PULSE RATE

By Martina P. Callum, MD
ARE CHILDHOOD IMMUNIZATIONS

ON YOUR BACK-to-SCHOOL LISTS?  
This past July, the Nigerian state of Kano announced the resumption of the polio vaccination program after tests proved the vaccine was safe.  The program had been suspended in Kano months earlier amid state leaders’  allegations that the vaccines would spread HIV and cause sterility.  This announcement and the controversy surrounding it took me back to a Sunday night in the 1950s when my mother announced to my father that all four of his children would receive the polio vaccine-soaked sugar cube in school the next day.
 My father was convinced that his children would catch polio and become crippled for the remainder of their lives if they survived the disease.  He was not alone in his fear; it gripped the entire nation.
If you were born after 1955 – the year Dr. Jonas Salk discovered the first polio vaccine, you may think polio was just some disease that was around for a short time and then disappeared. Prior to 1955, this horrible disease crippled thousands of healthy children.
Poliomyelitis, commonly known as polio, is caused by any of three polioviruses. It lives in the throat and intestinal tract of infected persons. The virus usually enters the mouth most often from hands contaminated with feces of an infected person.  Food and water are no longer believed to play a major part in the spread of polio. Paralysis of the legs is the most common complication but the muscles we use for swallowing and breathing can also become paralyzed. Total paralysis can occur within hours.
My father, a man with no formal education, knew the association between summertime activities and polio. “Remember President Roosevelt got polio after he went swimming.” Local and national health officials advised parents to keep their children away from open drains, unscreened windows and crowds. A report of one or two cases of polio could close public swimming pools, camps and movie theaters for the season. Even military draft inductions were halted.  I do not remember going to a public swimming pool before age seven.
These precautions worked for influenza and the plague but not for polio.  Improved sanitary conditions and other efforts to stop the spread of the disease may have allowed a relatively mild infantile condition to become an epidemic. Not all people who contracted polio knew they had it or ended up with permanent paralysis.  Most who were diagnosed, recovered.  Three thousand people died during the worst epidemic year, 1952, compared to the thirty-two thousand who died from tuberculosis in 1950.
Dr. Salk’s vaccine contained an inactive form of the virus that would protect us but not cause polio. My mother must have known and understood this because in spite of my father’s objections we did receive the vaccine in school the next day.  
A few years later a second type of the vaccine that contained small amounts of the live virus was developed.  Both types are in use today to immunize children.   This brings us back to Kano, Nigeria and the rest of the world.  Twenty million people living today have been crippled by polio.  In 1988, the World Health Organization (WHO) launched a program to eradicate it worldwide by the year 2000.  In the summer of 2003, polio remained a major public health problem in seven of the original 125 countries identified in 1988.  Four of the remaining seven countries accounted for ninety-nine percent of the new cases of the disease.
 In December 2003, fifteen million children in West Africa were at risk for contracting polio and Kano was refusing to participate in the mass immunization program. A 30% increase in new cases from the previous year had occurred. Polio was again on the rise, spreading from Kano to countries that had eradicated the disease — Ghana, Togo, Niger and Burkina Faso.  Comprehensive testing on imported vaccines lay to rest the fears of the Kano government officials. The public’s fear of further spread abated when Kano agreed to conduct the immunizations.  Years earlier, my father’s fears were laid to rest finally when he allowed my older brother to take me Clifton Park Pool.
Martina P. Callum, MD, a practicing Primary Care Physician since 1979, can be reached at MPCallumMD@aol.com