Toward a Virus-Free Polio Vaccine

Researchers are developing polio vaccines based on the viral capsid alone. When produced in recombinant systems, these could eliminate the need to propagate live poliovirus for vaccine production. 
By  | January 19, 2017

Polio is nearly eradicated. But vaccine campaigns will continue in case, for example, some remaining infections go undetected. With the current technology, the need to continue vaccinations poses a challenge to a poliovirus-free world because “the only way you can make [vaccines] at the moment is using a live virus,” virologist Andrew Macadam at the U.K.’s National Institute for Biological Standards and Control, told The Scientist. The oral polio vaccine (OPV) contains live, attenuated virus; the inactivated polio vaccine (IPV) is made by growing, then killing, virulent virus. Both of these vaccines could cause outbreaks, through reversion of OPV to a virulent form or through leakage of live virus from an IPV production plant, Macadam explained.
To circumvent these problems, Macadam and colleagues are working to develop new vaccines that contain no virus at all. These consist of empty viral capsids, the viruses’ protein coats, called virus-like particles (VLPs). In a study published today (January 19) in PLOS Pathogens, the team reported having created capsid-based vaccines that are stable and, in rodent experiments, worked as well as IPVs in protecting against polio.
The study “opens up the possibility of not having to use virus to produce a virus-like particle which is noninfectious” said Olen Kew, the national poliovirus containment coordinator at the US Centers for Disease Control and Prevention, who was not involved in the research. “The facilities which handle by far the largest amounts of poliovirus are the vaccine producers,” Kew told The Scientist, “so if you can produce a vaccine without handling any virus at all, then that risk is eliminated.”

See “Toward Eliminating Poliovirus—In the Lab

VLPs, which are already used in hepatitis B and human papilloma virus (HPV) vaccines, represent a potential solution. However, previous research indicated that poliovirus capsids were too unstable and temperature-sensitive to work as vaccines.
Using a combination of selection experiments and previous knowledge of stabilizing mutations, Macadam’s team identified mutations that render the viral capsids stable at higher temperatures. They then introduced these mutations into the poliovirus strains currently used to make IPVs, grew the viruses in cultured cells, and purified away the empty capsids. In addition to infectious particles, polioviruses produce empty shells during their life cycles.
To test efficacy, the team vaccinated mice transgenic for the human poliovirus receptor with VLPs they had created, then challenged the rodents with poliovirus. The mice vaccinated with VLPs had higher levels of neutralizing antibodies (which kill the virus) than those vaccinated with IPV, and all of the VLP-vaccinated animals survived the challenge.
Macadam led this study in collaboration with a multi-institutional consortium, funded by the World Health Organization (WHO), to develop VLPs. While the VLPs used in these experiments were produced using live poliovirus, Macadam’s collaborators are working to produce VLPs in recombinant systems, which would remove live poliovirus from the production process altogether. “There’s been very good progress already. We have VLPs that have been made in mammalian systems and in plant systems and have made some very good progress in the insect and yeast cells,” said Macadam.
The WHO’s Roland Sutter said he believes that VLPs could replace current polio vaccines, but there’s much work to be done. If successful, these could “make the world a much safer place,” he said.
H. Fox et al., “Genetically thermo-stabilised, immunogenic poliovirus empty capsids; a strategy for nonreplicating vaccines,” PLOS Pathogensdoi:10.1371/journal.ppat.1006117, 2017.
Post Polio Litaff, Association A.C _APPLAC Mexico
The polio vaccines developed in the 1950s by Jonas Salk and Albert Sabin allegedly eradicated one of the most feared diseases of the 20th century. The media hailed the success of these vaccines as a modern day miracle. However, the polio story has a much darker side that has mostly been kept a secret.
Both Sabin’s live virus vaccine given orally and Salk’s inactivated virus vaccine given by injection were far from perfect. In fact, in 1955 the vaccine used in Berkley, California infected some 200 children, leaving several dead and many paralyzed. Yet this incident proved minor compared to what was later discovered.
In order to grow large quantities of the poliovirus, scientists needed to use Rhesus monkey kidney cells, which carried many different viruses. As a result, their polio vaccine became contaminated with a cancer-causing virus carried by these monkeys. This vaccine was given to almost 100 million people.
The virus found in this particular polio vaccine was SV40, or simian virus. It is present in human tumors, and research has established it to be a contributing factor in the rise of many types of cancer, including mesothelioma, bone, and brain cancer.
When the government became aware of this, it was downplayed for fear the public would stop accepting vaccination.
TTAC - Polio Vaccine

Can the US Centers for Disease Control (CDC) Be Trusted?

