Memories of Polio

Memoir

By: Alakananda Mohanty

By: Martin Pernick

Source: "Do you Remember?" in Advancing Global Public Health. University of Michigan. Available online at 〈http://www.polio.umich.edu/history/memories.html〉 (accessed on December 10, 2005).

About the Authors: The writers of two these pieces contributed to the University of Michigan's fiftieth-anniversary celebration of a safe and efficacious polio vaccine.

INTRODUCTION

Poliomyelitis (polio or infantile paralysis) is a viral illness which has been known since the time of the ancient Egyptians some 3,000 years ago. It was further described by doctors at the end of the eighteenth century. In many of those infected, polio causes only mild symptoms. But in some cases the virus destroys nerve cells in the spinal cord and the base of the brain, causing a devastating illness and potentially fatal paralysis.

Polio epidemics have occurred throughout history. At the end of the nineteenth century, 50,000 people a year would be affected by epidemics in the United States. Franklin Roosevelt (1882–1945) was disabled by an attack in 1921; in 1938 he established the National Foundation for Infantile Paralysis, dubbed by American comedian Eddie Cantor (1892–1964) as the "March of Dimes," which was dedicated to fighting polio. Meanwhile, Harvard researchers Philip Drinker (1894–1972) and Louis Agassiz Shaw (1886–1940) developed an artificial respirator known as the iron lung to help those whose breathing muscles had been paralyzed by polio.

Thomas Francis (1900–1969) was a virologist who joined the new School of Public Health at the University of Michigan in 1941, where he established and directed a research laboratory for viral diseases. That same year, Jonas Salk (1914–1995) became a postgradute student at the university, studying vaccine development with Francis. Later in the decade, Francis turned his attention to enteric viruses, with an intense focus on polio, while Salk went on to develop a polio vaccine at the University of Pittsburgh Medical School. Francis ran the field trials for his former student, and on April 12, 1955, pronounced Salk's vaccine "safe, effective, and potent."

In the articles that follow, Pernick describes his participation in this trial; survivor Mohanty tells what it is like to suffer from a severe case of polio.

PRIMARY SOURCE

I was a second-grade student at the Hewlett Primary School in Hewlett, Long Island, outside New York City, when my parents enrolled me in the Salk Field Trials. I remember them explaining to me that some kids would get real vaccine and some kids would get water, in order to test whether it worked. I remember being bussed to some other site to get the shots and that the shots did not hurt as much as I expected.

I particularly remember the day the results were announced. My parents sat me down to tell me that the vaccine was the greatest discovery of my lifetime, that I had played a role in history, and that I was one of the lucky ones to get the real vaccine. My memories of that good news are also closely associated with my memory of my parents solemnly sitting me down in the same chair a few days later to tell me of a great loss to science—the death of Albert Einstein. In retrospect, I think perhaps those events had something to do with my becoming a professor of the history of medicine.

In the fall of 1955, I changed schools, moving to PS 66 in the New York City borough of Queens. Shortly after that, the NYC public schools began mass immunizations with the new vaccine. I remember refusing to take the shots, because I had already had them. Neither my teacher nor the principal believed me. The principal all but accused me of lying to avoid the pain of a shot, and sent a note home requiring my parents to come to school if they wanted me to not get the shot. In retrospect I suspect that (unlike the field trial) this school simply vaccinated everyone without asking or notifying parents, since if my parents had gotten some kind of consent form to sign they would have been able to explain my situation in advance.

I'm not sure, but I think my family pediatrician gave me one or two annual "booster" shots in the years immediately after the field trial series of three injections. I recall being told that was because no one knew yet how long the initial immunity lasted.

Before the vaccine my parents and friends were very aware of the polio epidemics of the early '50s. I remember before the vaccine being warned not to eat food that had fallen on the floor because if I did I'd "get polio." (After the vaccine I was still not allowed to eat food that fell on the floor, but the explanation switched to "germs" rather than specifically "polio.")

    Martin Pernick
    Professor of History
    University of Michigan
    Ann Arbor, MI

Tale of a Survivor It was the end of the summer of 1960 and my family and I had just returned from a rather tedious vacation from my ancestral village. I was getting ready to start school and I was extremely excited about wearing new clothes and meeting new friends. I was out in front of my home when I first experienced what seemed like flu symptoms. What bad timing—school starting and I was getting sick.

The next couple of days were a blur—our doctor visiting me at the house, family and medical personnel whispering in hushed tones. It was extremely difficult to sit up and I couldn't turn or bend my neck without a great deal of pain. Unimaginable pain began to take over my back. Polio never entered my mind.

As a precaution, my mother informed me, I was to have a spinal tap. And there it was … not even a margin-lined diagnosis. Polio. I must tell you, this was not a sympathetic disease in any sense of the word. The next few days were a nightmare and I don't mind telling you that when somebody asked me to participate here with my story, it brought back a flood of memories that I had suppressed. Once the word was out our neighbourhood went into immediate panic. Pools were drained. My family were shunned. Quarantine signs went up around my house and my brother was not allowed to go to school.

