Not our first viral terror: the age of polio

The age of polio: recalling another viral terror

in Community/Featured/Headline

By Jill Singleton

Author’s note: Back in 2002, I began researching a magazine article to commemorate the mid-century polio epidemic, but gave it up until a few weeks ago when I saw an article in the Wall Street Journal, by David M. Oshinsky, author of the 2006 Pulitzer Prize-winning history book: “Polio: An American Crusade.” The book’s first four words: “San Angelo in 1949” dropped my jaw and kickstarted this piece. Sadly, all those quoted are no longer here to object to my errors.

In the late 1940s, American life never looked brighter. Returning veterans were marrying their sweethearts, buying homes, creating that Baby Boom. The economy rocked. New vaccines were limiting viral diseases such as smallpox, diphtheria, yellow fever. Penicillin, though in scarce supply, worked miracles.

But not all was well. Each summer, a wave of parental terror would spread across the country— with the recurrence of poliomyelitis, or polio, the scourge also known as infantile paralysis.

“People used to dread summer,” recalled my father’s later medical partner, Charles Ross, M.D., who was a pediatric resident in Buffalo, New York, during the worst polio years.

Pools closed. Children stayed indoors. Movie houses, bowling alleys and churches shut their doors. Nobody knew how polio spread. Some thought it may have been carried by flies, mosquitos or tainted water. Some towns sprayed DDT daily. Handles were removed from drinking faucets. Privies were outlawed and public restrooms were closed. Some people didn’t trust the air in their tires. Nobody talked to strangers.

Unlike Covid-19, which attacks the elderly and infirm, polio preyed mostly upon the young. Like Covid-19, there was no known cure or prevention.

Hardest hit were small and isolated towns, including the one where I was born, San Angelo, Texas.

This story was originally published in the May edition of Climate Magazine. To view the magazine online, click on this link.

The Plague of Polio

In 1949, San Angelo, population 45,000, had the highest per capita incidence in one of the nation’s worst polio years. My sister was born at the height of the plague and at the time, my father, Jack W. Singleton, M.D., was the only pediatrician around.

“Parents were besides themselves,” Dr. Ross remembered. What made polio so terrifying was that, although 72 percent of cases were asymptomatic and 24 percent of the infections presented in mild form, “when it hit hard people became essentially helpless.” Mostly, people feared their children becoming permanently paralyzed and requiring one-on-one care for their entire lives.

Only a few anecdotes of the polio epidemics survive in my family. My oldest brother remembered my father, hearing that four pediatric iron lungs had been sent to the University of Texas Medical School in Galveston, called and said he was coming to get one, that day. With my brother (then about six) riding shotgun, he drove the 850-mile round-trip from West Texas to the Gulf Coast in our 1948 Plymouth coupe.

“I still don’t know how we wrestled that thing in the back of the car,” my brother said. What, I now wonder, were my father’s thoughts returning with the precious cargo? That summer half of San Angelo’s 160 hospital beds had polio sufferers. There would now be eight iron lungs. Would this be enough?

In 1949, “close to 40,000 cases were reported in the United States, one for every 3,775 people. San Angelo saw 420 cases, one for every 124 inhabitants, of whom 84 were permanently paralyzed and 28 died,” according to Oshinsky’s “Polio: An American Crusade.”

Like Covid-19, polio presented as a mild flu-like illness with low-grade fever, headache, sore throat, stiff neck, muscle weakness and stomachache. Most people didn’t even see a doctor and recovered in four to five days. A few patients would develop meningitis and one out of 200, mild paralysis. Often, those who recovered were left permanently weakened with undeveloped limbs and sometimes curved spines.

“(Those paralyzed) would lose the use of their legs first, then their arms. And if it was really severe, chest muscles and they went into respirators … and stayed all their lives,” Dr. Ross recalled. “Those that died, died fairly quickly of respiratory failure; usually they gave out in the first 24 hours. As medical people, we hated polio, because there was not a hell of a lot you could do.”

Nationwide, 20 percent of those paralyzed died. In San Angelo, it was more than 33 percent.

A Call for Help

San Angelo’s plight was so extreme, calls for help were answered from across the country. Stanford University sent a team of research doctors, as did Columbia, and my father’s alma mater in Chicago. The National Foundation for Infantile Paralysis (an organization started by Franklin Delano Roosevelt — himself a polio victim — and later known as the March of Dimes), served as a clearinghouse for much of the medical assistance. The Red Cross marshalled equipment and materiel while the Army Air Corps at nearby Goodfellow Field flew in blankets, medication, beds, respirators and other equipment.

The town’s black and Hispanic communities were hardest hit. Unusual for that time and place, polio wards were racially integrated at Shannon Memorial Hospital, an up-to-date, regional medical center, and free care was given all who needed it. Scores of townspeople volunteered day and night to care for the sick, especially when thunderstorms knocked out power and iron lungs had to be hand-pumped for hours on end.

My father worked around the clock, days at a time. At one point, my mother, Pat, recalled telling him: “Jack, you haven’t seen your own children for two weeks. You need to eat dinner at home tonight, then go back to the hospital.”

Extremely contagious, polio was transmitted through both the fecal/oral route and airborne droplets. Unlike Covid-19, polio was not new to the world. Egyptian hieroglyphics depict people with polio leg. Why this endemic virus became epidemic in the 20th century was a mystery unraveled when three strains were identified and epidemiologists linked transmission to factors as unrelated as modern sanitation and population mobility.

Polio Shots

Thanks to enormous, competing research efforts, polio largely disappeared after 1955 when vaccines were introduced. The first was a killed-virus developed by Jonas Salk. Boomer kids got a series of three Salk injections and annual boosters that left characteristic round scars on the upper arm. Then in the early 1960s, Albert Sabin’s attenuated live vaccine arrived in a sugar cube with a little red dot.

By the late 1990s, these vaccines, and a global eradication campaign funded by the March of Dimes, Rotary International, the Bill and Melinda Gates Foundation, and the World Health Organization, confined the disease to three countries: Afghanistan, Pakistan and Nigeria.

Our family left San Angelo in early 1953, when my father was recalled into the Navy during the Korean War. We came to California in 1954, and he practiced for 30 years in the East Bay. There were four of us kids in the family (Michael, Bill, Anne and me.) Before he died in 1995, my father left us an oral history, saying:

“I have loved my profession and I was lucky to be in it during the time of the greatest advancement in the history of medicine: the control or eradication of most infectious disease …. organ transplants … chemotherapy … heart surgery … (that) has saved countless lives. As I look back, I realize how fortunate I have been.”

Dr. Ralph Chase, a pediatrician who took over my dad’s San Angelo practice in 1953, wrote a local history of the epidemic, concluding with its greatest lesson:

“One should not look upon treatment but on prevention of disease as the most important mission of the physician and other health-care professional.”

Looking through the lens of the Covid-19 pandemic, it’s humbling to think how a tiny half-beast, a rudimentary, incomplete life form can bring our country, and the world, to a standstill. It’s not the first time, and probably won’t be the last.

Jill Singleton, a longtime Bay Area resident, spent nearly 25 years as Cargill’s public relations representative in the Bay Area, following stints as a government official and newspaper reporter.