If Polio Is Only a Plane Ride Away . . .

[Turquesa]

. . . .why haven't we had a case of wild polio in the U.S. since 1979? You'd think that without 100% vaccination compliance from the population, it would have struck us by now. What gives? Does this saying hold any weight?

[MyBoysBlue]

Most polio is no worse then a cold and only a very small percentage of those who get polio, somewhere around 1% I am just going from memory I don't have the stats in front of me, actually experience any paralysis. I think it is possible that we are experiencing mini outbreaks of polio but it just isn't causing paralysis. I think the saying is better applied to Measles.

[stik]

I haven't looked at the CDC stats lately, but I'm fairly certain that I have seen reports of a couple cases of wild polio in the US since 1979, primarily concentrated in unvaccinated populations. Wasn't there an outbreak in an Amish community a few years ago?

MyBoysBlue, the Mayo Clinic website backs up your stats. Given that 1% of cases of polio lead to paralysis, and given that a large chunk of the US population is vaccine compliant, and assuming that the polio vaccine actually works (which I realize is controversial on MDC, but I believe it works, and its efficacy helps account for this particular phenomenon) that would mean that only a small chunk of the population is actually at risk for contracting polio. A smaller chunk of that chunk is actually exposed to polio. And of those exposed, a smaller chunk actually catch it. 1% of the cases of polio caught by that final chunk lead to paralysis. That's not too small a number to make it into the CDC stats, but it is too small a number to make the news on any sort of reliable basis.

No vaccine even claims to be perfect, so a small percentage of vaccinated people are also at risk. Assuming a small failure rate, a small number of vaccinated individuals exposed to polio will get the disease, and 1% of those cases will also lead to paralysis. But again, this is 1% of a small chunk.

The Mayo clinic doesn't provide similar stats for the prevalence of post-polio syndrome.

[xmasbaby7]

I think this applies much more to measles, too.

Did anyone else here read the article in Science magazine from 2006 or 2007 discussing the problems of polio in Kashmir where it is endemic? The article said that despite vaxing the certain populations up to ten times, that vaccine was not making a dent in the cases?

I have looked for it since and couldn't find it.

To me, this is a real warning sign that its efficacy is not what some hope it would be and its decline in US has other factors involved.

[Deborah]

It isn't 1% getting paralysis. It is 1/10 of 1%. And that is only during a polio epidemic. Polio paralysis went up and down. It also varied widely in different parts of the world at different times. For example, in Hawaii from 1938-1947, children attending the same schools and living in the same neighborhoods, had widely varying rates of polio based on ethnicity. This could have had to do with genetics, diet, or toxin exposures. Here are the rates per 100,000 population: Caucasian 10.2; Part Hawaiian 9.0; Japanese 3.9; Chinese; 2.7; Filipino 1.6 and Hawaiian 1.3

The thing to consider with polio is why the invasive, paralytic type is so rare. If we start with the not unreasonable assumption that the illness in its normal state is mild and lives in a friendly symbiosis with the human race (supported by the evidence), then something must enable the invasive state and this something must not be there a lot of the time.

So, for example, those graphs showing a relationship between DDT use and polio incidence may be on to something. Does DDT cause some sort of damage which makes it possible for polio to go where it doesn't normally go?

There may be multiple factors which cause vulnerability.

One more point: polio used to be vanishingly rare in underdeveloped countries, and then it became a worldwide plague. At the same time, the developed world exported lots and lots of pesticides and other toxins into the developing world to increase agricultural production...

[alegna]

Originally Posted by stik

Wasn't there an outbreak in an Amish community a few years ago?

Nope- those cases were from the vaccine.

-Angela

[Jugs]

Dengue and lassa fever are also "just a plane ride away" but most people have never heard of them, let alone worried about them.

[mamadelbosque]

Something else to remmeber about polio is that the vast, vast, vast majority of people who were paralyised eventually got better. yes, some were permanently paralised, and some did die, but the vast, vast, vast majority did not.

