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Polio Pioneers: Dr. Jonas Salk & students
Young kids who received test inoculations helped end polio here
WHO: Polio public health risk
May 2014: The World Health Organization (WHO) labeled a current international spread of polio “an extraordinary event” and a public health risk to countries beyond Afghanistan, Pakistan, Middle Eastern and Central African countries.
This is only the second time in the WHO's history it has made such a declaration.
Of the 10 polio infected countries three have allowed the virus to spread beyond their borders. The WHO said polio has spread from Pakistan to Afghanistan, from Syria to Iraq and from Cameroon to Equatorial Guinea.
“If unchecked, this situation could result in failure to eradicate globally one of the world’s most serious vaccine preventable diseases,” said the WHO.
Over half a century ago, Americans lived in fear of an incurable disease that paralyzed young children – poliomyelitis, commonly known as polio or infantile paralysis.
Playing a major role in the eradication of polio in the U.S. was a medical researcher, whose life goal was to make a difference to humanity, and millions of elementary school children.
“Polio,” the Mayo Clinic explains, “is a very serious infection that causes paralysis of the muscles, including the muscles that enable you to walk and breathe.” It mostly cripples children, but there also have been adult victims of this dreaded disease, most notably President Franklin D. Roosevelt.
The first known case of polio outbreak in the U.S. occurred in 1894. The 20th century ushered in numerous polio epidemics. It started in 1916 with 27,000 cases and 6,000 deaths and the national toll grew larger every decade.
By 1952, polio was attacking close to 60,000 Americans a year. Approximately 75% of the reported cases occurred in people under 20 with 50% in kids under ten.
Parents in the 50s lived with the fear that their children would contract polio forcing their kids to use leg braces to walk or live confined in an iron lung machine that helped them breathe. (See photo.)
Infected individuals spread polio to healthy people by contact. And infantile paralysis quickly spread through many American communities, especially during the summer months. During the 50s, numerous community swimming pools, summer camps and movie theaters remained vacant as people shunned areas where they might contract the virus.
Polio is “transmitted through contaminated water and food or through direct contact with someone infected with the virus,” explains the Mayo Clinic. “Polio is so contagious that anyone living with a recently infected person is likely to become infected, too. People carrying the polio virus can spread the virus for weeks in their feces.”
Fight to end polio is not over
The last U.S. case of polio occurred in 1979.
Citizens in more than half of the world were contracting polio as recently as 1988 when the World Health Assembly set the goal to wipe polio off the map.
That number has continually declined over the last 2½ decades. By 1994, the Americas were polio-free. Soon the last cases were reported in China, followed by the Pacific and then Europe.
The Bill and Melinda Gates Foundation targeted polio in 2000s and focused on eradicating the virus in India. "India's urban centers are among the world's most densely populated. The country suffers from poor sanitation. Its 1.2 billion citizens are highly mobile and give birth to 27 million new Indians every year," Gates explained in a Wall Street Journal essay.
India's anti-polio campaign was a government-led initiative with the support of all of India's society, including "the poorest people in the most impoverished regions of the country," said the former Microsoft co-founder. Two million people spread out across the country and inoculated 170 million children during special days.
When India became polio-free in 2013 Gates called it "the most impressive global health success I've ever seen."
Today, the disease still continues to cripple children and adults in the Middle East, Central Africa, Pakistan and Afghanistan.
"The fight to end polio is not over," Gates said. "If the world maintains its funding and commitment, we can eradicate the disease globally within six years."
To counter the crippler the "March of Dimes" begins
Besides death, there’s nothing worse for a parent than to watch their once vibrant child quickly become incapacitated. So, many parents in the 1950s confined their children to their homes, which they sealed to keep out “infected” air.
"Polio was a terrible fear. You can't recognize what a fearful thing it was,” 90-year old Marjorie Adams told MedicineOnline.com. “There were people around who were crippled (with) polio. It was real. It was there with you," she said.
When children contracted the disease they were quarantined. It meant being separated from their parents for 14-days. After this two week period limited parental visits were allowed. During these visits kids remained in an isolation ward and parents talked to them through a window.
While polio wasn’t the U.S.’ worst disease the way it paralyzed young children moved a majority of Americans, even those without kids. In 1950s opinion polls Americans said a polio epidemic was second only to the atomic bomb in what they feared the most.
The country felt polio had to be conquered, the sooner the better.
Americans knew it would take money to defeat this scourge. They contributed millions to a national fundraising campaign, known as the March of Dimes. The foundation, established in 1938 by President Franklin Roosevelt, was originally known as the National Foundation for Infantile Paralysis.
It got its catcher name in 1939 when comedian/singer Eddie Cantor urged his radio listeners to send their loose change to Washington in “a march of dimes… reach(ing) all the way to the White House.” Soon, 2.7 million dimes and thousands of dollars flooded the White House. Huge contributions continued for decades.
