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, was admitted to the hospital unable to walk. I came. His legs were limp and weak, his abdomen was painfully swollen 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 in 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 mistrust of vaccination have caused 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 doubled down on their efforts. Two new oral polio strains were developed in June. Vaccine published in Nature. In the same month, Gavi, an organization that supplies vaccines to many parts of the world, approved a new combination vaccine Distribution is scheduled to start in 2024. An August article in the journal Nature reports: Afghanistan and Pakistan, the only countries where wild poliovirus is still endemic, are closer than ever to eradication.
However, polio is widespread and insidious.
In most people, polio does not cause symptoms.About 1 in 4 infected people mild symptoms, similar to a cold or gastroenteritis. In 100 he has symptoms of meningitis, neck pain and fever in 1 to 5 people.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 relentless and unforgiving. Symptoms of paralytic polio persist, and even those who recover often relapse decades later.post-polio syndromeIt will ultimately afflict the majority of the tens of millions of polio survivors around the world. Like the long-running COVID-19 pandemic, post-polio syndrome inevitably follows a polio epidemic, leaving behind an equally devastating secondary epidemic.
I never thought about polio until 2013, when I was a medical student. His symptoms were barely noticeable at first. His voice was hoarse, already phlegmatic with age, followed by a resonant snoring that exacerbated his grandmother’s already intolerable insomnia until she began to sleep upright on the couch. Ta.
The polio epidemic sparked the invention of the modern respiratory system. artificial lung And then came the ventilators we use in intensive care units today. But when he started gasping 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 incredibly emaciated on an examination table 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 writhing snakes in a cloth bag. Neurologists describe fasciculation as disorienting and gasping of dying muscle fibers, contracting violently without commanding motor neurons, and contracting helplessly.
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 was the place 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 global polio burden. However, thanks to widespread vaccination, No new polio cases It has been reported in India for over 12 years. The heartbreaking irony of paralytic polio in the 21st century is that it is preventable.
My grandfather, who passed away on February 14, 2016, was no tragedy. He was loved but exhausted and died at the age of 93. Three years before his grandfather died, 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 seen the world around me change beyond recognition.”
My grandfather lived to see the sequencing of the poliovirus and the development of the first polio vaccine. He lived to see polio eradicated in the United States and then in India. He lived to see polio almost thrown into the dustbin of history. But maintaining it requires vigilance.