Polio in USA, Track Record of Victims (1916-1955) then Control with Salk and Oral Polio Vaccines
Dr. Jonas E. Salk, MD and his team developed the killed poliovirus vaccine
Potential and actual polio victims were helpless until Salk and his team came up with a vaccine
By Conrado D. Fontanilla
It took 38 years for a vaccine to be developed to stop the polio virus in its track in striking down to death or to deformities Americans and other peoples in the world. To think that Jonas Salk was only two years old when polio incidence turned into an epidemic in 1916. He turned to polio research and development of vaccine in 1948, already prepared to take on the polio challenge. He told his mother, "I'm going to go into research," upon his graduation in high school. His invention of killed-virus polio vaccine, launched in 1955, has proven effective against the bug. From 27,000 Americans struck down in 1916 that peaked at 57,879 in 1952, the number of polio victims went down from 28,985 in 1955 until none has been reported since 1999 in the United States.
That counts 44 years, almost half a century, to conquer polio!
What follows is a track record of the ballooning tolls of polio in the United States and the progress of Salk and his team to "stomp this disease flat," in the words of President Franklin D. Roosevelt, a polio victim himself.
Year 1916. Polio struck 27,000 Americans, 9,300 of them were children residing in New York. There were 6,000 of the total victims whose affliction was fatal; 2,200 of them did not see another summer and 3,500 survived.
Jonas Salk, still two years old, lived in New York but was not afflicted with polio. His mother, Dora Salk, was spartan in sanitation. She did not allow Jonas to play with children in the neighborhood for fear of the polio bug. Dora did not allow her husband, Daniel, to enter their house with his shoes on from his work in a factory.
Year 1917. I got no figures for this year.
Dora Salk wanted Jonas to go to a rabbinical school. But Jonas "wanted his work to be widely felt." He wanted to use his "bigger skills" to reach a greater community. He told his mother he wanted to be a lawyer and become a congressman. At age 15 he finished high school at the New York City's Townsend Harris, then went on to enroll at the City College of New York. Then he changed his mind: he wanted to be a doctor, but he would not practice medicine. How could that be Dora Salk asked. "I'm going to go into research," Jonas replied (Kluger, J. Splendid Solution, Jonas Salk and the Conquest of Polio. 2004:227-36).
Year 1921. Franklin Delano Roosevelt, still a private law practitioner, was struck by polio on August 10. His search for cure brought him to Warm Springs in Georgia. He was paralyzed from the waist down and never recovered the use of his legs from age 39 to his death at age 63 due to hemorrhagic stroke.
Year 1927. Franklin liked the place so much that he convinced his law partner, Basil O"Connor, that their law office buy the spa. O'Connor could not see a future for the venture but he obliged anyway. Franklin D. Roosevelt and Basil O’Connor established the Georgia Warm Springs Foundation to serve as rehabilitation center for polio victims. (Theodore Roosevelt, president of the United States in the early 1900s, was Franklin's cousin.)
Year 1928. Franklin Roosevelt was elected governor of New York. Now, an elected public official, he had to divest himself of his interest (investment and management) in the Georgia Warm Springs Foundation. O’Connor took over the management of Georgia Warm Springs Foundation.
Year 1933. Franklin Roosevelt was elected president of the United States. In celebration of the President’s birthday, Birthday Balls were held all over the country, raising one million dollars the first time around for the Georgia Warm Springs Foundation. Roosevelt, thanking the donors, said it was his happiest birthday yet.
Year 1935. I got no figures for this year.
Dr. William Park "director of the bureau of laboratories for the New York Department of Health" and his assistant, Maurice Brodie, came up with a vaccine consisting of killed polio virus. Brodie was a Canadian who studied under Dr. Park. After graduation he went back to Canada for a clinical practice. When Dr. Park got involved in research against polio he called Brodie to come over and help him. It was the first time that such a vaccine was made. It was given a trial run that resulted in a fiasco.
"Many of the children who did not contract polio developed nasty abscesses at the site of the injection....Children who had been well before they received the vaccines were now very sick" (same source as above, pages 54-55).
However, their innovation would soon be adopted by Dr. Francis and Dr. Salk who modified it, as we shall see. ..
Year 1937. The Georgia Warm Springs Foundation outlived its scope, mainly due to the “enormous” amount of donations. It was proclaimed on September 23 as National Foundation for Infantile Paralysis by President Roosevelt. In addition to those raised during the Birthday Balls, and other fund-raising activities, one-dime donations came in from Americans.
