Polio: Have you been Vaccinated?

POLIO: HAVE YOU BEEN VACCINATED?

 Poliomyelitis.

It is a virus, and you mostly likely were vaccinated.  And as a result, the Americas were declared free of this pestilence in 1994, Europe in 2002.  Remember the “March of Dimes?”  2,680,000 of those little metal chimes were mailed to President Franklin D. Roosevelt when he started the campaign against polio in 1938.  Roosevelt died in 1945, the year they hired Jonas Salk to develop a vaccine.  But Salk did not do it alone.

Maybe you’ve heard of those others who had the disease, or have had members of your family or know friends who were so impacted.  Ida Lupino, Sir Walter Scott, Wilma Rudolph, Robert Oppenheimer, Mitch McConnell, Judy Collins, Franklin D. Roosevelt, Joni Mitchell, Jack Nicholaus, Alan Alda, Arthur C. Clarke, Frida Kahlo, Martha Mason, and my sister.  And there are many other victims alive today, still living in your community.

Okay, what does this little monster look like?  Unlike the large smallpox virus, the polio virus is even more tiny.  Maybe the smallest of these viral human predators.  Just a single strand of genetic material [RNA, ribonucleic acid] with 7,500 nucleotides [smallpox has a double strand of DNA, deoxyribonucleic acid, with 185,000 of those replicating nitrogenous base units] and a protein covering [the capsid], but without a protective lipid envelope [hence, not as effectively attacked by soap!].  Family Picornaviridae, which includes polio, rhinoviruses, foot and mouth disease, and viral hepatitis A.

Polio is generally spread through oral contamination with fecal material.  It first lodges in the intestines, where it forces the victim’s cells to reproduce itself.  Symptoms include fever, fatigue, headache, vomiting, back and neck stiffness, and pain and stiffness in the limbs.  It then can then move through the bloodstream to the central nervous system of its victim and paralyze muscle movement.

Although the lower extremities are frequently impacted, the large diaphragm muscle [responsible for breathing]can also be paralyzed.  This deadly condition can require long-term breathing assistance, which, in the past, involved the use of a bulky iron lung machine.  That is a very scary device.  A coffin-like setting, with only a mirror to describe your head’s surroundings.

Today, mechanical ventilators and other such machines assist in breathing, and are much in use during this Covid-19 crises.  Even modified sleep apnea machines [Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP) devices] have been considered as possible emergency aids for Covid-19 illness.  If you use one, you will know why.  I do.  But as originally built, they are not ventilators, and need also to be modified to prevent further spread of the virus.

Polio is an insidious, highly contagious disease.  And most of its victims shed copies of the virus even though they are asymptomatic [sound familiar?]. After immediately infecting one’s gut area, the virus forces the victim’s cells to reproduce its viral structure, copies of which then spread throughout the body’s lymphatic and bloodstream circulatory systems.  About one-fourth of those infected will progress to varying degrees of symptoms.  In some of these cases, polio will enter the nervous system, destroying neurons and causing paralysis or death.  Polio comes in three strains, the first of which is most debilitating and deadly.  If you survive infection, you may be immune, but only to the strain that contracted you.

In the United States, cases of polio peaked at nearly 60,000 in 1952, with about 3,000 children dying. Compare that to this year’s Covid-19 infections, with almost 14 million people infected, and more than 270,000 people dying [and both numbers rapidly increasing when this article was written, during the winter of 2020].

The word “Poliomyelitis” is taken from the Greek words for “gray,” “marrow,” and “inflammation.”  That is a scary enough sounding combination, when you recognize that there is no cure for the disease and you think that you might be the one infected.  It is mainly a disease of childhood, although Franklin D. Roosevelt contracted it at age 39, resulting in the permanent paralysis of his legs twelve years before he became President [some researchers believe he had Guillain-Barre Syndrome].