Much of the money went to the top medical researcher in the field Dr. Jonas Salk, head of the Virus Research Lab at the University of Pittsburgh. After eight years of studying the virus, Dr. Salk developed an experimental polio vaccine he felt would eradicate the disease. He successfully inoculated his own children, but it still needed further testing.
Click on image ▼ to enlarge
Cases of Paralytic Polio in the U.S.
Dr. Salk develops a vaccine and tests it on school kids
Normally the scientific community moves painstakingly slow when testing new medicines and vaccines, but the country’s obsession with ending polio prompted an accelerated scientific testing schedule.
In 1954, the Salk vaccine was tested on nearly 2 million U.S. elementary school children in 44 states before it was used nationwide. These tests were one of the largest clinical trials in medical history.
I was one of these students called “Polio Pioneers.” My parents volunteered me to be one of the children who would be the first to test the effectiveness of Salk’s polio vaccine.
For two months in the spring of 1954, I was among the numerous first, second and third graders at my school who left class near the end of the school day and went to the cafeteria. The lunch staff and the day’s food was gone, replaced by doctors, nurses, needles, rubbing alcohol and cotton swabs.
We each nervously entered the room and spoke in hushed tones. We rolled up our sleeves and each in turn was given a shot.
I don't remember much about the experience, other than being told after I was inoculated to put my head down on a cafeteria table and rest before leaving. I guess they wanted to make sure we didn't pass out or experience some other side effects from the shot.
As part of the double blind scientific testing, half of the children received the vaccine and the other half were injected with a pink water placebo. (I received the real serum and didn't have to get additional shots like the kids who got placebo injections.)
"One of the greatest events in the history of medicine"
About 300,000 volunteers assisted during the enormous medical trials. Healthcare professionals used over one million needles. It cost $5½ million dollars to buy one million doses of gamma globulin that was used in the vaccine, according to TeachSpace.org.
Typically, children were given two shots of the Salk vaccine spaced two weeks apart. A month later, the serum was injected for a third and final time. During the three school visits doctors and nurses also took blood samples from a select group of Polio Pioneers and several tests were conducted on their blood.
In 1955, almost exactly a year to the day of the beginning of the test inoculations, it was announced that Dr. Salk's new vaccine was effective and safe. Almost immediately a nationwide inoculation campaign began.
“The news caused a public sensation probably unequaled by any health development in modern times,” according to The New York Times. The chairman of the American Medical Association called it, "One of the greatest events in the history of medicine."
Dr. Salk is a national hero
The Salk vaccine drastically reduced the number of new cases of polio in the U.S. from 59,000 polio cases in 1952 to less than a thousand a decade later.
Dr. Salk never patented his vaccine, believing it belonged to the people and saying, "Can you patent the sun?" Forbes estimates he could have earned $7 billion from such a patent.
Although Dr. Salk never got rich from his discovery he earned lots of notoriety. He became a national hero. Time magazine listed him among the 100 most important people of the 20th century, in the company of Winston Churchill, Albert Einstein, Sigmund Freud and the Wright brothers.
The medical researcher received a special citation from President Dwight D. Eisenhower, who called him a "benefactor of mankind." Eisenhower thanked him in the name of "countless thousands of American parents and grandparents who are hereafter to be spared the agonizing fears of the annual epidemic of poliomyelitis." He added his appreciation for "all 164 million Americans, to say nothing of all the people in the world that will profit from your discovery."
Dr. Salk's medical research continued "to his last day"
Dr. Salk's research didn't stop his after his polio victory. With funds contributed by the March of Dimes Dr. Salk fulfilled one of his life’s dreams, the 1963 creation of a special research institute – the Salk Institute for Biological Studies.
In the San Diego facility he and other scientists focused on such diseases as multiple sclerosis, cancer, AIDS and Alzheimer's. Dr. Salk served as the center's director until 1975.
Dr. Francis Crick, president of the Salk Institute, discussed his colleague with The New York Times upon his death in 1995.
"Few have made one discovery that has benefited humanity so greatly," Dr. Crick told The Times. "Jonas was a man who, right to his last day, was actively in pursuit of another."
Will we see the end of polio?
POST SCRIPT: Until polio is totally eradicated from the planet it could make a comeback in the developed world, including the U.S. (See sidebar story above.)
Healthcare officials say we need to remain vigilant or we could see a return of polio, measles and other diseases covered by childhood vaccines.
"Younger people don't realize these diseases still exist," Montana Community Health Director and Polio Pioneer Boni Stout told the Pittsburgh Post-Dispatch. "We're a plane ride away from most of them. If we let our guard down, these diseases are going to be right back here." –TDowling
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© 2014 Thomas Dowling