At one point, the US Centers for Disease Control (CDC) admitted on its website that the polio vaccine had been contaminated. They later removed this information. (View a snapshot of this removed page at the link below.)
The original report disclosed that more than 98 million Americans received the contaminated vaccine between 1955 and 1963, and explained that SV40 could lead to certain types of cancer. Later this admission was downplayed to state that there was no proof the virus caused the cancers, and since not all doses of the vaccine were contaminated, an estimated 10 to 30 million Americans were all who were at risk.
The CDC repeatedly referred to studies done by two scientists which concluded that SV40 did not cause cancer in humans, only in lab animals.

Contaminated Vaccine Knowingly Dispensed to the Public

In 1959, Dr. Bernice Eddy of the National Institutes of Health discovered that the monkey kidney cells used to grow the poliovirus caused cancerous tumors when injected into hamsters. After reporting these findings, Eddy was excused from her job and assigned a new position. Not long after, the pharmaceutical company Merck made the same discovery.
In 1960, Merck scientists Dr. Maurice Hilleman and Dr. Benjamin Sweet (the Merck scientists who named the SV40 virus), published findings concluding that the polio vaccine was indeed contaminated with the SV40 virus. Hilleman later admitted (back then on tape) that Merck knew the vaccines were contaminated and continued to dispense them to the public anyway.
Subsequent in vitro studies in the 1960s demonstrated that SV40 caused brain tumors in animals and transformed normal human tissue into cancerous tissue. It was obvious that governing authorities wanted to keep this information under wraps, and so the SV40 scandal disappeared from the public eye for years.

An Old Scandal Rears Its Ugly Head

In the 1990s, a young Italian pathologist named Dr. Michelle Carbone discovered a link between mesothelioma and certain brain, bone, and lymphatic cancers, and the SV40 virus. He tested lung tissue from cancer patients, which revealed the presence of the SV40 virus, and every single oneof the hamsters tested with the virus developed mesothelioma and died within seven months.
Carbone published his findings in 1994 in a leading cancer research journal. For the first time, hard evidence showed (and was made public) that the SV40 could cause cancer in humans, and the long forgotten scandal of the 1960s awakened from its slumber.
In 1996, in an attempt to refute Carbone’s research, Dr. Howard Strickler and Dr. Keerti Shah responded with reports saying they could not detect SV40 in human tumors. Interestingly, Merck and Pfizer were paying Shah at the time for consulting, specifically on SV40. Strickler and Shah also both performed their research in pharmaceutical sponsored laboratories.
Later, in 2003, Shah testified before Congress that Strickler compromised a study by interfering with its controls. Strickler had conflicts of interest as he was a consultant/advisory board member for Merck and GlaxoSmithKline.

Supposed Regulations Do Not Solve the Problem

After numerous studies showing SV40 was cancer causing, weak regulations were put into place. Shockingly, the Division of Biologics Standards (DBS) of the National Institutes of Health (NIH) did not order a recall of any of the contaminated polio vaccines. They continued to distribute contaminated vaccines to an unsuspecting public until 1963. Finally, new federal regulations were put in place that required vaccines to be tested for SV40.
These new regulations required a waiting period of 14 days to see if the virus was growing before making the vaccine. However, it was later discovered that a slower growing form of the virus, which took 19 days to appear, could have been in the approved vaccines. Therefore, millions more people potentially received contaminated vaccine all the way through the 1990s because of these inadequate testing guidelines.
Cancer has risen exponentially since the 1960s, and by 2002 there were 61 reports from 49 different laboratories across the world suggesting an increased incidence of certain cancers caused by SV40.  The British journal The Lancet revealed SV40 was responsible for over 25,000 cases of non-Hodgkin’s lymphoma each year. By 2003, 60 more labs had been identified which demonstrated a connection to the SV40 virus and cancer.
Dr. Randy Tent, DC, ND, PhD, a highly renowned alternative doctor, reported at a health conference in 2013 that “one out of 200 people will have cancer directly caused by SV40.”

