The disease is caused by a virus, most cases do not cause any symptoms, and its disease – also asymptomatic – may cause complications even 25-40 years after infection. When its epidemic broke out, the whole world froze in fear. Only the vaccine brought the desired safety. Today most continents are free of Heine-Medin disease. Is it forever?
- Heine-Medin disease is an infectious disease caused by the polio virus
- Most patients have asymptomatic polio, but when symptoms appear, they are very severe. This includes paralysis of the spinal cord and / or the base of the brain
- In the 50s, a polio epidemic was declared, affecting most countries in the world
- The fight against Heine-Medin disease ended only with the development of a vaccine. The Polish scientist Hilary Koprowski is believed to be its discoverer
- You can find more such stories on the Onet homepage.
“Dirt is the enemy, cleanliness is the goal”
May 20, 1949. San Angelo, Texas, USA. A local newspaper sadly reports that one of the youngest citizens is ill. Nothing alarming – Heine-Medina disease has already appeared in the city (especially in late spring). Usually these were single cases and doctors dealt with them. But this time is different.
Queues of despairing parents begin to form in the hospital, carrying their feverish and crying children in their arms with undefined pain. A few days after the first incident of the season, the statistics are terrifying: 25 patients and as many as seven fatalities. They are the babies themselves.
After consulting the chief physician of San Angelo, the city authorities advise residents to be vigilant and to pay special attention to hand hygiene (the virus is transmitted via the faecal-oral route). It is not recommended to use swimming pools and gather in larger groups, parents were instructed to watch over their children about washing their hands and keeping their distance while playing.
Two weeks after the first case, the balance is not optimistic. Number of infected: 61. The city takes more decisive steps and announces the first restrictions: ban on indoor events, canceled outdoor concerts and sports tournaments, closed churches, bars, bowling alleys. The aura does not help against the virus – it’s 38 degrees Celsius, asking for cooling down in a public swimming pool. However, the residents approach the subject seriously – they stay at home, it’s only been a week.
Extremes emerge quickly. Some experts say: clean up after yourself, wash your hands, remove insects. Others add: no one understands anything anymore, we have lived to see the times when people shouldn’t even shake hands. It is not known if it is possible to talk freely with a neighbor. Dog owners are concerned – the virus is said to be spread by animals. Is keeping your distance and washing your hands really enough?
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The hospital and the city go further: they recommend the use of strong insecticides in homes. Manufacturers of specifics rub their hands, advertisements appear, encouraging them to apply preparations to walls and furniture in homes. The authorities are releasing two vehicles into the city that spray poison on the property. They do not know that several years later, substances containing this chemical compound will be considered toxic in many countries, and their use will be banned.
At the peak of the epidemic in July, the city hospital lacks beds. Most children under the age of 15 lie under respirators. It is from them that stool and tissue samples are collected so that scientists can develop a vaccine. The US government sends equipment, specialists, and donations to San Angelo. Eventually, the number of sick people starts to decline, but the statistics are still frightening: 420 cases (one in 124 inhabitants), 28 fatalities. 84 people are paralyzed.
The Pyrrhic victory of the Texas city did not change much in the wider landscape. The disease quickly spread across the country and crossed borders. The virus was not picky – it attacked equally wealthy and poorer neighborhoods, rich and poor, developed and developing countries. The 50s were for most of them a period of intense struggle with Heine-Medin disease. For scientists, a race against time to release a vaccine before polio decimates populations.
Aggressive virus
Acute widespread infantile paralysis, viral anterior horn inflammation of the spinal cord, Heine-Medin disease (or shortly: heinemedine) H14, poliomyelitis, polio – these are different names for the same infectious disease, which until recently was a powerful challenge for medicine. The disease is caused by the extremely dangerous poliovirus, which first attacks the lymph nodes and the circulatory system, and then spreads throughout the body, leading to the destruction of the nervous system. To date, three types of virus have been identified, and while each is structurally different, they are all equally virulent.
