Is a new pandemic of polio just around the corner?

Polio occupies a unique place in Australian history. It came at the beginning of the 20^th Century and remained for more than 50 years leaving an indelible imprint on Australian life. The long hot polio summers deeply influenced how we saw the disease, pain and suffering, and for lengthy periods panic, fear and hysteria prevailed.

For more than 50 years the disease seemed to strike at random, and unlike most infectious diseases affected the rich and the poor as well as city and rural dwellers. Children and young adults were the most commonly affected and for half a century fear of the disease was entrenched in our national experience becoming a source of dread, especially during Australian summers.

By the 1920s polio had become to be regarded as a fierce monster lurking in the dark hollows of human life, waiting to carry off young children.

The history of polio in Australia is really the history of how fear transformed our society. No one was able to predict the next outbreak or who the disease might target. No one had any real idea of how to avoid infection or how to protect their children.

Such circumstances bred widespread fear and panic. Schools were closed, gatherings of children prohibited, swimming pools emptied, picture theatres closed and many people were forbidden to go to work. Neighbours shunned neighbours and all levels of Australian and Local Government imposed strict quarantine procedures.

With little doubt polio had a shattering effect on young lives and the images of young children in a wheelchair, on crutches or in an iron lung transfixed the nation. For 50 years polio arrived each summer, striking without warning.

No one knew how it was transmitted or what caused it. Generally the medical profession largely relied on immobilization of the trunk and limbs of paralysed children and young adults by using plastic casts and splinting.

Overall the purveyors of popular medicines had a heyday.

Possibly as many as 40,000 Australians caught polio during the first half of the century but if the number of those who only exhibited minor symptoms is considered the number was probably in excess of 100,000. Overall Australia experienced some of the most severe polio outbreaks in the developed world particularly in the years 1937-51.

Two epidemics stand out as the most severe ever recorded. The 1937-38 epidemic in Tasmania and Victoria and the 1950-51 epidemic in South Australia and New South Wales.

The Tasmanian epidemic of 1937-38 stands out as the most severe in Australia’s history. With only a small population of 240,000 people Tasmania experienced 1,006 cases and 150 deaths, an overall rate of 42 cases per 10,000 people, the highest recorded in Australia’s history. In total 833 young Tasmanians aged under 15 caught polio in this outbreak including 644 aged under 9 years.

For many Australians the advent of the Salk and Sabin anti-viral treatment after 1956 saw polio gradually disappear but it left a legacy of crippled children and young adults.

Polio was thought to have disappeared following the development and widespread use of vaccines after 1956. Afghanistan and Pakistan remained the only countries where polio remained endemic.

But now we seem to be facing the re-emergence of polio throughout the developed world. Over the last few months cases of polio have been reported around our world and the virus has recently been discovered in wastewater in 8 boroughs of London as well as in parts of New York as well as a recent outbreak in Israel.

In Britain this is the first time in 40 years that polio has been officially reported and the last case of polio in the USA had occurred in 2013. Like Australia, the USA has a long history of polio outbreaks and between 1920 and 1955 tens of thousands of people were crippled by the disease each year. 

Today in Rockland and Orange Counties in New York, polio vaccination rates remain below 61 percent.  Rockland County is home to a large Hasidic Jewish community which has often been sensitive to vaccination.

In Britain the Government has recently announced that a polio booster shot will be made available for children aged from 1 to 9 years in London.

Two vaccines have been available for decades. One is inactive and given by injection while the other is live but weakened and taken orally. The inactive one was developed in the 1950s and remains a safe and effective way of killing the virus yet it seems while it provides protection the virus can still spread to other people. The oral vaccine developed in the 1960s possesses the ability to prevent transmission.

Over the last few decades we believed that like smallpox we had won the battle against polio but at the same time tended to overlook the fact that a late or post-polio syndrome appeared in a number of countries some years ago.

So, is polio only a plane or boat trip away from Australia? How much at risk do we remain? How many people in Australia have been vaccinated and how many would pursue vaccination if the disease arrived? Given that large numbers of Australians seem somewhat reluctant to vaccinate their children against an array of childhood infections are we now as vulnerable as we were 50 years ago?

If a polio epidemic broke out it could have a devastating effect upon young Australians and add yet another burden on our Government’s responsibility to protect us.