Christoph Diasio, M.D., a pediatrician at Sandhills Pediatrics in Southern Pines, has some sobering advice for parents who aren’t sure that they want their children vaccinated against childhood diseases.

“If you want to know about terror,” he says, “ask your parents or grandparents about what living in the 1940s or ’50s was like, when children would all of a sudden stop breathing or walking without a good reason why.”

Anyone who lived through that time recognizes the reason as polio, a terrifying disease that during its recorded peak paralyzed upwards of 10,000 children a year. Some children did not survive; others were confined for life to braces, wheelchairs or iron lungs.

“Back when polio was ravaging America, this conversation about whether to vaccinate or not would have been very different,” says Dr. Diasio. “People would probably have given you their house or their car for a dose of polio vaccine. We just don’t understand that today.”

While not all of the victims of polio were children—one of the most famous was Franklin Delano Roosevelt, who spent his entire presidency trying to conceal the fact that he was wheelchair-bound, most were. Some were babies, hence the name infantile paralysis.

According to “Fear of Polio in the 1950s,” by Beth Sokol, doctors called the disease poliomyelitis “to describe the condition in which the gray (polios) anterior matter of the spinal cord (myelos) was inflamed (-itis).”

“Until a cure was discovered, no one had the slightest idea where polio had come from or why it paralyzed so many children,” Sokol said. “People learned later that, oddly enough, it was the improved sanitary conditions (that) caused children to be attacked by the virus. Since people were no longer in contact with open sewers and other unsanitary conditions (that) had exposed them to small amounts of the polio virus as infants, when paralysis is rare, the disease grew from a very mild, uncommon occurrence to a terrifying epidemic.”

A post-war plague
Newspapers of the late 1940s and early 1950s were filled with stories about the ravages of polio on North Carolina’s children. From May to October of 1948 alone, daily headlines carried details that were eerily similar in story and tone. Only the numbers changed.

From the May 13, 1948, edition of The Sandhills Citizen: “Three Moore County Children Stricken By Polio.” June 10, 1948: “Six Cases Polio Reported in Moore County With One Death During 1948.” June 17, 1948: “Two More Cases Polio Reported In Moore County.” A 4-year-old Carthage boy. A 5-year-old Robbins boy. One of the deaths, the third of the year, was a 4-year-old Carthage girl who “died while being carried to the hospital.” As Moore County came to be recognized as the hardest hit spot in several states, County Health Officer J.W. Wilcox urged parents to keep their children away from crowds and gatherings. Local officials delayed the opening of school and desperately tried to curb the epidemic by spraying homes with DDT.

Courtesy High Point Museum, High Point, N.C., High Point Enterprise Collection

Moore County Hospital, the forerunner of today’s FirstHealth Moore Regional, established a Polio Convalescent Center that was staffed by two polio nurses sent by the National Foundation for Infantile Paralysis, a physiotherapist and other nurses recruited through the American Red Cross.

Only the coming of cold weather promised some relief from the terrible disease.

A man named Salk
By the mid-1950s, the headlines about polio had become decidedly different, however. Dr. Jonas Salk and a team of other scientists at the University of Pittsburgh had developed a vaccine that offered a promising shield.

Thousands of health care workers and lay people, reportedly the largest number in American history, volunteered to assist with vaccine field trials. Millions of people raised money to support the research effort and its goal of victory over polio.

Seventeen years of research preceded the April 12, 1955, licensure of the first polio virus vaccine and Dr. Salk’s entry into medical history. Hundreds of years of disease, paralysis and death came suddenly and dramatically to an end—at least in those countries with strong vaccination programs.

While there is still no cure for polio, Dr. Salk and his team of researchers found a way to prevent it. The National Foundation, today known as the March of Dimes, funded their research; and the impact of the vaccine was quick and striking. In 1955, there were 28,985 cases of polio in the United States. Just two years later, there were 5,894.

