![Polio Egyptian Stele](https://upload.wikimedia.org/wikipedia/commons/5/5c/Polio_Egyptian_Stele.jpg)
The history of polio (
poliomyelitis
Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 70% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe sym ...
) infections began during
prehistory
Prehistory, also known as pre-literary history, is the period of human history between the use of the first stone tools by hominins 3.3 million years ago and the beginning of recorded history with the invention of writing systems. The use of ...
. Although major polio
epidemic
An epidemic (from Ancient Greek, Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of patients among a given population within an area in a short period of time.
Epidemics ...
s were unknown before the 20th century,
the disease has caused
paralysis
Paralysis (also known as plegia) is a loss of motor function in one or more muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage. In the United States, roughly 1 in 50 ...
and death for much of human history. Over
millennia
A millennium (plural millennia or millenniums) is a period of one thousand years, sometimes called a kiloannum (ka), or kiloyear (ky). Normally, the word is used specifically for periods of a thousand years that begin at the starting point (ini ...
, polio survived quietly as an
endemic
Endemism is the state of a species being found in a single defined geographic location, such as an island, state, nation, country or other defined zone; organisms that are indigenous to a place are not endemic to it if they are also found elsew ...
pathogen until the 1900s when major epidemics began to occur in Europe.
[ Soon after, widespread epidemics appeared in the rest of the world. By 1910, frequent epidemics became regular events throughout the developed world primarily in cities during the summer months. At its peak in the 1940s and 1950s, polio would paralyze or kill over half a million people worldwide every year.
The fear and the collective response to these epidemics would give rise to extraordinary public reaction and mobilization spurring the development of new methods to prevent and treat the disease and revolutionizing medical ]philanthropy
Philanthropy is a form of altruism that consists of "private initiatives, for the Public good (economics), public good, focusing on quality of life". Philanthropy contrasts with business initiatives, which are private initiatives for private goo ...
. Although the development of two polio vaccines
Polio vaccines are vaccines used to prevent poliomyelitis (polio). Two types are used: an inactivated poliovirus given by injection (IPV) and a weakened poliovirus given by mouth (OPV). The World Health Organization (WHO) recommends all chil ...
has eliminated wild poliomyelitis in all but two countries (Afghanistan and Pakistan), the legacy of poliomyelitis remains in the development of modern rehabilitation therapy and in the rise of disability rights movement
The disability rights movement is a global new social movements, social movement that seeks to secure equal opportunity, equal opportunities and equality before the law, equal rights for all people with disability, disabilities.
It is made u ...
s worldwide.
Early history
Ancient Egyptian paintings and carvings depict otherwise healthy people with withered limbs, and children walking with canes at a young age. It is theorized that the Roman Emperor Claudius
Tiberius Claudius Caesar Augustus Germanicus (; 1 August 10 BC – 13 October AD 54) was the fourth Roman emperor, ruling from AD 41 to 54. A member of the Julio-Claudian dynasty, Claudius was born to Nero Claudius Drusus, Drusu ...
was stricken as a child, and this caused him to walk with a limp for the rest of his life. Perhaps the earliest recorded case of poliomyelitis is that of Sir Walter Scott
Sir Walter Scott, 1st Baronet (15 August 1771 – 21 September 1832), was a Scottish novelist, poet, playwright and historian. Many of his works remain classics of European and Scottish literature, notably the novels '' Ivanhoe'', '' Rob Roy' ...
. In 1773, Scott was said to have developed "a severe teething
Teething is the process by which an infant's first teeth (the deciduous teeth, often called "baby teeth" or "milk teeth") appear by emerging through the gums, typically arriving in pairs. The mandibular central incisors are the first primary te ...
fever which deprived him of the power of his right leg". At the time, polio was not known to medicine. A retrospective diagnosis
A retrospective diagnosis (also retrodiagnosis or posthumous diagnosis) is the practice of identifying an illness after the death of the patient (sometimes in a historical figure) using modern knowledge, methods and disease classifications. Altern ...
of polio is considered to be strong due to the detailed account Scott later made, and the resultant lameness of his right leg had an important effect on his life and writing.
The symptoms of poliomyelitis have been described by many names. In the early nineteenth century the disease was known variously as: Dental Paralysis, Infantile Spinal Paralysis, Essential Paralysis of Children, Regressive Paralysis, Myelitis of the Anterior Horns, Tephromyelitis (from the Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
''tephros'', meaning "ash-gray") and Paralysis of the Morning. In 1789 the first clinical description of poliomyelitis was provided by the British physician Michael Underwood
Michael Paul Underwood (born 26 October 1975) is an English television presenter, best known as a children's TV presenter on CBBC and CITV. He can be seen as a fifteen-year-old in an episode of ''The Crystal Maze'', then presented by Richar ...
—he refers to polio as "a debility of the lower extremities". The first medical report on poliomyelitis was by Jakob Heine
Jakob (or Jacob) Heine (April 16, 1800, Lauterbach, Black Forest, Germany – November 12, 1879, Cannstatt, Germany) was a German orthopaedist. He is most famous for his 1840 study into poliomyelitis, which was the first medical report on the d ...
