SAPP Saskatchewan Awareness of Post Polio Society Inc.


Polio


Polio [poliomyelitis or infantile paralysis] is not a new disease. In ancient Egypt, there were recorded cases of polio. Prior the to the 20th century, the virus was always present in the environment. This constant exposure to the virus allowed immunity to be built up and passed on to the next generation. A baby would receive antibodies to the polio virus from its mother which provided protection from the virus until the babies own immune system was capable of creating its own antibodies to the virus. Only in people who had absolutely no resistance or natural exposure [self-inoculation from the environment] to polio did the virus cause paralysis.

However at the beginning of the 20th century with the onset of modern sanitation practices and the development of modern plumbing, the polio virus no longer existed in the everyday environment. Exposure to the virus decreased and immunity declined in the general population. Though the polio virus had existed for thousands of years, it had seldom had the opportunity to cause epidemics as was now the case in the early 20th century.

The polio virus is a small RNA [ribonucleic acid] virus that has three different strains. The virus enters the body through the mouth, goes to the stomach and intestines where it begins to reproduce itself. It is then absorbed by the tiny capillaries in the walls of the intestine and from there it is carried by the bloodstream to the spinal cord. Once in the spinal cord, the virus heads directly to its one and only target, the motor neurons. These are the nerve cells that control physical movement. At this point, the viral infection will cause headaches and mild flu-like symptoms. However in those people who have no natural immunity or who have not been vaccinated the virus goes on to infect the entire spinal column and the brain stem which controls breathing. The mild flu-like symptoms now progress to a high fever, intense headache, vomiting, neck and back stiffness and finally paralysis.

People either die from the viral infection or they survive the viral attack [thus the term polio survivor] with varying degrees of loss of motor function. Some of the motor neurons are completely destroyed while others are only partially destroyed and still others are unaffected by the viral attack. Up to 20% of the motor neurons can be totally destroyed before there is any noticeable difference in physical movement to the polio survivor or to a casual observer. It is important to note that the sensory neurons are not affected by the polio virus thus there is no diminishment or loss of feeling even though paralysis has occurred.

One strain or form of the virus tends to concentrate its attack on the brain stem which contains the motor neurons that control breathing. This strain of polio is called bulbar polio. Damage to these neurons often result in paralysis of the respiratory muscles. The polio survivor is placed in an iron lung which physically inhales and exhales air for the polio survivor. To this day there are still polio survivors who must spend their entire day or most of their day in an iron lung or attached to an assistive respiratory machine to stay alive.

The other strain or form of polio centres its attack on the spinal column where it destroys the anterior horn cells which control movement of the trunk and muscle limbs. This strain of polio is called paralytic polio. However all three strains or forms of the polio virus can cause any combination of trunk, limb and respiratory paralysis or loss of function in varying degrees of severity.

After the infection, polio survivors very often regained use of their paralyzed limbs or respiratory muscles through endless exercises designed to strengthen and retrain the muscles to move again. Some polio survivors who left hospitals in wheelchairs were able to regain full use of their limb and trunk muscles. As well, some survivors of bulbar polio regained full use of their respiratory muscles. In other survivors where total loss of motor neurons began to exceed the 50% mark, there was irreversible paralysis in some limbs and a definite diminishment of function in the muscles. Recovery was never complete and many polio survivors experienced radical changes in their lives depending upon their age and situation in life at the time of the infection.

Those survivors who were adults had to undergo severe lifestyle changes due to loss of physical mobility. Some were forced to abandon their careers entirely while others were able to continue in their work areas by learning how to perform tasks in a wheelchair or while using braces and crutches. Others were able to find or create jobs which demanded less physical mobility. Relationships, personal or family, either survived and adapted to the new situation or ended.

Infants, children and teenagers were no less affected than the adults. Most of these returned to their families after hospitalizations but others were placed in foster homes or institutions. Weeks spent in isolation wards and months or even years spent in hospitals or rehabilitation centres had a traumatic emotional effect on the infants, children and teenagers. Children and teens often returned to find that they were no longer members of their peer groups. Infants returned to parents and siblings that they no longer recognized or even remembered.

Polio, though an ancient disease, is not eradicated in the world today nor is it vanquished by modern medicine. There is nothing that can stop or control the destruction of neurons by the polio virus. Nor are there any state of the art, high-tech gadgets that can return loss of motor function. No amount of sophisticated physiotherapy programs or machines will conquer the destructive effects of the polio virus. As in ancient times, one either survives the infection or one dies. Antibiotics no matter how powerful have absolutely no affect on a virus. The only preventative measure is vaccination.

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