Until last fall, when several polio cases were reported among unvaccinated children in an Amish community in central Minnesota, there had not been an outbreak in the United States in 26 years. The Amish typically decline to vaccinate their children, and the last previous outbreak, in 1979, also occurred within that group.

The 2005 outbreak affected only a handful of children and posed little threat in other parts of Minnesota, where about 98 percent of the children are vaccinated against the disease. Still, says Dr. Diasio, those cases and numerous Third World pockets are reasons for vigilance in what he calls an “incredibly global world.”

“These bad diseases still exist in many parts of the world that are just a few short plane rides away,” he says. “For example, in 1994, a child flew from India to Canada with an active case of polio. Because vaccination levels were so high in Canada, there were no secondary cases.”

Even though polio still circulates in Asia and Africa, the situation has improved there, too, with the advances of international vaccination efforts. Since 1988, when the Global Polio Eradication Initiative was begun—spearheaded by the World Health Organization, Rotary International, UNICEF and the U.S. Centers for Disease Control and Prevention (CDC)—more than two billion of the world’s children have received the polio vaccine.

The goal of the World Health Organization is to eradicate polio completely in this first decade of the 21st century.

Postscript
The Salk vaccine was made from an inactive or “killed” virus, which has the ability to immunize without running the risk of infecting the patient who receives an injected dosage. A few years after the Salk vaccine was introduced, Dr. Albert Sabin, who didn’t think it was strong enough, developed another vaccine from a weakened live virus.

Licensed in 1962, the Sabin vaccine quickly became the vaccine of choice because it was cheaper to make and, because it was administered orally, easier to take than the Salk. Ironically, however, the few cases of polio that now occur in vaccinated people are almost always caused by the Sabin vaccine itself, which—because it is live—can mutate to a stronger form.

According to the CDC, the current routine schedule for polio vaccination in the U.S. is four doses of the inactive vaccine given by injection at 2 months, 4 months, 6 to 18 months and 4 to 6 years.

CDC guidelines indicate the use of the oral vaccine in the U.S. only under the following circumstances: mass vaccination campaigns to control outbreaks of the disease, unvaccinated children who will be traveling in less than four weeks to areas where polio is still a problem, people with a life-threatening allergy to the injected vaccine and the children of parents who do not accept the recommended number of vaccine injections.

Children in the final category generally receive the oral vaccine on the third or fourth doses or both and only after their parents are informed about the risks of vaccine-associated polio.

Polio stories
Robbie Monroe and Jerry Vaughn share the lasting bond of polio. Both were stricken as children and continue to deal with the effects of the disease as they confront post polio syndrome, a condition that affects polio survivors anywhere from 10 to 40 years after their recovery from the initial attack and results in the further weakening of polio-weakened muscles.

Both Monroe and Vaughn are also members of the Sandhills Post Polio Support Group that is sponsored by FirstHealth of the Carolinas.

Robbie and Jewel Monroe

Robbie Monroe Robbie Monroe was just 5 months old when he contracted polio. His mother was 22 when she came down with the disease the following week. It was June 1948, and Moore County was becoming known as the hot spot in a multi-state polio epidemic.

Monroe’s polio, which affected his left arm and side, was considered mild. Still, he spent six months in various hospitals, first at the hometown Moore County Hospital, then at James Walker Memorial Hospital in Wilmington and then back at Moore after the hospital opened a polio treatment center.

“I had daily hydrotherapy, warm soaking baths, and was wrapped in warm, steamed Army blankets, which would cause us to sleep and get plenty of rest,” he recalls. “Later on, I remember, I had a small rubber ball that I had to squeeze a lot.”

Recovery was a longer haul for Monroe’s mother, Mary Elizabeth, whose paralytic polio affected her right arm and left leg in what was called “cross-body polio.” She had been standing in her yard, trying to cool off on a hot day by running water over her right shoulder, when she noticed that she couldn’t move her arm.

