History of poliomyelitis - AbsoluteAstronomy.com

The history of poliomyelitis (polio) infections extends into prehistory

Prehistory

Prehistory is the span of time before recorded history. Prehistory can refer to the period of human existence before the availability of those written records with which recorded history begins. More broadly, it refers to all the time preceding human existence and the invention of writing...

. Although major polio epidemic

Epidemic

In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

s were unknown before the 20th century, the disease has caused paralysis

Paralysis

Paralysis is loss of muscle function for one or more muscles. Paralysis can be accompanied by a loss of feeling in the affected area if there is sensory damage as well as motor. A study conducted by the Christopher & Dana Reeve Foundation, suggests that about 1 in 50 people have been diagnosed...

and death for much of human history. Over millennia, polio survived quietly as an endemic

Endemic (epidemiology)

In epidemiology, an infection is said to be endemic in a population when that infection is maintained in the population without the need for external inputs. For example, chickenpox is endemic in the UK, but malaria is not...

pathogen until the 1880s when major epidemics began to occur in Europe; soon after, widespread epidemics appeared in the United States. 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

Philanthropy etymologically means "the love of humanity"—love in the sense of caring for, nourishing, developing, or enhancing; humanity in the sense of "what it is to be human," or "human potential." In modern practical terms, it is "private initiatives for public good, focusing on quality of...

. Although the development of two polio vaccines has eradicated poliomyelitis

Poliomyelitis eradication

The global eradication of poliomyelitis is a public health effort to eliminate all cases of poliomyelitis infection around the world. The global effort, begun in 1988 and led by the World Health Organization, UNICEF and The Rotary Foundation, has reduced the number of annual diagnosed cases from...

in all but four countries, the legacy of poliomyelitis remains, in the development of modern rehabilitation therapy

Physical medicine and rehabilitation

Physical medicine and rehabilitation , physiatry or rehabilitation medicine, is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician having completed training in this field is referred to as a...

, and in the rise of disability rights movement

Disability rights movement

The disability rights movement is the movement to secure equal opportunities and equal rights for people with disabilities. The specific goals and demands of the movement are: accessibility and safety in transportation, architecture, and the physical environment, equal opportunities in independent...

s worldwide.

Early history

Ancient Egypt

Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...

ian 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

Roman Emperor

The Roman emperor was the ruler of the Roman State during the imperial period . The Romans had no single term for the office although at any given time, a given title was associated with the emperor...

Claudius

Claudius , was Roman Emperor from 41 to 54. A member of the Julio-Claudian dynasty, he was the son of Drusus and Antonia Minor. He was born at Lugdunum in Gaul and was the first Roman Emperor to be born outside Italy...

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. In 1773 Scott was said to have developed "a severe teething

Teething

Teething is the process by which an infant's first teeth sequentially appear by emerging through the gums. Teething may start as early as three months or as late, in some cases, as twelve months. The typical time frame for the first teeth to appear is somewhere between six and nine months...

fever which deprived him of the power of his right leg." At the time, polio was not known to medicine. A retrospective diagnosis

Retrospective diagnosis

A retrospective diagnosis is the practice of identifying an illness in a historical figure using modern knowledge, methods and disease classifications...

of polio is considered to be strong due to the detailed account Scott made.

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 language

Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...

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—he refers to polio as "a debility of the lower extremities". The first medical report on poliomyelitis was by Jakob Heine

Jakob Heine

Jakob Heine was a German orthopaedist. He is most famous for his 1840 study into poliomyelitis, which was the first medical report on the disease, and the first time the illness was recognised as a clinical entity...

, in 1840; he called the disease Lähmungszastände der unteren Extremitäten. Karl Oskar Medin

Karl Oskar Medin

Karl Oskar Medin was a Swedish pediatrician. He was born at Axberg, Örebro and died in Stockholm. He is most famous for his study of poliomyelitis, an illness often known as the Heine-Medin disease, named after Medin and another physician, Jakob Heine...

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

Epidemic

In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

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

Louisiana is a state located in the southern region of the United States of America. Its capital is Baton Rouge and largest city is New Orleans. Louisiana is the only state in the U.S. with political subdivisions termed parishes, which are local governments equivalent to counties...