Polio is not easy to diagnose. In as much as 90 – 95 percent. In some cases, the disease is asymptomatic, and even when symptoms do appear, they are similar to many other, less serious diseases: sore throat, diarrhea, fever. The percentage of patients who develop Heine-Medina disease in this way (technically speaking then of abortive polio) is about 4 – 8 percent. Most of them manage to produce antibodies and neutralize the virus.
The paralytic type is a rarer (about 0,5% of cases) and at the same time much more severe in the course and complications. As the name suggests, the infection causes neurons in the anterior horns of the spinal cord to be paralyzed. As a consequence, the sick person becomes partially paralyzed. Such paralysis may affect the legs, arms or the torso (spinal form), causing paralysis or paresis and, consequently, atrophy of the affected muscles. In another (bulbar) form, the nerve centers at the base of the brain are destroyed, resulting in problems with movement, speech, and even breathing. At worst, the two come together – paralysis affects both the spinal cord and the base of the brain. Mortality is highest in these cases.
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An equally dangerous symptom of infection with the virus is post-polio syndrome. It can occur several decades (from 25 to 40 years) after being infected (regardless of whether the patient was experiencing any symptoms, was unaware of the infection and was asymptomatic). Post-polio is a group of ailments such as deterioration of muscle efficiency, their rapid fatigue, chronic pain in muscles and joints, and sometimes problems with speaking, swallowing and breathing.
Heine-Medin’s treatment is purely conservative. The disease cannot be cured. The therapy is aimed at increasing the patient’s quality of life, e.g. through rehabilitation of weakened muscles or speech therapy. For this reason, so much importance is attached to preventive vaccination against polio.
The vaccine war
Today it is a matter of course – in most countries of the world the poliomyelitis vaccine is easily available and given to the youngest children (in Poland it is on the list of compulsory vaccinations and is fully reimbursed). This allowed for the almost complete elimination of the disease in the world (single cases of polio appear sporadically in only a few Asian countries).
Before that happened, however, scientists waged a real war to invent a panacea for Heine-Medin disease. War, not only a fight, because in addition to the overarching goal of developing a vaccine, researchers also competed with each other for priority and effectiveness. Although there were many research teams in the competition, three scientific personalities were important: Hilary Koprowski, Albert Sabin and Jonas Salk.
The first doctor from Warsaw, who settled in America for many years, conducted his experiments in Eastern Europe, Ireland and Africa. The American-funded Cyanamid Koprowski succeeded in producing nine million doses of a live virus vaccine. They were used, among others, in Poland, in 1959 (the first round of vaccinations was organized in Congo, nine years earlier), where polio had been taking its toll from the beginning of the decade.
The effect surpassed all expectations. In the four years following the administration of the first vaccine in the country, the number of cases of Heine-Medina disease fell from 30 to XNUMX a year, and deaths from a few hundred to just two. Today, Koprowski is considered the discoverer and developer of the first effective polio vaccine.
The second, an American doctor of Polish-Jewish origin (born in Białystok), also worked on a vaccine containing live viruses. With the support of the National Foundation for Children’s Paralysis, he conducted a large-scale vaccination campaign in the Soviet Union. Although he lost the fight for priority with Koprowski, his vaccine is now – along with Salk’s panacea – used all over the world in the prevention of polio.
Ultimately, it was the solution of the last of the three, Salk, that stood the test of time. Composed of dead viruses and administered – as the only one of the three – parenteral vaccine of a virologist from Harlem in New York, shortly after its first production (also co-financed by the National Foundation), saved two million American children from the disease (so many were treated as a panacea in the great polio prevention project in the 50s. XX century). The success of the vaccination program earned him fame and the title of a national hero.
Regardless of the course of research on the polio vaccine, the world has won the scientists’ race for the palm of priority. The preparations developed by three researchers helped to reduce and then completely eliminate Heine-Medin disease in most countries of the world. May the coronavirus, which in many respects – from symptoms (or their absence), through transmission to range – resemble polio, repeat its path and be eradicated as soon as possible with an effective vaccine.
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