“Money raised from donations and events would be distributed to all these scientific centers, and the greatest medical thinkers in the country would be authorized to spend it to rehabilitated the children the poliovirus had crippled. If they found an inoculation that could protect the healthy before they ever got sick, so much the better. The nation, Roosevelt declared, was going to stomp this disease flat” (Kluger, J. Splendid Solution, Jonas Salk and the Conquest of Polio. 2004:44).
Year 1938. I got no figure for this year.
Jonas Salk graduated from the medical school of New York University.
NFIP got support from a Board of Trustees that included 88 industrialist and Wall Streeters like David Sarnoff of RCA, Thomas Watson of IBM, Robert Woodruff of Coca-Cola Company and Arthur Kirsten, Jr. of West Indies Sugar Corporation.
Year 1939. 7,343 got sick of polio.
Year 1940-41. 9,000 were struck by polio. Up from year 1939.
Jonas Salk had his internship at the Mount Sinai Hospital. He had diagnosed correctly a man as having a diabetic coma. He prescribed insulin and saved the life of the man. Mainly for this feat, he was voted by his fellow interns as president of interns.
In 1941, the United States was dragged into World War II and Salk wanted to take to the battlefield as a non-combatant doctor. Dr. Thomas Francis, Jr. of Michigan University convinced him to do battle in the laboratory. In 1918, 44,000 American soldiers deployed in the European theater of World War I died of the Spanish flu pandemic of 1918. If Salk could help develop a vaccine against the flu he could help save more than 44,000 American soldiers. This flu pandemic killed an estimated 25 million people in the whole world.
Year 1942. I got no figure for this year. Dr. Salk finished his internship in Mount Sinai Hospital under Dr. Thomas Francis, Jr. head of the microbiology department, who was intrigued by the question of why a killed poliovirus could not be used to make a vaccine. Salk shared Dr. Francis' belief that killed polio virus could be used as vaccine. Dr. Francis was moving to the University of Michigan.
Year 1943. 12,450 were afflicted with polio. A decline compared with the toll in 1940-41.
Jonas Salk joined Dr. Francis in the University of Michigan.Dr. Francis and Dr. Salk were successful in coming up with an influenza vaccine They used killed virus in making the vaccine against H1N1, responsible for the flu pandemic in 1918. Now they had confirmed their hypothesis that killed virus can be used in making a vaccine.
Several doses of the flu vaccine were supplied to the American soldiers in the battlefields of Europe in WWII.
Year 1944. 19,029 were downed by polio. Up from the previous year.
Year 1945. 12, 829 got the polio. Down from the previous year.
President Roosevelt took a vacation at NFIP to recover strength from a tiresome conference with Prime Minister Winston Churchill of England and Marshall Joseph Stalin of USSR at Tehran, Iran where they decided the fate of the world after the war (Taylor, D. Franklin Delano Roosevelt. 1002). Earlier in March, he made a speech before U.S. Congress reporting that Hitler's Germany was now on the verge of defeat. He was on his wheelchair, the first time he did so before congress now in his fourth term as president. Many of those who saw him thought they would not see him again alive.
President Roosevelt died of hemorrhagic stroke in April as he was vacationing at the NFIP to regain some health.
He did not meet the man, Dr. Jonas Edward Salk, who would fulfill his dream to "stomp this disease flat." (Before his marriage, Jonas did not have a middle name. However, the father of his wife wanted him to have one. The father-in-law chose Edward.)
(I have a Hub "How Enemies Within (Free Radicals and X-rays) Killed Former U.S. President, Franklin D. Roosevelt").
The Americans loved President Roosevelt that they voted him to an unprecedented fourth term as president of the United States. (Now the president is limited to only two terms.) They were happy to donate 1 dime at a time to the NFIP that' s why the name "March of Dimes." They would line the sides of some streets with dimes. Since NFIP was a private foundation, it was not bound by political considerations with regard to rehabilitation of polio victims, controlling the virus, and giving research grants. So it could give research grants, as we shall see, to any talented scientist to stomp polio the way it saw fit. History has shown that the paths of President Roosevelt and that of Dr. Salk converged.
Year 1946. 25,698 got the polio. Up from the previous year.
Year 1947. 10,827 were down with or killed by polio. Down from the previous year.