Even Though Some Things Never Change, YOU Can

The response of the CDC to the SV40 scandal mimics their current denial of the autism-vaccine link. It appears the CDC selectively chooses which science they would like to follow when it comes to their covert vaccine agenda. Most often their “science” of choice comes from pharmaceutical sponsored laboratories, despite the presence of unbiased research proving that many vaccines are not safe.
Most people have received several doses of the polio vaccine throughout their life. With cancer affecting so many, and vaccines distributed so widespread, one must consider vaccines as a contributing factor, especially since they contain known carcinogens and cancer-causing viruses.
Regular cancer prevention needs to include detoxification from heavy metals and other carcinogens. When it comes to vaccines, do your own research. Read all vaccine package inserts and don’t just blindly trust doctors (who have to follow FDA rules) and government agencies such as the CDC whose track record is suspect when it comes to protecting the public.
Could there be a polio vaccine cancer connection?  Do you trust the CDC? What are your thoughts and please share this important article with your friends and family.
Post Polio Litaff, Association A.C _APPLAC Mexico

Paralysis Haunts ‘Polio Free’ India






India has a surge of children with paralysis. The causes are not hard to identify: the oral polio vaccine and redefinition of polio-induced paralysis to “acute flaccid paralysis”. The result of this fiasco is a plan to give non-live polio vaccines—and it comes at huge cost, negating the reason for using the oral vaccine.
Polio, often thought of as synonymous with paralysis and disability, has been given a new name in India. It is now known as AFP or acute flaccid paralysis. This and the fact that cases of polio caused by the oral polio vaccine (OPV) are not being reflected as polio have ensured that India is into its second year of “polio free” status. After this charade is maintained for one more year, India will be certified by the WHO as “polio free” and will be showcased as a success story of the Global Polio Eradication Initiative that was launched in 1988 by the World Health Assembly.
Smallpox was declared eradicated in 1980. According to medical researcher Professor William Muraskin, the experts involved in this exercise were looking for another opportunity to flaunt their skills. When they chose polio many eyebrows were raised. Polio was not on the priority radar of the countries where this exercise was to be launched. These developing nations were struggling to provide basic health needs. India, for example, is incapable of providing clean water, sanitation, hygiene, and nutrition for a majority of its population even 65 years after Independence. [Please see HEEALS for an on-the-ground organization in India dealing with this issue. –Editor]
Furthermore OPV was chosen to be the only weapon to eradicate polio. Dr T Jacob John pointed out that this vaccine, consisting of live viruses, is notorious for causing vaccine induced polio. Because those vaccinated tend to shed the virus in their stool, it can mutate into a virulent form, causing paralytic polio in others, even leading to polio epidemics.
Dr. Anant Phadke and C. Sathyamala argued that it is not possible to eradicate polio, a disease primarily of poor sanitation and nutrition, with a vaccine. Polio-like paralysis can also be caused caused by other factors. DDT and other pesticides, exposure to lead and arsenic, and vaccinations can trigger paralysis. Thus a holistic approach was needed to tackle the disease.
Medical textbooks reveal that exposure to polio viruses rarely results in paralysis. More than 95% of those exposed will show no symptoms at all. Of the rest, many will exhibit symptoms resembling a common cold, a few will suffer temporary lameness, and fewer than 1% will exhibit permanent paralysis. Exposure to the polio virus is actually the best immunity against viral polio. It offers permanent immunity to more than 99% exposed to it. According to Dr Yash Paul, those who become permanently paralyzed may have some inherent susceptibility that should be investigated.
Dr. Phadke pointed out that smallpox and polio eradication are two entirely different things. Polio viruses can infect children without causing any external symptoms and thus remain in circulation. He alleged that it was for the benefit of the developed nations, who could stop their vaccination programs once the wild polio virus was eradicated worldwide, and for the manufacturers, who were promoting the program because the OPV was discontinued in the developed countries due to its risks, that the polio eradication strategy was launched. This eradication effort, costing over 1.2 billion rupees, has broken the back of the Indian health system.
The National Polio Surveillance Project data show that the polio eradication program has increased paralysis among children—from 3,047 cases yearly in 1997 to 61,038 cases in 2012, most now being classified as AFP instead of polio. The Government does not reveal how many of these cases are due to the vaccine. It was observed in 2005 that, against 66 cases of polio caused by the wild polio virus that year, 1,645 were caused by the vaccine. Data reveals that those vaccinated are 6.26 times more likely to be paralyzed.
Many mutated virus strains are running loose in India. In Japan, after three months of use, 16 extremely virulent strains of the vaccine viruses and 78 strains in total were found in sewage and in its rivers. India has been using the vaccine since 1978, intensively since 1997, and one cannot even imagine how many virulent strains could be circulating in this country that is devoid of basic sewerage disposal and sanitation facilities.
Why are more than 60,000 children in India becoming paralyzed every year? Dr Neetu Vashisht has analyzed that the cases of AFP in India are directly proportionate to the number of doses of OPV given, implying a relationship. Taking into consideration the normal AFP rate, it has been deduced that in 2011, India has suffered 47,500 extra cases of paralysis. Studies have shown that death rates in children with AFP are twice as high as the death rate among children with polio paralysis.In Brazil, a study has implicated this vaccine in cases of Guillain Barré Syndrome, transverse myelitis, and facial palsy. Thus the claim of the Government that these cases of paralysis have no relation to the vaccine merits extensive investigation.
In April 2004 a memorandum was submitted to the WHO, UNICEF and the Government of India by Prof. Debabar Bannerjee and other eminent doctors pointing out that the WHO inflated 32,419 cases of polio to 350,000 to justify the program. The definition of polio has been changed repeatedly since the program was launched, thus automatically leading to a drastic fall in the number of cases. A significant number of children declared polio-affected by the polio virus were sufficiently vaccinated, and that children were being rendered paralytic directly due to the vaccine.
The memorandum also pointed out that polio eradication was not possible in India, as the vaccine viruses had mutated into virulent strains and were circulating. In August 2006, the Indian Medical Association reiterated the above and called for identifying the unfortunate victims and compensating them.
Today, throwing all caution to the wind, children are being given an unprecedented 50 doses of the vaccine and even those who should be medically exempt are being vaccinated. Dr Puliyel reveals that a synthetic version of the polio virus with a formula called ‘CHNOPS’ makes a mockery of the eradication effort.
Dr Pushpa Bhargava points out that polio was already on the decline even before the eradication effort began. Polio in India was concentrated in a few pockets of Uttar Pradesh and Bihar, which accounted for 96% of the cases reported. Improving sanitation and nutrition in these areas, along with routine rounds of the relatively safer inactivated polio vaccine (IPV), would have drastically reduced polio without taking resorting to the chicanery that has resulted in an unprecedented toll of disability in children in all parts of the country.
Hidden in the packet inserts of the OPV is an ominous statement saying that the vaccine has not been tested for causing cancer or infertility. The presence of untested monkey viruses, and phenol and polysorbate 80, both of which are endocrine disruptors, in the vaccine raises concerns. It is also known that the vaccine virus strains can lie latent in the body and cause polio decades after administration.
India is now preparing to launch the much costlier IPV all over the country, which will require money and trained manpower at a scale that it currently does not have, to counter the vaccine viruses in circulation. The wild polio viruses, which actually conferred immunity to children, are now no longer widely prevalent, leaving future children exposed to unexpected epidemics. The so called benefits of polio eradication have eluded this indebted country and its children face an uncertain future. It is important that lessons from this misadventure be learnt to oppose future assaults on the children of our country.
Editor’s Note: One must also ask how much these expenditures in vaccination have taken from true life and health preserving practices, such as bringing clean water and sanitation to people.

