Last Legs: Polio And Our Relentless Efforts

A disease on a last sprint before eradication, let us explore the rise and certain death of a disease called Polio.

1994

“Sir… we’ve lost South America!”

As alarms blare in the situation room, the Polio Commander takes a look at the preceding situation…

It is dire to put it simply.

“Quick, concentrate efforts on the remaining strongholds! We can’t be eradicated!”

The commander looks to Africa and Asia, two of the largest continents on Earth in terms of population and area. His hope is to establish new fortifications in the dense forests and remote deserts of Africa as well as the highlands of Asia.

This is his only hope of survival, as he tuned into the news channel.

“The WHO officially declares South America free of Polio. A massive victory that frees another continent.”

6 years later — 2000

The situation room has relocated to a much more secure area. The Polio commander stands, overseeing the work of everyone.

“Sir! I have news from the Western Pacific division!”

The commander turns around to find a Polio soldier with a report in his hand. He looks visibly shook…

“What’s the news corporal?”

The soldier mustered up every bit of courage he had.

“There is no news sir! They’re late for check-in. Last time they sent a signal telling us they’re being surrounded by the enemy!”

The commander looks stunned, this was a growing problem for the survival of the virus.

“That means the division is lost. We’ve lost the Western Pacific. Concentrate efforts into Southeast Asia and Western Africa! We’re on our last legs everyone. It’s time we give it our all.”

Then, the screen in the room flashed, showing a news article.

“The WHO officially declares the Western Pacific area — including large nations such as China and Japan — free of Polio.”

Each waking moment, the situation grows more dire for the commander, as reports flood in.

Little did we know, this was the story of one resentful, tormenting nation, hellbent on causing as much suffering as possible.

This is the story of… Polio

Creationist

Polio (known as Poliomyelitis) is a terrible and malicious disease, tormenting many humans ever since its existence. It hunted silently, often giving no signs of existence, until…

It marks a victim to torture.

But not just any victims. Polio is cruel in its targeting, often forgoing it all if it could infect any child. Children under 5 are most likely to suffer under this disease without any mercy shown.

But, our enemy is a villain, not quite a monster. Although it infects a lot of people, it only shows symptoms in 25% of cases, and only 0.5% experience paralysis.

It is unknown when Polio began, we had no data on its existence up until the Egyptians drew drawings depicting the virus’s symptoms. Their records show an Egyptian priestess with a withered leg, which means this disease started its terror spree over 3000 years ago.

A Free Enter?

The way Polio infects victims is an adventure of sorrow. Polio is primarily transmitted through the fecal-oral route (ABSOLUTELY DISGUSTING).

Common vectors of infection (how) includes contaminated water or food, direct contact (touching a contaminated substance and then touching your mouth), or less commonly through tiny droplets in the air (coughs or sneezes).

Now, where does it go when it does enter?

Well, your throat and intestines wouldn’t appreciate these guests much, because they are the primary breeding grounds for Polio once entry is made.

When Polio reaches the lining of your throat or intestines, it hijacks human cells and begins replicating itself (copying itself into thousands). From there, the virus moves to the lymphatic system (big oh no), a sort of immune system highway.

From here on out, there are 2 scenarios. And… pray that you get the better one.

First Scenario, your body finds out the virus exists. And… the lymphatic system is quite literally the command post for all your T-cells (captain cells). Your immune system will cleanup the virus with precision, making sure it stops dead in its place.

This scenario happens to about 95% of infected people.

In around 4% of cases, your body will experience mild symptoms, often resembling a flu. Common symptoms often include a high fever (up to 38C or 100.4F), a headache, a sore throat, and others. These symptoms often persist for about a week before disappearing.

And… the 1% remaining?

In those cases, the infection persists enough to cause secondary viremia. The virus breaches your blood vessels, and it begins attacking the Central Nervous System.

These cases often lead to paralysis, usually in the legs. This develops over a few hours to a few days.

