What, then, is the natural history of polio telling us? Beyond the lessons for containing polio outbreaks themselves, we suggest that a single-minded focus on germs – and an unwillingness to explore novel and potentially uncomfortable ideas from outside medical orthodoxy – is an inadequate strategy when it comes to modern diseases.
It’s hard to overstate the impact the polio experience has had on our modern medical culture, starting with the doctors who watched helplessly as its victims fell. J.R. Paul, in his definitive A History of Poliomyelitis, wrote how “the flowering of scientific medicine brought a new point of view, an era of sudden and incredible hope that something might be done after all.”
For a generation of medical professionals born in the heart of this period, the heroic conquest of poliomyelitis was among the most influential narratives that shaped their beliefs about medicine. These beliefs go far beyond science, as Paul suggests. “As the crusade heightened, the world looked on expectantly. … Much as our grandparents had contributed during the nineteenth century to missionary societies, our dimes and dollars went to another ‘religious’ cause, signalized by efforts to stamp out this pestilence and to alleviate the suffering and tragedy it inflicted.”
Paul leaves no doubt as to the hero of this new religious crusade. “[I]n due time, the disease was abruptly scotched by means of vaccination. It was to all intents and purposes finished. The crusade has been described as one of the greatest technical and humanistic triumphs of the age. It was one of those rare achievements which the world greeted as an example of what could be done when science and technology were directed to good use for mankind.”[i]
But the victory over the epidemics of poliomyelitis means our understanding of polio is essentially frozen in amber, circa 1955. Few diseases have been so completely conquered, at least at home, while being so incompletely understood, and that is not a good outcome. In leaving so many important topics on the table – why outbreaks occurred, why the pattern of contagion was so atypical for an infectious disease – scientists allowed some weak ideas to become conventional wisdom and some important ones to be missed.
The prevailing current explanation for the rise of poliomyelitis outbreaks is the “hygiene hypothesis,” which posits that such simple steps as clean underwear, better sanitation and good housekeeping, along with less exposure to germs like polio in early infancy, meant the effects of disease became much worse when children were finally exposed. This is not a satisfactory explanation, and it never has been – the epicenter of the 1916 epidemic was placed in possibly the filthiest place in The Bronx, an Italian immigrant community evocatively called Pigtown. And hygiene certainly doesn’t work very well to explain polio’s persistence among the world’s poorest, where sanitation is bad and public health infrastructure is close to nonexistent. (“One injection stops smallpox, The Times noted in its article of Gates’ polio drive, “but in countries with open sewers, children need 10 polio (vaccine) drops up to 10 times.”)
Yet those ideas have spread and now are used to explain other ailments that are likely also mostly environmental, such as asthma (hygiene hypothesis: because children no longer tumble around in the barnyard with farm animals, they are less likely to be exposed … etc.).
And the connection of other illnesses to pesticides, and environmental toxins in general, has been slow in dawning, though it is now becoming clear that a range of degenerative and neurological diseases are related to such exposures.
“In a new epidemiological study of Central Valley residents who have been diagnosed with Parkinson's disease, researchers found that years of exposure to the combination of … two pesticides increased the risk of Parkinson's by 75 percent,” reports Science Daily.
The Central Valley was also the setting for a study that found “women who live near California farm fields sprayed with organochlorine pesticides may be more likely to give birth to children with autism, according to a study by state health officials,” reported the Los Angeles Times.[ii]
“The rate of autism among the children of 29 women who lived near the fields was extremely high, suggesting that exposure to the insecticides in the womb might have played a role.” The findings echoes those from a 2005 study in Italy “pesticides known as organophosphates could cause neurological changes that lead to autism.”
Recall that the San Joaquin Valley, the Southern Half of the Central Valley of California, was the site of an 1890s outbreak of poliomyelitis, along with nearby San Francisco, Napa Valley, and other agricultural hubs. If mainstream scientists had made this connection between polio and pesticides a century ago – or even after the great epidemics ended in the 1950s – would pesticide use have continued in the same fashion, endangering great-great grandchildren of the first polio generation? Church bells might not have rung for this discovery, but the toll on later generations could have been greatly reduced.