Polio Wasn’t Vanquished, It Was Redefined



OPINION
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by Marco Cáceres 

The Salk vaccine has been widely hailed as the vanquisher of polio, and it is commonly used as the shining example of how vaccines are the miracle drugs for combating infectious diseases… and now even against diseases that are not infectious. Pick any disease, illness or disorder you want. You got cancer, cholera, peanut allergies, stress, obesity… we’ll develop a vaccine for it.
What the apologists for the Salk vaccine regurgitate from a common script (… some might say scripture) is that before the vaccine was introduced and tested on one million children—the so-called “Polio Pioneers”—in 19542 more than 50,000 people in the U.S. were contracting polio each year, and that by the end of the 1950s the numbers were down to less than 10,000.3 Ergo, the Salk vaccine saved the U.S. from polio. Open and shut case.
Hmm, not so fast.
What is conveniently omitted from this heroic story is that the reason the number of polio cases in the U.S. dropped so precipitously following the mass introduction of the Salk vaccine in 1955 was not medical, but rather administrative. Yes it’s true, in 1952 there were 52,879 reported cases of polio in the U.S. And yes, in 1955 the number went down to 28,985, and by 1959 it had dropped to 8,425.3 But first of all, it’s important to note that the numbers were already declining significantly prior to the initial use of the Salk vaccine. In 1953, there were 35,592 cases of polio in the U.S.3 So there were otherthings going on in the U.S. at the time totally unrelated to the Salk vaccine.
More importantly, though, in 1954 the U.S. government simply redefined polio. Yes, the government can do that. It does this kind of stuff occasionally in order to help it meet its public policy objectives when it is unable to actually achieve them. How often have you heard of Congress playing smoke and mirrors, gimmicks with the national budget deficit, or on the issue of the unemployment rate? Exactly.
When it comes to government and public policy, the truth is seldom absolute. That’s just the nature of the beast.
According to Dr. Bernard Greenberg, head of the Department of Biostatistics of the University of North Carolina School of Public Health:
In order to qualify for classification as paralytic poliomyelitis, the patient had to exhibit paralytic symptoms for at least 60 days after the onset of the disease. Prior to 1954, the patient had to exhibit paralytic symptoms for only 24 hours. Laboratory confirmation and the presence of residual paralysis were not required. After 1954, residual paralysis was determined 10 to 20 days and again 50 to 70 days after the onset of the disease. This change in definition meant that in 1955 we started reporting a new disease, namely, paralytic poliomyelitis with a longer lasting paralysis.1

Post Polio Litaff, Association A.C _APPLAC Mexico

How the DOT Will Make Planes More Accessible for People With Disabilities



Getty
Airlines will likely be required to expand their lavatory size to be more accessible for passengers in wheelchairs over the next three years. 
A long-standing argument over bathroom size and entertainment options finally found resolution. 