The paralysis isn’t usually permanent, and movement often will recover over the next few weeks and months. But some people are left with persistent problems. If the breathing muscles are affected, it can be life threatening.

As for long-term issues? Well, it’s more horrifying.

About 1 in 200 people often don’t regain full mobility, leaving them with some permanent paralysis. Others often suffer from problems that may need treatment and support.

Common ones include shrinking muscles, weakness, tight joints, and even deformities.

These are alarming symptoms, and even if 99% don’t experience the harsh effects, we must focus on the 1% that do. No one should experience the terror that the Polio virus and its army brings.

Two Vaccines — Two Risks

As Polio is such a big threat, people gathered around to pitch in their effort and skills to create a weapon that is capable of repelling the Polio Army.

INTRODUCINGGGGGGGGGGGGGG

The Inactivated Polio Vaccine (IPV) and the Oral Polio Vaccine (OPV). These are the two main vaccines we use to arm our population against the Polio Army. Both have their own advantages and bad effects.

The Inactivated Polio Vaccine (IPV) This vaccine was developed by Jonas Salk, an American virologist. This vaccine uses a dead version of the virus, making it impossible for people to get sick from the vaccine. The vaccine is administered via injection, delivering systemic immunity.

If you had this vaccine, your immune system will produce IgG antibodies that circulate your blood, killing the Polio viruses in the blood. This is why IPV is nearly 100% effective at preventing paralysis associated with Polio, as the virus quite literally can’t reach the nervous system.

However, this vaccine doesn’t really do a great job in creating immunity in your digestive tract (where Polio multiplies), as that requires IgA antibodies instead (which isn’t produced by your body even if you get the IPV vaccine).

So, while you might not get sick, you can still carry wild Polio virus around, which can spread to other people.

This vaccine is mostly administered in nations that no longer have wild Polio virus around, such as the US.

Fun Fact: Salk was practically treated as a national hero by the US public after his vaccine was released.

The Oral Polio Vaccine This is the second vaccine option, developed by Albert Sabin, it was fundamentally different from the Inactivated Vaccine. This vaccine used a weakened version of the virus. It was often administered either through two drops of the virus, or by the famous sugar cube method.

When you are administered this vaccine, the weakened virus will “infect” your gut, specifically your Peyer’s Patches, which are basically immune outposts. Your immune system will notice that these tiny destroyed protein hulls aren’t… food. They’re viruses.

Your body will begin to produce IgA antibodies, the type that destroys the virus in your gut.

A child who was administered the OPV vaccine will also “shed” the weakened virus in their poo, which yeah disgusting but that means other children also practically got a free dose of vaccine just by being around each other (sounds disgusting I know but hey).

Also, the vaccine viruses are so aggressive they often take up space the real Polio needs to replicate, it’s like filling the whole stadium with your team’s fans, leaving no room for the fans of the opposing team.

Unlike the IPV vaccine, the OPV vaccine is great for eradication as it prevents people from ever becoming vectors of infection again.

For a while, this vaccine was the preferred champion over the IPV vaccine. However, the virus still carries risks.

The first one being VAPP (Vaccine Associated Paralytic Polio). In very few cases (roughly 1 in 2.7 million), the weakened virus mutates and regains the ability to attack the nervous system. Sadly, the person might develop paralysis as if they actually caught wild Polio. This is a one-off case that affects the specific individual only.

The second one being VDPV (Vaccine Derived Poliovirus). When a vaccinated child sheds the virus in their shit, that virus can circulate in the sewage system or water supply for a very long time. In areas with low vaccination rates, the virus keeps jumping from person to person. The virus has a chance to mutate every jump.

After 12–18 months of spreading through an under-vaccinated community, the virus can fully “revert” to a form that is just as dangerous and contagious as wild polio. This is vaccine derived poliovirus. And it’s a big problem. Although we have destroyed Polio in many areas, the vaccine derived version still circulates in way more areas than actual wild poliovirus.

Fun Fact: Sabin hated Salk, criticizing him as just a “mere kitchen chemist.”

