The resurgence of preventable infectious diseases is raising concerns among public health experts and, particularly, those who remember a time when these illnesses were far more prevalent. With a top US vaccines adviser recently suggesting a reevaluation of routine childhood vaccinations, fears are growing that the United States could see a rise in cases of diseases like polio, a virus that can cause lifelong paralysis.
The concern isn’t simply about a potential increase in cases, but also about the healthcare system’s preparedness to handle them. “We don’t have a healthcare infrastructure to take care of a polio outbreak,” says Grace Rossow, an operating-room communications coordinator in Illinois who has experienced the long-term effects of polio since infancy. “They don’t know how to treat it. We see a massive problem if we have a resurgence of polio.”
Polio itself has no cure. Treatment focuses on supportive care to manage symptoms. However, a significant proportion – between a quarter and half – of those infected develop post-polio syndrome, a chronic condition that can manifest decades after the initial infection. Despite the effectiveness of vaccines in eradicating polio from the US, a growing number of healthcare professionals have limited or no direct experience with the disease.
Art Caplan, a professor of medical ethics at NYU Grossman Medical School, contracted polio during the Boston outbreak in the 1950s. His experience, which involved months in the hospital and a long road to recovery, profoundly shaped his perspective. “It got me to be very pro-vaccine,” he states. He expressed frustration with the recent suggestion by the Advisory Committee on Immunization Practices to reconsider routine childhood vaccines, stating, “If you could gather up the kids I saw die or become really severely disabled from 50 years ago, they would want you arrested… It’s horrifying, and the height of irresponsibility to leave the door open even a crack.”
The decline in polio expertise extends beyond direct patient care. Gordon Allan, an orthopedic surgeon and residency director at Southern Illinois University School of Medicine, notes a generational shift in medical training. He learned techniques for treating post-polio complications from previous generations of doctors, but those procedures are now rarely performed. “No one practicing has first-hand experience,” Allan explains. He describes specialized tendon transfer surgeries once common for polio patients as a “lost art.” Even when post-polio patients require joint replacements due to bone deformities, the procedures are more complex and carry higher risks given weakened muscles, and bones.
The long-term effects of polio are multifaceted. Patients often experience weakening muscles and bones, increasing their risk of falls and fractures. They may also develop scoliosis, chronic pain, fatigue, and difficulties with temperature regulation and cognitive function. Rossow emphasizes the challenges of navigating a medical system unfamiliar with the disease. “People do not know polio, they do not understand polio,” she says, describing how even neurologists may lack the necessary knowledge to provide appropriate care. She highlights the unique difficulties of treating polio, stating, “Physical therapy makes us worse.”
Rossow attributes the current situation to the success of the polio vaccine itself. “The polio vaccine has ‘absolutely been a victim of its own success’,” she explains. “People aren’t scared of polio any more,” leading to a diminished understanding of the risks and a reluctance to vaccinate. She stresses that vaccination remains the most effective way to prevent the disease and its debilitating consequences: “The only thing to fix polio is the polio vaccine.”
The potential for a resurgence is particularly concerning in communities with low vaccination rates. Caplan warns that in these areas, “you could really get polio under way before anybody realized that it was there.” He emphasizes the importance of maintaining a readily available vaccine supply to enable rapid deployment in the event of an outbreak. Rossow echoes this concern, adding that families who choose not to vaccinate are often the most vulnerable to the disease’s effects.
The current situation underscores the importance of continued vigilance and a commitment to maintaining high vaccination rates. While polio may have faded from memory for many, the experiences of survivors like Rossow and Caplan serve as a stark reminder of the devastating consequences of this preventable disease and the need to protect future generations.
