Poliomyelitis, or polio, is a viral disease that can invade the spinal cord and brain and can cause muscle weakness and atrophy. In severe cases it can cause paralysis in a matter of hours or result in death. There are three types of the disease: 1,2 and 3. The name poliomyelitis comes from the Greek terms polios , meaning gray, and myelon , for marrow, a reference to the gray area of the spinal chord that affected by the disease.
The polio virus lives and reproduces in the intestines and is spread from person to person by ingestion of anything contaminated with infected fecal matter. It often found in places where people live in crowded conditions with poor sanitation and is spread through waterways in which children play or drinking or bathing water tainted with contaminated feces. The highest transmission rates typically have taken place in the summer or when the weather has been hot. One problem with polio is that is it highly infectious but only a few sufferers have symptoms and those that don’t can transmit the disease.
Polio has been around for some time. Club feet, shortened legs and shrunken femurs found on 5,000-year-old ancient Egyptian mummies are believed to have been caused by the disease. Up until a vaccine for polio was invented by Jonas Salk in 1954, polio crippled and killed thousands of children and condemned thousands more to iron lungs. Among its victims was U.S. President Franklin Roosevelt. Polio has been eradicated in most of the developed world but remains in some places in the developing world.
The polio vaccine can be taken orally, often in form drops administered from an eye dropper. It is made from a live, weakened strain of the virus. In 1957, Dr, Albert Sabin developed oral vaccines for each of the three types of polio. The most common type used today is a vaccine first used in the 1960s that combines three vaccines invented by Sabin. At least four doses of the vaccine are needed to reach maximum effectiveness. In rare cases outbreaks of polio can be caused by the vaccine.
Websites and Resources on Health and Diseases: Centers for Disease Control and Prevention cdc.gov/DiseasesConditions ; Disease Pictures hardinmd.lib.uiowa.edu/pictures ; World Health Organization (WHO)statistics and data who.int/research ; World Health Organization (WHO) disease outbreak alert who.int/csr/disease ; Third World Traveler thirdworldtraveler.com/Disease/diseases ; Health Map healthmap.org ; Medline Plus medlineplus/healthtopics ; Merch Manuals (detailed info many diseases) merckmanuals.com/professional/index ; Health Images Directory healthline.com/directory/images
Polio has nearly been eradicated but wiping it off the map completely has proved to be problematic and expensive. A campaign to eradicate polio was launched in 1988. the original goal was to eradicate the disease by 1998. That goal proved to be elusive, then the goal was extended to 2005 but still not reached. In the process $5 billion was consumed, which probably could have been better spent fighting other diseases.
The last wild case of polio in the United States was in 1979. In South America the disease was eradicated in 1994. In Europe it was eradicated in 2002. In 2004, there were only 1,200 wild cases worldwide. They were mostly type 1 and to a lesser extent type 2. The last cases of type 2 polio were reported in 1999.
The Global Polio Eradication Initiative—a partnership of WHO, UNICEF, Rotary International, and CDC — was launched in 1988 with the goal of eliminating polio by 2000. More than $4 billion has been spent and more than billion children have been immunized in an aggressive vaccination programs and number of new cases worldwide from decreases from 350,000 cases in 1988 to fewer than 2,000 cased in four countries—India, Pakistan, Nigeria and Afghanistan—as of 2005. But it has not been eradicated. If polio is eradicated it will be only the second disease to be eliminated from the face of the earth. The first was smallpox.
Polio was eradicated in Egypt and Niger in 2005. This was regarded as major victory because the diseases had held on their for a long time in spite of a great efforts to wipe out. India reported only 64 cases on polio in 2005, compared to 130 in 2004. Pakistan reported 27 cases in 2005, compared to 48 in 2004. Polio is getting close enough to complete eradications that health officials are beginning to make plans of where to stockpile the virus if it is wiped out. Remaining trouble spots are in northern Nigeria,, remote regions of Pakistan and Afghanistan.
