SAPP Saskatchewan Awareness of Post Polio Society Inc.


MASTHEAD

ISSUE #21 OCTOBER 1996


President's Message

Here we are back to our support meetings again after another summer. I hope everyone enjoyed a good one. We have a number of events coming up both here and abroad.

But letís see what has happened over the summer, first we have an information page on the Saskatoon Free Net, with links to other polio organizations and web sites. Information is bountiful on the net and the possibilities are so great. We look forward to sharing lots of new information with you in upcoming newsletters.

Ron Johnson, President

*****

40 Years of Polio Prevention

*Reprinted from Abilities/summer 1994

Forty years ago, the largest medical experiment in history took place, testing a vaccine to prevent the escalating ravages of poliomyelitis. This was the Salk vaccine, named after Dr. Jonas Salk of Pittsburgh. Close to two million children across the United States and parts of Canada were involved in this field trial, which was orchestrated by the National Foundation for Infantile Paralysis (NFIP), or March of Dimes.

Canadian involvement in this massive experiment went far beyond testing a small amount of vaccine. The Canadian role was fundamental to the entire project, for without Connaught Medical Research Laboratories at the University of Toronto, there would not have been a trial, or a practical vaccine in the first place.

The broad and complex problem of polio dominated the first half of the 20th century. Major research progress was stymied until 1949, when a way was finally found to grow the polio virus in a test tube instead of relying on monkeys for all research. This Nobel Prize-winning advance greatly stimulated polio researchers, including those at Connaught Laboratories.

Dr. Andrew J. Rhodes had led a major polio research program at Connaught since 1947, and by 1951 he was also growing the polio virus in test tubes. Yet not enough virus was being produced to be practical for a vaccine until one of Rhodesí associates, Dr. Arthur E. Franklin, tried a new method that involved the nutrient base known as Medium 99. This medium was a conplex and chemically pure mixture of over 60 ingredients and was the first of its kind. Medium 199 had been developed at Connaught in 1949 by Dr. Joseph F. Morgan, originally for studying cell nutrition in cancer research. Morgan and Franklin were close friends and in the fall of 1951, after a discussion of the problems Franklin was having with growing the polio virus, Morgan supplied some 199 to see if it could help. To his surprise, 199 worked incredibly well.

Meanwhile, Salk was confident that an inactivated vaccine could prevent polio in humans as it seemed to in monkeys. However, his vaccine was not yet safe for human use, nor could he produce enough for the millions of families who were clamouring for protection from the dreaded disease. It was in solving these two major problems that Connaught researcher Dr. Leone Farrell came up with the "Toronto technique" to produce bulk quantities of the polio virus, using large bottles that were gently rocked in a series of specially designed machines.

In early 1952, when the NFIP and Salk first heard about the value of 199, it gave Salk confidence to prepare a vaccine that would now be safe to try on children. In January 1953, the residents of a home for children with disabilities near Pittsburgh were the first to get Salkís vaccine. In the meantime, the American March of Dimes poured money into Connaught to expand its methods of growing the virus for a large field trial. Connaught had already established a prominent international reputation for developing vaccines and other public health products, and since it was a non-commercial manufacturer, a more open and cooperative relationship with Salk and the NFIP was possible.

By the summer of 1953, Connaught was asked by the NFIP to provide all of the polio virus fluids required for a national field trial set to begin in the spring of 1954. Through the fall and winter of 1953-54, large bottles of the polio virus were sent in station wagons from Toronto, over the border to drug companies in Detroit and Indianapolis, where the virus was inactivated and processed into a finished vaccine. Monkey kidneys were needed for growing the virus, and during this time at least 165 monkeys were necessary per week to produce the 3,000 litres of virus fluids needed for the trial. To Salk, the efforts of Connaught in this project were "Herculean" in magnitude. Without their collaboration, there could had the experience or facilities to undertake such a financially risky project.

After a number of delays, the NFIPís mammoth vaccine trial began on April 26, 1954 and involved the elaborate tracking of some 1.8 million children who were either given the vaccine, injected with the harmless 199 as a placebo, or simply observed to see if they contracted polio or not. In appreciation of Connaughtís curcial role, the NFIP offered the Canadian government some surplus vaccine in May 1954 and invited them to take part in the trial. The lateness of the offer was not appreciated by Ottawa or most of the provinces. However, the seriousness of the unprecedented 1953 polio epidemic in some provinces, especially in the west, acted as a pressure on Manitoba, Alberta and the City of Halifax to accept the offer. As for Connaught and the federal government, their sights were set on an all-Canadian field trial of Salkís vaccine which would begin in the spring of 1955 no matter what the final results of the American trial were.

On April 12, 1955, the announcement of the highly anticipated field trial results turned into a major media event and a rare example of good news. After being immediately licensed, American vaccine producers rush-released their vaccine to the U.S. public with little government control. The Canadian trial was just starting by then, but unlike the situation to the south, the federal and provincial governments shared the full cost of the vaccine and distributed it free of charge to children in grades one to three, who were most susceptible to polio.

By the end of April, the public euphoria over the Salk vaccine was shattered when a total of 79 children given the vaccine from Cutter Laboratories in California contracted polio. This forced Cutterís vaccine off the market and also forced, by May 8, the cancellation of the entire U.S. vaccine program by the U.S. Surgeon General.

In Canada, the Minister of National Health and Welfare, Paul Martin, faces a difficult decision: What should Canada do? The Prime Minister didnít want the Canadian trial to continue, but based on the long experience of Connaught with polio research and the development of the vaccine, Martin maintained his confidence. The vaccine had not yet caused any problems in Canada and so the immunization program continued. It never did cause any Canadian troubles.

The Canadian faith meant a lot to Jonas Salk and bolstered his bruised confidence in the vaccine. The success story of the Canadian polio vaccine program attracted a lot of American press and political attention, sharply highlighting the contrasting levels of government interest in planning, testing, distributing and paying for the vaccine between the two countries. The prominence of the Canadian and Connaught vaccine program also played a major role in insuring its future international use in the control of polio.

The 1954-55 Salk vaccine field trial was unprecedented in medical history and not only demonstrated the value of the vaccine against paralytic polio, but also involved a strong Canadian connection that was crucial to the future control of this dreaded disease around the world.

Christopher J. Rutty

*****

Upcoming Events

Polio Regina Inc. "Accessing the Future" Conference í96: the one day event will be at West Harvest Inn, Regina, SK, on Saturday, October 26, 1996. Starting at 9:00 a.m., late Registration is $30.00. Contact Dan Black, (306)789-7058

Saskatchewan Abilities Councilís Farmers with Disabilities Program, MANAGING YOUR TWO MOST IMPORTANT ASSETS: YOUR HEALTH AND FINANCES: a conference for all audiences. November 14 & 15, 1996, 1:00 p.m., Heritage Inn, Saskatoon, SK Registration $35.00 per person/$80.00 per family (children under 19)

International Post-Polio Conference, November 8 - 10, 1996. Living with the Late Effects of Polio: Post-Polio Network (NSW) Inc. are the hosts. Contact Jean Skuse, (02)810-7864 or Nola Buck (2)636-6515 for information.


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