Paralytic Polio Research Articles

Multiple Sclerosis and Poliomyelitis in Australasia

In recent years various workers?for example, Kurland (1952), Kurland and Westlund (1953), Alter, Allison, Talbert, and Kurland (1960), and Acheson, Bachrach, and Wright (1960) ?have shown that in the northern hemisphere multiple sclerosis becomes increasingly prevalent with increasing distance from the equator. No comparable series of prevalence studies has yet been reported from the southern hemisphere, but in Australasia mortality statistics and a postal survey suggested that there is a similar gradient with latitude (Sutherland, Tyrer, and Eadie, 1962), and studies of the prevalence of multiple sclerosis in various regions of the State of Queensland, Australia, also suggest that this gradient occurs (Sutherland, Tyrer, Eadie, Casey, and Kurland, 1965). A recent hypothesis suggested by Poskanzer, Schapira, and Miller (1963) to explain the geographical distribution is of interest. It is widely recognized that poliovirus infection is very common in infancy in areas with poor standards of sanitation (as in many parts of the tropics), yet paralytic polio myelitis is rare. Where there are higher standards of sanitation (in general, in the more temperate zones) poliovirus infection occurs later in life and paralytic disease is more frequent. Poskanzer et al. (1963) drew attention to a resemblance between the geographical distributions of multiple sclerosis and clinical poliomyelitis, and to other features which suggested that the two diseases had similar epidemiological patterns. They postulated that multiple sclerosis, like paralytic poliomyelitis, represents an occasional neurological manifestation of a wide spread subclinical enteric infection. For each disease, age at initial infection determines the chances of neurological involve ment. From other data Schapira, Poskanzer, and Miller (1963) inferred that there may be some 20 years' delay between the original enteric infection and the subsequent development of multiple sclerosis.

Paralytic Polio and After

Paralytic Polio and After

Dreams of paraplegics.

Introduction Too little attention is given to the emotional problems of physically handicapped patients. Only occasionally are their personality problems discussed in the physical medicine literature. Emotional responses to serious physical injury are deeply repressed, particularly in the paraplegic, and consequently are difficult to appreciate. In this paper we are presenting a series of dreams in order to demonstrate underlying conflictual themes. In the literature Dawson points out that older patients suffering from cerebrovascular accidents do poorly in rehabilitation programs because of the anxiety associated with the need to integrate new neuromuscular patterns. 1 Zane describes certain personality types whose typical responses to any stress situation interfere with rehabilitation effects. 2 The psychological turmoil of the paraplegic or paralytic polio patient is described by Litin. He describes the phases of convalescence and finds the most severe psychiatric symptoms weeks or months after the injury in

Needed: more emphasis on disease prevention in internal medicine.

Preventive medicine is currently defined1as the science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency. Such objectives are rightfully an integral part of the practice of internal medicine, but few would deny that preventive measures tend to be displaced by the more strictly curative efforts of the busy practitioner. The ounce of prevention is too often overshadowed by the pound of cure. The unhappy results of this imbalance are found in medical wards, clinics, and physicians' offices everywhere. Examples include not only such obvious instances as the unvaccinated young adult with paralytic polio and the grossly overweight diabetic but also the patient with chronic pulmonary disease whose earlier asthmatic state was inadequately treated, the person with advanced rheumatic carditis who escaped proper prophylaxis, the peptic ulcer patient whose behavior invited recurrence and complication, the cirrhotic who could have been salvaged by

Preconceptions about vaccination against paralytic poliomyelitis.

Excerpt When one reflects upon the growing evidence that a killed-virus vaccine is likely to bring about the control of paralytic polio, there comes to mind the definition of science quoted by Gust...

News communications.

Just after the middle of the morning on Tuesday, April 12,1955, a colleague of mine went before an American Broadcasting Company microphone with the following bulletin: "A day of victory—victory over the dread disease of infantile paralysis. The official news has just now come from the outposts of the battle line. The announcement, after comprehensive, protracted scientific survey, is that the Salk polio vaccine is 80 to 90% effective in preventing paralytic polio. It is 60% effective against type 1 virus and 90% against disease caused by types 2 and 3. "The vaccine is safe, effective, and potent." On 3,700 radio stations and 500 television outlets across the United States that memorable midmorning, regular programming was being interrupted, fragmented, thrown out the window, as the words came pouring out of Ann Arbor, Mich. Network stations and big independents took the words directly from their men on the scene; tiny 250-watters

ギラン・バレー症候群を呈する多発性神経根炎患児から分離された1 Cytopathogenic Agent (柿木株) に関する研究

The formation of antiserum against this strain was observed in rabbit. The tissue culture fluid used as an antigen was weekly inoculated through intramuscular route. The neutralizing titre was 1:80 after a week which remained unchanged for several repeated inoculations.The antibody distribution of this “Kakiki strain” was screened in employment of the sera obtained from the group of the children with Guillain-Barre syndrome, paralytic polio, and control healthy individuals respectively. The figure revealed positive antibody presence 8/10 in Guillain-Barre syndrome, 3/10 in polio, and 6/10 in controls. The positives were mostly found in the sera age over 3 years in the view of age distribution. The relation of this Kakiki Strain to the Guillain-Barre Syndrome was discussed.