Of those who were infected with polio, a small percentage experienced paralysis, first feeling the sensation of “pins and needles” in their extremities.  Beginning in Europe in the mid 1800s, and flourishing in the United States in the Twentieth Century, it became the regular pandemic that came in the summer.

The modern history of polio involves the development of the Salk and Sabin vaccines in the 1950s, one using a killed virus [Salk], and one using a live, disabled one [Sabin].  People in the world, today, are still inoculated with the successors of these vaccines.  And before we discuss the World Health Organization’s (WHO) effort to eradicate polio completely, let’s look at the progression of polio through history.

Around 1400 BCE, the “Lion Gate” was constructed at the late Bronze Age Hittite site of Hattusa, in Turkey.  Ugarit, in Northern Syria, was thriving.  The Bronze Age Mycenaean Culture was beginning to dominate in the Mediterranean.  Assyria was ascendant in the Near East.  And the Shang Dynasty ruled in China.

Around the same time, a high priest named Ruma died at the temple of Astarte [Ashtoreth, Ishtar] in Memphis, the capitol of ancient Egypt [now in ruins 12 miles south of the great pyramids at Giza].  He was well thought of [or well wealthy enough] to have a funerary stelae erected with his visage.  He walked with a staff to compensate for a withered, shortened leg.  Was this the first artistic depiction of polio?

The disease was described in Britain in 1789 as “a debility of the lower extremities.”  A condition known as “infantile paralysis.”  In 1908, the virus was identified in Vienna by Karl Landsteiner and Erwin Popper, working with filtered human tissue and infecting two monkeys.

In many ways, polio became the disease of the industrial age, and one of dependable fright and fear in the United States.  In 1916, polio hit New York City especially hard, killing more than 2,000 people.  As today, many fled the city, and activities there were curtailed.

Living in the world now are 10 to 20 million survivors of this dreadful disease.  In 1948, George Marshall, then Secretary of State [yes, that same fellow], declared that a war on polio could be won after vaccines became available.  The World Health Organization (WHO), along with UNICEF (United Nations Children’s Fund), Rotary International, and the CDC (United States Centers for Disease Control and Prevention) followed up with such action.  WHO reported that the campaign of eradication had led to a drop from 350,000 cases in 1988, to 22 in 2017. And two of the three wild strains have been completely eradicated.  Unfortunately, Pakistan and Afghanistan are still fighting the disease.  And internationally, cases have been rising during the current Covid-19 pandemic.

The race to find a vaccine for polio is one of the most famous in history.  The first was developed by Jonas Salk in 1955, using an injection of the killed virus [Inactivated Polio Vaccine, or IPV], followed by an oral vaccine [Oral Polio Vaccine, or OPV], developed by Albert Sabin, which delivered a weakened form of the virus.

The impact of those vaccines was revolutionary.  Because of them, we are safer today.  OPV is no longer available in the United States [in part, because we are polio free, but also due to a potential release of a vaccine-derived polio virus, VDPV].  This success is due to worldwide cooperation and the development of vaccines.  Like smallpox, there is no cure for polio.  And the same is true for Covid-19, our current pandemic.

Polio vaccines are still routinely given to children.  The Centers for Disease Control and Protection (CDC) also suggests vaccination for adults who were never fully vaccinated, and traveling to polio risk areas, or health care workers treating polio patients.  Polio is still a viral disease of concern.  Check the CDC website for full information and precautions.

As a child, did you ever play the board game, “Candy Land?”  Maybe you played it recently with your children during our current Covid-19 pandemic. Las Vegas singer Ruby Lewis [a native of Shelbyville, Kentucky] recently streamed a dedication to the artist who invented the game.  Eleanor Abbott developed it for children in 1948, while staying in a San Diego hospital recovering from polio.

The tribute that Ms. Lewis sang is a good one for all of us to remember.  It was written in 1939, about a place sought by those seeking safety.  A place over there, “Over the Rainbow.”  A place of health, home, and good advice.

Go ahead and check out the lyrics.  It will make you feel better in this time of pandemic.