Dr. Salk moved with his family to University of Pittsburgh in Pennsylvania to become head of the laboratory there. With a substantial support by the university, he built up the laboratory according to his design. He listed polio among his research priorities.
Year 1948. I have no figure for this year.
Dr. Harry Weaver was director of research at the National Foundation of Infantile Paralysis. To fulfill the mandate of NFIP he looked for talented scientists. Salk already had a reputation as co-inventor of the flu vaccine. Weaver visited Pittsburgh University and Salk and his laboratory. NFIP made a grant of $148,000 to the laboratory for a polio typing study. Sarah Mellon Scaife Foundation of Pittsburgh, the largest philanthropic entity in town, joined the wagon and made a $35,000 grant. Mayor David Lawrence of the City Hall gave more laboratory space. Now the paths of President Roosevelt and Dr. Salk converged.
Year 1949. 42,033 were struck. Up from the previous year.
Salk went on to "track down a strong, stable, gold-standard sample of each of the three types of virus."
Year 1950. 33,300 got the polio bug. Down from the previous year.
Salk presented the results of polio typing research at the Second International Poliomyelitis Conference in Copenhagen opened by Queen Ingrid and presided by Niels Bohr, a Nobel Prize winner on physics. Of the samples, 85 percent were Type I, 12 percent were Type II, and 3 were Type III.
Year 1951. 28,386. Down from the previous year.
The NFIP Committee on Immunization met in December to decide which kind of virus to use in vaccine. It was decided that "Whether it was made from a killed virus or a live virus did not matter. The first vaccine that worked would be offered to the world" (Kluger, J. Splendid Solution. 2004:159). So if Dr. Robert Sabin came out first with an effective live-virus polio vaccine his invention would be given the first bat. There was a chance that the research grants for Dr. Salk would be terminated. Such was the double pressure: mounting deaths and deformed Americans owing to polio, and the intellectual and research competition.
Year 1952. 57,879. Almost double that of the previous year. This is the worst toll ever.
Dr. Salk tested the aqueous variety of his vaccine on 161 children and adults. On 71 participants, it incited antibody production against Type II virus; on 91 subjects it gave protection against all virus types. NFIP made another grant of $211,420. Methods of culturing poliovirus were being developed, so were ways of killing the virus without damaging their coats.
Year 1953. 35,592. Down from the previous year.
NFIP gave the Pittsburgh laboratory another grant of $255,472, making the total grant to $1.25 million in five years.
Dr. Weaver reported to the Board of Trustees of NFIP that a field trial of a new killed-virus polio vaccine being developed will take place this year. He did not mention Dr. Salk.
Year 1954. American children numbering 1.8 million were given shots of the killed-virus polio vaccine in the final trial on humans starting on April 26. Dr. Salk did not apply the double blind research design, considered as the gold standard. [Double blind means neither the nurse injecting the vaccine nor the child taking the polio shot knew whether the real one is being injected or not. Of course, Salk knew.] He rejected it as immoral in the development of the killed-virus vaccine even if he considered his formula very safe. He ensured that trial volunteers in the control and treatment were protected. He did not want a repeat of the Park-Brodie fiasco that occurred in 1935. Results would be announced the following year, on the 10th anniversary of the death of President Roosevelt.
There were barriers in the final phases in the development of polio vaccine. Rumors spread that the Salk vaccine kills people. A radio broadcaster announced in his program that the vaccine killed monkeys injected with the vaccine. Claims became thick that only live but weakened polio virus could make a vaccine. Thousands of volunteers were withdrawn from the scheduled trial who had to be replaced in a hurry to push through with the final tests. (I have a Hub "Rumors and Detractors Almost Derailed the Final Test of Polio Vaccine on 1.8 Million American Children.")
Year 1955. 28,985 were struck. Down from the previous year.
Dr. Francis, who was also director of the trial of the Salk vaccine on humans, announced the results of the trial in 1954: 68 percent effective against Type I polio, 100 percent effective against Type II polio and 92 percent effective against Type III polio. This was the year the Salk killed-virus polio vaccine was launched.
