Polio: An American Story by David M. Oshinsky《他們應當行走：美國往事之小兒麻痹症 》；兒童期的弱小兒麻痺病毒 (可能療程不完全)可突變成致癱瘓的病毒John Franklin Enders, “Father of Modern Vaccines”

John Franklin Enders, a Yale graduate, is known to many as the “Father of Modern Vaccines” due to his integral role in developing both the polio and measles vaccines. Read the full story on Manuscripts and Archives, Yale University Library page: http://campuspress.yale.edu/mssa/
Access the John Franklin Enders collection here: https://archives.yale.edu/repositories/12/resources/4495……
更多






88


3次分享


讚
















留言
分享

Polio: An American Story 

by David M. Oshinsky

此書為2006年美國埔里策大獎

他們應當行走：美國往事之小兒麻痹症 (這副標題中文有點問題)

• 作者： （美）戴維·M.奧辛斯基著
• 出版社：清華大學出版社
• 出版日期：2015/08/01
• 語言：簡體中文

本書講述了美國小兒麻痹症（脊髓灰質炎）肆虐時期的故事，以及為了治愈這種疾病而展開的競爭，重頭戲是索爾克（Jonas Salk）和薩賓（Albert Sabin）關於率先研制出疫苗的比賽。

書中詳述了20世紀30年代美國國家小兒麻痹症基金會成立的過程，這個基金會徹底改變了美國人募集科研資金的方式和對疾病的看法。脊髓灰質炎的研究顛覆了美國政府在允許新藥上市前對新藥的審批與檢驗方法，也改變了法律體系對藥廠責任與不安全產品的認定方式。

是扣人心弦的科學懸疑故事，也是社會與文化史，是認識戰後美國的一個窗口。非虛構寫作的典范，用人物的故事串起科學、社會、政治、金融各方面的變革。雖然是上個世紀美國的故事，對於今天的中國讀者依然極具吸引力。

Here David Oshinsky tells the gripping story of the polio terror and of the intense effort to find a cure, from the March of Dimes to the discovery of the Salk and Sabin vaccines--and beyond. Drawing on newly available papers of Jonas Salk, Albert Sabin and other key players, Oshinsky paints a suspenseful portrait of the race for the cure, weaving a dramatic tale centered on the furious rivalry between Salk and Sabin. He also tells the story of Isabel Morgan, perhaps the most talented of all polio researchers, who might have beaten Salk to the prize if she had not retired to raise a family.

Oshinsky offers an insightful look at the National Foundation for Infantile Paralysis, which was founded in the 1930s by FDR and Basil O'Connor, it revolutionized fundraising and the perception of disease in America. Oshinsky also shows how the polio experience revolutionized the way in which the government licensed and tested new drugs before allowing them on the market, and the way in which the legal system dealt with manufacturers' liability for unsafe products. Finally, and perhaps most tellingly, Oshinsky reveals that polio was never the raging epidemic portrayed by the media, but in truth a relatively uncommon disease. But in baby-booming America--increasingly suburban, family-oriented, and hygiene-obsessed--the specter of polio, like the specter of the atomic bomb, soon became a cloud of terror over daily life.

Both a gripping scientific suspense story and a provocative social and cultural history, Polio opens a fresh window onto postwar America.

POLIO: AN AMERICAN STORY

by David M. Oshinsky

© 2004 Oxford University Press Inc.

The following excerpt begins on page 282:

Sometimes forgotten amidst these triumphs and controversies are the lives that were affected most by

this devastating disease. Today the word “polio” describes a vaccine to be taken, not a disease to be

feared. “It’s interesting”, a polio survivor observed, “but even with my limp and all my braces I’ve worn

over all the years, people usually don’t have any idea what’s wrong with my legs.” Another survivor

recalled a young neighbor asking him whether his parents practiced “a strange sort of religion” that didn’t

permit vaccination. “To her, and to most others her age,” the man added, “there had always been a polio

vaccine.”

By conservative estimates, there are at least 400,000* survivors of paralytic polio in the United States.

