Polio historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

An Egyptian stele thought to represent a polio victim, 18th Dynasty (1403–1365 BC)

The effects of polio have been known since prehistory; Ancient Egyptian paintings and carvings depict otherwise healthy people with withered limbs, and children walking with canes at a young age.[1] The first clinical description was provided by the British physician Michael Underwood in 1789, where he refers to polio as "a debility of the lower extremities".[2] The work of physicians Jakob Heine in 1840 and Karl Oskar Medin in 1890 led to it being known as Heine-Medin disease.[3] The disease was later called infantile paralysis, based on its propensity to affect children.

Before the 20th century, polio infections were rarely seen in infants before six months of age, most cases occurring in children six months to four years of age.[4] Poorer sanitation of the time resulted in a constant exposure to the virus, which enhanced a natural immunity within the population. In developed countries during the late 19th and early 20th centuries, improvements were made in community sanitation, including better sewage disposal and clean water supplies. These changes drastically increased the proportion of children and adults at risk of paralytic polio infection, by reducing childhood exposure and immunity to the disease.

Small localized paralytic polio epidemics began to appear in Europe and the United States around 1900.[5] Outbreaks reached pandemic proportions in Europe, North America, Australia, and New Zealand during the first half of the 20th century. By 1950 the peak age incidence of paralytic poliomyelitis in the United States had shifted from infants to children aged five to nine years, when the risk of paralysis is greater; about one-third of the cases were reported in persons over 15 years of age.[6] Accordingly, the rate of paralysis and death due to polio infection also increased during this time.[5] In the United States, the 1952 polio epidemic became the worst outbreak in the nation's history. Of nearly 58,000 cases reported that year 3,145 died and 21,269 were left with mild to disabling paralysis.[7]

The polio epidemics changed not only the lives of those who survived them, but also affected profound cultural changes; spurring grassroots fund-raising campaigns that would revolutionize medical philanthropy, and giving rise to the modern field of rehabilitation therapy. As one of the largest disabled groups in the world polio survivors also helped to advance the modern disability rights movement through campaigns for the social and civil rights of the disabled. The World Health Organization estimates that there are 10 to 20 million polio survivors worldwide.[8] In 1977 there were 254,000 persons living in the United States who had been paralyzed by polio.[9] According to doctors and local polio support groups, 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.[8] Many List of polio survivors|notable individuals have survived polio and often credit the prolonged immobility and residual paralysis associated with polio as a driving force in their lives and careers.[10]

The disease was very well publicized during the polio epidemics of the 1950s, with extensive media coverage of any scientific advancements that might lead to a cure. Thus, the scientists working on polio became some of the most famous of the century. Fifteen scientists and two laymen who made important contributions to the knowledge and treatment of poliomyelitis are honored by the Polio Hall of Fame at the Roosevelt Warm Springs Institute for Rehabilitation in Warm Springs, Georgia, USA.

References

  1. Underwood, Michael (1793). Debility of the lower extremities. In: A treatise on the diseases [sic] of children, with general directions for the management of infants from the birth (1789) (fee required). Early American Imprints, 1st series, no. 26291 (filmed); Copyright 2002 by the American Antiquarian Society. 2. Philadelphia: Printed by T. Dobson, no. 41, South Second-Street. pp. pp. 254&ndash, 6. Retrieved 2007-02-23.
  2. Pearce J (2005). "Poliomyelitis (Heine-Medin disease)" (free registration required). J Neurol Neurosurg Psychiatry. 76 (1): 128. PMID 15608013.
  3. Robertson S (1993). "Module 6: Poliomyelitis" (PDF). The Immunological Basis for Immunization Series. World Health Organization. Geneva, Switzerland. Retrieved 2007-05-08.
  4. 5.0 5.1 Trevelyan B, Smallman-Raynor M, Cliff A (2005). "The Spatial Dynamics of Poliomyelitis in the United States: From Epidemic Emergence to Vaccine-Induced Retreat, 1910–1971". Ann Assoc Am Geogr. 95 (2): 269–293. PMID 16741562.
  5. Melnick JL (1990). Poliomyelitis. In: Tropical and Geographical Medicine (2nd ed. ed.). McGraw-Hill. pp. p. 558–76. ISBN 007068328X.
  6. Zamula E (1991). "A New Challenge for Former Polio Patients". FDA Consumer. 25 (5): 21–5.
  7. 8.0 8.1 "After Effects of Polio Can Harm Survivors 40 Years Later". March of Dimes. 2001-06-01. Retrieved 2007-08-07. Check date values in: |date= (help)
  8. Frick NM, Bruno RL (1986). "Post-polio sequelae: physiological and psychological overview". Rehabilitation literature. 47 (5–6): 106–11. PMID 3749588. |access-date= requires |url= (help)
  9. Richard L. Bruno (2002). The Polio Paradox: Understanding and Treating "Post-Polio Syndrome" and Chronic Fatigue. New York: Warner Books. pp. 105–6. ISBN 0-446-69069-4.