[ema-adama]

Originally Posted by stik

I haven't looked at the CDC stats lately, but I'm fairly certain that I have seen reports of a couple cases of wild polio in the US since 1979, primarily concentrated in unvaccinated populations. Wasn't there an outbreak in an Amish community a few years ago?

No, there were cases in unvaccinated Amish children that were linked back to the OPV strain. The children were infected with the polio virus, but showed no signs of polio (paralysis). In the 1940's 50's no one would have known they had polio, as polio was diagnosed clinically. In my understanding, this incident shows that polio in an infectious disease and that you can carry the polio virus if you are not vaccinated. It does not however mean that polio is the killer disease the pictures of the iron lungs displays. I always fail to make that leap. I would be interested to know just how many people carry the virus without knowing it, and also know what percentage of vaccinated children carry the virus. Obviously that is not going to happen, as it would be impossible to screen each and every child for polio virus.

MyBoysBlue, the Mayo Clinic website backs up your stats. Given that 1% of cases of polio lead to paralysis, and given that a large chunk of the US population is vaccine compliant, and assuming that the polio vaccine actually works (which I realize is controversial on MDC, but I believe it works, and its efficacy helps account for this particular phenomenon) that would mean that only a small chunk of the population is actually at risk for contracting polio. A smaller chunk of that chunk is actually exposed to polio. And of those exposed, a smaller chunk actually catch it. 1% of the cases of polio caught by that final chunk lead to paralysis. That's not too small a number to make it into the CDC stats, but it is too small a number to make the news on any sort of reliable basis.

I do not know the stats for children who have not been vaccinated for polio in the US. However, I was surprised to see a number of 100+ 000 children in the US who are not or are partially vaccinated. That is not an insignificant number. (I have lost my computer to a dowsing of water from my toddler, and lost all my bookmarks. Sorry I can't link to that)

I do not believe the vaccine is useless.

I do question whether the vaccine alone takes the credit for the dramatic decrease in polio in the USA. And I do think there is more to public health than mass vaccination.

Polio has been a difficult disease and vaccine for me to understand. It was on my list of definite vaccines before I started to look into the issue a bit more closely, although I was planning on a delayed administration. When I read that the percentage of children infected with polio virus who go on to develop polio was so small, and that the number of children who are permanently damaged is even smaller, I wondered what else I needed to know. I had just assumed polio was a dangerous disease that left the vast majority of it's victims paralyzed. Images of iron lungs and the prevaccine numbers of incidence helped to cement this idea.

I was then surprised to read the orthodox clinical reasoning for the treatment of paralytic polio in the 40's and 50's. As an OT specialized in splints, I was surprised to read of the recommended protocols for months of being in splints, to prevent the weak muscles from being overpowered by the stronger muscles. There was no understanding of muscle tone and how to normalize muscle tone. And I can tell you that I have never seen a positive result from splinting hands with high muscle tone, for instance after a stroke or in a child with CP. It is controversial, and there are OT's/PT's who advocate splinting for functional use, and I see their point. But that would never be weeks/months of splint, like the children in the 40's and 50's had. I have seen contractures after 3 weeks of splinting, for instance post tendon surgery. Contractures were a common complication for children following their discharge from hospital.

Sorry, that is a bit of a tangent. My point is that the more I looked into polio virus and the vaccine, the more I realized that the popular opinion of it is far too simplified. To the point where it is almost impossible to have a coherent discussion on the topic.

Again, I am not saying the vaccine is useless.

I just know that the graph and stats put forward are not indicative of what was going on. They tell a story of massive vaccine success, when it is clear that there were other factors, such as the reclassification of the polio diagnosis.

Again, this does not mean the vaccine doesn't work, but it does raise the question of just what else was contributing to the massive decline seen in the 50's. I think the discussion around various factors that create a clinical picture of acute flaccid paralysis can help bring the the issues into focus. Polio virus is not the only virus with the potential to cause acute flaccid paralysis.

To be rather pedantic, I am not saying polio virus doesn't cause acute flaccid paralysis in some. I am just saying it is not the only virus, and it would seem not all children are at equal risk.

About polio just being a plane ride away, I think measles is a better candidate. It's like saying meningitis is a plane ride away. It's not that simple.