Come Back of Polio
In recent years polio has made a come back in India, Pakistan, and Nigeria. Particularly alarming was an outbreak in Nigeria in 2003 that spread to Sudan, Ethiopia, other places in Africa, Yemen and Indonesia. were caused by strains brought in from Nigeria. The disease is though to have been carried from Nigeria to Sudan by workers and from there was carried by Hajj pilgrims to Mecca in Saudi Arabia, who transmitted it to other pilgrims who took the disease to their homes in Yemen and Indonesia, where it took hold in places where immunization rates were only 25 percent to 30 percent.
Other outbreaks have occurred. In 2005, polio was recorded in 27 countries, including 21 where it was reintroduced by people who had traveled to infected areas . In places where it was reintroduced countrywide vaccination campaigns quickly stopped transmission in 15 of the 21 countries. Progress has also been made in some places using vaccines from the 1950s designed for each of the three different types of polio.
About 93 percent of the cases reported in 2005 were either in Nigeria or originated there. The campaign to eradicate polio in Nigeria has been hampered by rumors that the polio vaccine caused sterilization in children and was part of a campaign by Western governments to depopulate Muslim countries. Although the rumors were quelled with help of health acre people from Indonesia, a Muslim country, immunizations were stopped for 11 months and that allowed polio to take hold in certain areas and from there travel around the globe.
Progress is being made in Nigeria. The government in northern Nigeria has stepped up their involvement. Now Somalia is a concern. Before 2005 not cases had been recorded since 2002. More than 150 cases were reported in 2005 and lawlessness in Somalia make reaching areas where the disease may be taking hold a big problem.
Smallpox is a disease caused by an airborne agent. It was one of the serious diseases before the 20th century. Highly contagious, it killed 30 percent of those who contacted it and usually inflicted terrible facial scars on those that survived. Over the centuries it ravaged Roman armies and nearly wiped out entire cities and towns.
Smallpox victims died a miserable and painful death. Early on victims had spots that could be mistaken for chicken pox. As times went on these develop into pustules that spread over the body, hardened and resemble infected bee stings. People that survived were left with terrible scars.
Smallpox is the only disease to have ever been eradicated. It was officially eradicated in 1980. The United States and Russia are the only places that have kept the smallpox virus. Vaccinations have stopped and people are vulnerable to it as they were in the past.
Smallpox was eradicated in 10 year campaign that lasted from 1967 to 1977. In the late 2000s there were reports of smallpox in eastern Uganda. A WHO investigation revealed that the disease was most likely chicken pox.
In 1796, England's Edward Jenner administered the first safe smallpox vaccine on one of his servants. At the age of eight Jenner was one of 800 people who underwent a series of experiments developed by Lady Mary Wortley Montagu, a once beautiful noblewoman who survived but was badly scarred by smallpox in Turkey, where she was told by a Turkish doctor about the folk practice in his country in which healers scraped children with the fluid from smallpox blister to give them life-long immunity.
Montagu used the procedure on her children, who suffered no ill effects, and convinced the Princess of Wales to do the same with her daughters. The only problem with Montagu's experiment was that 10 percent of those who received the procedure caught smallpox and died.
As a grown man Jenner was obsessed with finding a cure for smallpox. While doing his medical apprenticeship, he was told a story about milkmaids who suffered from cow pox but were immune to smallpox. His first vaccine contained material from cow pox pustules collected from the milk maid's hands. The method was not as dangerous as Montagu’s smallpox procedure because the antibodies developed as protection against cow pox also stopped smallpox and cow pox was not as dangerous as smallpox.
Jenner's vaccine not only offered protection against smallpox it also was the beginning of a disease-fighting strategy that has been used to tackle a host of diseases. The word "vaccination" comes from the Latin word for "cow."
Jenner was also a passionate ornithologist and accomplished amateur musician. He could have made a fortune from his procedure if he kept it secret but he chose to promote its use around the world for free while others around him profited from it. Before he was awarded a grant by Parliament he was called "the most poverty-stricken great man in Europe."
Book: Edward Jenner: The Cheltanham Years 1795-1823 by Paul Saunders (University Press of New England)
Image Sources: 1) 2) 3) 4) 5) 6) 7) 8)
Text Sources: CDC Health Information for International Travel, U.S. Department of Health and Human Services; National Geographic, New York Times, Washington Post, Los Angeles Times, Times of London, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.
© 2009 Jeffrey Hays
Last updated March 2011