By Dr. Kyle Smart, DO, Chief Medical Officer

Cucamonga Valley Medical Group

Imagine that you are living in the United States in the 1950s. Just as diphtheria is getting under control, a new disease is becoming prevalent: polio.

Polio was one of the most feared diseases of the 20th century for two reasons. First, no one was safe from polio. Unlike diphtheria which was thought to be a disease of children, polio did not and does not discriminate. Second, the rare, paralytic form of the disease left survivors with devastating, permanent disabilities.

Polio has been eliminated from the United States thanks to the polio vaccine. The last case of naturally-occurring polio in the country dates back to 1979. Despite these facts, we cannot lose sight of the reality that diseases which are preventable by vaccines could return, as we have recently seen with the measles.

Polio History

Polio is short for poliomyelitis and is caused by a virus that can lead to lifelong paralysis and in some cases, death.

The most feared form of paralytic polio was that of the breathing muscles. As you may recall from the diphtheria blog, diphtheria can cause difficulty breathing due to obstruction when a patient’s airway is blocked by the psuedomembrane, which forms in the nose and throat as a result of the infection.

In polio, breathing ceases because the respiratory muscles stop working due to paralysis.

Although tracheostomy and intubation was developed to help those with diphtheria, these alone did not save those impacted by polio in this way.

These polio patients needed a machine to breathe for them and in 1929, the mechanical ventilator was invented to combat polio’s rare, but fatal respiratory effects.

Today, ventilators are a common part of medicine and they go hand-in-hand with intubation. However, in the mid-1900s, the ventilators were not small, portable machines; they were massive metal tubes, in which a whole patient could fit inside.

These ventilators became known as the iron lung.

The iron lung was a machine which enclosed the patient’s entire body leaving only their head exposed.

With the body sealed inside the metal tube, alternating negative and positive pressures would draw air in and out of the lungs, allowing the patient to breath.

The use of the iron lung could be temporary, but was sometimes permanent! This was one of the first times that life could artificially be sustained.

At the time, this was a novel concept and was hailed as a great medical advancement.

I want you to transport yourself into that period of time when all of the current controversy surrounding life sustaining efforts were not an issue. Instead, the nation made a concerted effort to beat polio…together.

Did You Know? Polio Fact

Although at the time it was kept secret, United States President, Franklin Delano Roosevelt had contracted polio and as a result suffered from paralysis in his left leg.

President Roosevelt championed polio research and curative efforts. He not only funded such endeavors, but worked to raise public awareness of polio as a disease.

In 1938, polio research would get a celebrity endorsement and by using cutting-edge technology, the radio, to spread the message, the “March of Dimes” was born.

That year, the public mailed over 2.6 million dimes to the White House to fund polio research.

Polio Types & Symptoms Explained

There are two types of polio, non paralytic and paralytic.

Non paralytic polio

Polio in general is very contagious and spreads from human-to-human through bodily fluids, such as coughing or sneezing.  Like many viruses, infected people will initially develop flu-like symptoms such as:

• Body aches
• Fatigue
• Fever
• Muscle tenderness and weakness
• Nausea
• Neck stiffness or pain
• Sore throat
• Neck pain or stiffness

These usually resolve in about one week’s time.

However, the virus can travel from the respiratory tract through the bloodstream and can be especially damaging to the brain and spinal cord.

According to the Centers for Disease Control and Prevention (CDC), 1 out of 25 people who are infected with polio will get meningitis.

Furthermore, 1 out of 200 people will go on to develop various forms of permanent paralysis.

Paralytic polio

This is the most serious and rare form of polio. The first symptoms of paralytic polio presents itself as a headache or fever (these symptoms typically mimic those of non paralytic polio).

However, in about a week’s time, other signs will begin to appear which include:

• Loss of reflexes
• Loose and floppy limbs
• Severe muscle aches or weakness
  

Polio Vaccine

Borrowing from other vaccine advances, Dr. Hilary Koprowski selflessly tested himself with one of the first polio vaccine prototypes in 1948.  Further advances to the polio vaccine were made by Dr. Jonas Salk in the 1950s and in 1955, a vaccination for polio was made available to the public.

Since then, different vaccine options for polio have been developed. A live, oral dose of the poliovirus and an injection of inactivated poliovirus, the latter being more common.

The inactivated poliovirus vaccine is administered in the arm or leg depending on the person’s age with a hypodermic needle.

The CDC recommends that people receive four doses of the polio vaccine. The dosing schedule is as follows:

Dose 1 – 2 months old

Dose 2 – 4 months old

Dose 3 – 6 – 18 months old

Dose 4  – 4 to 6-years old (booster)

Why is the polio vaccine important?

The polio epidemics of the mid-1950s are relatively recent and still part of our collective memory.  Many of us can think of a grandparent or friend with post-polio paralysis.  Images of people in an iron lung rallied the nation to work together for a cure, a cure which came in the form of prevention through a vaccine.

The poliovirus can infect anyone. All ages, genders, ethnicity, and socio-economic groups are impacted by this disease.

It is beneficial every now and then to remember our past and the path that we have taken to be where we are at today.

We’re currently standing on the foundation of recent past generations, who suffered through rampant disease and happily embraced the inception of vaccinations.  Polio is certainly an example of this.

As always, CVMG supports the use of vaccines as recommended by the American Academy of Family Practice, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention.

If you have any questions about vaccinations or why CVMG has chosen a pro-vaccine stance, please do not hesitate to schedule an appointment with one of our providers.

References:

https://www.cdc.gov/polio/us/index.html

https://www.mayoclinic.org/diseases-conditions/polio/symptoms-causes/syc-20376512

https://www.cdc.gov/vaccines/vpd/polio/index.html