, in 1840; he called the disease ''Lähmungszustände der unteren Extremitäten'' ("Paralysis of the lower Extremities"). Karl Oskar Medin
Karl Oskar Medin (14 August 1847 – 24 December 1927) was a Swedish pediatrician. He was born at Axberg, Örebro and died in Stockholm. He is most famous for his study of poliomyelitis, a condition sometimes known as the Heine-Medin disease, ...
was the first to empirically study a poliomyelitis epidemic in 1890. This work, and the prior classification by Heine, led to the disease being known as ''Heine-Medin disease''.
Epidemics
Major polio epidemic
An epidemic (from Ancient Greek, Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of patients among a given population within an area in a short period of time.
Epidemics ...
s were unknown before the 20th century; localized paralytic polio epidemics began to appear in Europe and the United States around 1900. The first report of multiple polio cases was published in 1843 and described an 1841 outbreak in Louisiana
Louisiana , group=pronunciation (French: ''La Louisiane'') is a state in the Deep South and South Central regions of the United States. It is the 20th-smallest by area and the 25th most populous of the 50 U.S. states. Louisiana is borde ...
. A fifty-year gap occurs before the next U.S. report—a cluster of 26 cases in Boston
Boston (), officially the City of Boston, is the state capital and most populous city of the Commonwealth of Massachusetts, as well as the cultural and financial center of the New England region of the United States. It is the 24th- mo ...
in 1893. The first recognized U.S. polio epidemic occurred the following year in Vermont
Vermont () is a state in the northeast New England region of the United States. Vermont is bordered by the states of Massachusetts to the south, New Hampshire to the east, and New York to the west, and the Canadian province of Quebec to ...
with 132 total cases (18 deaths), including several cases in adults.[ Numerous epidemics of varying magnitude began to appear throughout the country; by 1907 approximately 2,500 cases of poliomyelitis were reported in New York City.
]
On Saturday, June 17, 1916, an official announcement of the existence of an epidemic polio infection was made in Brooklyn, New York
Brooklyn () is a borough of New York City, coextensive with Kings County, in the U.S. state of New York. Kings County is the most populous county in the State of New York, and the second-most densely populated county in the United States, be ...
. That year, there were 27,363 cases and 7,130 deaths due to polio in the United States, with over 2,000 deaths in New York City alone. The names and addresses of individuals with confirmed polio cases were published daily in the press, their houses were identified with placards, and their families were quarantine
A quarantine is a restriction on the movement of people, animals and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have been ...
d. Dr. Hiram M. Hiller, Jr.
Hiram Milliken Hiller Jr. (March 8, 1867 – August 8, 1921) was an American physician, medical missionary, explorer, and ethnographer. He traveled in Oceania and in South, Southeast, and East Asia, returning with archeological, cultural, zoolo ...
was one of the physicians in several cities who realized what they were dealing with, but the nature of the disease remained largely a mystery. The 1916 epidemic caused widespread panic and thousands fled the city to nearby mountain resorts; movie theaters were closed, meetings were canceled, public gatherings were almost nonexistent, and children were warned not to drink from water fountains, and told to avoid amusement parks, swimming pools, and beaches.[ From 1916 onward, a polio epidemic appeared each summer in at least one part of the country, with the most serious occurring in the 1940s and 1950s.][ In the epidemic of 1949, 42,173 cases were reported in the United States and 2,720 deaths from the disease occurred. Canada and the United Kingdom were also affected.
Prior to the 20th century, polio infections were rarely seen in infants before 6 months of age, and most cases occurred in children 6 months to 4 years of age.] Young children who contract polio generally develop only mild symptoms, but as a result they become permanently immune to the disease. In developed countries during the late 19th and early 20th centuries, improvements were being made in community sanitation
Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems ...
, including improved sewage
Sewage (or domestic sewage, domestic wastewater, municipal wastewater) is a type of wastewater that is produced by a community of people. It is typically transported through a sewer system. Sewage consists of wastewater discharged from residenc ...
disposal and clean water supplies. Better hygiene meant that infants and young children had fewer opportunities to encounter and develop immunity to polio. Exposure to poliovirus was therefore delayed until late childhood or adult life, when it was more likely to take the paralytic form.[
In children, paralysis due to polio occurs in one in 1,000 cases, while in adults, paralysis occurs in one in 75 cases. By 1950, the peak age incidence of paralytic poliomyelitis in the United States had shifted from infants to children aged 5 to 9 years; about one-third of the cases were reported in persons over 15 years of age.] Accordingly, the rate of paralysis and death due to polio infection also increased during this time.[ In the United States, the 1952 polio epidemic was the worst outbreak in the nation's history, and is credited with heightening parents' fears of the disease and focusing public awareness on the need for a vaccine.] Of the 57,628 cases reported that year, 3,145 died and 21,269 were left with mild to disabling paralysis.
