|Year : 2016 | Volume
| Issue : 2 | Page : 89-91
A tribute to Jonas Salk: A journey towards polio free world
Ranjan Sukhdeo Solanki, Ashok M Mehendale
Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
|Date of Web Publication||31-Aug-2016|
Ranjan Sukhdeo Solanki
Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Solanki RS, Mehendale AM. A tribute to Jonas Salk: A journey towards polio free world. J Mahatma Gandhi Inst Med Sci 2016;21:89-91
Polio was a medical oddity that baffled researchers for years. It was first recorded in 1835 and grew steadily more prevalent. It took a long time to learn that the virus was transmitted by fecal matter and secretions of the nose and throat. It entered the victim orally, established itself in the intestines, and then traveled to the brain or spinal cord. Many famous people were polio victims; Itzhak Perlman, one of the world's finest violinists, was permanently disabled at age four, and used to play sitting down. Actor Donald Sutherland, President Roosevelt, writer Arthur C. Clarke, writer Robert Anton Wilson, actress Mia Farrow, singer-musician Neil Young, Olympic dressage rider Lis Hartel, actor Alan Alda, musician David Sanborn, singer Dinah Shore, nuclear physicist J. Robert Oppenheimer, actor Lionel Barrymore, and Congressman James H. Scheuer were infected.
According to American historian William O'Neill, Paralytic poliomyelitis (its formal name) was, if not the most serious, easily the most frightening public health problem of the post war era.” He noted that the epidemics kept getting worse and its victims were usually children. By 1952, it was killing more of them than was any other communicable disease. However, polio did not gain national attention until 1921, when Franklin D. Roosevelt, former vice presidential candidate and soon to be governor of New York, came down with a paralytic illness, diagnosed at the time as polio. At the age of 39, Roosevelt was left with severe paralysis and spent most of his presidency in a wheelchair.
Before the advent of polio vaccination, it was considered a threat, second only to atomic bomb. Jonas Salk was deeply affected by the children crippled with Polio. He decided to dedicate his life to a broader cause affecting humanity than working on one-to-one basis or treating patients.
| Life Sketch of Jonas Salk|| |
Jonas Salk was born in New York City on October 28, 1914. He grew up poor in New York City, where his father worked in the Garment district. Education was very important to his parents, and they encouraged him to apply himself to his studies. He was the first member of his family to go to college. Parents, Daniel and Dora Salk, were Ashkenazi Jewish immigrants who had not received extensive formal education. He had two younger brothers, Herman and Lee, a child psychologist. When he was 13, Salk entered Townsend Harris High School, a public school for intellectually gifted students. In high school, “he was known as a perfectionist… who read everything he could lay his hands on.”
He entered the city college of New York intending to study law but soon became intrigued by medical science. While attending medical school at New York City, Salk was invited to spend a year researching influenza. The virus that causes flu had only been discovered and young Salk was eager to learn if the virus could be deprived of its ability to infect while still giving immunity to illness. Salk succeeded in this attempt, which became the basic of his later work on polio. During Salk's medical studies, he stood out from his peers, not just because of his continued academic success – but because he had decided that he would not practice medicine. He said his desire was to help humankind in general rather than single patients. It was the laboratory work, in particular, that gave new direction to his life.
| Beyond Medical School|| |
After completing medical school and his internship, Salk returned to study of influenza, the flu virus. World War II had begun and public health experts feared a replay of flu epidemic that had killed millions in the wake of the First World War. The development of vaccines controlled the spread of flu after the war and the epidemic of 1919 did not recur. In 1941, during his postgraduate work in virology, Salk chose to work in the laboratory of Dr. Thomas Francis at the University of Michigan. Francis had recently joined the faculty of the medical school after working for the Rockefeller Foundation, where he had discovered the type B influenza virus.
In 1947, Salk accepted an appointment to the University of Pittsburgh medical school. While working there with the national foundation for infantile paralysis, Salk saw an opportunity to develop a vaccine against polio and devoted a himself to this work for the next 8 years. By 1951, Salk had determined that there were three distinct types of polio viruses and was able to develop a “killed virus” vaccine for the disease. The vaccine used polio viruses that had been grown in a laboratory and then destroyed. Preliminary testing of the polio vaccine began in 1952. The testing expanded over the next 2 years, making it one of the largest clinical trials in medical history. Roughly 2 million children were given the vaccine during the test phase. A few weeks after the Watson tests, Salk injected children at the Polk State School for the retarded and feeble-minded. In November 1953, at a conference in New York's Waldorf-Astoria Hotel, he said, “I will be personally responsible for the vaccine.” He announced that his wife and three sons had been among the first volunteers to be inoculated with his vaccine. Salk's efforts were supported and promoted by the National Foundation for Infantile Paralysis and its president Basil O'Connor.
