Fears of polio resurgence as US vaccine adviser questions need for childhood shots | US healthcare

A resurgence of preventable infectious diseases, coupled with a re-evaluation of routine vaccine recommendations, is raising concerns among medical professionals and polio survivors about the nation’s preparedness for a potential polio outbreak. Experts warn that the healthcare system may lack the infrastructure and expertise to adequately address a widespread return of the disease.

A Forgotten Disease, A Fading Expertise

Grace Rossow, an operating-room communications coordinator in Illinois who experienced polio as an infant, expressed a stark assessment: “We don’t have a healthcare infrastructure to take care of a polio outbreak.” She emphasized the lack of familiarity with the disease among current medical staff, stating, “They don’t know how to treat it. It is a massive problem if we have a resurgence of polio.”

Polio itself has no cure; treatment focuses on supportive care. The long-term effects, however, can be debilitating. Art Caplan, a polio survivor from the 1950s Boston outbreak, vividly recalls the fear and uncertainty of his hospitalization, witnessing fellow children succumb to the disease or require the assistance of iron lungs to breathe. Even after a surprising recovery, he continues to use a walker due to leg weakness.

The Loss of Institutional Knowledge

Caplan, now a professor of medical ethics at NYU Grossman Medical School, noted a critical loss within the medical community. “There’s nobody left. They don’t see it,” he said, referring to the dwindling number of doctors with firsthand experience treating polio. This sentiment was echoed by Gordon Allan, a surgeon at Southern Illinois University School of Medicine, who observed that orthopedic practices have significantly changed since the era when polio was prevalent.

Allan explained that specialized procedures once common for treating post-polio complications, such as tendon transfers around the hip and ankle, are now rarely performed. He stated, “That’s a lost art.” He further noted that even procedures like total knee or hip replacements in post-polio patients are more complex due to poor bone quality and increased risk of complications.

Rossow, who contracted polio as an infant in India, highlighted the challenges faced by polio survivors in receiving appropriate care, even with a supportive medical team. She described polio as a disease that “defies conventional treatment,” and emphasized that physical therapy can sometimes worsen symptoms. She also noted that many neurologists lack familiarity with the condition due to its rarity.

The Impact of Declining Vaccination Rates

The success of the polio vaccine has, paradoxically, contributed to a decline in public awareness and a growing complacency regarding vaccination. Caplan expressed outrage at the suggestion by Kirk Milhoan, chair of the Advisory Committee on Immunization Practices, that routine childhood vaccines were being reconsidered due to decreased disease risk. He argued that those who lived through the polio epidemics would be “furious” at such a proposition.

Rossow warned that families who reject vaccination, particularly those in insular communities, are most vulnerable to outbreaks. She stated that in these communities, “you could really get polio under way before anybody realized that it was there.” She emphasized the importance of maintaining “huge reservoirs of vaccine available to rapidly deploy when the inevitable recurrence happens.”

Frequently Asked Questions

What are the long-term effects of polio?

Between a quarter and a half of patients develop post-polio syndrome, a lifelong condition characterized by weakening muscles and bones, fatigue, and other complications.

What is the current state of polio expertise in the US?

Experts report a significant decline in medical professionals with firsthand experience treating polio, leading to a loss of specialized knowledge and skills.

What is the most effective way to prevent polio?

According to experts, the most effective prevention is vaccination against polio.

As vaccination rates fluctuate and the memory of polio fades, what steps should public health officials and medical communities take to ensure preparedness for a potential resurgence of this debilitating disease?