A lasting public health victory: Polio vaccine at 50 years

The recent observance of the 50th anniversary of the development of polio vaccine paid appropriate tribute to one of medicine's greatest triumphs.

Only a small number of physicians practicing in the United States have seen a patient with polio. But the memory of the disease -- often called infantile paralysis at the time -- was an ominous specter for the generations of Americans who grew up in the first half of the 20th century.

Children of that era saw their playmates stricken. Some patients died; many more had paralysis of varying degrees of severity. Concerned, sometimes-terrified parents strove to protect their children through various levels of isolation or confinement. Community swimming pools were considered particularly dangerous, as were gatherings of large crowds of people. The disease seemed to peak in the summer but the method of transmission was unknown. (President Franklin D. Roosevelt was perhaps the most famous patient; he contracted polio in 1921 and used a wheelchair for the rest of his life.)

Polio outbreaks were sporadic and unpredictable, reaching a peak in 1952 when nearly 58,000 cases were reported.

Scientific advances in the late 1940s and early 1950s made possible a more intensive and effective search for a vaccine, culminating in the April 12, 1955, announcement by Jonas Salk, MD, that a polio vaccine had been successfully tested and was ready for public use. Five years later, the oral vaccine developed by Albert Sabin, MD, became available, and the eradication of polio became a reality. In 1960, there were only 2,525 cases in the United States; today polio is found only in a few areas of Africa.

The scientific knowledge and new technology that made the polio vaccine possible bore other fruits, leading to vaccines for measles, mumps, rubella and influenza. It also opened a door that researchers still use in their efforts against AIDS, avian flu, malaria and other infectious diseases that are second only to cardiovascular problems as the leading cause of death worldwide.

Polio immunization campaigns reached millions of Americans and many more millions around the world in just a few years. Those efforts provide a classic example of public health activity, combining the resources of the scientific community, the media, and professional and government organizations, all working for a common goal. The enthusiastic public participation in the polio immunization campaigns demonstrated the high regard in which the medical, scientific and public health communities were held.

The campaign to eradicate polio also offers lessons for today. The AMA Council on Scientific Affairs, which has committed itself to increased emphasis on public health issues, has identified a group of advocacy issues vital to improving the health of Americans. The list includes -- but isn't limited to -- tobacco, alcohol and substance abuse; AIDS prevention; obesity; environmental hazards; health literacy; and pediatric and adolescent health issues.

The AMA is among those organizations that have taken the lead in many of these areas. But such challenges are so daunting that broad-based cooperation is essential for deep and lasting progress. Significant progress is possible only if there is, in addition to the medical profession's knowledge and commitment, a sharing of information and trust among physicians and their organizations, public health agencies, the media, government agencies and appropriate voluntary health agencies.

In addition to polio, many of the communicable diseases that once devastated our planet have been controlled by effective immunization and prevention programs. But as the AMA council makes clear, there is no shortage of problems that must be addressed.