Thoughts on the return of polio

When polio case It emerged in Rockland County, just north of New York City, in July 2022, after which polioviruses with the same genetic sequence as the paralyzed man were found in three samples of sewage collected from near his home, and public health officials were alarmed. The man, from an Orthodox Jewish sect with generally low vaccination rates, was not immunized against polio.

Tariffs started from the World Health Organization.

The viral RNA sequence taken from the patient was close to that of the “live” (weak, aka attenuated) oral polio vaccine. was injured Vaccine-derived polio viruses (VDPV). Then finding the RNA sequence in the wastewater raised the situation to the required level Circulating vaccine-derived polioviruses (cVDPV). The United States now joins 30 other countries in seeing the resurgence of this infectious disease that was once thought to be on the verge of ending.

Around 95 percent Of those infected with wild poliovirus do not show symptoms. Others develop fever, muscle weakness, headache, nausea, and vomiting. One to two percent develop severe muscle stiffness and pain in the neck and back. It produces paralysis of less than one percent. Before widespread polio vaccination, mechanical ventilators called iron lungs were used to help children breathe, often for several months.

The role of the oral polio vaccine

The term “vaccine-derived” may imply that the vaccine induces an infectious disease to reappear, but that is not quite the case.

The new viruses differ slightly, in RNA sequence, from the oral polio vaccine that was introduced in the 1950s. It consists of an attenuated virus that replicates along the digestive tract of the child and is excreted with the stool.

To develop the oral polio vaccine – also known as OPV – Albert Sabin infected a series of animals with wild polio virus. The strategy allowed mutations to accumulate that weakened the virus enough to stimulate the immune response in people without causing symptoms. Children lined up in school cafeterias to eat the virus-carrying pink-stained sugar cubes that were an ingenious delivery method for the vaccine. Children’s feces released weakened polioviruses into wastewater, spreading OPV protection even to those who had not been vaccinated.

Gross, perhaps, but it works. However, the virus can mutate as it multiplies, as live viruses do. It could, like its ancestors, become able to reside in human neurons. Muscles are weakened, in some cases to the point of acute flaccid paralysis of poliomyelitis.

Passionate people enjoy protection – that’s most of us. But communities with low uptake of the vaccine make room for new viral mutations. This appears to be what is happening now.

Dr. Jose R. said: Romero, Director CDC’s National Center for Immunization and Respiratory Diseases When reporting the July 21 issue, “Polio vaccination is the safest and best way to combat this debilitating disease, and it is imperative that people in these unvaccinated communities get the latest updates on polio vaccination immediately. We cannot stress enough that polio is a serious disease with no cure. for him “.

Vaccines could, in theory, rid the world of polio. In 2013, experts from 80 countries signed the Scientific Declaration on Polio Eradication, which emphasized the danger of seeking control rather than eradication: “[W]Up to 200,000 cases per year could be expected within a decade if polio eradication efforts were halted, effectively reflecting the progress made over the past 25 years. Until the disease is eradicated, we will always be in danger of a re-emergence of the polio virus anywhere in the world.”

Only the injected and inactivated polio vaccine is now given in the United States, due to the ability of the oral vaccine to mutate. And the superbug live vaccine component was removed in 2014, which is what I covered Medscape.

Vaccine memories

I suspect a lot of people didn’t notice the polio news in the summer. The reasons varied: fatigue from the coronavirus, or just another disease that followed monkeypox, or unfamiliarity with polio. Perhaps they don’t remember the pink sugar cube or one of the many shots to protect against what were once called “childhood illnesses.”

I had a bunch of those illnesses that in a matter of days could empty a classroom, including measles for a month. So once I was old enough to understand vaccination, I would appreciate the protection my younger sister had against measles, and then my children against rubella and mumps. They tolerated chickenpox spots, the vaccine initially intended for children with leukemia and other risk factors that made the infection life-threatening.

Fortunately, vaccinations wiped out polio in a timely manner for me. But one of my early memories, which contributed to me becoming a scientist, is my mother’s fear of polio. I wrote in my baby book in 1954 “April 15 – the polio vaccine is perfect!!!”

She had good reason to celebrate. I wrote in the scientist:

“For parents of young children in the early 1950s, summer brought the horror of a fever that might break out Polio, “the fear prompted by images of Franklin D. Roosevelt’s battle with disease. Although only 1 percent of infected individuals developed severe symptoms when the virus invaded myeloid cells, the number of cases grew large enough to inspire a massive effort to develop A vaccine, including founding the Dimes March in 1938 to specifically fight polio.