Historical treatments
In the early 20th century—in the absence of proven treatments—a number of odd and potentially dangerous polio treatments were suggested. In John Haven Emerson John Haven Emerson (February 5, 1906 – February 4, 1997) was an American inventor of biomedical devices, specializing in respiratory equipment. He is perhaps best remembered for his work in improving the iron lung.
Early life
Emerson was born i ...
's ''A Monograph on the Epidemic of Poliomyelitis (Infantile Paralysis) in New York City in 1916'' one suggested remedy reads:
Following the 1916 epidemics and having experienced little success in treating polio patients, researchers set out to find new and better treatments for the disease. Between 1917 and the early 1950s, several therapies were explored in an effort to prevent deformities, including hydrotherapy
Hydrotherapy, formerly called hydropathy and also called water cure, is a branch of alternative medicine (particularly naturopathy), occupational therapy, and physiotherapy, that involves the use of water for pain relief and treatment. The term ...
and electrotherapy
Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term ''electrotherapy'' can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological dise ...
.
In 1939, Albert Sabin
Albert Bruce Sabin ( ; August 26, 1906 – March 3, 1993) was a Polish-American medical researcher, best known for developing the oral polio vaccine, which has played a key role in nearly eradicating the disease. In 1969–72, he served as the ...
reported that "In the experiments reported in the present communication it was found that vitamin C, both natural and synthetic preparations, had no effect on the course of experimental poliomyelitis induced by nasal instillation of the virus."
Surgical treatments such as nerve grafting
Grafting or graftage is a horticultural technique whereby tissues of plants are joined so as to continue their growth together. The upper part of the combined plant is called the scion () while the lower part is called the rootstock. The succ ...
, tendon
A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...
lengthening, tendon transfers, and limb lengthening and shortening were used extensively during this time. Patients with residual paralysis were treated with braces and taught to compensate for lost function with the help of calipers, crutches and wheelchairs. The use of devices such as rigid brace
Brace(s) or bracing may refer to:
Medical
* Orthopaedic brace, a device used to restrict or assist body movement
** Back brace, a device limiting motion of the spine
*** Milwaukee brace, a kind of back brace used in the treatment of spinal cur ...
s and body casts, which tended to cause muscle atrophy
Muscle atrophy is the loss of skeletal muscle mass. It can be caused by immobility, aging, malnutrition, medications, or a wide range of injuries or diseases that impact the musculoskeletal or nervous system. Muscle atrophy leads to muscle weakness ...
due to the limited movement of the user, were also touted as effective treatments. Massage and passive motion exercises were also used to treat patients with polio. Most of these treatments proved to be of little therapeutic value, however several effective supportive measures for the treatment of polio did emerge during these decades including the iron lung
An iron lung is a type of negative pressure ventilator (NPV), a mechanical respirator which encloses most of a person's body, and varies the air pressure in the enclosed space, to stimulate breathing.Shneerson, Dr. John M., Newmarket General ...
, an anti-polio antibody
An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the ...
serum, and a treatment regimen developed by Sister Elizabeth Kenny
Sister Elizabeth Kenny (20 September 1880 – 30 November 1952) was a self-trained Australian bush nurse who developed an approach to treating polio that was controversial at the time. Her method, promoted internationally while working in Austra ...
.
Iron lung
The first iron lung
An iron lung is a type of negative pressure ventilator (NPV), a mechanical respirator which encloses most of a person's body, and varies the air pressure in the enclosed space, to stimulate breathing.Shneerson, Dr. John M., Newmarket General ...
used in the treatment of polio was invented by Philip Drinker
Philip Drinker (December 12, 1894 – October 19, 1972) was an industrial hygienist. With Louis Agassiz Shaw, he invented the first widely used iron lung in 1928.
Family and early life
Drinker's father was railroad man and Lehigh University ...
, Louis Agassiz Shaw, and James Wilson at Harvard
Harvard University is a private Ivy League research university in Cambridge, Massachusetts. Founded in 1636 as Harvard College and named for its first benefactor, the Puritan clergyman John Harvard, it is the oldest institution of higher le ...
, and tested October 12, 1928, at Children's Hospital, Boston. The original Drinker iron lung was powered by an electric motor attached to two vacuum cleaner
A vacuum cleaner, also known simply as a vacuum or a hoover, is a device that causes suction in order to remove dirt from floors, upholstery, draperies, and other surfaces. It is generally electrically driven.
The dirt is collected by either a ...
s, and worked by changing the pressure inside the machine. When the pressure is lowered, the chest cavity expands, trying to fill this partial vacuum. When the pressure is raised the chest cavity contracts. This expansion and contraction mimics the physiology of normal breathing. The design of the iron lung was subsequently improved by using a bellows attached directly to the machine, and John Haven Emerson John Haven Emerson (February 5, 1906 – February 4, 1997) was an American inventor of biomedical devices, specializing in respiratory equipment. He is perhaps best remembered for his work in improving the iron lung.
Early life
Emerson was born i ...
modified the design to make production less expensive.[ The Emerson Iron Lung was produced until 1970.] Other respiratory aids were used, such as the Bragg-Paul Pulsator
The Bragg-Paul Pulsator, also known as the Bragg-Paul respirator, was a non-invasive medical ventilator invented by William Henry Bragg and designed by Robert W. Paul in 1933 for patients unable to breathe for themselves due to illness.