Type I poliovirus was “the one most likely to lead to epidemics and paralysis of the limbs. Type II was a milder virus than Type I, the likeliest to lead to asymptomatic cases, though in the weak or unlucky it could still paralyze or kill. Type III was the rarest of all and that was a very good thing since it was the one most likely to lead to bulbar polio, the infection of the medulla oblongata, the lower bulb of the brain, leading to paralysis of the diaphragm, destruction of breathing, and so often death….” (Kluger, J. Splendid Solution, Jonas Salk and the Conquest of Polio. 2004:99-100).
Year 1956. 15,150 were afflicted with polio.
A drastic decline from the previous year. The effect of the Salk vaccine now began to show. It was only a matter of time that more Americans could get the vaccine through their buttocks. The conquest of polio was on the march.
Year 1957. 5,467 got the polio.
Thanks to the Salk killed-virus polio vaccine, the toll was going down. It is the shape and size of the poliovirus (icosahedral with 5-fold, 3-fold, and 2-fold symmetry) that incite the immune system to produce antibodies. This principle was proven earlier in the flu vaccine. The formalin that Dr. Salk used to kill the poliovirus preserved their shape and size.T-helper cells (patrolman roving the body and coordinator) call on the T-killer cells (soldiers) to multiply fast for battle, and signal the macrophage, a B cell. (A T cell originated from the bone morrow, move to the thymus gland and developed there; a B cell originated from the bone morrow and developed there.) The macrophage plucks an antigen from the poliovirus and use it to mark the poliovirus. The T-killer cell finds the poliovirus by targeting the antigen and fights it with a weapon called antibody. An antibody latches on the surface of the poliovirus changing its shape and size such that no cell of the person fits it. If it cannot find a fit, the virus cannot enter a cell. A virus can only infect if it can get inside a live cell. A virus still in its form as RNA (ribonucleic acid), conventionally considered as non-living, becomes alive only when it gets into a live cell. 'Alive' means that the virus can multiply - polio virus multiplies in a live cell; overpopulation of poliovirus bursts the cell; spilled poliovirus infect other cells.
A dead poliovirus is one that had lost its capacity to infect and multiply. Dr. Salk wrote: “The theory of the killed-virus vaccine rests on the well-established fact that an inactivated virus, though it has lost the power to infect or multiply, may still act as an antigen stimulating the body to produce antibodies against specific virus” (Salk, J. E. “Vaccines for Poliomyelitis.” Scientific American April. 1955. in Microsoft Encarta 2009).
Killed poliovirus injected to the body accomplish the objective of vaccination: the production of antibodies by the immune system. One T cell or B cell can multiply into millions in a short time. The macrophages envelop and eat foreign body; the neutrophils produced by T-killer cells "eat" poliovirus; it does not matter if it is killed (those injected by vaccination) or RNA latched with antibody. The macrophage and neutrophils with their load of dead or (RNA) virus are ejected from the body. When the battle is over, the Suppressor cells signal the T and B cells to cease and desist (Jaret, Peter. “Our Immune System, the Wars Within.” National Geographic, June 1986). Some of the T cells and B cells die off after doing battle with the poliovirus; others would stay alive as Memory cell. These recognize any poliovirus: dead or plain RNA that would attempt to infect the same person. Memory cells incite the immune system to battle the poliovirus the way it did in the first encounter. Immunity is now established; vaccination is successful.
(I have a Hub "A Theory of How Salk Vaccine Kills Poliovirus It Marked with Antigens.")
Year 1961. 1,312 went down with polio. Again a drastic decline from the previous year.
The oral vaccine invented by Dr. Albert Sabin with live poliovirus also came into use in 1961-63 (Encyclopedia Britannica 2009).
Year 1969. 27 victims of polio were recorded.
Early 1970s. 12 polio cases reported each year.
Year 1974. 7 polio cases were reported.
“The last wild case of polio in the United States occurred in 1979. All of the tiny number of cases since then have been directly traceable to the virus in the live vaccine. Often the infection appeared not in the vaccinated child but in a vulnerable adult living in the household” (Kluger. J. Splendid Solution, Jonas Salk and the Conquest of Polio. 2004:317). A weakened virus in the vaccine could mutate into a virulent one and cause infection.
Year 1984-1996. Cases of polio was in the single digit.
Year 1999. No polio victim was recorded in the United States.
Year 2000. None reported in the United States. Only the Salk killed-virus polio vaccine was administered.