ギラン・バレー症候群を呈する流行性多発生神経根炎及び麻痺ポリオ患者のポリオウイルス中和抗体に関する研究

The paired sera obtained from two groups of patients with polio and with polyradiculoneuritis so-called Guillain-Barré syndrome (G. B.) encountered in the Setouchi area 1953-1955 were attested for the polio antibody of three types employing. tissue culture HeLa tubes. The objecives of this study were to clarify the relation of these two entities. The four piloting marks would be of significance; 1) polio antibody of G. B. against one of three types were revealed in 21 cases out of 24 (87.5%) while 3 cases (12.5%) of negative reading. This percentage is in good accordance with the polio antibody distribution in the placebo groups, 2) type distribution of G. B. was in the range of placebo groups, namely type I 11 (45.8%) II 11 (45.8%) and III 13 (54.2%). 3) yearly analysis of presence of polio antibody of G. B. was revealed in the vicinity of placebo groups, 4) This might be compared with the 100% positive reading in the polio antibody titer of paralytic polio groups against one of three types. 4 cases among these 23 cases showed double types (17.4%). Type I 14 cases (60.9%) II 5 (21.7%) and III (34.8%). The yearly variation of the type distribution manifested predominancy of type II in 1953, type I in 1954, type I and III equally in 1955.Accordingly it would appear probable that G. B. could be of dissimilar entity from polio, and the presence of polio antibody in G. B. would be of inapparent infection of polio in the process of continuous exposure to the polio virus as illustrated in the placebo groups. The data on the placebo groups will be shown in the following paper.

MANPOWER NEEDS NOW AND LATER

AFTER TWO WEEKS OF SPUTNIK and millions of words of discussion of its scientific and political effects, it was indeed a welcome change to read that an 80% reduction has taken place in paralytic polio in the past two years. Marion B. Folsom, Secretary of Health, Education and Welfare, attributes the reduction, in major part, to Salk vaccine. He has announced that for the first time enough vaccine is available to protect the 37 million Americans under 40 not yet vaccinated. All that is needed to give paralytic polio a knockout blow within the next year is to overcome the apathy of those who should be directly concerned. Availability of supplies is no longer a problem, and an increased export quota has been announced by the Department of Commerce. We mention the scientific triumph of the Salk vaccine because recalling it at this time may help us maintain perspective. The interest in earth satellites and ...

How the Present Poliomyelitis Vaccine Was Discovered

T HE first preliminary tests of the Salk poliomyelitis vaccine were reported in 1953. The making of such a vaccine had become possible, and reasonable grounds for a critical trial of it in man established, through a series of earlier discoveries. In 1908, Landsteiner and Popper first transmitted polio to monkeys by inoculating them with human spinal cord tissue from a fatal case. The next year, Flexner and Lewis confirmed this, and were able to pass the infection from monkey to monkey, using spinal cord tissue from one to inoculate the next. In this way, over the ensuing years, numerous of poliovirus, each from a different human source, were isolated at various laboratories. In 1909 it was further noted that monkeys surviving one attack of polio did not suffer a second when reinoculated with virus of the same strain. Moreover, when blood serum of surviving, immune monkeys was mixed with the strain of virus used originally to infect them, and then used to inoculate normal monkeys, it proved harmless. A similar mixture, of virus and serum of nonimmune monkeys, was by contrast fully infectious. That was the first demonstration of a neutralizing antibody against polio, a substance that appears in the blood of man as well as the monkey, and remains for years as a sign that infection has occurred. Until 1951, there was no way of identifying the virus, in suspected material, except to inoculate monkeys with it and produce the characteristic disease. To be sure that polio would be produced, the inoculation was usually made directly into the animal's brain; polio could be produced only irregularly when the virus was introduced by other routes. It was difficult at first to test for virus except in tissues removed aseptically after death. Body secretions and excretions of living subjects are contaminated with bacteria, which if inoculated into the brain could cause infection more rapidly than polio. Therefore, little was known about the behavior of the virus in living persons or animals until 1937 when methods for killing bacteria without inactivating virus in media containing both, were found. Stock strains of virus were preserved simply as infected monkey spinal cord tissue. When used to inoculate animals it was ground finely and suspended in fluid. The same material was used for experimental vaccines. Vaccination of monkeys was tried in 1910, and for 30 years thereafter, with little success. Some of the vaccines were treated with chemical or other agents designed to inactivate the virus. Vaccines of live, virulent virus also were tried. Most strains of poliovirus can be injected subcutaneously or intramuscularly in monkeys with only an occasional infection resulting. Such vaccines were not of course proposed for use in man, but unless live virus could be shown to immunize, little obviously could be expeced from inactivated-virus vaccines. Monkeys vaccinated with live virus were found to develop antibody rather regularly. When vaccinated monkeys were tested for resistance to infection, by inoculation with live virus in the brain, the results were less encouraging. Paralytic polio often ensued in splite of the presence of antibody in the animal's serum. The results with

