Your Health Checkup: Is Polio a Threat?

New cases of paralytic polio have turned up in the U.S. Dr. Zipes explains the reason for its return and if you should be concerned.

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“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

Order Dr. Zipes’ books, Ari’s Spoon, a new novel, as well as Bear’s Promise and Damn the Naysayers, A Doctor’s Memoir. Check out his website at dougzipes.com.

 

Polio is an ancient disease — noted perhaps as far back as 1400 B.C. — and was first clinically described in 1789. It spreads from human to human, primarily through fecal contamination from infected persons. One of the most famous people who suffered paralytic polio was the 32nd U.S. President, Franklin D. Roosevelt (1882-1945).

I remember as a young boy, maybe 9 or 10 years old, hearing my parents discuss whether it was safe for me to swim in the public swimming pool during the summer months in the late 1940s and early 1950s. Fear gripped people the world over, terrified about contracting polio and becoming paralyzed, condemned to leg braces to walk or an iron lung to breathe. The iron lung was a coffin-like mechanical respirator that enclosed the body from neck to foot and varied air pressure to pump air in and out of the lungs.

At that time, polio caused more than 15,000 cases of paralysis yearly. Doctor Jonas Salk was hailed as a miracle worker when he developed the injectable polio vaccine (an inactivated form of the virus) that was released to the public in 1955. Remarkably, he chose not to patent or profit from it in any way to maximize its global use. Doctor Albert Sabin followed soon after with an oral vaccine created from a weakened form of the live virus.

The number of polio cases fell to less than 100 in the 1960s and fewer than 10 in the 1970s. Polio was eliminated in all countries except Afghanistan and Pakistan. While worldwide travelers have brought polio to the U.S., no cases of polio caused by wild poliovirus had originated in the U.S. since the late 1970s. That changed recently when a case of paralyzing polio occurred in an unvaccinated individual in New York. Another case was reported in Israel. The virus has since been found in the wastewater of Jerusalem, London, and New York.

Even though mass immunization had eliminated polio from much of the world — polio vaccination is required for all children enrolled in U. S. public schools — outbreaks thought to be triggered by mutated forms of Sabin’s weakened live virus oral vaccination have occurred in countries where polio was considered eliminated. Because of this, the U.S. reverted to using Salk’s inactivated vaccine in the early 2000s, but many other countries have not because the oral vaccine is cheaper, easier to administer, and effective in stopping transmission.

What does the return of polio mean? Nothing for those already immunized, but for the unvaccinated, it is a shout out to get vaccinated. Most people today have forgotten the devastation of paralytic polio and are not rushing to get the vaccine. Fortunately, the paralytic form is infrequent — 1 in 200 to 2,000 of those infected — and the majority of those infected remain asymptomatic, with only a quarter experiencing flu-like symptoms. The vaccine is extremely effective and safe, and I think it is playing Russian roulette with one’s health not to get vaccinated, especially since there is now a version of the oral vaccine that cannot revert to an infectious state.

Because some communities in the U.S. remain resistant to vaccination, the future of what polio infections might cause in the U.S. and around the world remains unpredictable. Many conspiracy theories and false information abound about virtually any recommended course of health action, including polio vaccinations. It troubles me as a physician to know that there are many diseases medicine cannot cure, including polio, but can be prevented by vaccination, and then watch the unvaccinated become infected and sometimes die, with last words often lamenting, “If only I had listened and gotten vaccinated.”

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