Goodbye to Polio



July_19_TM_Profile_Tierney

Unlike most U.S. physicians, William Tierney, MD, has had several intimate run-ins with polio. Perhaps the strangest took place while he was in medical school at Indiana University in the mid-1970s.

It happened one night when Dr. Tierney got lost in the seemingly endless warren of tunnels that connects the school’s hospitals. The tunnels were surprisingly scary, he remembered. So it didn’t help when he turned a corner and came face to face with a half a dozen iron lungs.

The giant cylindrical devices were a medical marvel because they helped people breathe after polio had destroyed their respiratory muscles. But they were also objects of fear: Parents could imagine their polio-stricken children trapped in iron lungs just to stay alive.

What struck Dr. Tierney in those dark tunnels was how vaccination had changed the world of his childhood and made this unusual scene possible.

“Here were all these iron lungs from days gone by, and they were covered with dust because they hadn’t been used in a while,” said Dr. Tierney, now chair of the department of population health at  Dell Medical School at The University of Texas at Austin.

The internist grew up in the 1950s, when polio was a feature of everyday life. Newspapers regularly updated the number of local polio victims on the front page. Schools, theaters, and swimming pools closed if a child developed cold-like symptoms or some unexplained stiffness. Polio shrunk the leg of one of Dr. Tierney’s high school friends.

“He wasn’t the only one,” said Dr. Tierney, who sits on the Texas Medical Association’s Council on Science and Public Health. “There were people in wheelchairs and on crutches who had polio when they were younger. If you had a high school with 1,000 people, there would be a dozen or so who had had chronic mobility problems due to polio.”

Polio had hit even Dr. Tierney’s family. In 1953, when he was 2, his mother contracted the disease shortly after giving birth to his younger brother Tommy. She spent a year in the hospital but fortunately survived the illness with nothing more than weak shoulders.

But Dr. Tierney’s brother may not have been so lucky. Because of his mother’s hospitalization, the boy had little or no contact with her during his first year of life, and later Tommy struggled with addiction. For Dr. Tierney, polio’s potential impact on Tommy is more of a nagging, answerless question than a scientific fact, but he can’t help asking it.

“Who knows what long-term effect that had on him,” he said. “I can tell you that he became an alcoholic and ended up dying of alcoholic liver disease in his late 40s. Whether that was related to the adverse childhood event of being separated from your mother and being handled by various relatives in the first year of your life, I don’t know. But he’s the only one of my siblings who was an alcoholic.”

U.S. polio vaccination began in the mid-1950s and became universal by the mid-1960s when Dr. Tierney – then a junior high school student – ate a sugar cube full of polio vaccine. Success came quickly. Hospitals, which once had wards full of iron lungs, rapidly mothballed and then discarded the devices.

Worldwide, polio still thrived in countries that were slower to vaccinate. In the early 2000s, when Dr. Tierney did research in Kenya, he saw both young and old people who had lost the use of their limbs due to infantile paralysis. Fortunately, even then the number of new cases had mostly disappeared because of strong vaccination programs, he says.

“There are no anti-vaxxers there,” he said. “People get vaccinated because the ravages of the disease they are preventing are visible.”

Polio hit its peak when Dr. Tierney was born, and killed about a half-million people worldwide each year. Today, it remains endemic only in Afghanistan, Nigeria, and Pakistan – and all signs are that it’s almost gone there as well, according to the World Health Organization. Relentless vaccination programs, like the kind that killed off smallpox in 1980, seem to be on the verge of driving polio to extinction.

“This is one of the few times we’ve been able to wipe out a disease,” Dr. Tierney said. “[As with smallpox], they may stop vaccinating people against it when it doesn’t exist anymore. That’s actually pretty cool.”

 Tex Med. 2019;115(7):8-9 
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