with contaminated water and food or even by touching their mouth with contaminated hands. The first epidemic outbreak of polio in the U.S. occurred in Vermont in 1894, with a record of 132 cases. There were not many known ways to treat diseases but there were many scientists who had theories about ways to treat the disease. John Haven Emerson stated multiple (dangerous) remedies in his report, “Give oxygen through the lower extremities, by positive electricity. Frequent baths using almond meal, or oxidising the water. Applications of poultices of Roman chamomile, slippery elm, arnica, mustard, cantharis, amygdalae dulcis oil, and of special merit, spikenard oil and Xanthoxylin. Internally use caffeine, Fl. Kola, dry muriate of quinine, elixir of cinchona, radium water, chloride of gold, liquor calcis and wine of pepsin.” Others cited the use of vitamin C, hydrotherapy, electrotherapy, etc as useful treatments in treating polio. This was a disease in which caused much havoc on our country as it was something that nobody understood how it was transmitted or why it had any of the effects that it had. This resulted in a whirlwind of experimentation and public health efforts from this point out.
In 1908, Karl Landsteiner and Erwin Popper were able to discover that it was a virus in which caused polio, and they did this by actually transmitting the disease to a monkey. Just 8 years later in 1916, the biggest epidemic of polio occurred in the United States. This is the point in which polio was at its height and became something in which the public health began to take very serious. In 1921, Franklin Delano Roosevelt, our former president, contracted polio at age of 39 years old. This individual had a grand impact on how people looked at not only polio but even more so, those with disabilities… which is what polio was for many people, a disability, not just a disease.
FDR getting polio may have been one of the most important things to happen in regards to not only the knowledge of the disease but also the advancement in assessment, treatment and prevention methods of polio. Being a person who had a great amount of power and having a disease that affected all people, it was in his power to help people who had this disease and he did. In 1927, he formed the Warm Springs Foundation in the state of Georgia for polio rehabilitation. His efforts inspired others to use their intelligence and creativity for battling polio as well. In 1929, Philip Drinker and Louis Shaw were able to develop the “iron lung” to aid in patient’s respiration. There isn’t a device more associated with polio than the iron lung. Doctors who assessed and treated people in the early and acute stages of polio, saw that most of the patients were not able to breathe when the virus had taken control and its actions paralyzed muscles in the chest. With people at this stage, death wasn’t something that was surprising, and with the iron lung, death now wasn’t the only answer. These men invented a type of tank respirator that can basically maintain respiration artificially until a person was able to breathe on their own, usually after anywhere from 1-2 weeks. This device was powered by an electrical motor using 2 vacuum cleaners. The pump was able to change the pressure inside an airtight metal box, breathing- pushing air in and out of the lungs- for the patients that needed it. John Emerson was able to refine Drinker’s device and reduced the costs nearly in half. By this time, polio was one of the most serious infectious diseases.
In the 1930s, two strains of the poliovirus are discovered and not much later than that one more was discovered. In 1931, scientists were able to create the first filter which could trap viruses. Having these two things was amazing because now people were able to begin to experiment with vaccinations. In 1933, FDR was inaugurated president of the United States and he was able to gain much attention for polio and the disabilities that this disease caused. For his birthday a year later, there was an event called the “Birthday Balls’ to raise funds and awareness for the Warm Springs Foundation. In 1935, Maurice Brodie and John Kolmer tested vaccines for polio and unfortunately had a disastrous end. In 1938, our former president founded the National Foundation for Infantile Paralysis, or better known as the March of Dimes. The March of Dimes was and is still the most influential foundation in combating polio and further influential in raising awareness of disabilities, birth defects and infant mortality. In 1953, Dr. Jonas Salk and his conglomerates were able to develop a safe, inactivated, injected polio vaccination. After the March of the Dimes was responsible for the funding Jonas Salk’s polio vaccine, the organization expanded its focuses to even more issues such as the prevention of birth defects and infant mortality. This came with successful field trials and by 1955-1957 the incidence rate of polio in the United States fell by 85-90%. From 1957-1959, there were clinical trials of Albert Sabin's(another experimenter) live, vaccine which then replaced Salk’s vaccine because it was inexpensive and easier to administer.
In 1979, the last case of polio was caused by a “wild” virus in U.S. Although polio now isn’t as huge of a problem as it used to be, post-polio syndrome was discovered by people that had polio and the physicians that treated them. With the advancement and use of vaccinations, the complete eradication of polio became an objective: in 1985, Rotary International had launched the PolioPlus program and in 1988, World Health Organization, Rotary International, Centers for Disease Control, UNICEF and the Pan American Health Organization proposed the international campaign to eradicate the transmission of polio all over in the world. Finally, in 1999, the inactivated version of the polio vaccine replaced the oral version of polio vaccine as the recommended method of polio immunization in the United States. Thanks to the quite effective vaccine, the US has been free of polio since 1979.
But, this does not mean that there is not a risk of this disease or those like it lurking. As mentioned before, there is a polio-like disease in which is affecting people in the US. Though many people thought that this disease was polio, thankfully, the stool samples of all of the patient’s tested were not found to have poliovirus in their stool. The virus is called Acute Flaccid Myelitis which is a disease that affects the nervous system, including a part of the spinal cord in which will cause patients to have weak muscles and reflexes. This is why so many people compared this disease to polio, because it had a very similar, debilitating effect on the people it consumed. So, this means, the disease is still eradicated in our country. The reason why we were able to keep this disease off the radar is because people are getting vaccinated. There is an entire vaccination schedule for people to follow for themselves and their children, for not only polio but the many other diseases in which people are vulnerable to if they do not receive their immunizations. All of the 50 states require children to be given certain immunizations before attending any public school, and many times these stipulations will even extend to any children attending daycare and private schools. People who choose not to get vaccinated due to their own beliefs will be more susceptible to getting diseases such as polio because they do not have any resistance. They are causing future danger themselves by not getting vaccinated, because when all is said and done, the only reason that polio is out of sight and out of mind is because of the strictness of the vaccination policy. Even more so, who would want to risk getting polio? Unfortunately, there is still no cure for the disease, so why put yourself or your child at risk? If someone got polio today, there would be no way to treat the disease itself, only the symptoms it causes. Physical therapy along with heat therapy is used to stimulate the muscles, and antispasmodic drugs are given in order to relax the muscles. These things will only improve the mobility of the patient, it will not reverse any of the damage that has already been done.
As can be seen, polio is not a disease to be taken lightly. This disease claimed and affected many lives due to its devastating and immobilizing effects. It is crazy to think that something this serious could be maintained by something as simple as a vaccination, but it is that straightforward. Fortunately, in America, we are lucky to have routine vaccinations as a part of our public health system but other countries such as Nigeria, Pakistan and Afghanistan are not as blessed, they are the only 3 countries who have not been able to end the transmission of polio. We are to be wary of travelers as the last person to bring polio to the US was someone who traveled here from another country. With our public health’s standards set high in regards to keeping a high immunity to polio, this disease will remain eradicated in our country and hopefully others as well.