Timeline

So, let's dive into the timeline of Polio’s existence. We’ll be focusing on major dates that has a big impact on Polio. Most of these are taken from the Polio Eradication Initiative’s website, however much can’t be noted.

1580–1350 BC — First Records An Egyptian stele portrays a priest with a withered leg. This suggests that Polio has existed for thousands of years.

1789 — First Statement A British physician Dr Michael Underwood was the first to give a clinical description of Polio. He called it “debility of the lower extremities”

1840 — Investigation The first significant outbreak of infantile paralysis subsequently identified as Polio is documented in the US.

1907 — Categorization A Swedish pediatrician (or paediatrician), Dr Ivar Wickman, categorizes the different clinical types of Polio.

1908 — Early Research Austrian physicians Karl Landsteiner and Erwin Popper hypothesize that Polio may be caused by a virus.

1931 — Identification of Types Sir Macfarlane Burnet and Dame Jean MacNamara identify several types of Polio virus, known as types 1, 2, and 3.

By the way, there exist few sources that differentiate what Type 1, 2, and 3 Poliovirus do each. So, I gave up. If you want to know more about the different types you’d have to research deeper.

From the little bits of information I have gathered, it’s generally accepted that the three types of Poliovirus only differ in their transmission and paralysis rates.

“Type 1 is the most paralytogenic and used to be the most common cause of epidemics.”

From MSD Manuals, it’s likely true that Type 1 is the most aggressive type in the sense that it will lead to a very bad doctor’s visit about your neurons.

Type 2 Poliovirus is recognized to be a very efficient spreader, historically at least. We can’t really pinpoint what difference it has, but it was probably related to the replication in the gut phase. We do know it’s less likely to cause paralysis.

Nowadays, Type 2 is found as its Vaccine Derived version (VDPV) which continues to circulate in 31 countries.

Type 3 is the weakest of the three types. It didn’t spread as well as Type 1 or was it more transmissible than Type 2. It was last seen in 2012 and has been a footnote in most papers since its eradication announcement in 2019.

1955 — The First Weapon Dr Jonas Salk develops the IPV vaccine and licenses it. The vaccine will be used to grant people immunity against Polio. This vaccine helped push immunization efforts to children worldwide.

1961 — The Second Weapon Dr Albert Sabin develops the OPV vaccine. This vaccine rapidly replaces the IPV and becomes the vaccine of choice for most national immunization programs in the world, due to its ease-of-administering (you just give them drops to the mouth) and more importantly its intestinal immunity. This prevents people from spreading Polio. Populations which were administered IPV could still spread it to others, which is a big no for eradication efforts.

1988 — War Declaration The Global Polio Eradication Initiative (GPEI) is launched by the WHO. This is the second organized global effort since the Expanded Program on Immunization (EPI) at 1974.

1991 — The American Stronghold Falls Luis Fermin Tenorio in Peru becomes the last case of wild polio in the Americas. One entire continent is officially cleared of the Type 1 Poliovirus.

1997 — The Western Pacific Outpost Falls The last case of wild polio occurs in the WHO Western Pacific Region. She is a 15 month old girl called Mum Chanty living near Phnom Penh, Cambodia.

1998 — The European Stronghold Falls Melik Minas, a 33 month old unvaccinated child is the last child paralysed by indigenous wild poliovirus in the European region. A massive victory that cornered the virus and its army to a select few regions.

2000 — A New Challenger Appears Vaccine Derived Polio Virus (VDPV) has shown up! In 2000 it hit the region of Hispaniola (Haiti and Dominican Republic) with around 21 cases, leading to a new challenger.

2002 — Certification The European continent is certified to be free of wild Poliovirus. The commander can only watch as his territory slowly gets demolished.

2012 — The Intern is Eliminated The last case of wild Poliovirus Type 3 is recorded in Nigeria. Afterwards, the virus has no more cases.

2015 — Announcement 1 The WHO declares Type 2 wild Poliovirus as eradicated, causing massive celebration and a morale boost to eradicate the remaining Types.

