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Jenna Williams

Audrey Ragsac

Honors 221D

March 14, 2023

Polio: Prevention and Treatment of the 1950’s Epidemic and Now

I have always enjoyed imagining how different science and society will be in the future.

Whether it is flying cars, a cure for cancer, or something of a WALL-E universe, it is a fun and

hopeful thing to think about. On par with this, for my project, I wanted to look backward to a

time when people likely thought about the same thing. My first thought was to find a time when

people desperately needed a solution, then compare that time to the advancements we have made

today. This leads me to the question, “How have polio prevention and treatment methods

evolved since the 1950s?”

Polio, or poliomyelitis, is a disease characterized by paralysis due to poliovirus infection.

The virus enters through the fecal-oral route, which explains why this is a much more frequent

infection in children (dirty toys in mouthes, swimming pools). Much less common, the virus can

also be spread from coughing or sneezing; some scientists even hypothesize that it could be

spread by flies who travel from feces to human food (Polio + Prevention – GPEI, n.d.). This

virus has three strains: PV1, PV2, and PV3. While all three have similar symptoms, immunity to

one does not mean immunity to the others. Once inside the body, this non-enveloped, single-

strand RNA virus replicates locally in the throat, binding to the PVR receptor and hijacking the

cell’s machinery to create more viral proteins. Then the virus spreads and replicates in the small

intestine (enterovirus) and finally the bloodstream, killing each hijacked cell as it travels. While

it is unknown how the virus spreads to the central nervous system, it is proposed to be through
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the bloodstream or the intestinal barrier. If the virus binds with motor neurons on the spinal cord

or brain stem and causes paralysis, the patient will be diagnosed with poliomyelitis. This being

said, the poliovirus will only cause poliomyelitis in one percent of hosts. Seventy-five percent of

infected individuals will be asymptomatic (but can still transmit the virus), and twenty-four

percent will only experience flu-like symptoms (Poliomyelitis (Polio), n.d.).

Prevention measures at the beginning of the 1950s epidemic were similar to what we saw

for the plague or influenza. These advisements included avoiding open windows, crowds, and

new people. Pools, theaters, and schools were closed. Parents were told to keep their children

well-fed, bathed, and rested. While these measures helped, cases still increased, especially in the

summer and autumn when kids wanted to be outside (Sokol, 1997). What the country needed

was a vaccine. After cultivating the poliovirus in a lab, Jonas Salk created the Inactivated

Poliovirus Vaccine (IPV), distributed in 1955 as a shot in the leg or arm and protected against all

three strains of the virus. Inactivated poliovirus produces antibodies in the blood that prevent the

virus from spreading to the central nervous system, preventing paralysis or poliomyelitis. Just six

years later, another vaccine was approved, called the Oral Poliovirus Vaccine (tOPV), made by

Albert Sabin. This vaccine was in the form of drops and was often distributed in schools on sugar

cubes. The OPV uses a weakened form of the poliovirus to create mucosal immunity to all three

types of PV (Polio Vaccination: What Everyone Should Know, 2022). This means the virus

cannot replicate inside the host, protecting them from poliomyelitis.

As far as treatment at this time for those with poliomyelitis, the only option was

symptomatic care. This included fluids, pain medicine, and rest. Those with respiratory failure

were put in the iron lung, which used positive and negative pressure to keep the patient breathing

(Polio: Virus, Causes, Symptoms, Transmission & Treatment, 2022). People who experienced
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muscle atrophy were given crutches and wheelchairs to help increase their mobility. Along with

the physical burden this disease caused, care was difficult to find as hospitals were overwhelmed

entirely, and treatment was often expensive.

Today, the prevention of polio mainly focuses on vaccine distribution. While the US has

been polio-free since 1979, experts say a threat anywhere is a threat everywhere. Currently, types

two and three are considered eradicated, and type one is only present in Afghanistan and

Pakistan. Regardless, organizations everywhere are doing their part to get every child vaccinated.

