Getting Technical
the developed world primarily in cities during the summer months.
At its peak in the 1940s and 1950s, polio paralysed or killed over half
a million people worldwide every year. There was no known cure or
preventative vaccine.
Figure 2: Illustration of one of the
Corona Poliomyelitis viruses.
The consequences of the disease frequently left polio victims
marked for life and created vivid images of wheelchairs, crutches,
leg braces, deformed limbs and breathing devices, particularly the
iron lung. The original iron lung was powered by an electric motor
attached to two vacuum cleaners and worked by changing the
pressure inside the machine.
When the pressure was lowered, the chest cavity expanded,
trying to fill this partial vacuum. When the pressure was raised, the
chest cavity contracted. These induced expansions and contractions
followed the physical movements of normal breathing.
Figure 3: An iron lung
The design of the iron lung was subsequently improved by using a
bellows attached directly to the machine and the design modified to
make production less expensive. During polio epidemics the iron lung
saved many thousands of lives but the machine was large, cumbersome
and very expensive.
In the 1930s, an iron lung cost about USD1 500, about the same price
as a normal residential home in the US. However, patients could be
encased in the metal chambers for months, years and sometimes for
life, although, even with an iron lung, the fatality rate for patients with
various forms of polio often exceeded 90%. These drawbacks led to the
development of more modern positive-pressure ventilators and the use
of positive-pressure ventilation by tracheostomy.
Polio changed not only the lives of those who survived it, but was
also a significant factor in cultural changes. Polio started the emergence
of grassroots fund-raising campaigns that would revolutionise
philanthropy across a broad medical field including rehabilitation therapy
and, through campaigns for the social and civil rights of the disabled,
polio survivors helped to spur the modern disability rights movement.
Probably the most influential person involved was the American
President, Theodore Roosevelt, who kept his own lower body polio
paralysis hidden from the public. Roosevelt organised funding for
the non-profit National Institute of Infant Paralysis as a project, now
historically known as the ‘March of Dimes’, which encouraged every
American to send dimes to the White House to support treating polio
victims and researching a cure. In the process, he changed American
philanthropy, which had previously relied mainly on donations from
the wealthy.
In 1954, the March of Dimes organised a national field trial of 1.8
million schoolchildren, the largest medical study in history. The data
was processed and on April 12, 1955, six years from when Salk began his
research, the Salk polio vaccine was declared “safe and effective.” Church
bells rang and newspapers across the world claimed “Victory Over Polio.”,
Concurrently, a research group, headed by John Enders at the Boston
Children's Hospital, successfully cultivated the poliovirus in human tissue.
This significant breakthrough ultimately determined the development
of improved polio vaccines. Enders and his colleagues, Thomas H.
Weller and Frederick C. Robbins, were recognised and rewarded with
a Nobel Prize in 1954.
With the success of the polio vaccine, Jonas Salk, at age 39, became
one of the most celebrated scientists in the world. He refused a patent for
his work, declaring that the vaccine belonged to the people and that to
patent it could be likened to “patenting the Sun.”
Recently, Bill Gates explained why the Bill and Melinda Gates
Foundation had endorsed the eradication of polio worldwide as a top
priority. He joined the World Health Organisation, UNICEF, Rotary
International and others to help finish the job started by the Salk vaccine,
to minimise the menace of polio. An additional envisioned benefit would
be freeing up resources that would no longer have to be spent on the
disease itself.
The Bill and Melinda Gates Foundation has been involved in helping to
fight infectious diseases such as Ebola and malaria and has now included
those due to coronavirus infections. On February 5, 2020, the foundation
announced it would provide USD100-million to improve detection,
isolation and treatment efforts and accelerate the development of
coronavirus vaccines.
It is certainly alarming to see how the coronavirus (Covid-19) spreads
in ways similar to poliomyelitis. On October 24, 2019, World Polio Day,
the World Health Organisation announced that there were only 94 cases
of wild polio existing in the entire world. The success of the polio vaccine
started a whole series of vaccines that minimised or even negated many
of the effects of these types of infectious diseases during the second half
of the 20th century.
In the continuing and highly publicised global war against the
coronavirus, Covid-19, it is quite extraordinary and heartening to see
how citizens and governments of the world are rising to the occasion and
demonstrating what is possible when we all work together. RACA ‐
www.hvacronline.co.za RACA Journal I October 2020 37