Protect Your Children From Infantile Paralysis Or Poliomyelitis - Health - Diseases and Conditions

<p>For many years infantile paralysis has been the most feared of all the crippling diseases that affect mankind. Today as we look back on Infections and Immunity the year 1955 we stand on a new front where we can predict the ultimate elimination of infantile paralysis as a threat, just as typhoid fever and smallpox have been eliminated. This has resulted from the work of the National Foundation for Infantile Paralysis, which began raising funds for research on this disease in 1937. Up to that time the suspicion prevailed that this disease was caused by a virus, but the virus was not isolated. Today the viruses-there are several of them-have been isolated and grown in pure form outside the human body. For this work Enders and his associates received the Nobel Prize. When the virus could be grown outside the human body on monkey kidneys in pure form, the preparation of a vaccine was attempted by Dr. Jonas Salk and early experimentation indicated that the inoculation of a mixtu
re of killed viruses would produce in a child resistance against infection with this disease. </p>

<p>After pilot experiments a vast experiment was undertaken under the auspices of the National Foundation for Infantile Paralysis in which great numbers of children were inoculated and compared with a similar number who did not receive the inoculation. Once this effective experiment was reported on April 12, 1955, at Ann Arbor, Michigan, the vaccine was made available by various manufacturers throughout the United States. In the latter part of 1955, Dr. Alexander L. Langmuir of the United States Public Health Service surveyed the results. From New York State comes the report that the paralysis rate was four per 100,000 for vaccinated children contrasted with 20.9 for 100,000 for unvaccinated. From Minnesota the report indicated 2.7 for vaccinated compared with 30.1 for unvaccinated children. </p>

<p>In children ages seven and eight the attack rate was much lower than in younger and older children. The poliomyelitis vaccine was most widely used in children of seven and eight years. From other countries also came reports of the effectiveness of the vaccine. In Canada the rate was 1.07 for 100,000 for vaccinated children and 5.39 for 100,000 among unvaccinated children. In Denmark there was not one case of paralytic poliomyelitis among over 400,000 children who were vaccinated. Here is a situation of great hope because over a period of ten years greater and greater numbers of children will be vaccinated. </p>

<p>The vaccine in the meantime will be continuously improved by new techniques that are being studied in laboratories. Among these new techniques is a combined method of killing the virus using ultra-violet rays and the formaldehyde that is the substance used for killing the virus in the Salk vaccine. </p>

<p>As 1955 ended, a survey revealed that the number of admissions of children to hospitals for infantile paralysis had dropped 52 per cent among the eight-year-old children and 40 per cent among seven-year-old children. These were of course the principal age groups that received the Salk vaccine. Children from 15 through 19 years of age who had not received the vaccine had a decrease in hospital admission rates of only 12 per cent as contrasted with a decline in the general population of 17 per cent. All of this is taken as good evidence of the virtue of this vaccine. Estimates by epidemiologists indicate that some 1,700 cases of paralytic poliomyelitis were prevented in 1955 by the use of the vaccination.</p>

<p>For many years, mild, nonparalytic cases of infantile paralysis have been cared for suitably in the home. Unquestionably, however, the patient who has paralysis is far better off in the hospital than at home. In the hospital modem methods of treatment with hot packs, control of distortion due to weakened muscles, encouragement of recovery after paralysis and, particularly, the use of the respirator are made available. These may mean the difference between life and death.</p>

<p>Not much seems to be gained by isolating every patient with infantile paralysis. Such patients can be cared for in general hospitals as well as in hospitals devoted exclusively to infectious diseases.</p>

<p>Since the virus of infantile paralysis seems to be spread by excretions from the bowel, the excretions of patients should be considered infectious and should be disposed of with precautions that they do not spread contamination. Little seems to be gained by adding antiseptic substances to the excretions but disposal of the material in a suitable toilet and thorough cleansing of vessels, such as bedpans, are important.</p>

<p>Because infantile paralysis is so widespread, particularly in the nonparalytic form, any disease with fever occurring in children and young adults in the summertime must be regarded with suspicion, particularly in times of epidemic. A competent doctor can diagnose the disease, and suitable care during the early stages is significant. Far too often patients in the early stages are submitted to pulling, manipulation, rubbing, and all sorts of energetic treatments which are likely to do more harm than good. </p>

<p>As soon as there is a question that the patient may have poliomyelitis, bed rest is important. The patient without paralysis must be confined to bed for at least three or four days after the temperature has returned to normal. </p>

<p>Most orthopedic specialists recommend the firm, hard bed from the beginning. The muscle tightness and paralysis can be helped by a suitable bed. The bed should be fitted with a foot-board which is placed several inches beyond the mattress and allows room for pressure by the heels or toes of the patient when the patient lies on the back or on the stomach. This foot-board also protects the legs from the pressure of bed clothing and gives opportunity to avoid muscle weakness by such use as can be made of the limbs. If the legs are weak, the knees are usually supported in a slightly relaxed position.</p>

<p>Since poliomyelitis is such a frightening disease, the doctor must do everything that he can to prevent fear and terror on the part of the infected child or of the parents. Early in the disease the whole family must be adjusted to the fact that there is a medical problem. Such attention given early in the condition is likely to avoid nervous and psychotic disturbances at a later date.</p>

<p>In the early stages, infantile paralysis is treated exactly as one would treat other infectious diseases, like measles, scarlet fever, or whooping cough. The treatment is usually rest in bed with a light diet but particularly with good nursing care.</p>

<p>During the early stages of inflammation, the patient must be provided with relief from pain. The use of moist heat is now considered most effective, including the application of hot baths for small children or for older ones, and the hot packs applied for thirty-minute periods every four to six hours. The extreme ritual developed by recent techniques is not absolutely necessary. If patients revolt against hot packs, they should be discontinued.
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