We all know airplanes aren’t the best places to stretch or move around with ease. For passengers who use wheelchairs, though, it can be a nightmare. More and more stories have come out recently about the unfair and uncomfortable setup on planes for those with special and medical accessibility needs, and the U.S. Department of Transportation just announced they’re finally doing something about it.
From 
While airlines have complied with the regulations set out by the Americans with Disabilities Act (ADA) of 1990, previously unconsidered issues like inadequate bathroom size have been brought to light thanks to social media. Now, the DOT’s ACCESS Advisory Committee—which includes airline representatives, flight attendants, and people with disabilities—revealed they plan to make bathrooms on single-aisle aircrafts (a.k.a. six-abreast seating in a cabin below 13 feet of width), which account for most domestic and short-haul international flights, more accessible for those in wheelchairs or who need extra assistance on board. 
“The agreement reached by the ACCESS Advisory Committee is an important step towards ensuring that air travelers with disabilities have equal access to air transportation,” said U.S. Transportation Secretary Anthony Foxx in a release. “It is unfair to expect individuals with limited mobility to refrain from using the restroom when they fly on single aisle aircraft, particularly since single aisle aircraft are increasingly used for longer flights.” 
While the committee understands that the current size of the lavatory would not change immediately, they do want to require airlines to “take a number of steps to improve the accessibility of these lavatories short of increasing their size three years after the effective date of the final rule.” Along with better bathroom accessibility, they also want better “maneuverability standards for the aircraft’s on-board wheelchair.” In the future, they want all single-aisle aircrafts with more than 125 passengers to be required to have the more accessible, larger bathroom currently found on twin-aisle aircraft. It was not specified whether or not new planes would have to be built or if current ones would have to be reconstructed and who would take on that cost.
And that’s not the only issue the committee is proposing to tackle. They also want to require airlines to offer entertainment options for people who are blind, deaf, or hard of hearing, as most airlines generally do not provide in-flight entertainment with audio description or closed captioning. “It is also unfair for passengers who are deaf or blind not to be able to enjoy the same entertainment that is available to other passengers,” the committee added in the release. It's unclear how this would effect in-flight announcements, but current standards state that flight attendants can ask disabled passengers if they need to be notified separately if something is said over the public address speaker.This is a big win for the ACCESS Advisory Committee, as the decision was reached after seven months of negotiations. The committee is preparing to issue a notice of proposed rule-making based on this agreement in July 2017. But, one issue is still outstanding: reaching an agreement on on-board service animals

