Poliomyelitis is a disease that has probably been around since ancient times, but not necessarily caused by one virus, and prior to the 1900s: was never an epidemic disease.

This is one of the many fundamental contradictions of polio in that it emerged after most other infectious diseases had faded through proper hygiene and nutrition, and in countries with better sanitation and public health strategies. Another interesting fact is: poliomyelitis isn’t contagious. For you to understand that, we must talk about what poliomyelitis is.

What Exactly Is Poliomyelitis?

The word poliomyelitis describes a disease characterized by inflammation of the spinal cord or bone marrow that results in varying degrees of muscle weakness and paralysis, from partial and temporary, typically involving just one limb to much more severe forms such as multiple limbs and bulbar type, which can paralyze breathing, and result in death.

Polio means “gray” in Greek. Myelitis means inflammation. Thus the word poliomyelitis means the inflammation of the spinal cord (or gray matter).

Poliovirus (and other non-polio viruses) are enteroviruses that spread via the fecal oral route that in 95% of cases is completely asymptomatic, meaning it produces no symptoms. A few percent will have some mild symptoms, such as flu-like symptoms: fever, fatigue, nausea, stomach pain, etc.

Paralysis is a very rare and atypical consequence of a poliovirus infection, occurring in about 1 in 200 cases of poliovirus infection, or less than 1% of the time. There may be specific risk factors for paralytic poliomyelitis that are not often described, but my hunch is recent intramuscular injection is one of them, tonsillectomy is another, and a “fall” or extreme exercise may be a few more risk factors.

Other viruses such as other enteroviruses, or coxsackievirus, and chemicals such as the pesticides lead arsenate or DDT can cause the same set of symptoms of poliomyelitis, and its characteristic spinal lesion, and flaccid paralysis. Thus prior to the identification of viruses, and in the absence of laboratory tools, it’s impossible to know which virus or chemical caused a case or even an outbreak of poliomyelitis.

Before the 1900s, infantile paralysis, as it was commonly known as, was seen as sporadic cases and not associated with clusters or epidemics.

In 1909, Karl Landsteiner and Erwin Popper named what they thought was causing cases of poliomyelitis polio virus: a human virus that replicates in the gastrointestinal tract after ingestion. They named the virus after the condition, even though there were many potential causes and triggers of the affliction known as infantile paralysis, or poliomyelitis, but they would not know that at the time. As we can see, introducing the vaccine in a location does not remove all cases of poliomyelitis, and today we have a diagnosis Acute Flaccid Paralysis which is poliomyelitis.

After the vaccine was introduced in the mid-1950’s, many other cases of paralysis acquired new names: Guillain-Barré syndrome (GBS), acute flaccid paralysis (AFP), traumatic neuritis of the sciatic nerve secondary to IM injections (TNC), transverse myelitis–but commonly misdiagnosed as paralytic polio.

Teething Paralysis

In the 1800’s paralysis was seen in clusters of teething infants and coined teething paralysis. The medications given liberally to infants at this time were unregulated mercurial powders, arsenical solutions, and opioid cordials. Any of these ingredients alone or in combination could cause paralysis, seizures, convulsions, and death, etc. To learn more about the 1800’s solutions for teething, read this post.

The Shift From Sporadic To Epidemic

During the late 19th century and early 20th century, infantile paralysis changed from a comparatively rare disease for centuries, to an epidemic disease. The first recorded outbreak of infantile paralysis or poliomyelitis on US soil was in a rural part of Vermont in the summer of 1894, which involved a total of 130 cases. Dr. Charles Solomon Caverly documented and studied the outbreak, but there are many unanswered questions about this outbreak that suggests perhaps it was not poliovirus, based on what we know about the virus today.

• For instance, a high proportion of those affected had symmetrical paralysis of the limbs (69 cases had both legs paralyzed), whereas polio is characterized by an asymmetrical paralysis.
• Thirty cases had erythema, which is a reddening of the skin (rash), and two had urticaria, which is hives; and polio is not associated with either.
• Twelve cases had convulsions, and polio is not typically associated with convulsions.
• Of the 13 cases who never developed any paralysis, 7 died before paralysis had time to develop, which is another oddity because death due to poliomyelitis usually occurs because of paralysis of the lungs, and often it’s an ascending paralysis. I suppose in 1894 it could be possible to miss paralysis in your child, but it’s hard to say. Usually death is the result of paralysis, not some other thing.
• The age distribution is another oddity: 96 of the cases were under the age of 6, and 15 cases were over 14 years. One included case was a man in his 70s, and at least 9 were near the age of 21. The whole hygienic theory of polio is that older people had that early life exposure, but in this scenario it seems like older people were affected and had none of the expected immunity.
• Lastly, perhaps the finding most incompatible with a diagnosis of polio in this outbreak is the simultaneous paralysis of domestic animals: horses, dogs and fowls also died with these symptoms.

