Polio: Dangerous and Debilitating

Background

In the 1940s and 1950s, a polio epidemic in the US left tens of thousands paralyzed. One well-known victim was President Franklin Delano Roosevelt.  The President went to significant lengths to hide and mitigate the extent to which polio caused his health to deteriorate. His actions speak volumes to the tremendous sense of fear surrounding polio and its rapid spread, which only grew after his death. Although vaccination eventually eliminated the problem in the US, polio remains a threatening issue in some areas. 

Explanation

It can be easy to forget that this was once a deadly crisis in our own country not so long ago. Polio is a fatal disease that marks people for life, and it's still infecting people. Although there is a vaccine for polio, which has saved millions of lives and ended epidemics in many countries, it is not accessible to all who suffer from the disease. Thus, polio epidemics continue around the world.

Definition of Polio

Polio, or poliomyelitis, is a highly infectious disease caused by the poliovirus. It is transmitted person-to-person through the fecal-oral route or by shared contaminated sources of food or water. 

How it Works

The virus multiplies in the intestine and can then spread to the nervous system, leading to sepsis, which can cause spinal or respiratory paralysis. However, nonparalytic polio is more common and only causes mild flu-like symptoms, and the majority of people infected don’t even develop symptoms. But for those paralyzed, their lives are significantly changed, both by the disease and harmful stigmas surrounding people with physical disabilities. Polio mainly affects children under five years old. While there is an effective vaccine, there is no known cure for polio. 

The History

There is evidence that polio has existed for thousands of years, but it was especially widespread in industrialized countries in the first half of the 1900s. People panicked because the disease primarily targeted young children, spread very quickly, and marked victims for life with permanent paralysis. The epidemic was extensively covered in the media, especially after the Second World War, when more young adults started to become infected. The ubiquitous fear and coverage of polio fueled massive funding into prevention, treatment, and cures for the disease. 

Several therapies were given to people with polio, including the iron lung. People with respiratory paralysis, unable to breathe on their own, would have their entire bodies enclosed in the iron lung, which would allow them to breathe by varying the air pressure inside the device. Patients would spend up to weeks in severe pain and require constant care and psychological support. 

It wasn’t until the 1950s and 1960s that the vaccine was developed and distributed widely, eliminating polio as a public health issue in many countries. However, polio spread in middle- and low-income countries in the late 1980s and early 1990s. As the disease became more widespread across nations, global polio initiatives became more common. Polio was included in the first phase of the Expanded Program on Immunization, a global effort launched in 1974, as one of the key diseases included in a standard vaccine schedule. In 1988, the Global Polio Eradication Initiative, or GPEI, was launched, supported by several countries and non-government organizations. This was the largest international public health effort to date and has had marked successes, although the original goal of eradication by 2008 was not met. 

Due to these global efforts, two strains of wild poliovirus have been eradicated. However, a third type is still endemic in Afghanistan and Pakistan, where vaccination coverage isn’t universal and transmission continues. Obstacles to polio elimination include conflict, weak public health infrastructure, poor sanitation, and cultural barriers that generate distrust or aggression towards health workers. 

Why Care?

Polio is on the brink of being completely eradicated and becoming the third successfully eradicated disease after smallpox and rinderpest. The success of many polio eradication initiatives demonstrates the importance and feasibility of universal vaccine coverage, political cooperation and commitment, community involvement, and widespread education and awareness efforts. You can help by learning more and supporting organizations like Rotary, which helps fund and perform vaccination campaigns in the countries where polio is still endemic. 

Think Further

  1. What are some of the things that you think could be barriers to a universal vaccination campaign in a low-income country? What solutions would effectively address them?
  2. Imagine you were responsible for explaining the importance of universal cooperation in eradication campaigns for the mission page of a global initiative’s website. How would you explain why it is important for people to get their children vaccinated?
  3. Explain how some of the barriers to polio eradication could also have played a role in the increased transmission of COVID-19, SARS, or ebola.

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  1. Aylward, Bruce. “How we’ll stop polio for good.” Ted, Ted, 2011. https://www.ted.com/talks/bruce_aylward_how_we_ll_stop_polio_for_good/transcript?language=en
  2.  Hoffman, Jan. “Polio and Measles Surge After Disruption of Vaccine Programs.” The New York Times, The New York Times Company, 22 May 2020. https://www.nytimes.com/2020/05/22/health/coronavirus-polio-measles-immunizations.html.
  3. Kluger, Jeffrey. “What the History of Polio Can Teach Us About COVID-19.” Time Magazine, Time USA, 5 May 2020. https://time.com/5831740/polio-coronavirus-parallels/
  4. Chaturvedi, Gitanjali. The Vital Crop: Communication for Polio Eradication in India. SAGE Publications Pvt. Ltd., 2008.