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Vaccine memories of another time and place | New York Times | Chicago Tribune.

[DEC 31, 2020 AT 12:04 PM] Emma Goldberg writes:

Lizzo’s “Good As Hell” greeted the arrival of COVID-19 vaccines this month at Boston Medical Center, where the scene of dancing health care workers quickly spread on TikTok. Others shared triumphant selfies of their arms post-injection.

For Americans of a certain generation, the rollout evoked searing memories of an earlier era — one that rescued their childhood from fear and the sudden loss of classmates and siblings.

Lynne Seymour was 8 years old in 1955 when her mother, a nurse, let out a startling noise while listening to the radio at their home in Berkeley, California.

“She started jumping up and down, crying and laughing at the same time,” Seymour said. “It scared me a little because I didn’t know what was happening. So I said, ‘Mom, what is it?’”

Her mother explained that Dr. Jonas Salk, a medical researcher, had developed a vaccine for a dangerous virus. “It meant we wouldn’t have to worry about polio anymore, and children wouldn’t be in iron lungs, and we would go back to the swimming pool,” Seymour said. “It was like a dark cloud had lifted.”

The first polio epidemic in the United States began in Vermont in 1894, an outbreak that killed 18 people and left at least 58 paralyzed. Waves of pernicious outbreaks, targeting children, would mar the next half-century. In the country’s worst single year, 1952, nearly 60,000 children were infected, and more than 3,000 died. Many were paralyzed, notably including Franklin D. Roosevelt, who would become president and hide his disability. Others were consigned to life in an iron lung, a type of ventilator that encased a child’s body to ease breathing.

A litany of other celebrated figures also lived with the disease: songwriter Joni Mitchell, artist Frida Kahlo, Olympic sprinter Wilma Rudolph and Sen. Mitch McConnell of Kentucky.

Parents anxiously wondered how to keep their children safe from the disease, ordering them to stay away from swimming pools and movie theaters. They practiced the hand-washing routines that have become all too familiar to families this year. (It is now understood that the polio virus spread through consumption of water and food contaminated by fecal matter.)

Salk made an ambitious bet that he could develop a vaccine for polio using inactivated virus, which was killed using formalin. When his trial was successful in April 1955, church bells rang and households cheered.

American children had been taught for years to dread summer because it so often brought polio outbreaks. A vaccine promised that they could go out and play again, and swim without as much worry.

Stefan Krieger, 74, remembered his family’s enthusiastic reaction to the news. Just a few years earlier, he caught a cold and had to miss a friend’s birthday party; everyone else who attended, including his best friend, contracted polio.

“Many of us had a classmate whose sister or brother had been stricken,” said Arlene Agus, 71.

Agus’ school in New York City distributed the vaccine in alphabetical order, so she was the first to get the shot, with a lollipop as her reward.

“Over half-a-century later, I can still remember the expressions of relief from the long, winding chain of students standing behind me, grateful that they weren’t in my spot,” she said.

The federal government licensed the vaccine within hours of the announcement, and manufacturers began their production efforts. “An historic victory over a dread disease,” a newscaster’s voice declared in an April 12 reel from Metro-Goldwyn-Mayer. The announcement includes clips of men in suits rolling carts of vaccine shipments, much like this month’s images of coronavirus vaccine shipments. “Here, scientists usher in a new medical age.”

After all of the fanfare, some children remembered getting the vaccine as anti-climactic. Philip McLeod, 77, who was living in Nanton, Alberta, at the time, said he and his classmates were lined up very quickly, and then it was over. “It was hard to believe as a 12-year-old that was going to save your life, because it was so routine,” he said.

But visibly, the creek and the skating rink by his home, long abandoned out of fear — similar to the scenes today at many communal playgrounds and parks — once again filled with the sounds of children playing.

[See source article for image gallery.]

Among the first children in the country to receive the vaccine were Salk’s three sons. Peter Salk, the oldest, recalled their father gathering them near the kitchen table and instructing them to roll up their sleeves and expose their triceps. Then Salk moved from the stove, where he had sterilized needles and syringes, and injected his sons.

“It was an opportunity to demonstrate my father’s confidence in the work he had done,” Peter Salk said. “And to get us kids protected.”

When the shot was later administered in a 1954 field trial at their Pittsburgh elementary school, one of the teachers asked Darrell Salk, who was only 6 at the time, to comfort a crying schoolmate and explain that his father’s vaccine was safe.

“What did I know?” Darrell Salk said. “I was a kid. But I did my best to reassure him it was helping to protect people from a very nasty disease.”

As thousands of children began to receive the vaccine, the doctor’s sons got caught up in the waves of excitement. Five-year-old Jonathan Salk called his best friend to announce the good news: “Billy! I’m famous! And so is my father!”