It was the ...
and the "rocking bed" for patients with less critical breathing difficulties.
During the polio epidemics, the iron lung saved many thousands of lives, but the machine was large, cumbersome and very expensive: in the 1930s, an iron lung cost about $1,500—about the same price as the average home. The cost of running the machine was also prohibitive, as patients were encased in the metal chambers for months, years and sometimes for life.[ Even with an iron lung, the fatality rate for patients with ]bulbar polio
Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 70% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe sym ...
exceeded 90%.
These drawbacks led to the development of more modern positive-pressure ventilators and the use of positive-pressure ventilation by tracheostomy
Tracheotomy (, ), or tracheostomy, is a surgical airway management procedure which consists of making an incision (cut) on the anterior aspect (front) of the neck and opening a direct airway through an incision in the Vertebrate trachea, trache ...
. Positive pressure ventilators reduced mortality in bulbar patients from 90% to 20%. In the Copenhagen epidemic of 1952, large numbers of patients were ventilated by hand ("bagged") by medical students and anyone else on hand because of the large number of bulbar polio patients and the small number of ventilators available.
Passive immunotherapy
In 1950 William Hammon
William McDowell Hammon (July 4, 1904 – September 19, 1989) was an American physician and researcher, best known for his work on poliomyelitis. In his early twenties and prior to becoming a research physician, Hammon worked for four years as a ...
at the University of Pittsburgh
The University of Pittsburgh (Pitt) is a public state-related research university in Pittsburgh, Pennsylvania. The university is composed of 17 undergraduate and graduate schools and colleges at its urban Pittsburgh campus, home to the universit ...
isolated serum, containing antibodies
An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the ...
against poliovirus, from the blood of polio survivors.[ The serum, Hammon believed, would prevent the spread of polio and to reduce the severity of disease in polio patients.] Between September 1951 and July 1952 nearly 55,000 children were involved in a clinical trial
Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dietar ...
of the anti-polio serum. The results of the trial were promising; the serum was shown to be about 80% effective in preventing the development of paralytic poliomyelitis, and protection was shown to last for 5 weeks if given under tightly controlled circumstances. The serum was also shown to reduce the severity of the disease in patients who developed polio.[
The large-scale use of antibody serum to prevent and treat polio had a number of drawbacks, however, including the observation that the immunity provided by the serum did not last long, and the protection offered by the antibody was incomplete, that re-injection was required during each epidemic outbreak, and that the optimal time frame for administration was unknown.][ The antibody serum was widely administered, but obtaining the serum was an expensive and time-consuming process, and the focus of the medical community soon shifted to the development of a polio vaccine.]
Kenny regimen
Early management practices for paralyzed muscles emphasized the need to rest the affected muscles and suggested that the application of splints would prevent tightening of muscle, tendons, ligament
A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the:
* Peritoneal li ...
s, or skin that would prevent normal movement. Many paralyzed polio patients lay in plaster body casts for months at a time. This prolonged casting often resulted in atrophy
Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations (which can destroy the gene to build up the organ), poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply t ...
of both affected and unaffected muscles.[
In 1940, Sister ]Elizabeth Kenny
Sister Elizabeth Kenny (20 September 1880 – 30 November 1952) was a self-trained Australian bush nurse who developed an approach to treating polio that was controversial at the time. Her method, promoted internationally while working in Austra ...
, an Australian bush
"The bush" is a term mostly used in the English vernacular of Australia and New Zealand where it is largely synonymous with '' backwoods'' or ''hinterland'', referring to a natural undeveloped area. The fauna and flora contained within this ...
nurse from Queensland
)
, nickname = Sunshine State
, image_map = Queensland in Australia.svg
, map_caption = Location of Queensland in Australia
, subdivision_type = Country
, subdivision_name = Australia
, established_title = Before federation
, established_ ...
, arrived in North America and challenged this approach to treatment. In treating polio cases in rural Australia between 1928 and 1940, Kenny had developed a form of physical therapy
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient ...
that—instead of immobilizing affected limbs—aimed to relieve pain and spasms in polio patients through the use of hot, moist packs to relieve muscle spasm and early activity and exercise to maximize the strength of unaffected muscle fibers and promote the neuroplastic
Neuroplasticity, also known as neural plasticity, or brain plasticity, is the ability of Neural circuit, neural networks in the brain to change through growth and reorganization. It is when the brain is rewired to function in some way that diffe ...
recruitment of remaining nerve cells that had not been killed by the virus.[ Sister Kenny later settled in ]Minnesota
Minnesota () is a state in the upper midwestern region of the United States. It is the 12th largest U.S. state in area and the 22nd most populous, with over 5.75 million residents. Minnesota is home to western prairies, now given over to ...
where she established the Sister Kenny Rehabilitation Institute, beginning a world-wide crusade to advocate her system of treatment. Slowly, Kenny's ideas won acceptance, and by the mid-20th century had become the hallmark for the treatment of paralytic polio.[ In combination with ]antispasmodic
An antispasmodic (synonym: spasmolytic) is a pharmaceutical drug or other agent that suppresses muscle spasms.
