As a polio survivor who has done significant research on polio and written a memoir about my own experience, which included some of that scientific research, and one who has also written a book about dealing with disability and aging and ways of making life easier, I’m about to give my perspective on polio recently emerging in the US, and also on vaccination for polio.
I contracted polio when I was three in Los Angeles in 1951. The vaccine had not been fully developed yet, and in fact, was not in trials until 1954. I was among the small percentage of people who had residual paralysis after recovering from the initial onset and have lived with a fully paralyzed foot and partially paralyzed leg for seventy-one years now. This leg also did not develop fully, so it is atrophied and two inches shorter than the other. This has complicated and affected every aspect of my life for all of these decades.
Now, most people did not have this degree of disability, although many did die, a worse fate. Most of those who died were people who had bulbar polio, meaning it was in the lungs; these were the folks who needed an iron lung in order to breathe. There are three strains of live polio; bulbar (lungs), spinal, affecting the extremities, and type 3 which is ten times less likely to cause paralysis. However, among all people who have had polio, there is a 50-75% chance of eventually having Post-Polio sequelae, around 30-50 years after the first onset, because polio kills motor neurons. We have a lot of them, so can afford to lose just a few… temporarily.
Post-Polio results in new weakness, muscle pain and fatigue, making people who either didn’t know they had polio or forgot they had it as children feel, in perhaps their 50’s or 60’s, that they suddenly are aging very quickly. This is often misdiagnosed by doctors, few of whom know anything about polio anymore, as either a psychological attitudinal problem or chronic fatigue or arthritis (which are at least conditions that are more respected than “this is all in your head”). I have both Post-Polio effects and arthritis. I had to do my own research and find a doctor who knew polio in order to diagnose my conditions and define my treatment.
I was vaccinated in the 1954 trials, because there were three types of polio and I’d “only” had spinal. Most of us who are between 50 and 90 years old had our polio vaccinations as a matter of course. But when polio had essentially been eradicated in the US (reports differ, but I read five years ago that the last case was in 1999), people began to forget about it and think it was gone from the earth. Some parents (too many) stopped getting polio vaccinations for their children, thinking they were unnecessary, or, even worse, “unnatural” and that the body should be allowed to “heal itself” if it got any type of infection. I have met people in their 20’s and 30’s who have never heard of polio, which had left nearly a million people in the US with paralysis by 1959, until the nationwide vaccination campaign stopped the epidemic. It didn’t just go away. Vaccinations stopped it.
Now we’ve seen a new case, and possibly more cases to follow, in New York state. This happened because of a somewhat complicated set of circumstances, but it really boils down to the fact that the person who got it had not been vaccinated. He happens to be part of a religious community which does not believe in being vaccinated; they previously had a serious outbreak of measles in years past (which can also be lethal). The way he got the virus at this time is that he was exposed to someone who had had the oral polio vaccine, which “sheds” virus, because it’s made of live virus, unlike the killed virus that is inoculated, or injected with a needle. It is unusual to get polio in this way, and never happens to people that are already vaccinated.
Another aspect of the oral live vaccine is that very, very rarely, a patient will actually get the disease from the vaccine. This cannot happen with the killed inoculated vaccine, but, getting the oral vaccine is lower risk than the risk of getting wild polio itself in the areas where the oral vaccine is used, where cases abound. In rural areas of the world (namely only Afghanistan, Pakistan and Nigeria remaining at this point) where there is little refrigeration and also few people skilled in using a hypodermic syringe, the oral vaccine has been employed for decades. The person who had had the oral vaccine which shed and caused the young man in NY to get polio almost certainly was vaccinated in one of the Muslim countries I just listed, or another African country, the only ones I know of which use the oral, non-killed type. (For me, this creates further mystery because the patient who got polio was part of the Orthodox Jewish community, so one wonders what the connection was.)
The World Health Organization asked some years back that all countries stop using the oral vaccine and change to the inoculated vaccine. The US has not used the oral live virus for vaccination for decades. Since this still poses the problem of how to vaccinate people in countries which have no access to skilled personnel or good vaccine storage (necessary to keep the virus killed), scientists are now working on a vaccine to be sprayed in the nostrils which will be a virus which does not “shed” or result in a live case of the disease. But that’s just in the works and is not yet available.
The polio virus is spread either through droplets (coughed, sneezed or even just on the breath when speaking) in its very early stages, or through the fecal to oral route at any stage. This means that if a child has the virus and does not wash his hands after wiping his bottom after a bowel movement, and, for instance, holds hands with another child, who then puts his fingers in his mouth, you have a ready and quick route to infection. It may seem like this is not highly likely to happen, but it can also be transferred in food preparation by someone who has the virus and did not employ good hand washing. And many, many people are asymptomatic and do not know they are carrying the virus.
When I had it, I had a fever for a week, and it was a few days after the fever passed that I could not rise from the floor while playing. I was still contagious, and was so for at least two weeks, despite the fever being gone. My legs were suddenly paralyzed. This is essentially what happened to the man who had it in New York; sudden paralysis after a fever, they checked his blood, and yep, polio.
Polio virus has been found now in the sewage systems in the county where the man lives, and also in the sewage systems in some parts of the United Kingdom. This could become an epidemic, unless at least 95% of the population is vaccinated against polio, everywhere. If less than that, there is opportunity and even likelihood that more people will get it, and it will spread again, paralyzing mostly small children, since that is who the disease has historically infected. They are more likely to have less desirable hygiene and also play closely together.
Do you need to get vaccinated or get a polio booster? If you are sure you were fully vaccinated (for instance, if you remember getting the sugar cube vaccination in the 1960’s or later, which was the live Sabin vaccine, but, it worked, almost as well as the inoculated Salk vaccine), you don’t need to get vaccinated again unless you are going to an area in the world where you know there is polio, to be on the safe side.
If you were never vaccinated, you definitely need to do that right away unless you never plan to leave your house. Because now that it’s here, it can spread. If you don’t know if you were vaccinated, you can get a test to see if you have antibodies… however, the lab tests at this time are not being given for type 2, only for types 1 and 3! I can only think that this is because type 2 was the first to stop showing up in populations, but I don’t know this for a fact. So, if you are unsure, you can always get a polio booster. If your own doctor or local clinic says they do not give polio vaccinations, call a pediatrician’s office. They vaccinate children all the time and they will vaccinate you.
Whenever a person plans to travel to the continent of Africa, a polio booster is recommended. I had one a few years ago because there was some speculation that it might slow the effects of Post-Polio. I’m a pretty sensitive person, and I had no reaction to the vaccine except for a slightly sore arm for a day or so.
For a parent to make the choice that their child “doesn’t need” a polio vaccination is in my estimation a foolish and unkind choice. It means that their child can never travel, and it means they are vulnerable to this potentially devastating disease unnecessarily.
All of the diseases which have the possibility of damaging effects have vaccines available. For instance, being vaccinated against chicken pox not only ensures safety from that scarring disease, but 30-50% of people who had chicken pox later get shingles, which is far worse than chicken pox; it’s agonizingly painful. (I know from experience. There’s a shingles vaccine too, of course, but the first one was only 50% effective.)
Please encourage your children, your grandchildren, and your great grandchildren to be vaccinated, not only against polio but all the other preventable diseases. There are very few people who cannot get vaccinated due to something such as an immune deficiency, and we are helping to protect them as well by our not getting these awful diseases.