6/11/2016

Dr. Salk’s polio vaccine1952-1957




1952-1957: Jonas Salk's polio vaccine

1952-1957
Dr. Salk's polio vaccine
A dogged pursuit against a devastating disease
c. 1950
Rows of iron lungs with polio patients are arrayed at the Ranchos Los Amigos Respiratory Center in Los Angeles.
IMAGE: AS400 DB/CORBIS
Before the mid-1950s, polio was one of the most feared diseases in the world. Caused by a virus, it created annual epidemics. The disease hit children the hardest. Once contracted, the virus replicates rapidly and invades the nervous system of the victim. People infected are generally contagious for six weeks, even if they show no symptoms. 
The disease struck indiscriminately. Even U.S. President Franklin D. Roosevelt was affected, losing the use of his legs after a diagnosis at the age of 39. In 1938, he founded the National Foundation for Infantile Paralysis, to fund research into a cure. Roosevelt also founded the March of Dimes, a massive public fundraising effort to aid the afflicted and find a cure or vaccine. 
In 1952, there were almost 58,000 polio cases in the United States, leaving over 3,000 people dead and over 21,000 with varying degrees of paralysis. The most severe phase of the disease paralyzed the diaphragm and muscles of the chest, forcing victims to be placed in an iron lung in order to breathe. This imprisonment could last for up to a week, or even for years.
With major outbreaks occurring in the U.S. and Europe, the race was on to find a vaccine to prevent the virus from infecting more of the population. 
Sept. 10, 1952
Family members look on as girls are treated for polio in iron lungs.
IMAGE: BETTMANN/CORBIS
1945
Gypsy Rose Lee pulls out some cash to contribute to the March of Dimes during a fashion show at the New York Waldorf-Astoria.
IMAGE: NY DAILY NEWS ARCHIVE/GETTY IMAGES
Dr. Jonas Salk, the son of Jewish immigrants from Poland, was appointed by the University of Pittsburgh School of Medicine to tackle polio in 1947. For the next seven years, he worked 16-hour days, seven days a week.
In 1953, Salk's wife and three sons volunteered to be injected with a test vaccine based on an inactivated or “killed” polio virus. After preliminary tests a mass trial began. The head of the National Foundation for Infantile Paralysis strongly backed Salk, paving the way for the final, nationwide trial to be conducted. It involved vast numbers of health professionals and over 1.8 million schoolchildren.
The vaccine was announced to be "safe and effective" on April 12, 1955, the ten-year anniversary of Roosevelt's death.
The success of the trial was widely reported, leading to spontaneous celebrations across the country. Salk refused a ticker tape parade and did not patent his discovery. He understood the need for the vaccine to be distributed widely to begin the process of eradicating the disease, and made his knowledge available to many countries. If the majority of people were vaccinated, any that slipped through the cracks would be protected by herd immunity. Today polio has almost been eradicated.
March 26, 1953
Dr. Jonas Salk and research assistant E.J. Baily at a laboratory in Pittsburgh.
IMAGE: BETTMANN/CORBIS
c. 1955
Dr. Salk holds up jars of his newly-developed polio vaccine at his laboratory in Pittsburgh.
IMAGE: BETTMANN/CORBIS
The people, I would say. There is no patent. Could you patent the sun?
DR. JONAS SALK, ON THE QUESTION OF WHO OWNS THE PATENT TO THE VACCINE, APRIL 12, 1955
February 1954
Dr. Salk administers a trial vaccine to an eight-year-old at Frick Elementary School in Pittsburgh.
IMAGE: UNDERWOOD ARCHIVES/GETTY IMAGES
April 29, 1954
Dr. Leonard Becker administers a Salk test vaccine to seven-year-old Keith Harms of Lombard, Illinois.
IMAGE: BETTMANN/CORBIS
Jan. 31, 1956
Visiting Russian scientists look on as Dr. Salk administers his vaccine to nine-year-old Paul Anolik in Pittsburgh.
IMAGE: BETTMANN/CORBIS
April 1957
A girl awaits a polio shot and lollipop reward.
IMAGE: H. ARMSTRONG ROBERTS/CORBIS
c. 1956
Dr. Salk administers the vaccine to a young girl.
IMAGE: MONDADORI PORTFOLIO/GETTY IMAGES
He felt that he couldn't ask other parents to let him give this vaccine to their children if he wasn't willing to first try it on his own.
DARRELL SALK, SON OF DR. JONAS SALK
c. 1955
Dr. Salk and a nurse administer the vaccine to a student at Sunnyside School in Pittsburgh.
IMAGE: BETTMANN/CORBIS
December 1958
Elvis Presley visits six-year-old Robert Marquette in Frankfurt, Germany to raise funds for the March of Dimes. 
IMAGE: MICHAEL OCHS ARCHIVES/GETTY IMAGES
April 8, 1955
Dr. L. James Lewis, research associate of Dr. Salk, injects an anesthetized monkey with a test polio vaccine.
IMAGE: BETTMANN/CORBIS
April 9, 1955
Dr. Salk speaks to press in his laboratory four days before the announcement of the results of the nationwide vaccine test.
IMAGE: BETTMANN/CORBIS
April 12, 1955
A girl receives a Salk vaccine on the day of the official announcement that it was safe and effective.
IMAGE: BETTMANN/CORBIS
Post Polio Litaff, Association A.C _APPLAC Mexico

