The Death of a Disease: A History of the Eradication of Poliomyelitis

3. A Virus with a Long History

24 The Death of a Disease 24 3 A Virus with a Long History Egypt, 2000 B.C. and Europe, Twentieth Century Roma the Guardian was a priest of the Egyptian goddess Astarte. He is one of the central figures on a stele on display at the Glyptothek Museum in Copenhagen, a stone slab dating back to the eighteenth pharaonic dynasty (sixteenth to thirteenth centuries B.C.). He leans on a staff, his right leg withered and dangling, his foot in the equinus position . Roma is the oldest documented victim of poliomyelitis. In his book A History of Poliomyelitis, John Paul of Yale University, who was a polio researcher and one of the foremost authorities on the history of the disease, discusses what may have been cases of paralytic poliomyelitis in the works of Hippocrates. John Paul believes that the disease was endemic during classical Greco-Roman times.1 Although other researchers’ conclusions may vary, they all agree on one essential point: the poliovirus is at least three thousand years old. A Virus with a Long History 25 Closer to our time, polio has left traces in art of the sixteenth-century Flemish school. Two crippled figures appear in one of Pieter Bruegel the Elder’s paintings, The Fight between Carnival and Lent (1559). One figure, who has a maimed leg, walks with a wooden crutch. The other moves forward on his hands, his shrunken and bent legs strapped to splints and dragging behind him. Although this artistic testimony is not formal proof of poliomyelitis, it strongly suggests that both suffered from the disease. Polio went almost unnoticed during the centuries when famine, the plague, smallpox, and other diseases wiped out entire sectors of the population. In 1789, Michael Underwood , an English physician, was the first to describe “debility of the lower extremities,” which he attributed to “teething” or “fever.” The illness appeared to be rare and was not considered a serious problem. At about this time, polio struck a small boy, later to become its first famous victim. Sir Walter Scott (1771–1832), born in Edinburgh, lost the use of one of his legs when he was very young. His parents decided to send him to stay with his grandparents in the Highlands. To keep the handicapped child’s mind occupied, his aunt and grandmother sang him ballads and told him tales and ancient legends. As he grew up, Scott, imbued with nostalgia for the past, revealed a talent for writing. Among his many works is the immensely popular novel, Ivanhoe. In 1840, Jacob von Heine, a German physician, noted a significant number of cases of “infantile paralysis” and described the clinical symptoms. Thirty years later, in 1870, Alfred Vulpian, a French neurologist, concluded that the disease was contagious and wrote a description that is still valid today: “This atrophic paralysis is apparently an acute infectious disease, which results from an infection of the 26 The Death of a Disease body that is usually localized in a limited region of the spinal cord.” In 1881, a polio epidemic broke out in a small town in northern Sweden. Some twenty children suddenly came down with diarrhea, malaise, and fever. Six years later, in Stockholm, forty-four children were stricken with a similar illness. Three of them died. Their doctor, the pediatrician Oskar Medin, carried out autopsies on the bodies and found that the disease had attacked the nerves of the spinal cord and the base of the brain. His observation of these two series of cases led him to conclude that the disease was infectious . In 1888, S. Cordier, a French physician, retrospectively described thirteen cases of infantile atrophic paralysis that occurred in the summer of 1885 in the village of Sainte-Foy l’Argentière, near the city of Lyon. Five of the children were less than seven months old when they fell ill. Poliomyelitis had always been endemic, with sporadic cases observed in children. Now, at the close of the nineteenth century, polio was causing epidemics. Outbreaks paralyzed hundreds of people. The fear of polio spread. In 1894, the disease caused an outbreak in Vermont when 119 children were diagnosed with polio. Another epidemic in Sweden in 1905 killed hundreds of children and left nearly one thousand paralyzed. A Swedish physician, Ivar Wickman, put forward the hypothesis that this was a contagious disease; individuals carrying the infectious agent transmitted it to others. A more intense scientific...