Nor has the polio vaccine, for all of its efficacy, been a risk-free remedy. There were accidents and deaths from the beginning – starting with the Cutter incident in the first weeks of the mass vaccine campaign, in which tainted shots paralyzed dozens of children and killed five. [iii] [iii] There is ongoing debate about whether a cancer-causing monkey virus, SV-40, infected millions of doses of vaccine in the 1960s and may be causing cancers today.[iv] There is the theory that mass vaccine trials in Africa in the 1950s gave rise to the AIDS epidemic – an idea that has been dismissed and derided by the medical industry with the same religious disregard for inconvenient truths as we’ve seen in other man-made epidemics.[v]
And the live virus vaccine now in use in South Asia and Africa indisputably spreads the virus and, in a small percentage of case, causes poliomyelitis. For that reason alone, vaccination may perpetuate polio in the service of eradicating it. The vaccine strain also can and does mutate. (“Polio spreads fast in Nigeria after rare mutation,” reads a 2009 headline.)[vi] The only thing better than ending polio epidemics, in short, would have been not causing them in the first place. The real polio narrative is an American tragedy as much as the triumph of scientific medicine.
Yet triumphalism is an ongoing legacy of The Age of Polio. Merely invoking the word today can shut down debate over public health, especially concerns over any aspect of vaccination policy. Asked during the presidential campaign of 2008 whether he favored vaccination choice, Barack Obama responded: “I believe that it will bring back deadly diseases, like polio."[vii]
In a similar vein, a commenter on our blog who identified herself as Kim asked, “What would you like us to do? Let's stop all immunizations. Guess what will happen? Measles, mumps, rubella, tetanus, polio, influenza will all come back. We will now not only have people scarred from the diseases, but so many people dying. People do not remember when people actually died from these diseases because they have been literally obliterated from the industrial nations.
“I would give just about anything to have a grandmother, but she died from polio when my mother was 17 months old. I have empathy for those with autistic children, but we have gotten so focused on immunizations that we do not look at any other causes. So the next time you hug your child remember my mother who cannot remember any hugs from her mother. Be thankful you have a child to hug.”
In offering our new narrative, we recognize the very real suffering over a very long time. In 1916, the year of the epochal Northeastern epidemic, a New Jersey nurse named Charlotte Talley wrote an article for The American Journal of Nursing with the antiseptic title, “Tracing the Sources and Limiting the Spread of Infantile Paralysis.”[viii] But her descriptions were deeply empathetic:
“’Blease, blease, do something,’ pleaded a Polish mother hysterically, clasping her hands in supplication, her mouth quivering. ‘They took my boy to ‘ospital and see,’ showing the bathtub full of soiled clothing, ‘here are all the clothes from the sickness and no water to wash ‘em. Landlady said she get plumber today. She gets no one.’”
The epidemic turned health workers into bystanders to despair.
“A little girl of nine had died of paralysis after a few days of great suffering. She had been a beautiful, bright, lovable child, the pride of the household,” Talley wrote. Apparently, despite all her parents’ precautions, she had played with a neighbor child with an inapparent infection and may have been exposed to the virus that way.
“Where was God?” asked Talley. “It is difficult to understand how such things are permitted by Providence to occur. Evidently human intelligence is expected to work out this serious problem in order to prevent such disasters.”
The suffering of polio’s victims is honored by learning all of its lessons, including the danger of environmental toxins and the perils of ignoring their role in modern disease; the risk of focusing all of our energy on vaccinations as magic bullets, and the fundamental ethical obligation to search for the truth without fear or favor. Only then can we work out the real nature of illnesses that confront us here and now, ranging from autism to Parkinson’s to the persistence of poliomyelitis itself. Only then can we begin to prevent such disasters as The Age of Polio.
(This is the last in a series, which will be published as one article on Wednesday.)
Dan Olmsted and Mark Blaxill are co-authors of The Age of Autism – Mercury, Medicine, and a Man-made Epidemic, published in paperback in September by Thomas Dunne Books. Olmsted is Editor, and Blaxill is Editor at Large, of ageofautism.com .