. A fifty-year gap occurs before the next U.S. report—a cluster of 26 cases in Boston

Boston

Boston is the capital of and largest city in Massachusetts, and is one of the oldest cities in the United States. The largest city in New England, Boston is regarded as the unofficial "Capital of New England" for its economic and cultural impact on the entire New England region. The city proper had...

in 1893. The first recognized U.S. polio epidemic occurred the following year in Vermont

Vermont

Vermont is a state in the New England region of the northeastern United States of America. The state ranks 43rd in land area, , and 45th in total area. Its population according to the 2010 census, 630,337, is the second smallest in the country, larger only than Wyoming. It is the only New England...

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. That year, there were over 27,000 cases and more than 6,000 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

Quarantine

Quarantine is compulsory isolation, typically to contain the spread of something considered dangerous, often but not always disease. The word comes from the Italian quarantena, meaning forty-day period....

d. Dr. Hiram M. Hiller, Jr.

Hiram M. Hiller, Jr.

Hiram M. Hiller, Jr. , was an American physician, medical missionary, explorer, and ethnographer. He traveled in Oceania and in South, Southeast, and East Asia, returning with archeological, cultural, zoological, and botanical specimens and data for museums, lectures and publications...

, 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.

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 suffer 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

Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic...

, including improved sewage

Sewage

Sewage is water-carried waste, in solution or suspension, that is intended to be removed from a community. Also known as wastewater, it is more than 99% water and is characterized by volume or rate of flow, physical condition, chemical constituents and the bacteriological organisms that it contains...

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 1/1000 cases, while in adults, paralysis occurs in 1/75 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 would be 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

John Haven "Jack" Emerson 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:...

'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

Hydrotherapy, formerly called hydropathy, involves the use of water for pain-relief and treating illness. The term hydrotherapy itself is synonymous with the term water cure as it was originally marketed by practitioners and promoters in the 19th century...

and electrotherapy

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 disease. The term has also been applied specifically to the use of...

. In 1935 Claus Jungeblut reported that vitamin C

Vitamin C

Vitamin C or L-ascorbic acid or L-ascorbate is an essential nutrient for humans and certain other animal species. In living organisms ascorbate acts as an antioxidant by protecting the body against oxidative stress...

treatment enhanced resistance to poliomyelitis in monkeys.
However follow up experiments reported by Albert Sabin and Jungeblut himself were unable to confirm the initially promising results. Later, Fred Klenner published his own clinical experience with vitamin C in the treatment of polio, however his work was not well received and no large clinical trials were ever performed.

Surgical treatments such as nerve grafting

Medical grafting

Grafting refers to a surgical procedure to move tissue from one site to another on the body, or from another person, without bringing its own blood supply with it. Instead, a new blood supply grows in after it is placed. A similar technique where tissue is transferred with the blood supply intact...

, tendon

Tendon

A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension. Tendons are similar to ligaments and fasciae as they are all made of collagen except that ligaments join one bone to another bone, and fasciae connect muscles to other...

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 braces and body casts, which tended to cause muscle atrophy

Muscle atrophy

Muscle atrophy, or disuse atrophy, is defined as a decrease in the mass of the muscle; it can be a partial or complete wasting away of muscle. When a muscle atrophies, this leads to muscle weakness, since the ability to exert force is related to mass...

due to the limited movement of the user, were also touted as effective treatments. Massage and passive motion exercises were also used to treat polio victims. 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

Iron lung

A negative pressure ventilator is a form of medical ventilator that enables a person to breathe when normal muscle control has been lost or the work of breathing exceeds the person's ability....

, an anti-polio antibody

Antibody

An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...

serum, and a treatment regimen developed by Sister Elizabeth Kenny

Elizabeth Kenny

Elizabeth Kenny was an unqualified Australian nurse who promoted a controversial new approach to the treatment of poliomyelitis in the era before mass vaccination eradicated the disease in most countries.-Youth:...

Iron lung

The first iron lung used in the treatment of polio victims was invented by Philip Drinker

Philip Drinker

Philip Drinker was an industrial hygienist. With Louis Agassiz Shaw, he invented the first widely used iron lung in 1928.-Family and early life:...

, Louis Agassiz Shaw, and James Wilson at Harvard, 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

Vacuum cleaner

A vacuum cleaner, commonly referred to as a "vacuum," is a device that uses an air pump to create a partial vacuum to suck up dust and dirt, usually from floors, and optionally from other surfaces as well. The dirt is collected by either a dustbag or a cyclone for later disposal...

