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Sunday, March 26, 2017

How we beat polio

On the 64th anniversary of Salk announcing he had a vaccine for polio, I offer my story of how we spared children from this horrible disease.

In 1894, the first epidemic of poliomyelitis broke out in Rutland, Vermont. While paralysis from polio was rare, it occurred often enough to warrant fear among parents.

After former vice presidential candidate Franklin Delano Roosevelt was paralyzed by polio in 1921, the profile of polio rose, particularly 17 years later when he was president and founded, in 1938, the private National Foundation for Infantile Paralysis, best known for its March of Dimes fund-raising and awareness-raising campaigns.

This is why FDR is on the dime.

In 1953, the foundation's search for a vaccine was rewarded, when Dr. Jonas Salk developed his famous vaccine, which led to a massive double-blind test in 1954, in which the parents of more than 1.8 million children in America, Canada and Finland volunteered their children to participate. This alone was an amazing development, which showed the depth of parental concern.

Jonas Salk was born in New York City on October 28, 1914, to Ashkenazi Jewish immigrants, who had no formal education themselves.

By 13 he was in high school -- Townsend Harris High School, a public school for intellectually gifted students -- and went on to City College of New York.

His mother wanted him to be a lawyer. He became a doctor. She may be the only Jewish woman in the history of New York who didn't want her son to become a doctor.

He chose New York University for medical school, in part because unlike Yale and other Ivy League schools it had no quota for Jewish students.

Salk later faced discrimination at research facilities, as they, too, had quotas that limited the number of Jewish people on their staffs.

It is incredible that prestigious institutions chose people by their skin color or religion, and not their brilliance. This continues today. We call it affirmative action. Its real name is discrimination.

Just as another NYU alumnus, Walter Reed, conquered yellow fever, Jonas Salk set out to conquer disease, rather that treat it.

"My intention was to go to medical school, and then become a medical scientist. I did not intend to practice medicine, although in medical school, and in my internship, I did all the things that were necessary to qualify me in that regard. I had opportunities along the way to drop the idea of medicine and go into science," Salk said.

"At one point at the end of my first year of medical school, I received an opportunity to spend a year in research and teaching in biochemistry, which I did. And at the end of that year, I was told that I could, if I wished, switch and get a Ph.D. in biochemistry, but my preference was to stay with medicine. And, I believe that this is all linked to my original ambition, or desire, which was to be of some help to humankind, so to speak, in a larger sense than just on a one-to-one basis."

Salk's first success came with influenza, working with his mentor, Thomas Francis, who was the first American to isolate a flu virus. He taught at New York University, and when he moved on to the University of Michigan, Salk followed.

Their first flu vaccine was used to protect American soldiers in World War II. Disease often kills more men than bullets. This was a feat that in some ways was as important as his polio vaccine.

Pneumonia and influenza were responsible for the largest number of infectious disease deaths throughout the century, although tuberculosis was a major killer in the first half of the century.

Between 1900 and 1909, infectious deaths averaged 797 per 100,000 people annually.

By 1980, this had fallen to 36 deaths per 100,000 in 1980.

After World War II, Salk set out to fight another battle, polio. But Salk did not work in isolation. John Franklin Enders, Thomas Huckle Weller, and Frederick Chapman Robbins succeeded in developing a culture of a animal virus — poliovirus — in vitro.

The importance of this discovery applied to other viruses, and Enders earned the title of Father of the Modern Vaccine.

Salk joined the University of Pittsburgh, where he determined there were three distinct types of polio viruses. He set out to develop a "killed virus" vaccine for the disease.

Getting a live virus to was problematic in that it had to come from a human. Enter, wittingly, Henrietta Lacks, a black woman who was the mother of five.

She developed cancer of the cervix and died 4 1/2 months after the birth of her last baby. Missus Lacks had been treated at Johns Hopkins, where despite blood transfusions and other efforts to keep her alive, she died of uremic poisoning on October 4, 1951, at age 31.

Part of her would prove to be immortal, and while she would not live to raise her own babies, she would save the lives of countless other babies.