急性灰白髄炎のウイルス学的血清学的研究

(1) From 1954 to 1956 the authors isolated 51 strains of cytopathogenic agents mostly from feces of patients with paralytic poliomyelitis using human embryonic skin-muscle tissue culture. As a result of typing we found 31 strains of type I (70%), 7 strains of type II (15%), 7 strains of type III (15%) and 6 untypable agents. 70 to 80 per cents of causative agents of paralytic poliomyelitis belonged to type I in Japan in the above period.(2) Neutralization test using 100 TCD 50 of three types of poliovirus vs. undiluted and diluted (1:10) sera from healthy individuals was done on 209 specimens from Tokyo. The percentage positive was lowest at 6-11 months after birth, increasing rapidly, and the adult level (80-100%) was reached about 4 to 6 years of age. This pattern of the age distribution of antibody is almost equal to those obtained in Cairo, Egypt, and French Morocco. In the case of diluted sera the final level attained was 60-80 per cent, so that about 20 per cent of immune adults were considered having antibody titer less than 1:10.(3) 46 per cent of paralytic polio occurred in the first year of life in Tokyo 1955, and steep increase of neutralizing antibody was seen among examinees belonging to the same age group. It means that paralytic sequelae are very likely to occur in the primary infection without protection of antibody.(4) Analysis of antibody for one or more types of poliovirus in various age groups shows that infection by any one type interfere with heterotypic infections, in other words there exists some degree of cross immunity between heterotypes.(5) Antibody titers of the pooled sera which were composed of an equal quantity of sera from individuals belonging to the same age group were minimum (antibody titer against type II and III were zero, but that of type I was 1:3 to 1:8) under one year of age, rose up to maximum (1:64 to 1:128) at 4 to 6 years of age, then declined a little and kept at a level (1:16 to 1:32) thereafter in Tokyo.

Definitions of Time and Recovery in Paralytic Polio Convalescence

In addition to the manifestation of pathological body symptoms and processes, the course of a disease is marked by significant changes in the perspectives of the victim and his family. Communications of hospital personnel on the problems of prognostic uncertainty and the gradient structuring of the physiotherapeutic regime had the effect of lengthening the recovery-time perspective of child polio cases and their parents and altering their concept of recovery. This had both functional and dysfunctional consequences for the paralyzed child's eventual return to home and community.

Acute Poliomyelitis of the Mother, with Aural Lesions in the Premature Infant

Pregnancy is recognized as one of the factors that promote the development of poliomyelitis. Anderson (1948) quoted statistics according to which the incidence of polio in pregnant women was twice or three times the expectancy. Polio in the last trimester was more serious than in the first six months. Aycock (1946) related that pregnancy predisposes to acute polio, with a tendency for the disease to occur in the first trimester in women carrying a male and in the third trimester in those carrying a female fetus. Evidence to the effect that the polio virus cannot break through the placental barrier was advanced from several sides (Huerny, 1942; Froevig, 1947; Stokes, 1948; Blechmann and Oliveau, 1948). It would seem that not much danger awaits the progeny from direct transmission of the virus during gestation. But Aycock (1941) suggested that infection can be initiated during pregnancy, as paralytic polio was observed in

Brief of Presidential Address: The 1954 Trial of the Poliomyelitis Vaccine in the United States

(1) Poliomyelitis is a relatively rare disease. From past experience, the rate of paralytic polio in the study areas might be anticipated to be about 30 cases per 100,000 children aged 6-9 years. Given this attack rate, table I shows the probability of obtaining a statistically significant result (5% level) for various numbers of children and for various degrees of true effectiveness of the vaccine. With a vaccine that actually was 50% effective, about half a million children would be needed to make the risk of an inconclusive result small. Table II shows

The Drinker Respirator: Its Use in Anterior Poliomyelitis Cases

+N_ ~URSING a poliomyelitis patient is always an interesting, often an exciting, often a heartrending task. It is particularly so when the patient has that type of the disease which makes him a possible candidate for the respirator. A post paralytic polio, still in the acute stage of the disease, who has a paralysis indicating involvement of the cord their special symptoms, problems and methods of treatment. It is the patient in the former type of the disease for whom the respirator is of undoubted value, whose life is, in fact, dependent upon it. The Drinker respirator is still in the stage of development and there are new models constantly in the making; but the principles are the same for all.