Smooth muscle spasm
One type of antispasmodics is used for smooth muscle relaxation, especially in tubular organs of the gastrointesti ...
medications to reduce muscular contractions, Kenny's therapy is still used in the treatment of paralytic poliomyelitis.
In 2009 as part of the Q150
Q150 was the sesquicentenary (150th anniversary) of the Separation of Queensland from New South Wales in 1859. Separation established the Colony of Queensland which became the State of Queensland in 1901 as part of the Federation of Australia. Q15 ...
celebrations, the Kenny regimen for polio treatment was announced as one of the Q150 Icons
The Queensland's Q150 Icons list of cultural icons was compiled as part of Q150 celebrations in 2009 by the Government of Queensland, Australia. It represented the people, places and events that were significant to Queensland's first 150 years. ...
of Queensland for its role as an iconic "innovation and invention".
Vaccine development
In 1935 Maurice Brodie
Maurice Brodie (1903–1939) was a British-born American virologist who developed a polio vaccine in 1935.
Early years and education
Brodie was born in Liverpool, England, the son of Samuel Broude and Esther Ginsburg. The family immigrated to Ott ...
, a research assistant at New York University
New York University (NYU) is a private research university in New York City. Chartered in 1831 by the New York State Legislature, NYU was founded by a group of New Yorkers led by then-Secretary of the Treasury Albert Gallatin.
In 1832, the ...
and William Hallock Park
William Hallock Park (December 30, 1863 – April 6, 1939) was an American bacteriologist and laboratory director at the New York City Board of Health, Division of Pathology, Bacteriology, and Disinfection from 1893 to 1936.
Biography
Park was bor ...
of the New York City Department of Health, attempted to produce a polio vaccine, procured from virus in ground up monkey
Monkey is a common name that may refer to most mammals of the infraorder Simiiformes, also known as the simians. Traditionally, all animals in the group now known as simians are counted as monkeys except the apes, which constitutes an incomple ...
spinal cords, and killed by formaldehyde
Formaldehyde ( , ) (systematic name methanal) is a naturally occurring organic compound with the formula and structure . The pure compound is a pungent, colourless gas that polymerises spontaneously into paraformaldehyde (refer to section F ...
. Brodie first tested the vaccine on himself and several of his assistants. He then gave the vaccine to three thousand children. Many developed allergic reactions, but none of the children developed an immunity to polio. During the late 1940s and early 1950s, a research group, headed by John Enders
John Franklin Enders (February 10, 1897 – September 8, 1985) was an American biomedical scientist and Nobel Laureate. Enders has been called "The Father of Modern Vaccines."
Life and education
Enders was born in West Hartford, Connecticut on Fe ...
at the Boston Children's Hospital, successfully cultivated the poliovirus
A poliovirus, the causative agent of polio (also known as poliomyelitis), is a serotype of the species ''Enterovirus C'', in the family of ''Picornaviridae''. There are three poliovirus serotypes: types 1, 2, and 3.
Poliovirus is composed of an ...
in human tissue. This significant breakthrough ultimately allowed for the development of the polio vaccines. Enders and his colleagues, Thomas H. Weller
Thomas Huckle Weller (June 15, 1915 – August 23, 2008) was an American virologist. He, John Franklin Enders and Frederick Chapman Robbins were awarded a Nobel Prize in Physiology or Medicine in 1954 for showing how to cultivate poliomyelitis ...
and Frederick C. Robbins
Frederick Chapman Robbins (August 25, 1916 – August 4, 2003) was an American pediatrician and virologist. He was born in Auburn, Alabama, and grew up in Columbia, Missouri, attending David H. Hickman High School.
He received the Nobel Prize in ...
, were recognized for their labors with the Nobel Prize
The Nobel Prizes ( ; sv, Nobelpriset ; no, Nobelprisen ) are five separate prizes that, according to Alfred Nobel's will of 1895, are awarded to "those who, during the preceding year, have conferred the greatest benefit to humankind." Alfr ...
in 1954.
Two vaccines are used throughout the world to combat polio
Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 70% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe s ...
. The first was developed by Jonas Salk
Jonas Edward Salk (; born Jonas Salk; October 28, 1914June 23, 1995) was an American virologist and medical researcher who developed one of the first successful polio vaccines. He was born in New York City and attended the City College of New Y ...
, first tested in 1952 using the HeLa
HeLa (; also Hela or hela) is an immortalized cell line used in scientific research. It is the oldest and most commonly used human cell line. The line is derived from cervical cancer cells taken on February 8, 1951, named after Henrietta La ...
cell, and announced to the world by Salk on April 12, 1955. The Salk vaccine, or ''inactivated poliovirus vaccine'' (IPV), consists of an injected dose of killed poliovirus
A poliovirus, the causative agent of polio (also known as poliomyelitis), is a serotype of the species ''Enterovirus C'', in the family of ''Picornaviridae''. There are three poliovirus serotypes: types 1, 2, and 3.