When I arrived at City's largest hospital with hundreds of others, I was strapped to a gurney and lined up in the queue, as there were no beds available. My parents were literally dragged away to avoid any contact with me.

As I recall, when I was lifted into a bed it was with a medical staff clothed in long smock, masks and gloves … again no contact. I was wheeled into a ward with others.

If you asked me what was my worst experience while battling this disease, I would have to say the pain: constant intensified, horrific physical pain. There was a nurse who had worked with polio patients and developed a treatment procedure that involved massage, exercises, and wrapping affected limbs to reduce muscle spasms and the resultant pain. When I tell you I counted the hours in between these treatments, it is not an exaggeration and my entire torso was wrapped. As a result of these treatments, I was left with blisters, but the submission of pain temporarily was worth it.

After the first few days, I had visitors. First to see me were my parents. You could tell by their eyes they were horrified as to what I must have looked like. So went my days, sobbing parents, and the constant pain….

My best recollection is that perhaps two weeks after I entered the hospital, the pain subsided, and I was to be released to go home. My disabilities not yet compiled, nonetheless, I was deemed not contagious and with many stipulations set free. Keep in mind, I had not had the opportunity to try and walk during my stay and the doctors told my parents that I might never walk again without crutches. How I must have looked: my curly locks all matted, [thin] as a rail all curled up in a wheelchair being pushed to my parents. I still remember as I approached them, I asked the nurse to stop and I stood up and took a few steps into the arms of my father.

My follow-up visits were to be at the hospital for physical therapy and regular visits to orthopaedic department. My residual disabilities were limited to the left side of my body. One leg was shorter and my spine had a curvature. I also had a muscle weakness in my lower back, which has stayed with me.

The road back is never easy, but with the love and support of family and friends, the stigma of polio affliction was soon forgotten. I now approach the over-40 time of my life, and some of the old aches and pain occur once again.

The bottom line is that polio survivors are just that—survivors. We did what we had to do then and we have to make the best of what comes along now. We live with polio every day of our lives, be it a bad memory, a nagging pain, or a fear of a limb that may decide to give up…. But we go on. Being a part of the Polio Immunisation program seems right to me. If my involvement can spare just one child from the agonies of this dreadful disease, then it will be worth recounting the past. Now you can go and say, "I met someone today who survived polio." I thank you for your time, patience, compassion, and most of all your friendship.

    Alakananda Mohanty
    Communications Associate
    Rotary International PolioPlus Program
    New Delhi, India

SIGNIFICANCE

Alfred Sabin (1906–1993) developed an oral polio vaccine in the mid-1950s. Although an oral vaccine is always preferable to an injectable, like the Salk vaccine, early trials of the Sabin vaccine were problematic. His vaccine was a weakened form of polio virus, while the Salk vaccine was an attenuated, or "killed" version. Some healthy volunteers actually developed polio as a result of having taken the Sabin vaccine because the virus in it became active in their bodies. Sabin modified his vaccine and there were further clinical trials between 1958 and 1960. The Sabin vaccine then superseded the Salk in the United States and elsewhere and paved the way for the eradication of polio in the Western hemisphere in 1994.

Polio can be a devastating disease, especially for the young, and the World Health Organisation (WHO) has committed itself to eradicating it in same way as it has smallpox. This goal has not yet been achieved, although good progress has been made. The eradication involves mass vaccination and this has proved difficult in areas affected by conflict. However, WHO manages to negotiate a temporary cease-fire on occasion to hold a mass vaccination day. In a conflict, both sides have an interest in eradicating disease among their populations, so this is a feasible way forward, so long as the appropriate negotiations take place. There have been outbreaks in recent years in Somalia, Yemen, and Sudan, but action is being focused now upon these countries. These outbreaks are thought to have arisen by transmission from Nigeria, where polio is still endemic, as it is in Pakistan and Afghanistan, although there are few cases. As of late 2005, the total number of cases of polio, globally, was about 1,500.

Meanwhile, Western countries cannot be complacent. Where people refuse vaccination for their children, polio outbreaks can still occur, as happened in The Netherlands in 1993. The Sabin polio vaccine, while convenient and effective, keeps the virus in circulation, albeit in a weakened form. Furthermore, people with compromised immunity, such as those with HIV/AIDS, could act as a potential reservoir for the poliovirus. Therefore, scientists encourage continued vaccination against polio at the present time, even though the disease has been greatly diminished.

FURTHER RESOURCES

Books

Lock, Stephen, John M. Last, and George Dunea, eds. The Oxford Illustrated Companion to Medicine. Oxford, UK: Oxford University Press, 2001.

Web sites

Advancing Global Public Health. "Thomas Francis." 〈http://www.polio.umich.edu/history/francis.html〉 (accessed November 23, 2005).

University of Virginia. Historical Collections at the Claude Moore Health Sciences Library. "Iron Lung." 〈http://historical.hsl.virginia.edu/ironlung〉 (accessed January 4, 2006).