Some recovered much of their muscle function through a process of muscle regeneration whereby

surviving nerve cells developed extra branches, known as axonal sprouts, which reattached themselves

to orphaned muscle fibers. Others endured multiple surgeries to reconstruct a “dropped foot,” realign a

shortened leg, or straighten a badly curved spine – surgeries that required stapling of bones, the

lengthening of tendons, and the fusing of joints. Many still walk with the aid of canes and crutches, wear

a built-up shoe to compensate for a shorter leg, use motorized wheelchairs to move about, or need a

respirator to help them breathe. What polio survivors have always had in common, however, is a drive to

excel in the face of physical disability. Studies have compared them to the hard-driving over-achieving

individuals associated with Type A personality. In the words of one survivor: “We were [taught] to be

tough and gritty. I did what was expected…I needed to have a disciplined life with a no-quit attitude.

That was what worked.”

According to Dr. Lauro Halstead, director of the post-polio program at the National Rehabilitation Hospital

in Washington, D.C., most survivors developed “a special relation to their bodies unknown to able-bodied

persons. They experienced a new mastery over their muscles and movements, an element of

control…that carried over into other aspects of their lives and probably accounts for why so

many…excelled at school and work.” Surveys have shown polio survivors to be better educated than the

general population, with higher incomes and marriage rates as well. “Don’t let any [of us] tell you they

just want to be ‘normal’ like everyone else,” a survivor wrote in a questionnaire, We have to be better than

anyone else just to break even…and that may not be enough.”

Following years of surgery, rehabilitation and exercise, polio survivors came to regard their condition as

stable. They saw polio as a static disease, unlikely to return or worsen with age. But this comforting

assumption was challenged in the 1980’s, as polio survivors began to experience health problems eerily

reminiscent of their earlier ordeal. *(400,000 to 1,000,000 is another figure often used)

The symptoms were alarming: joint pain, sensitivity to cold, difficulties with breathing

and swallowing, progressive muscle weakness, and extreme fatigue. There were so many cases that

polio survivors formed support groups to pool information and alert the medical community to their plight.

Most American doctors of the post-Salk, post-Sabin era had never treated a case of polio. Their

ignorance of the disease, beyond the importance of immunization, was distressing.

In 1984, Dr. Halstead and others organized the first international conference on the delayed effects of

polio. The idea was to increase public awareness and spur medical research. The organizers attached a

handle to these multiple symptoms – Post-Polio Syndrome (PPS). “Without a name there was, in

essence, no disease,” Halstead recalled.” “Having a name -even if imprecise and misleading as to

causation – at least confers an element of credibility.”

In the past two decades, researchers have studied PPS at some length. Most believe that the fatigue and

muscle weakness experienced by so many polio survivors are due to wear and tear on existing nerve

cells – a theory bolstered by the three to four decades it took for these complaints to be voiced. According

to researchers, the motor neurons that survived the initial polio attack and sprouted extra branches have

degenerated over time. Part of this is due to the normal aging process, but a larger part, it appears, is

caused by the heavy demand put on these remaining motor neurons. “It’s as if you had a ten-cylinder car

Page 2 of 2

before you had polio and have a four-cylinder car afterward – a car that has driven just fine for forty years

or more,” a researcher explained. “At some point, the engine is going to break down.”

Though no conclusive diagnostic test yet exists for PPS, the percentage of polio survivors suffering from

progressive muscle weakness and extreme fatigue is estimated to be as high as 50 percent. Moreover,

those who endured the severest cases of polio and made the greatest functional recovery are the most

likely to be affected. Dr Halstead presents himself s an example. Contracting polio as a college student

in 1954, he moved, “from iron lung to wheelchair to foot brace and then to no assistive device at all.”

Though his right arm remained paralyzed, he sped through medical school, took up competitive squash

and mountain climbing, and convinced himself that “polio is behind me. I have finally conquered it.” But

in the early 1990’s, Halstead wrote, “I had begun developing new weakness in my legs. As the weakness

progressed over a period of month, I went from being a full-time walker who jogged up six flights of stairs

for exercise to having to use a motorized scooter full-time at work.” Halstead had no doubts about his

condition. It was the same one he had been diagnosing in other polio survivors for a decade.