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

John Haven "Jack" Emerson 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:...

modified the design to make production less expensive. The Emerson Iron Lung was produced until 1970. Other respiratory aids, such as the "rocking bed" were used in 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 exceeded 90%.

These drawbacks led to the development of more modern positive-pressure ventilators and the use of positive-pressure ventilation by tracheostomy. 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 Hammon

William McDowall Hammon 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 medical missionary in the former Belgian Congo. After returning, he received his...

at the University of Pittsburgh

University of Pittsburgh

The University of Pittsburgh, commonly referred to as Pitt, is a state-related research university located in Pittsburgh, Pennsylvania, United States. Founded as Pittsburgh Academy in 1787 on what was then the American frontier, Pitt is one of the oldest continuously chartered institutions of...

isolated serum

Blood serum

In blood, the serum is the component that is neither a blood cell nor a clotting factor; it is the blood plasma with the fibrinogens removed...

, containing antibodies 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 trial

Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...

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 that 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 splint

Splint (medicine)

A splint is a device used for support or immobilization of limbs or of the spine.It can be used:* By the emergency medical services or by volunteer first responders, to immobilize a fractured limb before the transportation; it is then a temporary immobilization;* By allied health professionals such...

s would prevent tightening of muscle, tendons, ligament

Ligament

In anatomy, the term ligament is used to denote any of three types of structures. Most commonly, it refers to fibrous tissue that connects bones to other bones and is also known as articular ligament, articular larua, fibrous ligament, or true ligament.Ligament can also refer to:* Peritoneal...

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

Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations , poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, disuse or lack of exercise or disease intrinsic to the tissue itself...

of both affected and unaffected muscles.

In 1940, Sister Elizabeth Kenny

Elizabeth Kenny

, an Australian bush nurse, arrived in North America and challenged this approach to treatment. Having treated polio cases in rural Australia between 1928 and 1940, Kenny had improvised a form of physical therapy

Physical therapy

Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...

that - instead of immobilizing afflicted limbs - aimed to relieve pain and spasms in polio patients through the use of hot, moist packs to relieve muscle spasm, and the advocated early activity and exercise to maximize the strength of unaffected muscle fibers. Sister Kenny later settled in Minnesota

Minnesota

Minnesota is a U.S. state located in the Midwestern United States. The twelfth largest state of the U.S., it is the twenty-first most populous, with 5.3 million residents. Minnesota was carved out of the eastern half of the Minnesota Territory and admitted to the Union as the thirty-second state...

where she established the Sister Kenny Rehabilitation Institute

Sister Kenny Rehabilitation Institute

The Sister Kenny Rehabilitation Institute, located at 28th Street and Chicago Avenue in Minneapolis, is the leading rehabilitation provider in the region. The Institute is named after Sister Elizabeth Kenny, an Australian woman trained in nursing — the title “Sister” is used in British countries to...

, 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

Antispasmodic

An antispasmodic is a drug or a herb that suppresses muscle spasms.-Smooth muscle spasm:One type of antispasmodics is used for smooth muscle contraction, especially in tubular organs of the gastrointestinal tract...

medications to reduce muscular contractions, Kenny's therapy is still used in the treatment of paralytic poliomyelitis.

Vaccine development

In 1935 Maurice Brodie, a research assistant at New York University

New York University

New York University is a private, nonsectarian research university based in New York City. NYU's main campus is situated in the Greenwich Village section of Manhattan...

, attempted to produce a polio vaccine, procured from virus in ground up monkey

Monkey

A monkey is a primate, either an Old World monkey or a New World monkey. There are about 260 known living species of monkey. Many are arboreal, although there are species that live primarily on the ground, such as baboons. Monkeys are generally considered to be intelligent. Unlike apes, monkeys...

spinal cords, and killed by formaldehyde

Formaldehyde

Formaldehyde is an organic compound with the formula CH2O. It is the simplest aldehyde, hence its systematic name methanal.Formaldehyde is a colorless gas with a characteristic pungent odor. It is an important precursor to many other chemical compounds, especially for polymers...