Post Polio Litaff, Association A.C _APPLAC Mexico

6 key numbers in the fight to end polio




We are close to eradicating a human disease for only the second time in history. A global public-private partnership has reduced the poliovirus caseload by 99.9% over the last 30 years, but there’s still plenty of work to do. 
Even before we reach that milestone, the knowledge and infrastructure built to fight polio is being repurposed to take on other global challenges. 
3 countries where polio is still endemic 
Fewer than 40 children were paralysed by polio in 2016, the lowest number in history. This is a dramatic decrease from the estimated 350,000 cases per year in 125 countries that the world saw in 1985 - the year that Rotary International initiated a worldwide effort to eradicate this terrible disease. 
In 1988, Rotary was joined in the effort by WHO, the U.S. Centers for Disease Control, UNICEF (and more recently the Gates Foundation) to create the Global Polio Eradication Initiative (GPEI). 
Today the virus is limited to a few areas in just three countries – Pakistan, Afghanistan and Nigeria.
Image: Rotary International
In response, Nigeria intensified surveillance activities to pinpoint where the virus is circulating.
In Pakistan, innovative tactics are being used to focus polio immunization drives. Health workers are trained in the use of cellphone data reporting, which allows real-time recording of immunization coverage and public health surveys of populations. 
In Afghanistan, the program continues to adapt in order to reach the maximum number of children possible despite a volatile security situation.
155: the number of countries involved in largest coordinated vaccine switch in history
There are three different strains of the poliovirus. Once a strain is eliminated (type 2 was officially eradicated in September 2015), we have to match our vaccines to the remaining strains to protect children globally. 
This transition is a massive undertaking, requiring significant funding and coordination to accomplish global health feats that have never been attempted.
To give you a sense of scale, the largest and fastest globally coordinated vaccine switch in history (to target poliovirus types 1 and 3) was successfully conducted over two weeks in April 2016, with 155 countries taking part.
Image: Rotary International
$60 billion: the cost of infectious disease epidemics per year
The spread of infectious diseases is consistently among the world’s top 10 risks in terms of impact. The eradication of polio will mean no child will ever be paralyzed by this debilitating disease again. However, we must use the knowledge and infrastructure built up over many years by the GPEI to take on other global health threats.
Dramatic progress on improving children’s health beyond polio is already underway – resulting in a decreasing number of children dying from other preventable diseases in countries with strong polio infrastructure. Polio drops are now often delivered alongside essential services including nutrition support, primary health care and other vaccines.
Image: Rotary International
By identifying the overlap between what the polio programme has to offer and country-level priorities for strengthening health systems, we can make a lasting difference to global health overall, and significantly reduce the gap in the impact of infectious diseases between middle income and poorer countries.
20 million: the number of volunteers participating
Since the GPEI was launched in 1988, Rotary and other volunteers have raised funds, built awareness, and advocated for their national governments to support polio eradication.
Image: Rotary International
A volunteer can administer the two drops of oral polio vaccine to a child, and participate in National Immunization Days, which attempt to vaccinate every child under five years of age in endemic or at-risk countries. Millions of health workers are also helping us reach children who have never before been vaccinated.
$1.5 billion: the amount needed to eradicate polio
This may sound expensive, but, in the words of Dr. Jonas Salk, who invented the first effective polio vaccine, “which is more important, the human value of the dollar, or the dollar value of the human?”
Funding has already contributed to many important successes of our programme. In 2016, Rotary funded the work of 52,676 vaccinators and 2528 supervisors in Iraq to keep up strong immunization coverage. Investments made to polio eradication are also contributing to future health goals by documenting the knowledge, lessons learned and assets of the programme.
Image: Rotary International
Funds also make possible the programme’s extensive surveillance and laboratory network to tell us where polio does (and does not) exist – a painstaking task given only one in 200 cases of polio results in paralysis. This network is already instrumental for taking on public health challenges beyond polio, such as Ebola.
While we undoubtedly still have work to do and funds to raise, we are confident in the good work of our volunteers and members to get us to our goal of eradication. Read and be inspired by their stories and successes here – a world free from polio is certainly within our reach.
4: the factor by which health savings exceed the cost of polio eradication
Immunization as a public health investment is incredibly good value. Every dollar spent on vaccinations in the US saves $3 in direct healthcare costs and $10 societally. A polio-free world will reap financial savings and reduce healthcare costs by up to $50 billion through 2035. In fact, we’ve already saved $27 billion since the GPEI was launched, and low-income countries account for 85% of the savings, not to mention the immeasurable alleviation of human suffering.
Image: Rotary International
Conversely, if we allow polio to spread again, it would cost upwards of $35 billionmore in treatment expenses and economic losses, so it’s a no-brainer that we have to commit all our resources to finish the job once and for all.