Researcher George Gey discovered her cells could be kept alive, and grow. Before, such cells survived only a few days and scientists spent more time trying to keep the cells alive than on research with the cells. Gey named the cells from Lacks, HeLa, in her honor.

Scientists considered her cells immortal as they did not die after a few divisions. This boosted research enormously.

George Otto Gey was born on July 6, 1899, in Pennsylvania to German immigrants. He and his wife Margaret started the Tissue Culture Laboratory at Johns Hopkins University. Not only did he retrieve Henrietta Lacks's immortal polio virus, but he developed the roller drum, which is used to nurture cell cultures.

Despite the polio vaccine, Enders, Weller and Robbins shared the Nobel Prize in Physiology or Medicine in 1954 — not Salk.

Enabling a vast array of vaccines was more important than developing a vaccine for one disease, no matter how heart-wrenchingly polio disabled and killed children.

The development of the Salk vaccine required mass production. The cells from Henrietta Lacks were the first to be put in mass production, and in 1955 the first cells to be successfully cloned.

Salk's work would gain him world recognition. He chose not to patent the vaccine.

But research on polio vaccines continued, and in 1962, a rival, Albert Bruce Sabin, introduced the first oral polio vaccine, which quickly supplanted the Salk vaccine. It was cheaper and did not require using a needle on children.

If you don't have polio, you likely should thank him. I remember taking that sugar cube in 1962 at Audubon Junior High in Cleveland when I was 8.

Sabin was born on August 26, 1906, in BiaƂystok, Poland, which was then part of Czarist Russia. he was Ashkenazi Jewish. When he was 16, the family emigrated to New York City, where he too enrolled in New York University.

Salk and Sabin were unfriendly rivals, but their vaccines have nearly eradicated polio. Only 416 cases were reported to the World Health Organization in 2013.

The near eradication of polio could have been done by Europe. After all, France gave us the smallpox vaccine. But Lady Liberty lured the oppressed to the United States. Harvard or Yale could have had the prestige of educating the eradicators. But their bigotry left the job to New York University.

The work of Thomas, Enders, Wellers, Robbins, and Reed also led to these marvelous vaccines. Newton was correct about standing on the shoulders of giants. Salk stood on theirs. Sabin on his.

And then there is Henrietta Lacks. Without her, where would we be?

In her lifetime, her children could not attend school with white children in most of the United States. And yet, her death meant thousands of white children were spared the pain of polio.

You wonder if given the same opportunities others in America had, what Henrietta Lacks and her husband David "Day" Lacks may have come up with.

Because we do know that despite a lesser discrimination, two Ashkenazi Jewish men were able to help conquer polio.


My first collection of "Exceptional Americans" is available here. And the Kindle version is here.

Volume 2 is available on Kindle.

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  1. I was in 5th grade at Albion Road Elementary School in North Royalton, Ohio (a Cleveland suburb) when we all lined up in the gymnasium-cafeteria and were given the sugar cubes. For us kids, it was that simple!

  2. Salk and Sabin were real blessings.

  3. Actually, Don, it's no longer affirmative action. It's now Diversity (All Hail Diversity!) Keep up. GOC

  4. I was part of the double blind test. I had a shot, sugar cubes came later. I have a little pin (like a political pin) that has Polio Pioneer on it, dated 1954.Wonder if I actually had the vaccine? Later I did take the sugar cube, and have had a booster too.

  5. I used to have a boss who had polio and had to use crutches all the time. He would always tell everyone how he was born the year before the polio vaccine was invented. If he hadn't been such a creep we would've felt sorry for him.

  6. Great read. Thank you for posting. Many memories of those afflicted and of taking the cube.

  7. Remember those unlucky souls who were trapped in iron lungs? Those were scary looking machines and it must have been awful for the victims.

  8. Don, I remember being in a study by Salk, et al, in Kanawha City in Charleston as a 4/5 year-old in 1954. In that summer our parents volunteered us for the study. Every 4 weeks the word would go around the neighborhood that the vampires were afoot.