For those too old to remember the Beatles, polio vaccinations were a part of childhood. By 1955, young people in many countries had received injections of the inactivated polio vaccine by Jonas Salk. By 1962, children were lining up at school, sticking out their tongues to receive pink-stained lumps of sugar impregnated with Albert Sabin’s live, attenuated oral polio vaccine.

Neither Salk nor Sabine applied for patent protection for their inventions.

I received polio vaccinations in May, June, and October of 1956. Grateful parents across the United States realized that if enough people were vaccinated, the active virus would have nowhere to infect, and polio would disappear. They had an intuitive understanding of the concept of herd immunity, if not by that name.

Thanks to the vaccine campaign, the last naturally occurring cases of polio in the United States were in 1979, although the wild virus continued to arrive from elsewhere. By 1994, the World Health Organization declared the Americas polio-free.

Confronting polio during my career as a science journalist

A recent case of polio in Rockland County made me think about my few connections to the disease.

I knew older siblings of my friends who had it, a friend in college and another in graduate school who was faltering, a legacy of childhood polio.

In 1980, my college colleague Sheryl Adler was on the team that discovered the RNA sequence of a key poliovirus gene that enables the virus to reproduce, a notable paper in cell. She was known best as an early Deadhead and a great cook. Unfortunately, Cheryl passed away young due to a neurological disease. I last saw her on The Phish Show.

In 1993, I met two people who would become my co-authors for several editions of two textbooks on anatomy and physiology. We had half a day to kill in Chicago between flights to our publisher, so, being obsessive, we visited the International Museum of Surgical Sciences. Surprised, we christened the extensive exhibition of laboratory glassware at the Bong Museum. Our laughter ceased immediately when we reached an iron lung. We’ve imagined a baby trapped inside for months or even years while the inflator mimics moving lungs. Surprised, we have appreciated, once again, the value of vaccines. How I wish the vaccinator had an understanding of the history of infectious diseases! Those who are in childhood are unfamiliar Because Vaccines defeated them.

In 2014 I was a call speaker In the march of the dimes. Roosevelt, who contracted polio at age 39 and lost the use of his legs, originally named the organization the National Polio Foundation. The donations were initially from wealthy celebrities, but when polio cases rose, Roosevelt sought help from the public. Singer Eddie Kantor jokingly asked the audience to send a dime to the president. After nearly 3 million dimes appeared in the White House, the name was changed to Marching Dimes.

Jonas Salk was the first speaker at the March of Dimes in 1971. I was honored when the organization asked me to participate. I’ve spoken at universities in four cities in New York, and I’ve been compensated with a mug full of M&M’s and a T-shirt.

CODA: Hesitancy Vaccine Is Déjà vu Again

I’ve published thousands of articles since receiving my PhD in genetics in 1980. One from 2004 is chilling: Vaccines, Victims of Their Own Success, with the subtitle “Why the Most Effective Public Health Intervention provokes a mixed response from the public.” featured in the scientist (I wrote for them for 17 years, until one day a new editor came along and fired all the regular employees.) Some quotes from experts, who are still in their institutions, can frightfully come in today in the wake of the COVID pandemic:

People in the United States want a quick fix rather than prevention, so they prefer drugs over vaccines. “In other places, people are afraid of drugs and side effects and prefer vaccines,” said Shan Lu, a primary care physician at the University of Massachusetts Medical School who worked on a vaccine against HIV.

“In developed countries, we no longer suffer from infectious diseases for which there are vaccines, so the risks of the vaccine are seen as greater than the risks of the disease. But it is true because the vaccine is being used,” said Stanley Plotkin, inventor of the rubella vaccine.

In the 1950s, polio affected every neighborhood. Now normal polio is far from everyday life for most people. “But when a young girl in California gets side effects from the polio vaccine, it hits the papers,” said Neil Hernden, MD, chief of pediatrics at Strong Memorial Hospital at the University of Rochester in New York.

“In the past, medication was administered under a more paternalistic model, with the public trusting that they were receiving the appropriate service. Today, people are more involved in their care, know more, and expect more,” said Mark Opval, MD, medical director of the Detroit Medical Center for Occupational Health Services. .

Those fears that have reverberated for decades are hard, sometimes crazy, to disentangle. But the main message that anti-vaccination opponents seem to miss is the duty to think beyond themselves to protect society.

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