All news outlets are abuzz with the news of the Ebola virus. Fall is flu shot season, back to school vaccine time, a pharma scheduled opportunity to put disease talk at every American dinner table. Below is the seven part series Dan Olmsted and Mark Blaxill wrote on Polio - which continues to evoke panic and a larger than life (or death) response among many. As Dan wrote in his "perch" on AofA, "Are you thinking what I'm thinking? CDC/NIH leave smallpox vials laying around, expose workers to anthrax, freak out about the flu in China, then import Ebola via Americans who tragically came down with it. Something wrong with this picture. -0-..."
Managing Editor's Note: Below is the 7 part series in full for you to share, FB, Tweet. Thank you.)
By Dan Olmsted and Mark Blaxill
1. The Wrong Narrative.
Polio is the iconic epidemic, its conquest one of medicine’s heroic dramas. The narrative is by now familiar: Random, inexplicable outbreaks paralyzed and killed thousands of infants and children and struck raw terror into 20th century parents, triggering a worldwide race to identify the virus and develop a vaccine. Success ushered in the triumphant era of mass vaccination. Now polio’s last hideouts amid the poorest of the poor in Asia and Africa are under relentless siege by, among others, the Bill & Melinda Gates Foundation. Eradication is just a matter of time, and many more illnesses will soon meet the same fate.
But based on our research over the past two years, we believe this narrative is wrong – and wrong for reasons that go beyond mere historical interest. The misunderstanding of polio has warped the public health response to modern illnesses in ways that actually make them harder to prevent, control, and treat.
The reality, we believe, is that the virus itself was just half the epidemic equation -- necessary but not sufficient to create The Age of Polio. Outbreaks were not caused solely by poliovirus – the microbe was an ancient and heretofore harmless intestinal bug -- but by its interaction with a new toxin, most often innovative pesticides used to treat fruits and vegetables.
This alternative narrative makes better sense of the natural history of polio, and it resolves a number of anomalies that remain to this day. It suggests why poliomyelitis outbreaks emerged, evolved, and exploded the way they did; it probably solves, for the first time, the enduring riddle of why Franklin D. Roosevelt was afflicted 90 years ago this summer on Campobello Island; and it may mean today’s billion-dollar-a-year eradication effort is misguided, if not downright quixotic.
These are large claims. Let us explain.
Polio was a strange illness, never fully understood even by those who devoted their lives to studying and subduing it. It was a summer plague, coming on in late spring and all but vanishing in the fall. Many thought contagion had something to do with water, and Americans kept their children away from swimming pools in droves.
There is a profound distinction between poliovirus – an enterovirus, one that enters through the mouth and takes up residence in the GI tract and bloodstream – and poliomyelitis, the paralytic form of the illness. In the vast majority of cases, the virus causes either a minor illness or an inapparent infection.
But in 1 or 2 in 100 cases, the virus somehow gets past multiple defenses and into the nervous system, where it finds its way to the anterior horn cells at the top front of the spinal column. There, it preferentially attacks the gray-colored motor neurons (polio means gray in Greek) and causes inflammation of the protective myelin sheath (myelitis). This interferes with nerve signals to the muscles and can lead to temporary or permanent paralysis of the limbs and the respiratory system. A small number of people who contract poliomyelitis -- on the order of 1 percent -- die.
The first recorded U.S. outbreak was in 1841 in West Feliciana, Louisiana (10 cases, no deaths). There was a half-century gap until the next cluster, in 1893 in Boston (26 cases, no deaths). Then, in 1894, came what is widely regarded as the first major epidemic, in Rutland and Proctor, Vermont (132 cases, 18 deaths). Thirty more outbreaks – from such seemingly disparate locations as Oceana County, Michigan, and California’s Napa Valley -- were reported in the United States through 1909. The worst by far was New York in 1907, with 2,500 cases and a five percent mortality rate, a harbinger of the 1916 epidemic in the Northeast that killed 2,000 in New York City alone.[i]
What is most remarkable about this list is that so few outbreaks of paralytic polio were recorded anywhere in the world before the latter 19th century. Poliomyelitis is considered an ancient scourge, but the evidence supporting that belief is quite threadbare. An oft-cited Egyptian drawing depicts a priest with a withered leg that could have stemmed from paralytic polio, but for most of recorded history there were few observations of the sudden-onset fever and paralysis in infants that characterizes the disease. The earliest well-documented case of infantile paralysis in an individual is widely considered to be Sir Walter Scott, afflicted as an infant in 1773.[ii]
There is little question that the poliovirus was endemic in humans for millennia; there may even have been isolated cases of poliomyelitis for much of that period. Yet the poliovirus did not trigger widespread outbreaks of poliomyelitis. Setting aside for now the 1841 Louisiana outbreak, reported retrospectively, something seems to have happened around 1890 to launch The Age of Polio in the United States. And something else must have changed around the end of World War II to create the large modern epidemics seared into the minds of older Americans, thousands of whom are poliomyelitis survivors and almost all of whom know someone who was afflicted.
While we have not written about polio, we have seen this pattern before. In our book, The Age of Autism – Mercury, Medicine, and a Man-made Epidemic, we argued that something happened in the 1930s to launch The Age of Autism.[iii] We proposed it was the commercialization of ethyl mercury compounds for use in pesticides – seed disinfectants and lumber preservatives – and in vaccinations; we offered evidence of those inventions in the family backgrounds of the first autism cases identified in the medical literature, in 1943. Similarly, we proposed that the sharp rise in autism cases beginning around 1990 tracks with the federal government recommending several more mercury-containing shots.