87. Corralling wild polio

Sunday September 6 2020

My husband’s Aunt Jean was one of the last of the Greatest Generation of our family when she passed in 2016. She was a remarkably intelligent woman, with a sharp sarcastic wit that kept you at constant attention.

Jean was not a woman to be dismissed. She was a force, a go-getter.

And a polio survivor.

You do not want to mental spar with this one.

Born during the Great Depression in rural West Virginia, Jean contracted poliomyelitis as an otherwise healthy young girl, which resulted in full paralysis of her left leg and partial in her right. She shared with us that her father made her first leg braces by hand because no fate would dare alter her life course.

Poliomyelitis attacks the nervous system, causing either full or partial paralysis, and in many cases, results in death. In the first half of the twentieth century, tens of thousands of Americans had polio. Jean’s home state of West Virginia reported the 1940’s and 1950’s as their largest number of cases. Jonas Salk’s vaccine was introduced in 1955 and within two years, polio cases in the US dropped by 85-90%.

West Virginia Public Broadcasting published an article in 2015, “Defeating Polio, The Disease That Paralyzed America”, that give a descriptive first-hand account by two men who lived during the mid-century polio scare in the US. Absolutely worth the read.

Each summer, polio would come like The Plague. Beaches and pools would close — because of the fear that the poliovirus was waterborne. Children were kept away from crowds, so they often were banned from movie theaters, bowling alleys, and the like. 

David M. Oshinsky, author
Polio: An American Story

In 1979, the last case of polio caused by wild poliovirus in the United States is reported and in 1994 our country is certified polio-free. Odds are good that our youngest generations have never met a polio survivor.

The hallmarks of the Polio Era were children on crutches and in iron lungs, shuttered swimming pools, theaters warning moviegoers to not sit too close to one another.

Making historical news in our modern times, the CDC announced on August 25, 2020 the the African Region as officially certified wild-poliovirus free.

Last month, people.

I have to admit, this caught me by surprise. It just wasn’t on my radar, this nearly three decade mission to eradicate polio in the African nation and how bad things were there. I mean, we’ve had the vaccine for sixty-five years and continued to modify it to greater efficacy. Doesn’t everyone have access to this modern pharma?

I’m feeling pretty stupid right now. And while we’re over here complaining that wearing a face mask is a political stance and a violation of our civil rights, I imagine we sound like spoiled children.  

Twenty-four years ago, the late South African President, Nelson Mandela, started the campaign to “kick polio out of Africa,” at a time when 75,000 African children were being paralyzed by polio every year.

If you want to go fast, go alone. If you want go far, go together.

African proverb

The challenges were great, with a distrust in western medicine, violence against healthcare workers, migration of nomadic tribes, and healthcare workers traveling to remote and insecure areas of the region.

Over many years and thanks to the dedicated efforts and sacrifices of health workers, community volunteers, traditional and religious leaders, parents, and country leadership with support from donors, all children, even those in the most remote and insecure areas, have been reached with polio vaccine. Today, about 220 million children across the African region are immunized against polio every year. https://www.cdc.gov/polio/why-it-matters/africa-kicks-out-wild-polio.htm

Imagine what it takes to coordinate the healthworkers and resources, and of course the vaccine itself, to immunize 220 million children each year. It feels overwhelming to consider, but thanks to greater minds than mine, it happens.

Despite enormous challenges to reach every child with polio vaccine, a promise made in 1996 by African leaders has been a promise kept. In August 2019, Nigeria, the last wild polio endemic country in Africa, passed three consecutive years without a reported case of wild poliovirus, which opened the door for the official certification process to review data and documents from all 47 countries in the African region.

In the shadow of Africa’s success, it’s important to note there are still two nations with active epidemics of wild polio. Afghanistan and Pakistan are seeing a rise in cases since 2017. In addition to similar challenges seen in Africa, there is also a ban on medical campaigns by the insurgency.

And the work is far from being done in Africa, and actually, never will be. But it sounds like there’s a process of controlled procedures. And the results have provided a jump start for for surveillance and diagnostic efforts against other disease threats, such as Ebola, measles, and COVID-19.

And that’s some wonderful news in today’s global climate.

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