Still, much like the atmosphere surrounding the debut of this month’s coronavirus vaccines, introduction of the polio immunization was bittersweet for many families who had already lost relatives.

Jean Norville, 72, remembered her older brother Tommy as a “saint,” so gentle-hearted that when she slammed her finger in a car door, he said he wished it were his own instead. Tommy fell sick with polio in October 1951, and his parents drove at speeds exceeding 100 mph to a hospital in Louisville, Kentucky, where he was put in an iron lung. Their mother, refusing to leave Tommy’s side, slept in the hospital bathtub.

He died soon afterward. The neighbors were so afraid of getting polio that Norville’s family held Tommy’s funeral with an empty coffin. When the vaccine arrived, Norville’s mother rushed her children to the health department to get the shot.

“Think of Tommy,” her mother said.

For Catherine Griffice, 79, the cure for polio carries a special legacy. Her father, Frederick Bland, caught the disease in 1948 when he was a third-year medical student. Paralyzed and unable to climb stairs, he was carried out of the house on a chair and taken by ambulance to a hospital, where he died four days later.

Her mother remarried to another doctor, who then vaccinated all of their neighbors in Wittenberg, Wisconsin. “He did it in honor of my dad,” Griffice said.

The initial polio vaccine rollout did not go smoothly. Within a month, six cases of polio had been linked to a vaccine manufactured by Cutter Laboratories in Berkeley, California. It was soon discovered that Cutter had failed to completely kill the virus in some vaccine batches, a mistake that caused more than 200 polio cases and 11 deaths. The surgeon general asked Cutter to issue a recall, and distribution ground to a halt.

Months later, in the summer and fall of 1955, Boston was hit by a polio outbreak, and Ellen Goodman, then 6 years old, became sick. “I remember being in bed, and I felt this electric current going up and down my arms and legs,” she said. “Then I went to move, and my left leg was numb.”

Decades later, Goodman, 71, suffers post-polio syndrome, with symptoms including chronic fatigue and difficulty walking. “My life has been defined by this disease,” she said. “To think it could have been avoided.”

The vaccine program restarted months later, and polio cases fell sharply. Elvis Presley agreed to be vaccinated on national television to build public confidence in the shot. But the disease did not disappear. U.S. case counts rose again beginning in 1958, especially in urban areas. The country’s last case from community spread was recorded in 1979. Although two strains of polio have been eradicated, a third remains and still circulates in Afghanistan and Pakistan.

For those scarred by memories of the polio epidemic, a vaccine against COVID cannot arrive soon enough. Many older Americans, particularly vulnerable to the disease, have been shut in and separated from their children and grandchildren for much of this year.

Norville has not left her home since February and is eagerly waiting for a shot. “My son said, ‘If I could, I would bring you the vaccine today.’”

For the Salk family, the relief is accompanied by a sense of pride, given their father’s role in advancing scientific understanding of immunization. But the sons are also worried about opposition to inoculation against any disease.

“He would have been delighted,” Darrell Salk said of his father. “But he would be horrified by the number of people concerned about using the vaccine. I can see him closing his eyes and shaking his head.”

c.2020 The New York Times Company


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Hesitant to get the COVID-19 vaccine? ‘Think of those you love,’ says woman whose brother contracted polio before its vaccine | Chicago Tribune.

[DEC 31, 2020 AT 1:34 PM]

Barbara Leek, on the left, then 18, with her little brother, Butch, 11, and her younger sister Janice, 16, taken in 1962. Butch contracted the polio virus in 1953. He died three weeks before his 18th birthday.
Barbara Leek, on the left, then 18, with her little brother, Butch, 11, and her younger sister Janice, 16, taken in 1962. Butch contracted the polio virus in 1953. He died three weeks before his 18th birthday. (Provided by Barbara Leek / HANDOUT)

Jerry Davich writes:

Barbara Leek’s younger brother, Butch, was 9 months old when he was diagnosed with polio in the summer of 1953.

“Polio was so terrifying to everyone back then,” recalled Leek, who was 7 at the time. “So many children got polio that summer, during the last polio epidemic in California. Butch was one of them.”

Barbara Leek’s younger brother, Butch, was 9 months old when he was diagnosed with polio in the summer of 1953.
Barbara Leek’s younger brother, Butch, was 9 months old when he was diagnosed with polio in the summer of 1953. (Provided by Barbara Leek / HANDOUT)

Leek remembers visiting a large medical building with her family so doctors could examine Butch. She and her younger sister waited alone in the massive lobby with high ceilings and low hopes for their brother’s fate.

“Our mother came to get us so we could say goodbye to Butch. He had to be admitted to the hospital,” Leek said. “We walked to the area where he was held, but doctors would not let us see him because polio was so contagious.”