In 1955, Salk's years of research paid off. Human trials of the polio vaccine effectively protected the subject from the polio virus. When news of the discovery was made public on April 12, 1955, Salk was hailed as a miracle worker. He further endeared himself to the public by refusing to patent the vaccine. He had no desire to profit personally from the discovery, but merely wished to see the vaccine disseminated as widely as possible.
Salk's new vaccine was transformed by Alan John Beale's team, based in Glaxo, England, into something which could be manufactured on the enormous scale which the widespread threat of poliomyelitis required. Within minutes of Francis's declaration that the vaccine was safe and effective, the news of the event was carried coast to coast by wire services and radio and television newscasts. Across the nation, there were spontaneous celebrations business came to a halt as the news spread. It was also declared “a victory for the whole nation” as Jonas Salk became world famous overnight and was showered with awards. When the vaccine was approved for general use in 1955, Salk became a national hero. In its first few years, the vaccine had a remarkable impact on the number of new cases of polio reported. There were more than 57,000 cases in the USA in 1952, according to the College of Physicians of Philadelphia. A decade later, that number fell to less than a thousand. The Salk vaccine was replaced with a live virus vaccine developed by Albert Sabin around this time because it was less expensive and easier to use.
| Salk's Biophilosophy|| |
Salk describes his “bio philosophy” as the application of a “biological, evolutionary point of view to philosophical, cultural, social and psychological problems.“ He went into more detail in two of his books, Man's Unfolding, and The Survival of the Wisest. In an interview in 1980, he described his thoughts on the subject, including his feeling that a sharp rise and an expected leveling off in the human population would take place and eventually bring a change in human attitudes:
“I think of biological knowledge as providing useful analogies for understanding human nature… People think of biology in terms of such practical matters as drugs, but its contribution to knowledge about living systems and ourselves will in the future be equally important… In the past epoch, man was concerned with death, high mortality; his attitudes were antideath, antidisease,” he says. “In the future, his attitudes will be expressed in terms of prolife and prohealth. The past was dominated by death control; in the future, birth control will be more important. These changes we're observing are part of a natural order and to be expected from our capacity to adapt. It's much more important to cooperate and collaborate. We are the co-authors with nature of our destiny.”
| Remaining Eradication Efforts|| |
In 1988, numerous international medical organizations launched a campaign to eradicate polio globally, as had been successfully done for smallpox. By 2003, polio had been eradicated in all but a few countries, among them Afghanistan, Nigeria, and Pakistan., However, mullahs in Northern Nigeria began to oppose the vaccination program, claiming that it was a plot to spread AIDS and sterility and prevented any vaccination. Polio cases in Nigeria tripled over the next 3 years.
In Pakistan, in 2007, opposition was violent to vaccinations in the Northwest Frontier Province, where a doctor and a health worker in the polio eradication program were killed. Since then, the Taliban has blocked all vaccinations in the Swat Valley of Pakistan. As a result, Pakistan was the only country in 2010 to record an increase in cases of polio, according to the WHO, along with having the highest incidence of polio in the world. Meanwhile, the Bill and Melinda Gates Foundation, which has spent $1.5 billion, plans to spend another $1.8 billion through 2018 to help eradicate the virus. In 1980, Salk pointed out the renewed interest in his killed virus vaccine, particularly in developing countries. “The 'live' virus vaccine is highly effective in developed countries…,” he said, “but in the developing countries, where polio is on the increase, the drawback is that the live virus fails to establish the infection that leads to immunity because of intestinal inhibitors in the population.” Recent evidence of this was found in Iran, where a number of children receiving the oral vaccine became infected with polio, leading Iranian researchers to recommend using the killed virus in the future.
Dr Salk's last years were spent searching for a vaccine against AIDS. Jonas Salk died on June 23, 1995. He was 80 years old. The 100th anniversary of his birth in 2014 was the occasion for renewed appreciation and celebration of Dr. Salk's contribution to humanity. With his groundbreaking vaccine, Salk had earned his place in medical history. He will always be remembered as the man who stopped polio.
| References|| |
Rose DR. “Fact Sheet – Polio Vaccine Field Trial of 1954.” March of Dimes Archives; 11 February, 2004.
John B. Jonas Salk and the Polio Vaccine. Bear, Delaware: Mitchell Lane Publishers; 2002. p. 30-2.
How India Managed to Defeat Polio. BBC, 13 January, 2014.
Pakistan's Peshawar World's 'Largest Reservoir' of Polio. Agence France-Presse, 17 January, 2014.