Poliovirus is composed of an ...
. In 1954, the vaccine was tested for its ability to prevent polio; its field trials grew to be the largest medical experiment in history. In 1955, it was chosen for use throughout the United States. By 1957, following mass immunizations promoted by the March of Dimes
March of Dimes is a United States nonprofit organization that works to improve the health of mothers and babies. The organization was founded by President Franklin D. Roosevelt in 1938, as the National Foundation for Infantile Paralysis, to comba ...
, the annual number of polio cases in the United States was reduced, from a peak of nearly 58,000 cases, to 5,600 cases.[
Eight years after Salk's success, ]Albert Sabin
Albert Bruce Sabin ( ; August 26, 1906 – March 3, 1993) was a Polish-American medical researcher, best known for developing the oral polio vaccine, which has played a key role in nearly eradicating the disease. In 1969–72, he served as the ...
developed an oral polio vaccine
Polio vaccines are vaccines used to prevent poliomyelitis (polio). Two types are used: an inactivated poliovirus given by injection (IPV) and a weakened poliovirus given by mouth (OPV). The World Health Organization (WHO) recommends all child ...
(OPV) using live but weakened ('' attenuated'') virus. Human trials of Sabin's vaccine began in 1957 and it was licensed in 1962. Following the development of oral polio vaccine, a second wave of mass immunizations led to a further decline in the number of cases: by 1961, only 161 cases were recorded in the United States. The last cases of paralytic poliomyelitis caused by endemic
Endemism is the state of a species being found in a single defined geographic location, such as an island, state, nation, country or other defined zone; organisms that are indigenous to a place are not endemic to it if they are also found elsew ...
transmission of poliovirus in the United States were in 1979, when an outbreak occurred among the Amish
The Amish (; pdc, Amisch; german: link=no, Amische), formally the Old Order Amish, are a group of traditionalist Anabaptist Christian church fellowships with Swiss German and Alsatian origins. They are closely related to Mennonite churches ...
in several Midwest
The Midwestern United States, also referred to as the Midwest or the American Midwest, is one of four Census Bureau Region, census regions of the United States Census Bureau (also known as "Region 2"). It occupies the northern central part of ...
ern states.
Legacy
Early in the twentieth century polio became one of the most feared diseases of the developed world. The disease hit without warning and required long quarantine
A quarantine is a restriction on the movement of people, animals and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have been ...
periods during which parents were separated from children: it was impossible to tell who would get the disease and who would be spared.[ The consequences of the disease left polio survivors marked for life, leaving behind vivid images of ]wheelchair
A wheelchair is a chair with wheels, used when walking is difficult or impossible due to illness, injury, problems related to old age, or disability. These can include spinal cord injuries ( paraplegia, hemiplegia, and quadriplegia), cerebr ...
s, crutches, leg braces, breathing devices, and deformed limbs. However, polio changed not only the lives of those who survived it, but also affected profound cultural changes: the emergence of grassroots
A grassroots movement is one that uses the people in a given district, region or community as the basis for a political or economic movement. Grassroots movements and organizations use collective action from the local level to effect change at t ...
fund-raising campaigns that would revolutionize medical philanthropy
Philanthropy is a form of altruism that consists of "private initiatives, for the Public good (economics), public good, focusing on quality of life". Philanthropy contrasts with business initiatives, which are private initiatives for private goo ...
, the rise of rehabilitation therapy and, through campaigns for the social and civil rights of disabled people, polio survivors helped to spur the modern disability rights movement.
In addition, the occurrence of polio epidemics led to a number of public health innovations. One of the most widespread was the proliferation of "no spitting" ordinances in the United States and elsewhere.
Philanthropy
In 1921 Franklin D. Roosevelt
Franklin Delano Roosevelt (; ; January 30, 1882April 12, 1945), often referred to by his initials FDR, was an American politician and attorney who served as the 32nd president of the United States from 1933 until his death in 1945. As the ...
became totally and permanently paralyzed
Paralysis (also known as plegia) is a loss of motor function in one or more muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage. In the United States, roughly 1 in 50 ...
from the waist down. Although the paralysis (whether from poliomyelitis, as diagnosed at the time, or from Guillain–Barré syndrome
Guillain–Barré syndrome (GBS) is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation or pain often ...
) had no cure at the time, Roosevelt, who had planned a life in politics, refused to accept the limitations of his disease. He tried a wide range of therapies, including hydrotherapy
Hydrotherapy, formerly called hydropathy and also called water cure, is a branch of alternative medicine (particularly naturopathy), occupational therapy, and physiotherapy, that involves the use of water for pain relief and treatment. The term ...
in Warm Springs, Georgia
Warm Springs is a city in Meriwether County, Georgia, United States. The population was 425 at the 2010 census.
History
Warm Springs, originally named Bullochville (after the Bulloch family, which began after Stephen Bullock moved to Meriwether ...
