Poliomyelitis (from the Greek words polio = grey and myelos = marrow or of the spinal cord), polio for short, was one of the most feared diseases in the early twentieth century. Originally known as infantile paralysis, this disease terrorized families with the threat of death or paralysis to hapless children and adults. Creeping into towns and cities as the weather warmed each summer, it was never predictable where and when this insidious disease would strike. Once cases occurred, entire towns shut down as fearful families kept their children home and avoided public places. Fortunately, most infected people had either no symptoms or mild nondescript symptoms such as fever, headache, and gastrointestinal distress (nausea and vomiting) from which they fully recovered. Only about 1% of all infections progressed to severe disease that attacked the central nervous system (CNS), but these cases could be tragic. These individuals often suffered permanent damage leading to partial or full paralysis, with the most severe cases leading to death because of paralysis of the breathing muscles. As one frightened young patient stated, “I could talk, I could open and close my eyes, and I could turn my head from side to side on my pillow, but otherwise I could not move at all” (Kehret 1996). While only a small minority of the total infections, these paralytic cases were often devastating and left behind a legacy of permanently crippled victims. The 1952 outbreak was the worst in U.S. history with approximately 58,000 cases, 3145 deaths, and over 21,000 people left with some degree of paralysis. While the subsequent 3 years saw a modest decline in cases, the early 1950s still produced a total of over 100,000 cases and nearly 4000 deaths. Keep in mind that the number of cases reported was likely a vast underestimate. Inapparent infections would not have been detected and even mild gastrointestinal cases might not have been attributed to polio. With polio rampant, the introduction of the first polio vaccine in 1955 was greeted enthusiastically by the public. Mass vaccination events organized by fearful communities were widespread as parents desperately sought to protect their children. Because of these public health efforts, within 10 years polio was tamed and by 1965 there were only 72 total polio infections reported in the U.S. with 16 deaths. By 1980 the U.S. was polio-free and has remained free ever since. The few naturally acquired cases in this country since 1980 have been in individuals who became infected elsewhere in the world before returning home. This remarkable conquest of a devasting infection in one generation was all thanks to vaccines and our campaigns of mass inoculation against this disease. Similar campaigns in every country have nearly abolished this disease. In 2022, only three countries (Afghanistan, Mozambique, and Pakistan) reported endemic polio for a total of 30 confirmed cases (There were an additional 871 vaccine-derived cases from 24 countries and we’ll return to this below). Like smallpox, the virus causing polio has no natural reservoirs other than humans. If we can stop all human cases we should one day soon see the complete elimination of poliovirus from the world.

Poliovirus: An Insidious Plague

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发表日期：

2025年

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Van G. Wilson

摘要

Poliomyelitis (from the Greek words polio = grey and myelos = marrow or of the spinal cord), polio for short, was one of the most feared diseases in the early twentieth century. Originally known as infantile paralysis, this disease terrorized families with the threat of death or paralysis to hapless children and adults. Creeping into towns and cities as the weather warmed each summer, it was never predictable where and when this insidious disease would strike. Once cases occurred, entire towns shut down as fearful families kept their children home and avoided public places. Fortunately, most infected people had either no symptoms or mild nondescript symptoms such as fever, headache, and gastrointestinal distress (nausea and vomiting) from which they fully recovered. Only about 1% of all infections progressed to severe disease that attacked the central nervous system (CNS), but these cases could be tragic. These individuals often suffered permanent damage leading to partial or full paralysis, with the most severe cases leading to death because of paralysis of the breathing muscles. As one frightened young patient stated, “I could talk, I could open and close my eyes, and I could turn my head from side to side on my pillow, but otherwise I could not move at all” (Kehret 1996). While only a small minority of the total infections, these paralytic cases were often devastating and left behind a legacy of permanently crippled victims. The 1952 outbreak was the worst in U.S. history with approximately 58,000 cases, 3145 deaths, and over 21,000 people left with some degree of paralysis. While the subsequent 3 years saw a modest decline in cases, the early 1950s still produced a total of over 100,000 cases and nearly 4000 deaths. Keep in mind that the number of cases reported was likely a vast underestimate. Inapparent infections would not have been detected and even mild gastrointestinal cases might not have been attributed to polio. With polio rampant, the introduction of the first polio vaccine in 1955 was greeted enthusiastically by the public. Mass vaccination events organized by fearful communities were widespread as parents desperately sought to protect their children. Because of these public health efforts, within 10 years polio was tamed and by 1965 there were only 72 total polio infections reported in the U.S. with 16 deaths. By 1980 the U.S. was polio-free and has remained free ever since. The few naturally acquired cases in this country since 1980 have been in individuals who became infected elsewhere in the world before returning home. This remarkable conquest of a devasting infection in one generation was all thanks to vaccines and our campaigns of mass inoculation against this disease. Similar campaigns in every country have nearly abolished this disease. In 2022, only three countries (Afghanistan, Mozambique, and Pakistan) reported endemic polio for a total of 30 confirmed cases (There were an additional 871 vaccine-derived cases from 24 countries and we’ll return to this below). Like smallpox, the virus causing polio has no natural reservoirs other than humans. If we can stop all human cases we should one day soon see the complete elimination of poliovirus from the world.