Post Polio Litaff, Association A.C _APPLAC Mexico

How to Spot and Prevent Deep Vein Thrombosis



When the Clot Thickens

Illustration of the veins in the lower leg and a close-up of a blood clot lodged in a vein.
Lots of things can cause pain and swelling in your leg. But if your symptoms stem from a blood clot deep in your leg, it can be dangerous. Blood clots can happen to anyone, anytime. But some people are at increased risk. Taking steps to reduce your chances of a blood clot forming in your veins can help you avoid potentially serious problems.
Blood clots can arise anywhere in your body. They develop when blood thickens and clumps together. When a clot forms in a vein deep in the body, it’s called deep vein thrombosis. Deep vein blood clots typically occur in the lower leg or thigh. 
“Deep vein thrombosis has classic symptoms—for example swelling, pain, warmth, and redness on the leg,” says Dr. Andrei Kindzelski, an NIH blood disease expert. “But about 30–40% of cases go unnoticed, since they don’t have typical symptoms.” In fact, some people don’t realize they have a deep vein clot until it causes a more serious condition. 
Deep vein clots—especially those in the thigh—can break off and travel through the bloodstream. If a clot lodges in an artery in the lungs, it can block blood flow and lead to a sometimes-deadly condition called pulmonary embolism. This disorder can damage the lungs and reduce blood oxygen levels, which can harm other organs as well. 
Some people are more at risk for deep vein thrombosis than others. “Usually people who develop deep vein thrombosis have some level of thrombophilia, which means their blood clots more rapidly or easily,” Kindzelski says. Getting a blood clot is usually the first sign of this condition because it’s hard to notice otherwise. In these cases, lifestyle can contribute to a blood clot forming—if you don’t move enough, for example. Your risk is higher if you’ve recently had surgery or broken a bone, if you’re ill and in bed for a long time, or if you’re traveling for a long time (such as during long car or airplane rides). 
Having other diseases or conditions can also raise your chances of a blood clot. These include a stroke, paralysis (an inability to move), chronic heart disease, high blood pressure, surgical procedure, or having been recently treated for cancer. Women who take hormone therapy pills or birth control pills, are pregnant, or within the first 6 weeks after giving birth are also at higher risk. So are those who smoke or who are older than 60. But deep vein thrombosis can happen at any age.
You can take simple steps to lower your chances for a blood clot. Exercise your lower leg muscles if you’re sitting for a long time while traveling. Get out of bed and move around as soon as you’re able after having surgery or being ill. The more active you are, the better your chance of avoiding a blood clot. Take any medicines your doctor prescribes to prevent clots after some types of surgery. 
A prompt diagnosis and proper treatment can help prevent the complications of blood clots. See your doctor immediately if you have any signs or symptoms of deep vein thrombosis or pulmonary embolism (see the Wise Choices box). A physical exam and other tests can help doctors determine whether you’ve got a blood clot. 
There are many ways to treat deep vein thrombosis. Therapies aim to stop the blood clot from getting bigger, prevent the clot from breaking off and moving to your lungs, or reduce your chance of having another blood clot. NIH scientists continue to research new medicines and better treatment options.
If you think you may be at risk for deep vein thrombosis, talk with your doctor.  