One of Butch’s doctors told the family they needed to be quarantined. Another doctor said they did not. It was an uncertain time in our country, plagued with mysteries about a potentially dangerous virus that lurked around every corner.

“We went home, and the rest of my memories of that summer are playing with only my sister,” Leek said. “Janice and I spent the summer reading comics in the open trunk of my mother’s car. No one could play with us because of the fear of polio.”

Their family never figured out how Butch contracted polio, a contagious virus that could be spread through contact with an infected person or transmitted by contaminated food or water. The incurable virus — which is now easily preventable with a vaccine — could cause paralysis and other serious health complications.

“Butch was just beginning to pull himself up to stand when he got polio,” said Leek, whose family moved from California to Oklahoma when she was a girl.

Butch remained in the hospital past his first birthday. His sisters were showed a photo of him in his large metal hospital crib. He was very thin and pale. When he finally was allowed to return home, his left leg was already visibly different. His mother wrapped hot towels around his limp legs.

“The paralysis had taken his ability to stand, much less walk,” Leek said.

Like so many other “polio kids,” Barbara Leek's younger brother, Butch, walked with large metal braces or wooden crutches. A wheelchair became part of his daily life, as did physical therapies and limited bodily abilities.
Like so many other “polio kids,” Barbara Leek's younger brother, Butch, walked with large metal braces or wooden crutches. A wheelchair became part of his daily life, as did physical therapies and limited bodily abilities. (Provided by Barbara Leek / HANDOUT)

Butch eventually lost use of his legs. Like so many other “polio kids,” he walked with large metal braces or wooden crutches. A wheelchair became part of his daily life, as did physical therapies and limited bodily abilities.

“But Butch was an active child, full of personality. He never lost his sense of humor,” Leek said.

Butch enjoyed watching his favorite Three Stooges on television, as well as two hilarious comedians named Abbott and Costello. Butch, who was whip smart, also escaped his physical fate by reading Marvel Comics, once even talking on the phone with legendary comic book creator, Stan Lee.

The boy, inflicted with a cruel destiny, marveled at the everyday abilities of those superheroes. His own body continued to be slayed by complications from the polio virus. At 11, he was diagnosed with a terminal kidney condition. His health gradually deteriorated into his adolescence. He wouldn’t live to be an adult.

In the early 20th century, polio treatments were limited to pain-relief medications, physical therapies and at-home quarantines. Or use of the infamous “iron lung,” a metal coffin-like chamber that aided respiration. It held the same horrifying imagery as ventilators do today with hospitalized COVID-19 patients.

“They were frightening,” Leek said.

In March 1953, just a few months before Butch got polio, a medical researcher named Dr. Jonas Salk announced on a national radio network that he had successfully tested a vaccine against polio. He also published a scholarly paper later that month. Salk almost instantly became a national celebrity. Parents everywhere knew his name and the hope of his vaccine.

“I remember getting the Salk vaccine shots when they were first available. Janice and I were on a priority list because our brother had had polio,” Leek recalled.

In 1954, clinical trials using the Salk vaccine and a placebo began on nearly two million American schoolchildren, according to History.com. In 1955, it was announced that the vaccine was safe and effective. A nationwide inoculation campaign began. In 1962, an oral vaccine developed by Polish-American researcher Albert Sabin became widely available.

“We were also part of the Sabin oral polio vaccine,” Leek said. “We were children so, of course, our parents gave consent for the vaccines. I am grateful that they did.”

Butch wasn’t as fortunate as his older sisters. He died of three weeks before his 18th birthday, officially from kidney disease. His family always believed he died from the ravages of the poliovirus. It didn’t matter if it would labeled as “complications from” or not, similar to so many deaths from COVID-19.

“He was the personality of our family. We miss him dearly, even 50 years later,” said Leek, who’s 76 and lives in Gary.

Barbara Leek, 76, a lifelong educator who came to Gary in 1969, urges people to “follow the guidelines of science,” as her parents did when she was a girl living in an uncertain time in our infected country. (Provided by Barbara Leek / HANDOUT)

Barbara Leek, 76, a lifelong educator who came to Gary in 1969, urges people to "follow the guidelines of science," as her parents did when she was a girl living in an uncertain time in our infected country. (Provided by Barbara Leek / HANDOUT)

“At this stage of my life, I find myself again confronted with the issue of vaccines,” she said. “I am eager to get the COVID-19 vaccine. I want to sign up to be placed on a list.”

Her younger sister became ill in late March and had to be hospitalized. She continues to suffer symptoms from this new coronavirus, Leek said.

“They call patients like her long haulers because COVID symptoms continue long after the acute stage of the illness,” she said.