Like her son, she was hospitalized first at Moore County Hospital, then at James Walker Memorial and then back at Moore. Unlike him, she also went to Warm Springs, Ga., and the rehabilitation center founded by the country’s most celebrated victim of polio, President Franklin Roosevelt. She was there for nine months before returning to Aberdeen and her family.

Mary Elizabeth Monroe worked, eventually owning her own flower shop, and raised a family that included another son before dying, at age 50 of bone cancer, in 1977.

Despite his weakened left upper body, Robbie Monroe attended Aberdeen Elementary and later Aberdeen High, graduating in 1966. “During high school, sports was a big part of my life, especially baseball,” he says. “I didn’t feel any different than the other kids in class as I felt I could do anything they could. I just had to figure out a different way of doing it. An example was playing baseball. I had to throw and catch with the same hand.”

After 16 years in the printing industry, Monroe took a job as a correctional officer with the N.C. Department of Correction in Hoke County. He married (the former Jewel Thompson), was promoted to correctional sergeant, continued to play ball, volunteered as a Boy Scout leader and co-owned a national record-holding NHRA Drag Racing team. But his physical condition began to deteriorate in 1999 with two strokes and symptoms of what was later diagnosed as post polio syndrome.

He had a total knee replacement in 2001 and a total hip replacement in 2003 before retiring on disability in 2004.

“Living with the after-effects of polio is what I have lived with all of my life,” Monroe says, “and is the only way I have known. I really did not notice that I had a disability when I was growing up.”

Jerry Vaughn

Jerry Vaughn Jerry Vaughn turned 13 a month after he contracted polio in May 1953. He was at Lake Junaluska on a church trip for junior and senior high school students when he got sick. “Everything I tried to eat couldn’t go down my throat,” he recalls.

Vaughn isn’t sure how he got polio, but he believes the virus entered his body through silver-dollar-sized sunburn blisters, the result of a long day outdoors that included a swim in the city lake. When it came time to go to camp, “I had polio, but didn’t know it,” he says.

Despite the obvious severity of his illness, Vaughn stayed at camp for the entire week before enduring a long trip back home to High Point made even longer by periodic stops so he could get off the bus and throw up.

Within an hour or two of his arrival home, he was in an ambulance and on his way to a polio hospital in Greensboro. He has no memory of the trip or the next few weeks.

“The first two months, I was like in a coma,” he says. “There is a void in my life of about a month to six weeks.”

He was kept in an oxygen tent and on a rocking bed to help him breathe.

Following a six-week quarantine, Vaughn was moved to a 400-bed ward “with everyone else.” His treatment included whirlpool baths and being wrapped, head to toe, in steamy, pot-boiled blankets.

He badgered doctors and nurses alike with his constant questions. “I wanted to know what was going on,” he says.

Determined to get well and get home, he became a guinea pig for treatment— 20 minutes in the whirlpool, 20 minutes of therapy and a hour of rest before the rigorous routine started over again.

He left the hospital the week before Christmas, 50 pounds lighter than when he had gone in and walking “some.” His braces and crutches stayed behind at the hospital, but the therapy continued for the next 10 to 12 years.

Because he could attend eighth-grade only part time, his friends brought him his homework, wrote down the answers he provided and turned his work in for him. Still, he graduated from high school and attended college before embarking on a series of successful careers that included manufacturing, marketing, sales and management. He married wife Phyllis in 1964. They have three children and now have nine grandchildren. He moved to the Sandhills in the mid-‘70s and has been civically active ever since.

“I never really considered myself being disabled, just slowed slightly,” Vaughn says.

Early symptoms of what Vaughn now knows to be post polio syndrome began as early as the late 1970s, but “really didn’t hit me until 1993,” he says. Various hospitalizations and tests followed, and eventually he was back in the wrist and leg braces that he had sworn he would never use again.

Despite the setbacks, Vaughn refuses to give in to the disease that has plagued him for more than 50 years. “I’m full of energy, hell-bent for leather, and I don’t let anything get me down,” he says.