(see below). In 1938 Roosevelt helped to found the National Foundation for Infantile Paralysis (now known as the March of Dimes
March of Dimes is a United States nonprofit organization that works to improve the health of mothers and babies. The organization was founded by President Franklin D. Roosevelt in 1938, as the National Foundation for Infantile Paralysis, to comba ...
), that raised money for the rehabilitation
Rehabilitation or Rehab may refer to:
Health
* Rehabilitation (neuropsychology), therapy to regain or improve neurocognitive function that has been lost or diminished
* Rehabilitation (wildlife), treatment of injured wildlife so they can be retur ...
of people with paralytic polio, and was instrumental in funding the development of polio vaccines
Polio vaccines are vaccines used to prevent poliomyelitis (polio). Two types are used: an inactivated poliovirus given by injection (IPV) and a weakened poliovirus given by mouth (OPV). The World Health Organization (WHO) recommends all chil ...
. The March of Dimes changed the way it approached fund-raising. Rather than soliciting large contributions from a few wealthy individuals, the March of Dimes sought small donations from millions of individuals. Its hugely successful fund-raising campaigns collected hundreds of millions of dollars—more than all of the U.S. charities
A charitable organization or charity is an organization whose primary objectives are philanthropy and social well-being (e.g. educational, religious or other activities serving the public interest or common good).
The legal definition of a cha ...
at the time combined (with the exception of the Red Cross
The International Red Cross and Red Crescent Movement is a Humanitarianism, humanitarian movement with approximately 97 million Volunteering, volunteers, members and staff worldwide. It was founded to protect human life and health, to ensure re ...
). By 1955 the March of Dimes had invested $25.5 million in research; funding both Jonas Salk's and Albert Sabin's vaccine development; the 1954–55 field trial of vaccine, and supplies of free vaccine for thousands of children.[
In 1952, during the worst recorded epidemic, 3,145 people in the United States died from polio.]
Rehabilitation therapy
Prior to the polio scares of the twentieth century, most rehabilitation therapy was focused on treating injured soldiers returning from war. The disabling effects of polio led to heightened awareness and public support of physical rehabilitation, and in response a number of rehabilitation centers specifically aimed at treating polio patients were opened, with the task of restoring and building their remaining strength and teaching new, compensatory skills to large numbers of newly paralyzed individuals.[
In 1926, Franklin Roosevelt, convinced of the benefits of ]hydrotherapy
Hydrotherapy, formerly called hydropathy and also called water cure, is a branch of alternative medicine (particularly naturopathy), occupational therapy, and physiotherapy, that involves the use of water for pain relief and treatment. The term ...
, bought a resort at Warm Springs, Georgia
Warm Springs is a city in Meriwether County, Georgia, United States. The population was 425 at the 2010 census.
History
Warm Springs, originally named Bullochville (after the Bulloch family, which began after Stephen Bullock moved to Meriwether ...
, where he founded the first modern rehabilitation center for treatment of polio patients which still operates as the Roosevelt Warm Springs Institute for Rehabilitation
Warm Springs Historic District is a historic district in Warm Springs, Georgia, United States. It includes Franklin Delano Roosevelt's Little White House and the Roosevelt Warm Springs Institute for Rehabilitation, where Roosevelt indulged in ...
.
The cost of polio rehabilitation was often more than the average family could afford, and more than 80% of the nation's polio patients would receive funding through the March of Dimes.[ Some families also received support through philanthropic organizations such as the ]Ancient Arabic Order of the Nobles of the Mystic Shrine
Shriners International, formally known as the Ancient Arabic Order of the Nobles of the Mystic Shrine (AAONMS), is an American Masonic society established in 1870 and is headquartered in Tampa, Florida.
Shriners International describes itself ...
fraternity, which established a network of pediatric hospitals in 1919, the Shriners Hospitals for Children
Shriners Children's is a network of non-profit medical facilities across North America. Children with orthopaedic conditions, burns, spinal cord injuries, and cleft lip and palate are eligible for care and receive all services in a family-center ...
, to provide care free of charge for children with polio.
Disability rights movement
As thousands of polio survivors with varying degrees of paralysis left the rehabilitation hospitals and went home, to school and to work, many were frustrated by a lack of accessibility
Accessibility is the design of products, devices, services, vehicles, or environments so as to be usable by people with disabilities. The concept of accessible design and practice of accessible development ensures both "direct access" (i. ...
and discrimination they experienced in their communities. In the early twentieth century the use of a wheelchair
A wheelchair is a chair with wheels, used when walking is difficult or impossible due to illness, injury, problems related to old age, or disability. These can include spinal cord injuries ( paraplegia, hemiplegia, and quadriplegia), cerebr ...
at home or out in public was a daunting prospect as no public transportation
Public transport (also known as public transportation, public transit, mass transit, or simply transit) is a system of transport for passengers by group travel systems available for use by the general public unlike private transport, typical ...
system accommodated wheelchairs and most public buildings including schools, were inaccessible to those with disabilities. Many children left disabled
Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be cognitive, developmental, intellectual, mental, physical, se ...
by polio were forced to attend separate institutions for "crippled children" or had to be carried up and down stairs.[
As people who had been paralyzed by polio matured, they began to demand the right to participate in the mainstream of society. Polio survivors were often in the forefront of the ]disability rights movement
The disability rights movement is a global new social movements, social movement that seeks to secure equal opportunity, equal opportunities and equality before the law, equal rights for all people with disability, disabilities.
