2/24/2017

American Presidents and Infectious Diseases

July 3, 2013 Karie Youngdahl
We've expanded and updated a popular post from 2012 by History of Vaccines former intern Alexandra Linn.  
 Happy Fourth of July! In honor of this historic U.S. holiday we’ve compiled a list showing how infectious diseases have affected the lives of our most heralded leaders – the American presidents. These concise accounts are evidence that diseases can strike anyone, anywhere at any time, and even in the White House.
Life of George Washington The Christian. Painted by Stearns. Lith. by Reigner. NLMGeorge Washington (1789-97)
The first president of the United States witnessed more epidemics of infectious disease than any other president, so much so that PBS NewsHour published a blog post entitled “The Nine Deadly Diseases That Plagued George Washington.”
In 1751, a 19-year-old Washington traveled to visit his half-brother who was sick with tuberculosis in Barbados. While visiting, George came down with smallpox but fully recovered despite a few scars. Unfortunately, his tubercular half-brother could not overcome his disease and died in 1752.
In 1793, yellow fever hit Philadelphia in what is now regarded as one of the most notorious epidemics of the disease in history. Washington had to flee along with much of the city’s population to remain out of reach of the mosquitoes that spread yellow fever.
Washington is thought to have been a victim of diphtheria around the age of 15 and malaria at the age of 17. He was a frequent victim of dysentery, or bloody diarrhea, while serving in the French and Indian War and other battles. Washington is also thought to have suffered from quinsy (tonsillitis), carbuncle (a large potentially cancerous bump on his face), epiglottitis (a throat infection that can be caused by Haemophilus influenzae bacteria),  and pneumonia.  
Washington’s death may have been partly the result of epiglottitis following a cold. He died at the age of 67 on December 14, 1799, after having endured his fair share of diseases.
John Adams (1797-1801) 
Adams’s  wife, Abigail, acquired typhoid fever in October 1818, which led to her death on the 28th of the month.
Adams underwent smallpox variolation; he described the process and results this way:
“In the Winter of 1764, the Small Pox prevailing in Boston, I went with my Brother into Town and was inocculated under the Direction of Dr. Nathaniel Perkins and Dr. Joseph Warren. This Distemper was very terrible even by Inocculation at that time. My Physicians dreaded it, and prepared me, by a milk Diet and a Course of Mercurial Preparations, till they reduced me very low before they performed the operation. They continued to feed me with Milk and Mercury through the whole Course of it, and salivated me to such a degree, that every tooth in my head became so loose that I believe I could have pulled them all with my Thumb and finger. By such means they conquered the Small Pox, which I had very lightly, but they rendered me incapable … of speaking or eating in my old Age, in short they brought me into the same Situation with my Friend Washington, who attributed his misfortune to cracking of Walnuts in his Youth.”— John Adams, Autobiography Part 1
Interestingly, Adams was the first president approached about the discovery of vaccination. In 1800, Benjamin Waterhouse, a strong advocate and frequent correspondent of Edward Jenner, wrote to President Adams about the new practice of using cowpox as a preventative for smallpox. Adams, however, did not respond, and Waterhouse was forced to try again by contacting the more receptive vice-president Thomas Jefferson.
Thomas Jefferson  (1801-09) 
In 1806, following Waterhouse’s correspondence about Jenner’s innovation, Jefferson advocated for smallpox vaccination in America. In fact, after learning about the discovery, Jefferson invited Native American tribal leaders to Washington to show them the practice – using pictures and translated instructions.
Andrew Jackson (1829-37) 
At age 14, Jackson contracted smallpox while being held prisoner by the British during the War of Independence. Jackson recovered and later became the seventh president of the United States. However, his brother Robert, who also contracted the disease while imprisoned, died.
Martin Van Buren (1837-41)
In 1807, Van Buren married his childhood sweetheart Hannah Hoes. They had four sons. Hannah became ill withtuberculosis and died in 1819. Her death was devastating to Van Buren and he never remarried.
William Henry Harrison (1841) 
Harrison was the first president to die in office: he succumbed to pneumonia only one month after his inauguration in 1841.
James K. Polk (1845-49) 
