Polio has had a far-reaching effect on medicine. The successful development of a safe vaccine after years of effort was a triumph of enormous propertions. It involved the eager participation of millions of ordinary Americans, initially through door-to-door fund-raising and later in volunteering their children to participate in the 1954 field test of the Salk vaccine. The massive research effort to develop a polio vaccine led to many discoveries that have since revolutionized the fields of virology and immunology.

The polio epidemics accelerated the development of rehabilitation medicine. In contrast to traditional medicine with its focus on the curing and repairing of diseased organs, rehabilitation medicine emphasizes the rebuilding of body functions and the teaching of the skills necessary for independent living. The principles developed to treat polio patients decades ago are essentially the ones used today to rehabilitate persons with head and spinal injuries, strokes and degenerative disorders.

The intensive care unit that is now an integral part of every modern hospital is another legacy from the era of polio epidemics. When large numbers of polio patients requiring iron-lung ventilators started to overwhelm the staff in rehabilitation centers, the iron lungs were clustered together so they could be readily monitored by only a handful of nurses. In addition, regional respiratory centers were created to treat the most severely affected polio patients. Some of these centers have survived and continue to provide care for persons with spinal-cord injuries.

The money that originally funded these respiratory centers was raised by the National Foundation for Infantile Paralysis, which later became known as the March of Dimes. It was Eddie Canter, the famous singer and entertainer, who suggested that Americans could be asked to mail dimes to support the fight against polio. For a while, the fight against polio brought out many of the best qualities of American society: neighbors carried food to families quarantined at home, teen clubs raised money to help hospitalized classmates, and women's groups adopted local polio wards for the year.

Then the vaccines were developed, and not only did polio disappear in America but the war against polio seemed to be forgotten--along with the survivors. Once held up as examples of heroic human fortitude, thousands of polio survivors who continued to need medical and financial help were largely ignored by the public. As veterans of other wars would continue to discover, the public does not like to be reminded of the wounded and the dead after the war is over. Also, as with other conflicts, the polio war left more wounded and uncounted survivors than are generally recognized.

Even the miracle vaccines have their problems. Most scientists agree that the Sabin oral vaccine is superior to Salk's injected one; however; the oral polio vaccine is not free of risk. In fact, it causes the very disease it is designed to prevent in 10 to 15 people every year because of either a mutation in the virus or an immune deficiency in the recipient that allows the weakened virus to take hold and produce paralysis. The federal government has changed its vaccination policy and is now recommending two initial immunizations with the injected killed-virus vaccine followed some time later by two doses of oral live-virus vaccine. In theory, this combination provides the advantages of both vaccines and, we hope, will end forever this nation's rendezvous with polio.

The Author

Further Reading
POST-POLIO SYNDROME. Edited by Lauro S. Halstead and Gunnar Grimby. Hanley & Belfus, Philadelphia, 1995.
A SUMMER PLAGUE: POLIO AND ITS SURVIVORS. Tony Gould. Yale University Press, 1995.
CURRENT TRENDS IN POST-POLIOMYELITIS SYNDROME. Daria A. Trojan and Neil R. Cashman. Milestone Medical Communications, New York, 1996.
IN THE SHADOW OF POLIO: A PERSONAL AND SOCIAL HISTORY. Kathryn Black. Addison-Wesley, 1996.
POST-POLIO SYNDROME: A NEW CHALLENGE FOR THE SURVIVORS OF POLIO. A CD-ROM published by Bioscience Communications, New York, 1997.
MANAGING POST-POLIO: A GUIDE TO LIVING WELL WITH POST-POLIO SYNDROME. Edited by Lauro S. Halstead. NRH Press and ABI Professional Publications, Falls Church, Va., 1998.