It is made u ...
that emerged in the United States during the 1970s, and pushed legislation such as the Rehabilitation Act of 1973
The Rehabilitation Act of 1973 () is a United States federal law, codified at et seq. The principal sponsor of the bill was Rep. John Brademas (D-IN-3). The Rehabilitation Act of 1973 replaces preexisting laws (collectively referred to as the V ...
which protected qualified individuals from discrimination based on their disability, and the Americans with Disabilities Act
The Americans with Disabilities Act of 1990 or ADA () is a civil rights law that prohibits discrimination based on disability. It affords similar protections against discrimination to Americans with disabilities as the Civil Rights Act of 1964 ...
of 1990.[ Other political movements led by polio survivors include the ]Independent Living
Independent living (IL), as seen by its advocates, is a philosophy, a way of looking at society and disability, and a worldwide movement of disabled people working for equal opportunities, self-determination, and self-respect. In the context o ...
and Universal design
Universal design is the design of buildings, products or environments to make them accessible to people, regardless of age, disability or other factors. It addresses common barriers to participation by creating things that can be used by the ma ...
movements of the 1960s and 1970s.
Polio survivors are one of the largest disabled groups in the world. The World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
estimates that there are 10 to 20 million polio survivors worldwide. In 1977, the National Health Interview Survey reported that there were 254,000 people living in the United States who had been paralyzed by polio. According to local polio support groups and doctors, some 40,000 polio survivors with varying degrees of paralysis live in Germany, 30,000 in Japan, 24,000 in France, 16,000 in Australia, 12,000 in Canada and 12,000 in the United Kingdom.[
]
See also
* List of polio survivors
Poliomyelitis (often simply called polio) is an acute viral infection that involves the gastrointestinal tract and occasionally the central nervous system. Poliovirus is acquired by faecal–oral or oral transmission. Prior to the introducti ...
* Polio Hall of Fame
The Polio Hall of Fame (or the Polio Wall of Fame) consists of a linear grouping of sculptured busts of fifteen scientists and two laymen who made important contributions to the knowledge and treatment of poliomyelitis. It is found on the outside w ...
* Cutter Laboratories
Cutter Laboratories was a family-owned pharmaceutical company located in Berkeley, California, founded by Edward Ahern Cutter in 1897. Cutter's early products included anthrax vaccine, hog cholera (swine fever) virus, and anti-hog cholera serum ...
* Hickory, North Carolina
Hickory is a city located primarily in Catawba County, with formal boundaries extending into Burke and Caldwell counties. The city lies in the U.S. state of North Carolina. At the time of the 2020 census, Hickory's population was 43,490. Hickor ...
* Polio eradication
Polio eradication, the permanent global cessation of circulation by the poliovirus and hence elimination of the poliomyelitis (polio) it causes, is the aim of a multinational public health effort begun in 1988, led by the World Health Organiz ...
Notes and references
Further reading
* A memoir by a childhood survivor of polio.
* Awarded the 2006 Pulitzer Prize
The Pulitzer Prize () is an award for achievements in newspaper, magazine, online journalism, literature, and musical composition within the United States. It was established in 1917 by provisions in the will of Joseph Pulitzer, who had made h ...
for history.
* Classic history.
* Memoir, history, medicine.
* A history of polio from accounts written by survivors. Limited preview available from Google Books.
External links
A History of Polio (Poliomyelitis)
History of Vaccines, a project of the College of Physicians of Philadelphia
The College of Physicians of Philadelphia is the oldest private medical society in the United States. Founded in 1787 by 24 Philadelphia physicians "to advance the Science of Medicine, and thereby lessen human misery, by investigating the disease ...
.
What ever happened to Polio?
An exhibit from the Smithsonian National Museum of American History.
* ttp://www.cbc.ca/archives/categories/health/public-health/polio-combating-the-crippler/topic---polio-combating-the-crippler.html CBC Digital Archives - Polio: Combating the CripplerVideo and radio reports related to polio
Poliovirus in New Zealand 1915–1997
*
Polio: A Virus' Struggle
'—an amusing yet educational graphic novella from the ''Science Creative Quarterly'' (in PDF
Portable Document Format (PDF), standardized as ISO 32000, is a file format developed by Adobe in 1992 to present documents, including text formatting and images, in a manner independent of application software, hardware, and operating systems. ...
format).
Fermín: Making Polio History
An article about Luis Fermín Tenorio Cortez, the last case of polio reported in the Americas.
A UK Polio survivor
An account of John Prestwich who lived 50 years in an iron lung.
Post-Polio Health International
{{DEFAULTSORT:History Of Poliomyelitis
Poliomyelitis
Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 70% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe sym ...
Polio