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1 “There could be almost complete confidence that, if and when a [polio] vaccine [was] developed, the American people would back the scientific trials necessary to test its effectiveness.”1 This assertion was penned in 1956, at a time when the eradication of the fearsome disease, polio, was well under way. Funded by the National Foundation for Infantile Paralysis (NFIP), the vaccine developed by Dr. Jonas Salk and evaluated in a massive 1954 clinical trial was found to be safe and effective.2 Such characterizations of public support for human medical experimentation were evidently assumed and linked to earlier developments . What had come before the polio vaccine trial to normalize enrolling millions of healthy children to test a new medical intervention? What role did publicity play in shaping perceptions of medical research? This book attempts to unravel these questions, while delving deeper into the nature of medical experimentation conducted on an open population in mid-­ twentieth century. At a time when most Americans trusted scientists and the NFIP, but knew no model for a mass clinical trial, their mutual encounter under the auspices of conquering disease was shaped by politics, marketing, and, at times, deception. Poliomyelitis—­ or polio, as it became abbreviated—­ is a contagious oral-­ fecal viral disease.3 Contaminated food, hands, and objects are the most common means of spreading the virus from person to person.4 Smaller than bacteria, viruses such as polio are microscopic entities that were known to medical scientists before the 1890s but not viewable until the widespread use of the electron microscope during the 1940s.5 Polio infects a living cell and uses it as a host in which to replicate until the viral copies rupture the cell membrane; the copies may then spread to new cells. There are three known serotypes of Introduction 2 Selling Science poliovirus, and an individual requires protective immune antibodies to each type to guard against illness. When the virus is ingested by a nonimmune individual, it can cause a gastrointestinal infection and produce symptoms resembling a mild flu.6 All persons infected with the disease, irrespective of its severity, will pass the virus in their feces. Although most sufferers will recover from the intestinal infection and develop lasting immunity to the offending viral serotype, in approximately 5 to 10 percent of cases the poliovirus will pass into the bloodstream, where it targets the motor neurons of the spinal cord. As the attack progresses, lesions develop in the gray matter of the spinal cord, informing the Greek-­ derived term: polios (gray) myelos (marrow), itis (inflammation ).7 Although adults can become afflicted, polio holds a peculiar affinity for children, which inspired the clinical synonym infantile paralysis. Depending on the severity, location, and number of spinal lesions, patients may experience paralysis of the extremities and the respiratory muscles. Complications arising from severe infections can lead to death.8 When polio arose in epidemic form in America at the turn of the twentieth century, no means to prevent the disease existed, and its nature was poorly understood.9 As the disease appeared to propagate during warm weather, summer soon became known as “polio season.”10 To thwart the spread of polio, public health departments closed areas where contagion appeared highest, such as playgrounds, cinemas, and swimming pools, and encouraged hygiene and fly eradication programs.11 Even though public health efforts controlled other diseases, such as cholera and typhoid, polio did not respond to collective health activism and persisted even in salubrious neighborhoods.12 Parents and health workers waited with trepidation for news of the next outbreak. Health professionals and researchers struggled to understand what factors predisposed individuals to a polio infection.13 Although flies and immigrants were blamed initially, shifts in scientific knowledge challenged assumptions.14 Most scientists theorized that society’s growing adherence to hygienic practices denied infants exposure to the virus while still protected by maternal antibodies.15 Doctors could only counsel vigilant lifestyle choices for polio prevention: stay clean, avoid changes in temperature, get plenty of rest, and avoid crowded places. Out of desperation, citizens turned to quarantine to isolate the ill and regulate the regimens of the healthy.16 Communities attempted, with limited success, to control this seemingly random affliction that defied public health ordinance. A truly national effort to battle polio emerged through the vision of Franklin Delano Roosevelt.17 In August 1921, thirty-­ nine-­ year-­ old Roosevelt was stricken with an illness believed to be polio during a family vacation at Introduction 3 Campobello Island...


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