. 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 at the Boston Children's Hospital, successfully cultivated the poliovirus

Poliovirus

Poliovirus, the causative agent of poliomyelitis, is a human enterovirus and member of the family of Picornaviridae.Poliovirus is composed of an RNA genome and a protein capsid. The genome is a single-stranded positive-sense RNA genome that is about 7500 nucleotides long. The viral particle is...

in human tissue. This significant breakthrough ultimately allowed for the development of the polio vaccines. Enders and his colleagues, Thomas H. Weller and Frederick C. Robbins, were recognized for their labors with the Nobel Prize

Nobel Prize in Physiology or Medicine

The Nobel Prize in Physiology or Medicine administered by the Nobel Foundation, is awarded once a year for outstanding discoveries in the field of life science and medicine. It is one of five Nobel Prizes established in 1895 by Swedish chemist Alfred Nobel, the inventor of dynamite, in his will...

in 1954.

Two vaccines are used throughout the world to combat polio. The first was developed by Jonas Salk

Jonas Salk

Jonas Edward Salk was an American medical researcher and virologist, best known for his discovery and development of the first safe and effective polio vaccine. He was born in New York City to parents from Ashkenazi Jewish Russian immigrant families...

, first tested in 1952, 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

Poliovirus

. In 1954, the vaccine was tested for its ability to prevent polio; the field trials involving the Salk vaccine would grow to be the largest medical experiment in history. Immediately following licensing, vaccination

Vaccination

Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...

campaigns were launched, by 1957, following mass immunizations promoted by the March of Dimes

March of Dimes

The March of Dimes Foundation is a United States nonprofit organization that works to improve the health of mothers and babies.-Organization:...

the annual number of polio cases in the United States would be dramatically reduced, from a peak of nearly 58,000 cases, to just 5,600 cases.

Eight years after Salk's success, Albert Sabin

Albert Sabin

Albert Bruce Sabin was an American medical researcher best known for having developed an oral polio vaccine.-Life:...

developed an oral polio vaccine (OPV) using live but weakened (attenuated) virus. Human trials

Clinical trial

Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...

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 would lead 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

Endemic (epidemiology)

transmission of poliovirus in the United States were in 1979, when an outbreak occurred among the Amish

Amish

The Amish , sometimes referred to as Amish Mennonites, are a group of Christian church fellowships that form a subgroup of the Mennonite churches...

in several Midwestern states.

Legacy

Early in the 20th century polio would become the world's most feared disease. The disease hit without warning, tended to strike white, affluent

Affluence in the United States

Affluence in the United States refers to an individual's or household's state of being in an economically favorable position in contrast to a given reference group...

individuals, required long quarantine

Quarantine

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 victims marked for life, leaving behind vivid images of wheelchair

Wheelchair

A wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it is propelled by motors or by the seated occupant turning the rear wheels by hand. Often there are handles behind the seat for someone else to do the pushing...

s, crutches, leg braces, breathing devices, and deformed limbs. However, polio changed not only the lives of those who survived it, but also effected profound cultural changes: the emergence of grassroots

Grassroots

A grassroots movement is one driven by the politics of a community. The term implies that the creation of the movement and the group supporting it are natural and spontaneous, highlighting the differences between this and a movement that is orchestrated by traditional power structures...

fund-raising campaigns that would revolutionize medical philanthropy

Philanthropy

, the rise of rehabilitation therapy and, through campaigns for the social and civil rights of the disabled, 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 D. Roosevelt

Franklin Delano Roosevelt , also known by his initials, FDR, was the 32nd President of the United States and a central figure in world events during the mid-20th century, leading the United States during a time of worldwide economic crisis and world war...

became totally and permanently paralyzed from the waist down. Although the paralysis

Franklin D. Roosevelt's paralytic illness

Franklin D. Roosevelt's paralytic illness began in 1921 at age 39, when Roosevelt got a fever after exercising heavily at a vacation in Canada. While his bout with illness was well known during his terms as President of the United States, the extent of his paralysis was kept from public view. After...

(whether from poliomyelitis, as diagnosed at the time, or from Guillain-Barré syndrome

Guillain-Barré syndrome

Guillain–Barré syndrome , sometimes called Landry's paralysis, is an acute inflammatory demyelinating polyneuropathy , a disorder affecting the peripheral nervous system. Ascending paralysis, weakness beginning in the feet and hands and migrating towards the trunk, is the most typical symptom...

) had no cure at the time, Roosevelt, who had planned a life in politics

Politics

Politics is a process by which groups of people make collective decisions. The term is generally applied to the art or science of running governmental or state affairs, including behavior within civil governments, but also applies to institutions, fields, and special interest groups such as the...

