In the summer of 2022, thousands of years after Roma’s death and decades after the Americas were declared polio-free, a 20-year-old man from Rockland County, New York, arrived at the hospital unable to walk. I came. His legs were limp and weak, his abdomen was painfully distended, and his neck was stiff. Scientists found fragments of the poliovirus that destroyed the man’s spinal cord and left him paralyzed in the man’s stool and in wastewater systems in Rockland County and New York City. this year, four children of israel A positive poliovirus test resulted in Virus detected It is found in wastewater throughout Europe and Africa.
This global resurgence appeared to be the result of a more modern pandemic, covid-19.
Pandemic lockdowns, overburdened public health infrastructure and growing public distrust of vaccinations have led to dozens of infections. Millions of children lack essential vaccinesIt was a devastating blow to herd immunity, and the World Health Organization described it as the worst setback for vaccinations in 30 years. Global polio eradication initiative was launched in 1988 with the elusive official mission of eradicating polio by the year 2000.
In response, scientists redoubled their efforts. In June, two new types of oral polio were developed. Vaccine published in Nature. In the same month, Gavi, an organization that supplies vaccines to many parts of the world, Approved new combination vaccine Scheduled to start distribution in 2024. An August article in the journal Nature reports: Afghanistan and Pakistan, the only countries where wild poliovirus remains endemic, are closer than ever to eradication.
However, polio is widespread and insidious.
In most people, polio causes no symptoms.Approximately 1 in 4 infected people mild symptoms, similar to a cold or gastroenteritis. In 100 people, 1 to 5 people have symptoms of meningitis, neck pain, and fever.Only 1 in 200 people infected with polio will develop the disease. paralytic poliothe virus damages the brain and spinal cord.
Paralytic polio is rare, yet unforgiving. Symptoms of paralytic polio persist, and even those who recover often have a recurrence decades later.postpolio syndrome” It ultimately afflicts the majority of the tens of millions of polio survivors around the world. Like long-term COVID-19 infections, post-polio syndrome inevitably occurs after a polio outbreak, leaving a second, equally devastating outbreak in its wake.
I had never thought about polio until 2013, when I was a medical student and my grandfather, then in his 90s, was beginning to suffer from post-polio syndrome. His symptoms were barely noticeable at first. His voice, already hoarse and phlegmatic with age, then developed resonant snoring, which worsened his grandmother’s already intolerable insomnia, until she started sleeping upright on the couch. Ta.
The polio epidemic sparked the invention of the modern respiratory system. artificial lung And then along came the ventilators that we use today in intensive care units. But when he started gasping for breath in his sleep, my grandfather, Ravi Prakash, made it clear that he was not interested in intensive care.
That summer, I was starting my final year of medical school, but I still didn’t know what kind of doctor I was going to be. When I visited India, I followed my grandfather to a neurologist. There his grandfather lay on the examination table, incredibly weak under a cloth gown.
the neurologist showed me the seizures bondage The movements of my grandfather’s withered left leg were sudden and rhythmic, like a snake writhing in a cloth bag. The neurologist explained that fasciculation is when dying muscle fibers become disoriented and gasp, contracting violently and helplessly without commanding the motor neurons to contract.
By examining my grandfather’s feet, his neurologist was able to understand part of his story and even predict his future. The rural village where my grandfather grew up had no underground sanitation facilities, and this was where he first contracted polio as a child, and within a few months, his faint cough turned into a painful, unrelenting pain. I became afraid to eat.
Although it was difficult for my grandfather to remember when he contracted polio as a child, his case was far from unique. Until the early 2000s, India It is responsible for 85 percent of the world’s polio burden. However, thanks to widespread vaccination, No new polio infections It has been reported in India for more than 12 years. The heartbreaking irony of paralytic polio in the 21st century is that it is preventable.
My grandfather’s death on February 14, 2016 was not a tragedy. He died at the age of 93, much loved but exhausted. Three years before his grandfather passed away, his grandfather dictated his autobiography, even though he had a slight sense that something was wrong with his body. “My name is Ravi Prakash,” he began. “I am 89 years and 10 months old. I have watched the world around me change beyond recognition.”
My grandfather lived to see the poliovirus sequenced and the first polio vaccine developed. He lived to see polio eradicated in the United States and then India. He lived to see polio almost consigned to the dustbin of history. But maintaining it requires vigilance.
