Title: Polio and Post-Polio Syndrome
Category: Access To Children's Health Care
We are very close to eradicating polio in the North and South American continents. There have been no cases of wild polio in North America for several years; however, there were a thousand cases of polio in South America in 1986. This has improved to only nine cases in 1991, the last one being in October of 1991. The World Health Organization with the help of Rotary International and other groups including the American Academy of Pediatrics has actively worked together since 1985 to eradicate polio world wide.
In order to be certain there is no polio left, it will require three years of active surveillance confirming no cases of paralytic polio. This is probably a possibility in the relatively near future. There are still pockets of polio virus in very poor areas around the world so it is critical that all the groups working together continue their efforts. Rotary International should be commended for actively helping to raise money and good will toward this worthy goal.
Polio vaccine is usually given as a pink liquid called Oral Polio Vaccine. This is the Sabin vaccine which was developed in the fifties and given world wide in the sixties. This vaccine has helped tremendously to better immunize the world against polio.
Unfortunately, a rare case of this oral polio vaccine can cause symptoms in a highly susceptible individual such as the cancer patient on chemotherapy or an AIDS patient. With all the AIDS cases around, it is important to avoid giving oral polio vaccine to a person with active AIDS. These patients receive the older form of polio vaccine which is the killed virus and is not actively excreted from the body. This is called IPV, or inactivated polio vaccine. All Health Units have this vaccine and any patient with AIDS or immune suppression for any other cause can receive the vaccine through their Health Unit or physician. Children in homes with AIDS patients or cancer patients on chemotherapy should receive the IPV vaccine. Post-polio syndrome is a term used to describe chronic progressive changes occurring in patients who had polio in the past. Usually 20 to 30 years after having active paralytic polio patients notice a progressive weakening of their good muscles which have over compensated for so many years. The exact cause of post-polio syndrome is still being researched and is not clearly understood. I personally believe it is a wear-out phenomenon from over use and overachieving, typical of most post-polio victims. In other words, due to having a weak leg or arm, children who had polio in the 20's through 60's over-compensated building stronger arms or a single stronger leg to make up for the weaker limbs. They usually overcompensated in other ways too, such as academically or socially. Unfortunately, this over-compensation does take its toll eventually and most post-polio victims suffer from progressive back pain, leg pain and decreased mobility. There are several post-polio support groups around the country sponsored by the March of Dimes including one in Lafayette.
In researching post-polio syndrome, I have done a lot of soul searching of my own. I had polio in 1954, which is one of the last epidemic years in the United States. I certainly was an over-achiever and over-compensated trying to participate in numerous sports and activities. I realized finally, in high school, that I couldn't play competitive football or basketball but still persisted in sports such as swimming, golf, tennis and later racquetball. Over the past 11 1/2 years since I have been in practice, I have noticed a slow and progressive weakness in my back muscles as well as leg muscles. This fortunately has been very slow and progressive and, despite scaring me every winter, has not been too bad.
The back pain, however, is fairly significant in cold weather and during times of heavy stress such as busy times of hard work and too much bending. Because of this progressive back pain and advice from several physicians specializing in post polio syndrome, I regret I will have to slow down and limit my practice to pediatric allergies only. I will always be thankful that I had the opportunity to practice general pediatrics like my Dad, who inspired me to want to be a good pediatrician like himself. I am thankful that I was able to recruit three fine pediatricians to come to Opelousas. They are Dr. Tom Jones, Dr. Greg Glowacki, and Dr. Rebecca Guidry. This makes me feel much better knowing that my general pediatric patients will have wonderful options for their care. We are also blessed with two other fine pediatricians still in very active practice in our community, Dr. Charles Bertrand and Dr. Thad Kretchmer. My mentor, Dr. George Prather is still active on occasion as well.