[Crafty]

Did anyone else here read the article in Science magazine from 2006 or 2007 discussing the problems of polio in Kashmir where it is endemic? The article said that despite vaxing the certain populations up to ten times, that vaccine was not making a dent in the cases?

I have looked for it since and couldn't find it.

To me, this is a real warning sign that its efficacy is not what some hope it would be and its decline in US has other factors involved.

To me, that sounds less like a warning than it does a sign that there's something in the genetics of that particular group that make them resistant to this particular vaccine. It happens and vaccines can't control for every single genetic group and their particular variances.

[Turquesa]

So this leads me to guess that there are two possible scenarios:

1. It is a plane ride away, and it's already spread here. But everybody was unaware that they had it.

2. A poor person from Kashmir would have to board a commercial carrier to the United States and, because polio requires a fecal-oral transmission, poop in somebody's local water supply. Hygiene otherwise seems comparatively good here, so it's a hard case to make.

To the PP wondering where I heard that there was no wild polio in the U.S. since 1979, here is a decidedly pro-vax website that confirms it:

Due to a concentrated effort to eradicate polio from the world, there have been no cases of "wild" (i.e., natural) polio acquired in the United States since 1979, and no cases of wild polio acquired in the entire Western Hemisphere since 1991.

[Deborah]

It isn't just one population.

Children are getting vaccinated 15 or 20 times in parts of India and Africa and still getting polio.

There are several possibilities:

Something in the environment is causing vulnerability to the virus and making the children unable to muster immunity. Some things that are known to cause acute flaccid paralysis: injections (provocation polio) and exposure to certain toxins. Some areas in India have extremely high levels of arsenic in the drinking water.

The model: virus causes paralytic polio, vaccine provides immunity to virus is way too simple. The virus rarely causes paralytic polio and the vaccine quite often fails to provide immunity to the virus.

[Deborah]

some info from the CDC on multiple doses:

Multiple OPV

The reason you find children from other countries with multiple doses of polio vaccine isn’t because they don’t know what they are doing. You are witnessing the polio eradication program in action. They basically vaccinate every child in the entire country who is five years of age or younger on the same day. They do this for several cycles on two immunization days each year. Therefore, you are going to see kids with 4, 5, 6, or more polio doses.

What they are not saying: in countries where they are still having outbreaks of polio they keep vaccinating over and over and over again because they are still having outbreaks of polio. At some point, if you keep doing the same thing over and over again and it isn't working, do you reconsider what you are doing?

http://www.cdc.gov/vaccines/vpd-vac/...o-polio.htm#a1

[Emmeline II]

Originally Posted by stik

I haven't looked at the CDC stats lately, but I'm fairly certain that I have seen reports of a couple cases of wild polio in the US since 1979, primarily concentrated in unvaccinated populations. Wasn't there an outbreak in an Amish community a few years ago?

No. After an immune compromised infant that had been in a few hospitals was found to have the OPV strain in her stool, her community was tested and others were found to have it as well; no one actually had a clinical case of polio.

[AFWife]

Originally Posted by Emmeline II

No. After an immune compromised infant that had been in a few hospitals was found to have the OPV strain in her stool, her community was tested and others were found to have it as well; no one actually had a clinical case of polio.

And that was considered an "outbreak"?

[caned & able]

Originally Posted by AFWife

And that was considered an "outbreak"?

Yes.

[AFWife]

Originally Posted by caned & able

Yes.

I don't understand (truly) how "having the virus in your system without ANY symptoms" is an "outbreak"...

[caned & able]

I don't understand (truly) how "having the virus in your system without ANY symptoms" is an "outbreak"...

that is the health department's definition; it is also a way to confuse the situation and scare people into lining up for a vaccine they do not need.

...and ebola is also only one plane ride away.

[alegna]

Originally Posted by AFWife

I don't understand (truly) how "having the virus in your system without ANY symptoms" is an "outbreak"...

Because they are aiming at eradicating that virus. Eliminating it from the planet earth. Therefore, having it show up, still running around, means that they're that much further from their goal.

-Angela

[caned & able]

There is going to be a long wait for that.