When Polio, Every Parent's Nightmare, Fell to Dr. Salk
By HOWARD MARKEL, M.D.
Published: April 12, 2005
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For much of the first half of the 20th century, polio conjured up every
parent's worst nightmare: children who could not walk without steel braces;
others imprisoned in large tank respirators called iron lungs, gasping for
every breath. Still others died.
But on April 12, 1955, Americans learned that Dr. Jonas Salk had developed a
safe and effective vaccine against polio. Thanks to successful immunization
programs in the decades since, parents today can rest easy knowing that
polio is preventable and rare.
Marking the 50th anniversary of the vaccine are two new books and several
exhibits that re-examine this remarkable chapter in the history of American
medicine, including celebrations at the University of Michigan, where the
vaccine trial was conducted and its efficacy was announced 50 years ago and
at the University of Pittsburgh, where Salk did his research.
In "Splendid Solution: Jonas Salk and the Conquest of Polio," published by
Putnam, Jeffrey Kluger writes about how Salk became an international
celebrity. Mr. Kluger, a senior writer for Time, describes the aggressive,
often bitter rivalry between Salk and another virologist, Dr. Albert Sabin.
Even though Salk's vaccine, an injection made from killed virus, was
developed first and is the vaccine most often used in the United States
today, it was derided by many virologists as a stopgap measure that was
superseded by Dr. Sabin's oral vaccine, made from live-attenuated virus and
introduced in 1963.
The first major American epidemic of polio, or infantile paralysis, began in
June 1916. New York was hit especially hard, with more than 9,000 cases and
2,343 deaths. Jonas Salk was 20 months old at the time and, as Mr. Kluger
recounts, his mother, Dora, kept him and their Manhattan apartment
scrupulously clean, in the belief that doing so would protect against polio.
In the four decades that followed, doctors struggled to prevent and treat
the mysterious disease. During epidemics, which typically occurred in the
summer, movie theaters and swimming pools closed and public libraries
disinfected their collections.
In "Polio: An American Story," published by Oxford University Press, David
Oshinsky, a historian at the University of Texas, describes how the National
Foundation for Infantile Paralysis revolutionized the enterprise of medical
research in the United States. The foundation started long-term research
grants, as well as indirect financing to support universities where
researchers were based, and required those who received its grants to share
their ideas with other scientists - all essential elements of medical
Polio was not limited to children, though they were the epidemiological
focal point of the disease and the selling point of the crusade for a cure.
The most famous adult polio patient was President Franklin D. Roosevelt, who
was infected at 39 and used a wheelchair for the rest of his life.
In 1937, Roosevelt and his former law partner, Basil O'Connor, started the
infantile paralysis foundation or, as it came to be known, the March of
Dimes, to conquer and treat polio. The foundation became the gold standard
for philanthropies devoted to eliminating diseases, and it pioneered
fund-raising techniques like national publicity campaigns, celebrity
endorsements and donation canisters, featuring attractive children.
In his book, Mr. Oshinsky notes that the public's fear of polio often
outweighed its actual threat. In many of the worst epidemics in this
country, 30,000 people or fewer contracted the disease, a far lower number
than the annual incidence of other childhood killers now contained by
vaccines, like measles, diphtheria and whooping cough.
Eighteen years passed between the establishment of the foundation and the
completion of the complex trial on 1.8 million children that confirmed
Salk's vaccine as safe and effective. For many, the presumed conquest of
polio helped create the expectation that well-financed, well-executed
medical science could cure all that ails us.
Sadly, polio cannot yet be relegated to history. Last year, 1,263 cases were
diagnosed, primarily in the polio-endemic nations of Nigeria, India,
Pakistan, Niger, Afghanistan and Egypt. Polio is mainly transmitted by
fecal-oral contact; about 1 infection in 200 leads to irreversible
paralysis, usually in the legs.
In December 2004, a case was discovered in Mecca a few weeks before its
annual pilgrimage, which draws two million Muslims. As a result, public
health officials have increased surveillance and immunization efforts to
prevent a serious outbreak. The World Health Organization hopes to eradicate
polio globally by the end of this year.
Dr. Howard Markel, a professor of pediatrics and the history of medicine at
the University of Michigan, is the author of "When Germs Travel."