Polk served one term in office and died of cholera three months after returning home to Tennessee in 1849.
Zachary Taylor (1849-50) 
Taylor was the second president to die in office. While traveling in the summer of 1849, Taylor came down with violent diarrhea and fever. Although he recovered, he came down with similar symptoms a year later on July 4, when he was diagnosed as having “cholera morbus” or gastroenteritis. Four days later Taylor died following extensive diarrhea, vomiting, and stomach pains.
Abraham Lincoln (1861-65)
Lincoln delivered the Gettysburg Address in the afternoon of Novermber 19, 1863, and he began to feel weak and feverish just a few hours later. By the fourth day of his illness, it was clear that Lincoln had smallpox. He remained ill for about four weeks. Lincoln recovered, although his valet, William H. Johnson, who also contracted the disease, did not. 
Chester A. Arthur (1881-85)
Arthur’s wife Ellen (Nell) Arthur died of pneumonia at age 42– a few years before Arthur was inaugurated as president.
Benjamin Harrison (1889-93)
A president of the famed “Gilded Age,” Harrison died of pneumonia in 1901.
Woodrow Wilson (1913-21)
Wilson is said to have contracted Spanish influenza while he was in France helping to negotiate the Treaty of Versailles in the spring of 1919. This influenza pandemic had a great effect on World War I, leaving many soldiers dead of flu rather than guns or gases.
Calvin Coolidge (1923-29)
Coolidge's son Calvin Coolidge Jr. died of blood poisoning, or septicemia, the result of an infected blister on his foot, in 1924. The boy was just 16 years old.
Franklin D. Roosevelt Presidential Library and MuseumFranklin Delano Roosevelt (1933-45)
In August 1921budding statesman Franklin Delano Roosevelt fell ill with polio during a visit to his family’s summer retreat in Canada. His legs remained paralyzed and he had to use a wheelchair for the rest of his life (he refused to be photographed in his paralyzed state to avoid rumors of weakness and debility).
Roosevelt’s personal experience with polio became one of the most important aspects of the efforts to develop a vaccine. In 1938, Roosevelt became the icon of the “March of Dimes,” a grass-roots fundraising effort where people all over the country sent dimes to the president to help fund the National Foundation for Infantile Paralysis. Over the years the March of Dimes raised millions of dollars: the fruit of their efforts was Jonas Salk’s inactivated poliovirus vaccine, tested in 1954 on 2 million children or “polio pioneers,” and Sabin’s oral polio vaccine, licensed in 1962.
Dwight Eisenhower (1953-61)
Eisenhower's son Doud Dwight (Icky) Eisenhower died of scarlet fever in 1921 at age three. Scarlet fever is usually caused by streptococcal bacteria and was a significant cause of death for childen before antibiotics were available.
Gerald Ford (1974-77)
By Ford’s time infectious diseases like smallpox and typhoid fever were no longer major killers. The age of vaccines had dawned and Ford met with Maurice Hilleman and other scientists on March 3, 1976 to discuss a vaccine response to swine influenza. Ford helped get Congress to commit funds to a nationwide vaccination program that had an ignominious end
Jimmy Carter (1977-81)
Under Carter’s presidency the first comprehensive childhood vaccination program was launched in 1977. Betty Bumpers, wife of Arkansas then-Governor Dale Bumpers, contacted the administration advocating for improved immunization efforts. Jimmy Carter’s wife, Rosalynn Carter, became involved and helped Mrs. Bumpers to advocate for state laws requiring vaccination for school entry.
In 1991, Mrs. Bumpers and Mrs. Carter started an immunization campaign called “Every Child by Two,” which works to ensure that all American children immunized against common diseases by the age of 2.
Barack Obama (2009-  )
Obama has frequently spoken of his daughter Sasha's bout with meningitis (pathogen unknown to us) when she was an infant. Sasha survived, and today is a healthy adolescent.
As you can see, infectious disease have shaped the lives of many American leaders and their families. If you’ve heard of other presidents or world leaders who have been victims of infectious disease, post your comment below: we’d love to hear from you and add to our ongoing research.
Bibliography
Saunders, Paul. Edward Jenner: The Cheltenham Years 1795-1823. Hanover, NH: University Press of New England, 1982, 110.

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

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movie

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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