2016 — A Change of Weapons The world stops using the Trivalent vaccine and switches to Bivalent (Types 1 and 3 only) as Type 2 has already been eradicated and including it would only amplify the growing issue of Type 2 VDPV.

2019 — The Intern is Found Dead The WHO declares Type 3 wild Poliovirus as eradicated. There only exists one more Type that circulates.

2026 — Now? Type 1 wild Poliovirus still exists in Afghanistan and Pakistan. However, Vaccine Derived Poliovirus has surged and infected many other countries.

If you wanna read more, check out our sources! This is simplified to keep it short and concise.

Fading As with my other blogs, this is the final thoughts I have with Polio and our civilization.

I believe that the eradication program has surpassed our expectations and restricted affected victims to only two major areas, Afghanistan and Pakistan. Just as Smallpox was eradicated, this Polio eradication attempt has lit the flame for many children and babies around the world. We have eradicated Polio from 99% of the world.

Bliss now reigns over many nations. Children are free of paralysis. Babies won’t have to face respiratory failure. Adults won’t be hit by the funeral of their very own children. The world has grown much more peaceful ever since Polio was mostly eradicated.

And yet… it hasn’t fully faded.

Today, the Polio Eradication Campaign is halted in the distant steppes of Afghanistan and Pakistan, unable to penetrate the broken trust locals wield over that area.

Residuals of the CIA’s 2011 fake-vaccination program (Hepatitis B)— aimed to aid in efforts against Osama bin Laden — kept vaccines from reaching high-risk zones, as it effectively shattered the foundation of why vaccines even work.

Trust

And worst yet, we don’t know when vaccine programs can continue in these areas. The eradication program is for now halted in its tracks. We have eliminated 99% of the virus, yet the 1% stands undisturbed.

Every day, many children are paralyzed as their own parents watch unable to do much. The Taliban and local militias have obstructed efforts, believing that control will be better than to ever trust global programs. Even when they open up, they will never allow total cooperation.

So, what will we do?

Right now, efforts to rebuild trust on vaccine programs and establish some form of security in Afghanistan is in progress, but the very foundation will take years and unfortunately many deaths to simply reconstruct.

And… what about you dear reader?

All things start small, but you will need to employ the best tactic we have, prevention. If you can, vaccinate yourself and others if you deem Polio to be a risk. If you want to create a lasting impact, join worldwide programs as volunteers or donators. Participate in awareness campaigns. Lastly, acknowledge it will be a long battle. Polio won’t be eradicated soon, but it is our job that in the end it is eradicated.

Our efforts have to be concentrated, but actions have to be concrete and fulfilled with parties cooperation. We have to make sure that whatever happens, whoever administers the vaccination, whoever manages the program, and whoever cooperates, won’t be a victim or a perpetrator.

So, let’s close it off. We will emerge triumphant, but only if we put in our effort and trust to the ones leading the operation. Let’s go!

Do you think Polio can rebound if we cornered it? What are your thoughts on the situation in Afghanistan and Pakistan? Do you support vaccine usage? Let me know in the comments!

Sources:

• https://www.who.int/news-room/fact-sheets/detail/poliomyelitis
• https://www.mayoclinic.org/diseases-conditions/history-disease-outbreaks-vaccine-timeline/polio
• https://polioeradication.org/about-polio/history-of-polio/
• https://www.mayoclinic.org/diseases-conditions/polio/symptoms-causes/syc-20376512
• https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/
• https://www.britannica.com/science/vaccine-associated-paralytic-polio
• https://www.msdmanuals.com/professional/infectious-diseases/enteroviruses/poliomyelitis
• https://www.who.int/teams/health-product-policy-and-standards/standards-and-specifications/norms-and-standards/vaccine-standardization/poliomyelitis
• https://pubmed.ncbi.nlm.nih.gov/11896235/

These are not all the sources I used, if you want to find out more, search about it online! Also yes this is messy but Polio is such a documented and urgent virus that there are too any sites.