, refused to accept the limitations of his disease. He tried a wide range of therapies, including hydrotherapy

Hydrotherapy

in Warm Springs, Georgia

Warm Springs, Georgia

Warm Springs is a city in Meriwether County, Georgia, United States. The population was 478 at the 2010 census.-History:Warm Springs first came to prominence in the 19th century as a spa town, due to its mineral springs which flow constantly at nearly 32 °C...

(see below). In 1938 Roosevelt helped to found the National Foundation for Infantile Paralysis (now known as the March of Dimes

March of Dimes

The March of Dimes Foundation is a United States nonprofit organization that works to improve the health of mothers and babies.-Organization:...

), that raised money for the rehabilitation

Physical medicine and rehabilitation

of victims of paralytic polio, and was instrumental in funding the development of polio vaccines. 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 at the time combined (with the exception of the Red Cross). 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 truth, however, poliomyelitis was never the monstrous killer it was portrayed as in the media, not even at its height during the 1940s and 1950s. In 1952, during the worst recorded epidemic, 3,145 people, including 1,873 children, in the United States died from polio. That same year over 200,000 people (including 4,000 children) died of cancer

Cancer

Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

and 20,000 (including 1,500 children) died of tuberculosis

Tuberculosis

Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

. According to David Oshinsky

David Oshinsky

David M. Oshinsky is a Pulitzer Prize-winning American historian; he currently holds the Jack S. Blanton chair in history at the University of Texas at Austin and is a distinguished scholar in residence at New York University....

's book Polio: An American Story: "There is evidence that the March of Dimes over-hyped polio, and promoted an image of immediately curable polio victims, which was not true. The March of Dimes refused to partner with other charity organizations like the United Way."

Rehabilitation therapy

Prior to the polio scares of the 20th century, most rehabilitation therapy

Physical medicine and rehabilitation

was focused on treating injured soldiers returning from war. The crippling effects of polio lead 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 the remaining strength of polio victims and teaching new, compensatory skills to large numbers of newly paralyzed individuals.

In 1926, Franklin Roosevelt, convinced of the benefits of hydrotherapy

Hydrotherapy

, bought a resort at Warm Springs, Georgia

Warm Springs, Georgia

, where he founded the first modern rehabilitation center for treatment of polio patients which still operates as the Roosevelt Warm Springs Institute for Rehabilitation.

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 fraternity, which established a network of pediatric hospitals in 1919, the Shriners Hospitals for Children

Shriners Hospitals for Children

Shriners Hospitals for Children is a network of 22 non-profit hospitals 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-centered environment, regardless of the patients’...

, 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

Accessibility is a general term used to describe the degree to which a product, device, service, or environment is available to as many people as possible. Accessibility can be viewed as the "ability to access" and benefit from some system or entity...

and discrimination they experienced in their communities. In the early 20th century the use of a wheelchair

Wheelchair

at home or out in public was a daunting prospect as no public transportation system accommodated wheelchairs and most public buildings including schools, were inaccessible to those with disabilities. Many children left disabled by polio were forced to attend separate institutions for "crippled children" or had 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

Disability rights movement

that emerged in the United States during the 1970s, and pushed legislation such as the Rehabilitation Act of 1973 which protected qualified individuals from discrimination based on their disability, and the Americans with Disabilities Act of 1990. Other political movements led by polio survivors include the Independent Living

Independent living

Independent living, as seen by its advocates, is a philosophy, a way of looking at disability and society, and a worldwide movement of people with disabilities working for self-determination, self-respect and equal opportunities...

and Universal design

Universal design

Universal design refers to broad-spectrum ideas meant to produce buildings, products and environments that are inherently accessible to both people without disabilities and people with disabilities....

movements of the 1960s and 1970s.

Polio survivors are one of the largest disabled groups in the world. The World Health Organization

World Health Organization

The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

estimates that there are 10 to 20 million polio survivors worldwide. In 1977, the National Health Interview Survey reported that there were 254,000 persons 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.

External links

General:

A History of Polio (Poliomyelitis) History of Vaccines, a project of the College of Physicians of Philadelphia.
What ever happened to Polio? An exhibit from the Smithsonian National Museum of American History.
The Middle-Class Plague: Epidemic Polio and the Canadian State.
CBC Digital Archives - Polio: Combating the Crippler Video 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 format).

People and polio:

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

The source of this article is wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL.

Early history

Epidemics

Historical treatments

Iron lung

Passive immunotherapy

Kenny regimen

Vaccine development

Legacy

Philanthropy

Rehabilitation therapy

Disability rights movement

See also

Further reading

External links