The United States only uses the IPV and doses children four times before they turn six. Other

countries use a mix of the bOPV and IPV. In these countries, the current OPV has been reduced

from protecting against all three strains to just numbers one and three. This is because of cases in

communities with low vaccination rates or immunocompromised individuals where the second

strain from the OPV grew strong enough to cause PV outbreaks. This is called vaccine-derived

poliovirus (Goodman, 2022). In places that need protection from the second strain, individuals

will get the IPV instead of or in addition to the bOPV. One advantage of the bOPV is that it

prevents the virus from spreading to others because an infected individual will not shed the virus

in their feces. The IPV, however, only protects the host (similar to asymptomatic cases), meaning

that unvaccinated people in IPV using regions can still get poliomyelitis even with herd

immunity (Patel, 2015).

Treatment today sadly looks very similar to the 1950s. While we have not found a cure

for poliomyelitis, we have advanced supportive care to make the disease more livable for those

with it. Physical therapy and heat are used to stimulate atrophied muscles, and antispasmodic

medication is used to relax the muscles (Polio + Prevention – GPEI, n.d.). We also have
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switched to a positive pressure ventilator for people unable to breathe independently. While these

measures help increase mobility, we still desperately need a cure for this disease.

As explored above, the only option to eradicate poliomyelitis is to ensure all individuals

get vaccinated. In recent years, especially with COVID, we have seen increasing antivaccine

sentiment. As Gretchen LaSalle, a physician and clinical assistant professor at WSU, noted, “The

rise of the internet and social media as outlets where people get their news and information, and

the proliferation of misinformation online, has absolutely contributed to [vaccine hesitancy].”

(Taylor, 2022) With infinite amounts of misinformation spread online, the real question presents

itself: what is the most effective way to educate people about the importance of vaccines?
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References

Goodman, B. (2022, August 23). Why some vaccinated people can still spread polio.

CNN. Retrieved March 4, 2023, from https://www.cnn.com/2022/08/23/health/polio-

spread-vaccine-explainer/index.html

H.V, W. (2014, Dec 12). Before the Vaccines: Medical Treatments of Acute Paralysis in

the 1916 New York Epidemic of Poliomyelitis. NCBI. Retrieved March 4, 2023, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293735/

Patel, M. (2015, Jan 19). Polio endgame: the global introduction of inactivated polio

vaccine. Taylor & Francis Online. Retrieved Mar 4, 2023, from

https://www.tandfonline.com/doi/abs/10.1586/14760584.2015.1001750

Poliomyelitis (Polio). (n.d.). Hawaii Disease Outbreak Control Division. Retrieved March

4, 2023, from https://health.hawaii.gov/docd/disease_listing/poliomyelitis-polio/.

Polio + Prevention – GPEI. (n.d.). Global Polio Eradication Initiative. Retrieved March

4, 2023, from https://polioeradication.org/polio-today/polio-prevention/

Polio Vaccination: What Everyone Should Know. (2022, Oct 12). CDC. Retrieved March

4, 2023, from https://www.cdc.gov/vaccines/vpd/polio/public/index.html

Polio Vaccine: Vaccine-Derived Poliovirus. (2022, Sept 20). Centers for Disease Control

and Prevention. Retrieved March 4, 2023, from

https://www.cdc.gov/vaccines/vpd/polio/hcp/vaccine-derived-poliovirus-faq.html.

Polio: Virus, Causes, Symptoms, Transmission & Treatment. (2022, August 5). Cleveland

Clinic. Retrieved March 4, 2023, from

https://my.clevelandclinic.org/health/diseases/15655-polio
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Sokol, B. (1997). Fear of Polio in the 1950s. The Beat Begins. Retrieved March 4, 2023,

from http://www.plosin.com/beatbegins/projects/sokol.html

Taylor, C. (2022, January 26). Covid vaccine skepticism fueling wider anti-vax sentiment,

doctors say. CNBC. Retrieved March 4, 2023, from

https://www.cnbc.com/2022/01/26/covid-vaccine-skepticism-fueling-wider-anti-vax-

sentiment-doctors-say.html