Post Polio Litaff, Association A.C _APPLAC Mexico

How the U.S. Battled Polio



| June 22, 2011

Talk to anyone old enough to remember polio epidemics in the U.S., and you will see the fear in their eyes as they talk about those terrible and unsettling times. For decades, no one knew why thousands of children would suddenly be stricken—usually in midsummer—with many dying or left permanently paralyzed.
Today, most of us in the U.S. don’t even think about polio. But if you go to villages in India’s Bihar Province or the northern states of Nigeria, or the southern part of Afghanistan, you will see that very same fear in the eyes of parents who worry that their child might be next.
I’m a dogged advocate for polio eradication and have written about it in many other articles on the Gates Notes. We are very close to ridding the world of this terrible disease once and for all. It will take focus and commitment to get it done, but I am confident we can.
That’s why I’m a fan of David Oshinsky’s insightful book, Polio: An American Story. (I’m not alone here, as it received the Pulitzer Prize for history in 2006.) It is a fascinating account of the search for a vaccine to stop the polio epidemics that swept the U.S. in the first half of the 20th century, and the remarkable efforts that led to its successful eradication from the U.S. and most other countries. Reading Oshinsky’s book a few years ago broadened my appreciation of the challenges associated with global health issues and influenced the decision that Melinda and I made to make polio eradication the top priority of the foundation, as well as my own personal priority.
Oshinsky retraces the steps of researchers trying to puzzle together how to create an effective vaccine. He’s a gifted storyteller who makes complex scientific subjects easy to understand and also captures the mood of a country terrorized by an invisible and little-understood disease. He describes in meticulous but never-boring detail the people and politics associated with one of the most important medical breakthroughs in history. 
I found it interesting that the first recorded polio epidemic in the U.S. didn’t occur until 1894, in rural Vermont. By 1908, Karl Landsteiner, a Viennese researcher who later won a Nobel Prize for his discovery of the different human blood types, isolated the poliovirus by injecting monkeys with an emulsion from the spinal cord of a boy who had just died of polio. It was one of several important breakthroughs in the early 20th century battle against killer infectious diseases, including malaria, tuberculosis, diphtheria, typhoid, and syphilis.
In 1916, a polio outbreak in New York City quickly spread to adjacent states. Despite intensive sanitation measures of the kind that had helped control other epidemic diseases such as cholera and typhoid fever, 27,000 people died that summer. In New York City, 80 percent of those who died were under five. 
I knew that Franklin Delano Roosevelt contracted polio, but did not realize until reading Oshinsky’s book how significant an influence FDR had on the search for a vaccine. He was struck in the fall of 1921 while on a family vacation in Canada. The news stunned Americans, who at the time believed the disease mainly occurred among poor children in slums. FDR was 39 and from a wealthy New York family.
For thousands of polio victims, Roosevelt symbolized that life could go on for those disabled by the disease. He helped found the National Foundation for Infantile Paralysis, now known as the March of Dimes, which provided aid to victims and funded polio research. I was impressed that even as president, FDR would often respond personally to letters sent to him by other victims. Yet, Roosevelt also went to great lengths—abetted by a cooperative press corps—to hide the fact that he needed leg braces and handrails to stand, and a wheel chair to get around. I can’t imagine an American president being able to do that today, but FDR was greatly admired at a time when the nation was dealing with a world war and the Great Depression. Somehow, he persuaded the media that obscuring the extent of his disability was necessary to reassure the public that he was healthy and capable of holding public office.
I was also fascinated by the media savvy and marketing sophistication of the March of Dimes, which used famous Hollywood actors to get out its message and was the first philanthropic organization to introduce the idea that millions of Americans—not just the wealthy—could play an important role in helping solve big social problems. In 1938, Americans mailed nearly 2.7 million dimes directly to the White House in support of that year’s March of Dimes campaign.
We sometimes take for granted the speed of scientific breakthroughs today. Yet, Oshinky’s book reminded me of the painstaking efforts scientists often must undertake. Forty years after the polio virus was discovered, scientists still didn’t know what caused it. Theories ranged from rotten fruit to houseflies to contaminated milk. They didn’t know the mechanism by which it attacked the central nervous system. They didn’t know if there was just one type of polio, or many. And they didn’t know how to grow poliovirus safely, and in large enough quantities, to produce vaccines.
Also, researchers were divided over whether a “live-virus” vaccine or a “killed-virus” vaccine would be more effective. Most virologists believed a live-virus vaccine would stimulate higher antibody levels in the blood and create a lasting immunity. Advocates of the killed-virus vaccine believed it could be just as effective, and would eliminate any risk that someone receiving an immunization could contract polio.
Jonas Salk, a young researcher at the University of Pittsburgh, was one of those who believed a killed-virus vaccine would work. It had, after all, been effective against cholera, typhoid, and diphtheria. From 1949 to 1951, Salk and his team conducted extensive testing on thousands of monkeys, using samples from human polio victims and from monkeys who had contracted the virus after being injected with the human samples. Salk’s work confirmed what had been suspected but not yet proven—all of the identified and tested strains of poliovirus fit into one of three distinct types. 
About the same time, John Enders, a researcher at Harvard, figured out how to grow poliovirus that would be safe and could be mass produced. But scientists were still stymied over how the virus was transmitted and traveled through the body. Several prominent researchers had long believed that it entered through the nose and traveled directly to the central nervous system, bypassing the bloodstream. If that was the case, a vaccine that stimulated antibodies in the bloodstream would have done no good.
Two scientists working independently, Dorothy Horstmann at Yale and David Bodian at Johns Hopkins, upended the prevailing thinking with a breakthrough discovery. Previous researchers had been unable to detect poliovirus in the blood because they were not looking for it soon enough. Horstmann and Bodian discovered that the poliovirus is in the bloodstream for only a brief period of incubation before the body’s immune system creates antibodies that destroy it. 
Salk was relentless in his pursuit of a vaccine. He began human trials against the backdrop of the worst outbreak of polio on record in the U.S.—57,000 cases in 1952. By the spring of 1954, more than 1.3 million children had taken part in the largest vaccine trial in history. It took a year for the results to be reported, and when they were, church bells tolled, factory whistles rung, and then-President Dwight Eisenhower—a war hero—broke down in tears.
Although not 100 percent effective, the Salk vaccine was considered a huge success and a great relief for an edgy nation. In 1956, the number of polio cases in the U.S. dropped by 50 percent compared to the year before, and by another 50 percent the following year. 
Meanwhile, Sabin was about to undertake the largest medical experiment in world history—a live-virus vaccine administered to 10 million children in Russia. It, too, proved a success. Considered more effective and easier to administer than the Salk vaccine, Sabin’s oral vaccine won out by 1963. 
Oshinsky’s narrative ends at about this point, but the quest to completely eradicate polio is still ongoing. In 1987, the World Health Organization launched a global initiative to eradicate polio worldwide. Since that time, about 2.5 billion children have been vaccinated, and the number of polio cases has decreased by 99 percent. Last year there were fewer than 1,500 cases in just four countries—India, Nigeria, Pakistan, and Afghanistan. 
While this is fantastic progress, the last remaining cases pose a serious danger. If not completely eliminated, polio will spread back into countries where it has previously been eradicated, killing and paralyzing perhaps hundreds of thousands of children.
The foundation is deeply involved in this final push, and I am personally committed to doing what I can to rid the world of this dreaded disease once and for all.

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