“The year after Salk died, the Centers for Disease Control ruled that in order to eliminate the final lingering cases of polio in the United States, the live vaccine invented by Albert Sabin would be phased out and replaced by the killed formulation invented by Jonas Salk. On January 1,2000, that transition was complete and Salk vaccine returned, at least in the United States” (Kluger, J. Splendid Solution, Jonas Salk and the Conquest of Polio. 2004:319).
Year 2003. About 700 polio cases were reported for the whole world; three-quarters of them were recorded in Nigeria, Pakistan and India. Polio cases were owing to failure to vaccinate not to the inadequacy of the vaccine itself. In fact, some countries resisted administering the the Salk vaccine, like England, some early years after the vaccine was out for the taking.
It took Dr. Salk and his team some six years to come up with the killed-virus polio vaccine. The hopes of potential and actual polio victims that his vaccine would soon be forthcoming must have been inscrutable; at the same time, almost an unbearable pressure on the part of the scientists.
Looking back, it was not a complete disaster -- an important innovation came out of the work of Dr. William Park, "director of the bureau of laboratories for the New York Department of Health" and Maurice Brodie, a Canadian assistant of Dr. Park. They used killed virus, a technology later on adopted and improved upon by Dr. Salk.
Dr. Park and Brodie deserve some accolades in the development of the Salk polio vaccine. Had they been given further support in their research they might have succeeded in the same direction that Dr. Salk had done. Instead, they were vilified mainly because there was a strong rival idea, the prevalent one at that time, that only live and weakened virus could serve as a vaccine. Brodie was so committed to conquering polio that the fiasco destroyed him as a person, so much of a hint was given by author Jeffrey Kluger in his book "Splendid Solution, Dr. Jonas Salk and the Conquest of Polio."
Monkeys might appreciate accolades if sufficiently trained. They, too, deserve our gratitude: the rhesus monkeys from India and macaques monkeys from the Philippines. Some 36,000 macaques were sacrificed for their kidneys in the development of Salk vaccine (Compton encyclopedia). The Philippines was annexed by the United States in 1902 to 1946.
Polio remains a menace. Vaccine is for prevention of infection. What if one had been infected? There should be a cure. This could be the reason why Salk still did research on multiple sclerosis (MS) after the success of the vaccine named after him. MS is similar to polio as it afflicts the nervous system where the sheath and the axon (of nerve cells) degenerate or may result in loss. But while polio is caused by a virus (under the framework of the germ theory of disease), MS appears to be caused by free radicals. And MS still remains unconquered. The cure for polio might be the cure for MS and vice versa. Another challenge for medical researchers like Salk.
One can think of the affliction of President Franklin Roosevelt with polio in 1921 as too remote to say that it could have paved the way for Dr. Salk and his team to develop the polio vaccine. One could further speculate that there could have been other paths toward the conquest of polio. However, history has shown that his search for cure for his own polio deformities lead him to the establishment of the National Foundation for Infantile Paralysis. Now fondly called March of Dimes, this foundation provided the scientific atmosphere, even if stiff competition, and the funds for Dr. Salk and his team to develop the Salk polio vaccine. .
New entries as of November 9,2012
Lessons may be learned from the development of Salk vaccine.
The National Foundation for Infantile Paralysis or March of Dimes is a foundation created as such by Pres. Roosevelt. It is unlike a government agency whose funds and budgeting is subject to political pressure. A foundation that caters to the interest of the people will pursue such aim independent of politics and profit considerations like that of Big Pharma. In the present stand off between conventional medicine and integrative medicine on cancer and heart disease, Big Pharma pursues its interests at the expense of the people who are potential and actual victims of cancer and heart disease. Big Pharma throws its weight against alternatives that threaten its market. For example, the coronary artery bypass graft surgery (CABG) and angioplasty that are a billion dollar industry, including cancer. There is an emerging mode of prevention, treatment and cure for heart disease and cancer that Big Pharma is blocking. This is the free radical theory of diseases. This framework pinpoints causes of these disease whereas conventional medicine tags risk factors. Risk factors are not causes and modes of prevention, treatment and cure based on them are bound to fail. Big Pharma is a stakeholder in conventional approaches to heart disease and cancer.
Market forces did not decide the use of Salk killed poliovirus vaccine. It was the capability of this vaccine that decided the issue in its favor. Pharmaceutical companies benefited from the formula of Dr. Salk as they were given the license to manufacture this vaccine. Market forces, manipulated by Big Pharma, are controlling research and development of modes and drugs to prevent, treat and cure cancer and heart disease.