The recognition of PPS has had a powerful bonding effect on a group that showed great trouble

acknowledging its past. “Until recently,” a polio survivor noted, “most of us tended to avoid [each] other

and polio help groups. We knew we weren’t physically normal, but if we thought about it at all, we

considered ourselves as inconvenienced, not disabled.” Brought together by common fears and

concerns, polio survivors began to relive the memories they had long suppressed: the splitting headaches

and widening paralysis that signaled the disease, the excruciating spinal tap that confirmed it, the terror of

the isolation ward, the grief-stricken parents, the long separation from family, the multiple surgeries, the

months spend in a body cast, the feeling of helplessness, humiliation, and loss. Dr. Richard Owen, a

polio survivor who founded the Post-Polio Clinic at the Sister Kenny Institute in Minneapolis, recalled that

he and other victims were often treated at teaching hospitals, where, “clad only in little cloth things that

hardly covered us and our embarrassment,” they became perfect subjects for clinical demonstration. “For

many of us,” Owen added, “the acute illness and convalescence was during adolescence with the impact

of polio superimposed on all the usual stresses and strains of growing up. Barriers to building, activities,

opportunities, and associations added to frustration and, in some cases, social isolation of young people

with the residuals of poliomyelitis. Many barriers…were self-imposed. Various coping mechanisms often

covered true feelings of loss. Denial often led to distorted reality.”

Those days are over. The concerns over PPS created a powerful network to deal with physical and

psychological issues facing polio survivors, which in turn fueled a growing disability-rights movement

across the United States. Polio survivors played a key role in lobbying for the passage of the Americans

with Disabilities Act of 1990, which prohibits discrimination against the disabled and requires physical

access to most public spaces. More symbolically, they joined with disability-rights activists to protest a

new memorial for Franklin Delano Roosevelt in Washington, opened by the National Park Service in

1997, which largely ignored the president’s struggle with polio. The park service insisted it was only

reflecting FDR’s own desire to portray himself as able-bodied. “With the country ravaged by the Great

Depression and yearning for strong leadership,” it said, “Roosevelt realized the need to continue this

façade.” But polio survivors wanted Americans to remember him “as both heroic and disabled,” arguing

that his disability had been integral to his character, and an essential part of who he was and what he

accomplished. In the end, the park service reluctantly added a ten-foot statue of Roosevelt seated in his

wheelchair. The concession spoke volumes to those who best understood the late president’s dilemma.

“Our national disability politics has come a long way since the 1930’s,” an activist explained. “Shouldn’t

our national aesthetics now take up the challenge to transform the meaning of disability?

---

Man found to have been shedding virulent strain of polio for 30 years


Weakened form of polio from childhood immunisations lived on in subject’s gut, mutating into a strain which could cause paralysis in the unvaccinated
The polio virus. The British man was found to be carrying a form of the virus which had mutated from the weakened form used in vaccines. Photograph: Dennis Kunkel/Microscopy, Inc.


Emily Mobley

Thursday 27 August 2015 19.00 BSTLast modified on Friday 28 August 201511.42 BST




A British man with an immune deficiency has been shedding a highly virulent, mutant strain of polio virus for nearly 30 years as a result of childhood vaccinations.

The discovery has prompted scientists to warn of other patients who could unwittingly trigger fresh outbreaks of the disease in regions where people are not sufficiently protected against the illness.



Africa's year free of polio is giant step towards eradication

Read more

Researchers analysed more than 100 stool samples from the man and found mutated versions of the polio virus capable of causing paralysis. They believe he has been shedding the mutated strain for 28 years.


The man had a full course of polio vaccinations, which included three doses of weakened live virus at 5, 7 and 12 months, followed by a booster jab when he was about seven years old. He was later diagnosed with a condition that suppresses the immune system, affecting its ability to kill viruses in his gut.


Tests on the viruses found in the man’s stool samples revealed they had mutated from the weakened form used in the vaccines into a more dangerous strain.


People who are fully vaccinated against polio are not at risk, but in countries where routine vaccination is not encouraged, similar immune-deficient patients could potentially start a new polio outbreak.


The man received the older oral polio vaccine (OPV) that contained a weakened form of the virus, and was often given on a sugar cube. In 2004, the UK switched to an inactivated polio vaccine (IPV) which is injected.


The discovery, reported in the journal Plos Pathogens, has implications for health officials who are close to eradicating polio from the three remaining countries where the virus is still circulating: Pakistan, Afghanistan and Nigeria.


Before the disease can be completely wiped out, mutated strains of polio virus derived from vaccines must be tackled. To that end, the World Health Organisation is set to trial a new vaccine next April.


But work still needs to be done to eradicate polio worldwide, and this discovery of a mutated poliovirus in the UK, among others in Slovakia, Finland and Estonia, presents an extra hurdle before the finish line.


“These viruses could potentially cause poliomyelitis in susceptible people, so it is very important to maintain high levels of vaccine coverage,” said Javier Martin of the UK National Institute for Biological Standards and Control.


“We are working on an end-game strategy,” he added.