Concerns Mount Over Polio Resurgence as Healthcare System Prepares

With a rise in preventable infectious diseases and a leading US vaccines advisor suggesting a reevaluation of all vaccine recommendations, there’s growing apprehension among experts about an increase in polio cases. Survivors of the disease are expressing doubts about the medical system’s ability to handle such a resurgence.

“Our healthcare system isn’t equipped for a polio outbreak,” stated Grace Rossow, who coordinates communications in an operating room in Illinois. She has experienced long-term health issues since contracting polio as a baby.

“They really don’t know how to treat it. The implications would be massive if polio makes a comeback,” she remarked.

There’s no known cure for polio; treatment for acute cases mainly involves supportive care. Research indicates that between a quarter and half of those infected develop post-polio syndrome, which is a lifelong condition. However, thanks to effective vaccines, encountering polio cases has become increasingly rare for doctors.

Art Caplan, one of the last Americans affected by polio during the 1950s Boston outbreak, was just seven when he experienced paralysis in his neck and legs. He spent half a year in a specialized ward for children, where he witnessed other kids deteriorating, some tragically passing away. Miraculously, he managed to regain the use of his legs, though the reasons remain unclear.

Caplan had to undergo years of physical therapy to learn how to walk again, and now, as his legs have weakened once more, he relies on a walker. Over the years, he’s observed that polio specialists have gradually retired or left the field.

“There’s nobody left to treat it,” Caplan, now a medical ethics professor at NYU, pointed out. “They simply don’t see it anymore.”

Gordon Allan, an orthopedic surgeon at Southern Illinois University, highlighted the dramatic shifts in his specialty compared to earlier eras. He learned how to manage post-polio treatment from seasoned doctors, but even back then, the number of patients was declining.

“No one practicing nowadays has real experience with it,” he noted. He remarked that he’s nearing the end of the line among specialists who understand how to address long-term issues survivors face, saying, “Orthopedic practices evolved away from polio-related treatments.”

Patients grappling with post-polio often face declining muscle and bone strength, which impedes their mobility and makes them prone to falls that can lead to fractures. They may also suffer from scoliosis and experience severe joint pain, fatigue, and challenges relating to temperature control.

In his field, Allan mentioned that surgeries like tendon transfers, typically performed to enhance strength, are now infrequently done, particularly around the ankle. He believes expertise in complex tendon transfers around the hip has become nearly forgotten.

Moreover, some post-polio patients might develop deformations that require knee or hip replacements. However, these surgeries are considerably more complex due to weaker bones and require intense rehabilitation, especially given the common occurrence of muscle weakness.

“The best defense is simply to avoid getting polio,” he emphasized, underscoring the significance of vaccination.

Grace Rossow contracted polio as a baby in an Indian orphanage. Born in 1992, she came along long after the vaccine was developed, even though many children in India still face challenges accessing it. She fell ill at around four to nine months of age and now relies on a wheelchair due to paralysis in her left leg.

“I have a supportive medical team that listens to my concerns, but I worry future polio survivors might not have that advantage. People often just don’t understand polio. I describe it as the ‘hold my beer’ of medicine. Treatments that you think should work often don’t. In fact, physical therapy can sometimes worsen our condition,” Rossow explained.

She also noted instances of neurologists who, due to their lack of exposure to polio, can’t adequately understand or treat her. “It’s not their fault; they don’t know about my experience.”

Rossow believes that the polio vaccine’s success has unintentionally led to its downfall. “People aren’t afraid of polio anymore,” she asserted, pointing out that the everyday challenges of living with a vaccine-preventable disease are often overlooked. “We can’t be fixed, and that’s the issue. The only real solution for polio is the vaccine itself.”

For Caplan, his experience profoundly influenced his views. “It definitely made me very pro-vaccine,” he shared.

He expressed anger upon hearing Kirk Milhoan, chair of the Advisory Committee on Immunization Practices, discuss reconsidering routine childhood vaccinations due to lowered risks for diseases like polio. “That infuriates me,” he stated.

“If you could gather up the children I witnessed suffer or die fifty years ago, they’d want accountability. It’s horrifying and utterly irresponsible to leave even the slightest chance open for a recurrence,” Caplan said.

As more families opt out of vaccinations, especially following the US’s reduction in recommending vital vaccinations, Caplan voiced concerns: “We’re setting ourselves up for a resurgence.”

Rossow echoed that warning, noting how “deeply religious and antivax families, who refuse to believe these diseases pose any threat, may ultimately pay the price.”

In communities where vaccination rates are low, Caplan cautioned that “polio could spread before anyone realizes it’s happening.” He also stressed that preparedness involves ensuring substantial vaccine reserves are available to deploy swiftly when cases arise.