The Polio Crusade

THE POLIO CRUSADE IN AMERICAN EXPERIENCE A GOOD VIDEO THE STORY OF THE POLIO CRUSADE pays tribute to a time when Americans banded together to conquer a terrible disease. The medical breakthrough saved countless lives and had a pervasive impact on American philanthropy that ... Continue reading..http://www.pbs.org/wgbh/americanexperience/polio/

Erradicación de La poliomielitis

Polio Tricisilla Adaptada

March Of Dimes Polio History

Dr. Bruno

video

movie

movie2

A 41-year-old man developed an acute illness at the age of 9 months during which, following a viral illness with headache, he developed severe weakness and wasting of the limbs of the left side. After several months he began to recover, such that he was able to walk at the age of 2 years and later was able to run, although he was never very good at sports. He had stable function until the age of 18 when he began to notice greater than usual difficulty lifting heavy objects. By the age of 25 he was noticing progressive difficulty walking due to weakness of both legs, and he noticed that the right calf had become larger. The symptoms became more noticeable over the course of the next 10 years and ultimately both upper as well as both lower limbs had become noticeably weaker.

On examination there was wasting of the muscles of upper and lower limbs on the left, and massively hypertrophied gastrocnemius, soleus and tensor fascia late on the right. The calf circumference on the right exceeded that on the left by 10 cm (figure1). The right shoulder girdle, triceps, thenar eminence and small muscles of the hand were wasted and there was winging of both scapulae. The right quadriceps was also wasted. The wasted muscles were also weak but the hypertrophied right ankle plantar flexors had normal power. The tendon reflexes were absent in the lower limbs and present in the upper limbs, although the right triceps was reduced. The remainder of the examination was normal.

Figure 1

The patient's legs, showing massive enlargement of the right calf and wasting on the left

Questions

1
What is that nature of the acute illness in infancy?
2
What is the nature of the subsequent deterioration?
3
What investigations should be performed?
4
What is the differential diagnosis of the cause of the progressive calf hypertrophy?

Answers

QUESTION 1

An acute paralytic illness which follows symptoms of a viral infection with or without signs of meningitis is typical of poliomyelitis. Usually caused by one of the three polio viruses, it may also occur following vaccination and following infections with other enteroviruses.1 Other disorders which would cause a similar syndrome but with upper motor neurone signs would include acute vascular lesions, meningoencephalitis and acute disseminated encephalomyelitis.

QUESTION 2

A progressive functional deterioration many years after paralytic poliomyelitis is well known, although its pathogenesis is not fully understood.2 It is a diagnosis of exclusion; a careful search for alternative causes, for example, orthopaedic deformities such as osteoarthritis or worsening scoliosis, superimposed neurological disorders such as entrapment neuropathies or coincidental muscle disease or neuropathy, and general medical causes such as respiratory complications and endocrinopathies.3

QUESTION 3

Investigations revealed normal blood count and erythrocyte sedimentation rate and normal biochemistry apart from a raised creatine kinase at 330 IU/l (normal range 60–120 IU/l), which is commonly seen in cases of ongoing denervation. Electromyography showed evidence of denervation in the right APB and FDI with polyphasic motor units and complex repetitive discharges, no spontaneous activity in the left calf and large polyphasic units in the right calf consistent with chronic partial denervation. Motor and sensory conduction velocities were normal. A lumbar myelogram was normal. Magnetic resonance imaging (MRI) scan of the calves is shown in figure2.

Figure 2

Axial T1 weighted MRI scan (TR 588 ms, TE 15 ms) of the calves, showing gross muscle atrophy and replacement by adipose tissue on the left, and hypertrophy of the muscles on the right, with only minor adipose tissue deposition

QUESTION 4

The differential diagnosis of the progressive calf hypertrophy is given in the box.

Causes of calf muscle hypertrophy

Chronic partial denervation

  • radiculopathy

  • peripheral neuropathy

  • hereditary motor and sensory neuropathy

  • spinal muscular atrophy

  • following paralytic poliomyelitis

    Neuromyotonia and myokymia

  • Isaac's syndrome

  • generalised myokymia

  • neurotonia

  • continuous muscle fibre activity due to: chronic inflammatory demyelinating polyradiculopathy, Guillain Barre syndrome, myasthenia gravis, thymoma, thyrotoxicosis, thyroiditis

    Muscular dystrophies

    Myositis

    Infiltration

  • tumours

  • amyloidosis

  • cysticercosis

    Link here