Barbara Leek's younger brother, Butch, died three weeks before his 18th birthday. His family always believed he died from the ravages of the poliovirus. (Provided by Barbara Leek / HANDOUT)

Barbara Leek's younger brother, Butch, died three weeks before his 18th birthday. His family always believed he died from the ravages of the poliovirus. (Provided by Barbara Leek / HANDOUT)

Butch may have been a “long hauler” from the aftereffects of the polio virus, she believes.

“I have lived through the pain of having a family member’s life tragically changed by an epidemic. While many survived polio, their disabilities have been lifelong. Many did not survive. Some, like Butch, died later, of apparent complications from polio,” Leek said.


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Vaccination in the Philippines: experiences from history and lessons for the future | Human Vaccines & Immunotherapeutics.

[Pay to View Full Text] [Received 30 Sep 2020, Accepted 19 Oct 2020, Published online: 24 Dec 2020]

Abstract.

In anticipation of a potential vaccine for COVID-19, vaccine uptake may be critical in overcoming the pandemic, especially in countries like the Philippines, which has among the highest rates of infection in the region. Looking at the progress of vaccination in the country – its promises, pitfalls, and challenges – may provide insight for public health professionals and the public. The history of vaccination in the Philippines is marked by strong achievements, such as the establishment and growth of a national programme for immunization, and importantly, the eradication of poliomyelitis and maternal and neonatal tetanus. It is also marred by critical challenges which provide a springboard for improvement across all sectors – vaccine stock-outs, strong opposition from certain advocacy groups, and the widely publicized Dengvaxia controversy. Moving forward, with recent surveys having shown that vaccine confidence has begun to improve, these experiences may inform the approaches taken to address vaccine uptake. These lessons from the past highlight the importance of a strong partnership between health leaders and the local community, bearing in mind cultural appropriateness and humility; the engagement of multidisciplinary stakeholders; and the importance of foresight in preparing public health infrastructure for the arrival of a COVID-19 vaccine.


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Acute flaccid myelitis: cause, diagnosis, and management | The Lancet.

[This article is available free of charge. Simply login to access the full article, or register for free if you do not yet have a username and password] [Published: December 21, 2020]

Summary.

Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. Following the acute phase of AFM, patients typically have substantial residual disability and unique long-term rehabilitation needs. In this Review we describe the epidemiology, clinical features, course, and outcomes of AFM to help to guide diagnosis, management, and rehabilitation. Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host–virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.


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Vaccination coverage rates for Diphtheria, Tetanus, Poliomyelitis and Pertussis booster vaccination in France between 2013 and 2017: Learnings from an analysis of National Health System Real-World Data | Vaccine.

[Open Access] [Received 24 March 2020, Revised 9 November 2020, Accepted 7 December 2020, Available online 21 December 2020]

Highlights.

* Boosters vaccination coverage rates are insufficient, far below the target of 95%.

* The right vaccine is not always used, and vaccinations are often delayed.

* New vaccination recommendations require several years to be implemented.

Abstract.

Background.

Maintaining a high vaccination coverage rate (VCR) throughout the lifetime and complying with the National Immunization Program are essential to optimize the protection of the population. The study objectives were to evaluate the evolution of the VCRs and the compliance with the vaccination visits for the diphtheria, tetanus, poliomyelitis and pertussis boosters in France since the changes implemented in the 2013 National Immunization Program.

Methods.

Cumulative booster VCRs were estimated at all vaccination visits, from 2013 to 2017, among persons eligible for a booster vaccination from a 1/97th random sample of French claims data. Broader age groups around the recommended ages by the vaccination schedule (6, 11–13, 25, 45, 65, 75, 85, 95y) were used: all persons aged 5 to 8, 10 to 15, 21 to 29, 41 to 49, 61 to 69, 71 to 79, 81 to 89 and 91 to 99.

Results.

Over the study period, the diphtheria-tetanus-poliomyelitis booster VCRs increased, reaching in 2017: 73.3% at 8 years old, 75.6% at 15 years old, 46.6% at 29 years old, 38.4% at 49 years old, 36.3% at 69 years old, 30.8% at 79 years old, 22.1% at 89 years old and 11.0% at 99 years old. The pertussis VCRs were also increasing at all vaccination visits, in particular at the vaccination visits at 6 and 11–13 years old (from 16.4% to 63.8% and from 50.3% to 61.2%, respectively). Delayed vaccinations were observed at all vaccination visits.

Conclusion.

VCRs for Diphtheria, Tetanus, Poliomyelitis and Pertussis booster vaccination increased from 2013 to 2017 while remaining suboptimal across all ages and lower in the adult populations. The analysis also shows that the introduction in 2013 of a pertussis vaccination at 6 years of age was relatively well-established in 2017 while other changes in recommendations were slowly or partially implemented.


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