Caverly writes:

“That domestic animals suffered with human beings in our epidemic is a noteworthy fact and one, so far as i can learn, hitherto unobserved.”

One fact about poliovirus we know today is humans are the only host for the virus. It actually took years to adapt monkeys to be able to be infected by the virus in a lab, and even then it was only done so through intracerebral injection, not oral exposure.

Not every epidemic attributed to poliovirus was really caused by the poliovirus

Physicians were seeing poliomyelitis the disease from a range of causes, including poisons such as arsenic, DDT may set the conditions for the virus to become invasive, and also after medical procedures, known as “provocation polio”, including after vaccination, and tonsillectomy.

Not only could toxins and procedures predispose children and adults to developing the paralysis, but sharing improperly sterilized syringes and surgical utensils between patients is not a sanitary or safe practice.

In the 1940s and 1950s more cases of paralysis emerged–1952 being the highest number of reported cases ever. What happened in the 1940s and 1950s that was different?

DDT and Polio

In 1945, DDT (dichloro-diphenyl-trichloroethane) came on the US market used both as an agricultural pesticide and as a household insecticide. The organochlorine chemical was used in a variety of both commercial and domestic applications including entire communities, swimming areas, dairies and farms, streets, alleys, and inside the home–even in places that come in contact with infants and food.

Even though its negative health effects were known in the 1940s, it would not be banned until 1972, due to Rachel Carson’s phenomenal 1962 book Silent Spring, which inspired John F. Kennedy to lay the groundwork for the formation of the EPA (Environmental Protection Agency).

DDT was even thought to ‘prevent polio’ by killing ‘polio carrying insects’ (even though that’s not how it actually spread) so it was sprayed in large quantities during epidemics, in areas where people, especially children, would play.

It’s toxicity to the central nervous system was unknown at the time. DDT is an endocrine disruptor, and a human carcinogen. DDT is a nerve poison in insects and mammals.

The peak uses for DDT in these contexts, ie. directly on people, was right during the years of this unusual peak in polio cases.

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In the late 1940s, DDT was being linked to a new gastrointestinal disease in conjunction with an elusive virus x.

The authors of the article published in 1949, write that a new, strange syndrome has appeared in the USA in the recent years, which is most likely caused by some kind of infection, and got called ‘virus X’.

The syndrome is accompanied by acute gastroenteritis, nausea, vomiting, abdominal pain, diarrhea, runny nose, cough, sore throat, joint pain, muscle weakness, fatigue and paralysis.

It turned out later that all of these symptoms were caused by DDT. 

Provocation Polio

As early as 1942, epidemiologists were collecting information that children who had a recent operation were more likely to have paralytic polio.

They found that tonsillectomies were causing some cases of respiratory paralysis due to bulbar polio. The procedure was at its heyday in the early 1950s: about 1.5 million children were getting their tonsils out every year. This may explain why paralytic polio increased throughout the late 1940s.

But another medical procedure would also take the world by storm: vaccination.

DPT was rolled into one vaccine in 1948, which combined vaccines for diphtheria, pertussis and tetanus. Prior to this, an infant or child may have received the vaccines separately. At this time, all syringes and needles were being reused between multiple patients or children. A doctor would only have one syringe for his entire practice. Disposable syringes would not be invented until the mid-1950s, and not mass produced until the 1960s.

Researchers at the time found that DPT vaccination was linked with limb paralysis. Case-control studies confirmed that children with paralytic polio were more likely to have received a vaccination in the affected limb within the previous month.

When it was discovered that the DPT vaccine was contributing to rates of paralysis, vaccination campaigns during epidemics were halted. This would be known as provocation polio. But people would not know that this was a significant cause of polio during the 1950s.

I am so surprised most people don’t know this to this day.

DPT vaccine was not the only vaccine to cause invasive polio. Or let me say it another way, polio was not the only thing to be caused by recent injection.

During these same years, cases of invasive hib disease, or haemophilus influenzae would also triple through the years of 1940 to 1980.

The Cutter Incident

The first polio vaccine, known as the Salk vaccine, came out in 1955. By April, more than 200,000 children in five Western and mid-Western USA states received a polio vaccine in which the process of inactivating the live virus proved to be defective.

Within days there were reports of paralysis and soon the first mass vaccination program was called off.

In what would become known as the Cutter Incident, the faulty vaccine caused 40,000 cases of polio, leaving 200 children with varying degrees of paralysis and killing at least 10, but most likely more.

Some of the people who died were family members of the vaccinated children, as well as some of the vaccinated children. Also, there would be many reports of children who got all 3 doses of the Salk vaccines who would still die of polio.

In many places, there were MORE cases of polio after the introduction of the polio vaccines, than before. This is because the vaccine contained live virus, which was contagious and could infect others very easily.

In developing nations they still use a live virus oral polio (the US finally switched to inactive polio vaccine in the 1990s). But the live polio virus vaccine causes more cases of polio today than wild strain polio.