Medicine: Polio Preventive

First time that a doctor recognized infantile paralysis as a separate disease was in England in 1784. First known case in the U.S. was in 1841. Vermont had the first U.S. epidemic, with 132 cases, in 1894. In 1907 and 1908 New York City had 2,000 cases, 130 deaths. In 1916 occurred the nation’s worst epidemic of the disease. New York City had 8,928 cases, of whom 27% died. That year 7,130 children died of infantile paralysis in the U.S. In 1921 Franklin Delano Roosevelt contracted the disease. In 1931 Brooklyn was terrified by an epidemic which laid 4,000 children low. Last summer California suffered an epidemic, with 1,300 children mildly affected (TIME, July 16).

Infantile paralysis, also called poliomyelitis, is caused by a virus which destroys muscle-controlling nerves, mostly in the spinal cord. Eighty percent of cases occur in children under ten years, 98% in children under 15 years. The U.S. contains 37,000,000 boys and girls under 15 years.

The disease’s mortality rate runs up as high as 30%. Once a person is infected, the only specific treatment has been to inject him with “convalescent” serum taken from someone who has survived an attack of the disease. Not all survivors show signs of paralysis. And not all of the paralyzed are permanently so. If a paralyzed muscle twitches when the doctor applies an electric current to it, the nerve is not entirely destroyed. By careful training the muscle can learn to work again. If the nerve is dead, the muscle wastes away and never recovers. President Roosevelt will probably never again walk without braces but by persistent effort, massages and Warm Springs water he has trained the withered muscles of his legs to take up part of their duties.

Hope of conquering infantile paralysis first arose in 1910 when Dr. Simon Flexner of the Rockefeller Institute for Medical Research discovered the virus which causes the disease. He found it in the mucous membranes of the nose and throat, and suspected that it might exist along the olfactory nerve. Not until last year did Dr. Maurice Brodie of Manhattan and Dr. Arthur Roland Elvidge of McGill University discover that the virus did travel up the olfactory nerve to the brain, then to the spine.

That discovery accelerated the search for a vaccine which could immunize children against infantile paralysis. Blood of persons who have survived the disease contains invisible substances called antibodies which neutralize the virus. Hence they are immune. When serum from such blood is injected into a child’s veins, the child also becomes immune.

But health officers cannot well goaround bleeding adults who have had the disease to obtain the base for a serum to immunize a whole community’s children. In the long hunt for a more practical serum none has been more assiduous than Dr. William Hallock Park, longtime director of the research laboratories of New York City’s Department of Health.

Early this year Dr. Brodie, who works on Dr. Park’s staff, discovered that, if he mashed the spinal cords of infected monkeys with formalin, the resultant mixture would immunize other monkeys against live virus.

To make certain that the long-sought vaccine was not harmful to humans, Drs. Park, Brodie and laboratory associates vaccinated themselves. Unharmed by their experiment, they decided to make the ultimate test on children. Two dozen were vaccinated, with their parents’ consent.

Last week Dr. Park announced that, as he had anticipated, the two dozen were utterly unharmed by Dr. Brodie’s vaccine and, according to monkey tests, definitely immune to infantile paralysis. At once he inoculated four dozen more children. Periodically during the next year he will test the blood of all the children just to make utterly sure that the immunity continues.

Front pages loudly proclaimed that at last infantile paralysis could be prevented, perhaps some day stamped out altogether. Parents flocked to Dr. Park for vaccine, and old fears subsided in many a home. But, as usual, there was a practical hitch in last week’s good news: the expense and difficulty of collecting enough vaccine to immunize the 37,000,000 U.S. children under 15. Although all kinds of monkeys may serve for the manufacture of the vaccine, the best kind is Macacus rhesus from India. To import one rhesus monkey to the U.S. costs $9. After it is infected, killed, and its spinal cord ground up with formalin, at a processing cost of $3 more, the finished vaccine is only enough to inoculate twelve children. But even if $37,000,000 were available for nation-wide immunization, the supply of rhesus monkeys in India is by no means unlimited.