Polio and nobel prizes: Looking back 50 years

In 1954, John Enders, Thomas Weller, and Frederick Robbins were awarded the Nobel Prize in Physiology or Medicine "for their discovery of the ability of poliomyelitis viruses to grow in cultures of various types of tissue."5370 This discovery provided for the first time opportunities to produce both inactivated and live polio vaccines. By searching previously sealed Nobel Committee archives, we were able to review the deliberations that led to the award. It appears that Sven Gard, who was Professor of Virus Research at the Karolinska Institute and an adjunct member of the Nobel Committee at the time, played a major role in the events leading to the awarding of the Prize. It appears that Gard persuaded the College of Teachers at the Institute to decide not to follow the recommendation by their Nobel Committee to give the Prize to Vincent du Vigneaud. Another peculiar feature of the 1954 Prize is that Weller and Robbins were included based on only two nominations submitted for the first time that year. In his speech at the Nobel Prize ceremony, Gard mentioned the importance of the discovery for the future production of vaccines, but emphasized the implications of this work for growing many different, medically important viruses. We can only speculate on why later nominations highlighting the contributions of scientists such as Jonas Salk, Hilary Koprowski, and Albert Sabin in the development of poliovirus vaccines have not been recognized by a Nobel Prize.

[French specificities in the history of vaccination. The end of an exception?]

Five years after the National Health minister launched the vaccination program against hepatitis B in 1994, French public health experts are not satisfied by the coverage rate among young people. Is this stagnation related to the controversial way the program was initially managed and to the debate that has raged on the link between the vaccine and multiple sclerosis? Is the popular reaction of distrust specific to the vaccine or does it reveal a growing concern towards the whole vaccinal enterprise? More generally, is it the end of the almost unconditional French acceptance of vaccines? A historical retrospective on the history of vaccination in the country of Louis Pasteur.

Polio vaccine: The first 50 years and beyond

A conference on "Polio vaccine: the first 50 years and beyond" was held in Toronto, Canada, June 2005. The purpose of the conference was to bring together regulators, manufacturers, academics and public health authorities to celebrate the accomplishments of the past 50 years, to consider the challenges of achieving and sustaining polio eradication and to review standardization and regulatory issues around existing and new polio vaccines. In the final session of the conference the following summary of the meeting was presented.

Passive immunization against poliomyelitis: the Hammon gamma globulin field trials, 1951-1953

Poliomyelitis has gone from being one of the worst scourges of the 20th century to nearing eradication in the 21st. This success is well known to be attributable to the Salk inactivated and Sabin attenuated poliovirus vaccines.However, before introduction of these vaccines, William McDowall Hammon of the University of Pittsburgh Graduate School of Public Health led the first major breakthrough in prevention of the disease by using passive immunization in one of the earliest double-blind, placebo-controlled clinical trials. This study provided the first evidence that antibodies to poliovirus could prevent the disease in humans.

[The history of polio in Sweden - from infantile paralysis to polio vaccine]

Although other epidemics declined due to improved hygiene and sanitation, legislation, and vaccination, polio epidemics appeared in Sweden in 1881 and at the turn of the 20th century the disease became and annual feature in the Swedish epidemiological pattern. Due to the vaccination starting in 1957 epidemics ceased to exist in Sweden around 1965. This article deals with the history polio epidemics in Sweden, 1880-1965 and gives a brief description of: the demographical influence of polio, how did the medical authorities investigate and try to combat it, and the different comprehensions of how polio affected its victims.A study of polio incidence in Sweden at the national level during 1905-1962 reveals that the disease caused major epidemics in 1911-1913 and 1953. At the beginning of the 20th century polio primarily attacked children up to 10 years of age, and at the end of the period victims were represented in all age groups, but mainly in the ages 20-39. Due to its enigmatic appearance, polio was not considered as an epidemic infectious disease during the 19th century. Sweden's early epidemics enabled Swedish medical science to act and together with American research institutes it acquired a leading role in international medical research on the disease. In the 1955 Jonas Salk produced the first successful vaccine against polio but also Sweden developed its own vaccine, different in choice of methods and materials from the widely used Salk-vaccine.

[History of poliomyelitis infection in the world and in Poland ]

The history of poliomyelitis infection in the world with special regards to Poland has been described. The main clinical and epidemiological features of disease have been outlined, especially these that helped to start global polio eradication initiative. Study and search for safe and effective vaccine have been presented. An impact of vaccination on epidemiological situation of poliomyelitis in the world and in Poland has been illustrated. The general principles and results of global poliomyelitis eradication program have been reported.

[The history of poliomyelitis in Norway--disease, society and patients]

The first epidemic of poliomyelitis in Norway was reported in 1868. Over the course of the 20th century, a total of 23,000 cases of acute poliomyelitis were registered, and the disease caused much suffering and fear before vaccination was introduced in 1956. After 1960, treatment and rehabilitation facilities for polio patients were gradually converted to other uses. Today there are 5,000-10,000 persons with sequelae poliomyelitis in Norway, many of them suffering from late effects of poliomyelitis, so-called postpolio syndrome. Thus there is still a need for multidisciplinary services for these patients, even though the poliovirus could be eradicated in a few years' time.

Poliomyelitis: the role of the military in the final campaign

Poliomyelitis remains a disease of significance to military medicine. The medical branches of the military of many nations have much to contribute in the final 4 years of the campaign to eradicate poliomyelitis from the world. The service requirements of immunization remain a logistic charge on the defense health services of all nations. Risks to unimmunized troops remain current in the poliomyelitis endemic regions of Europe, Asia, and Africa; and recent epidemics in India, West Africa, and Albania have involved military personnel in containment programs. The 20th century has seen global attempts to eradicate seven diseases--hookworm, yellow fever, yaws, malaria, smallpox, dracunculiasis, and poliomyelitis. The first four of these were total failures, in spite of huge military logistic resources, especially in the case of yellow fever and malaria. But the global eradication of smallpox, achieved in 1979, led to the World Health Organization's Declaration of a Smallpox-Free World in 1980. Its success ranks as one of the greatest achievements in the history of medicine. Lessons learned and encouragement derived from that program led to the institution of the Poliomyelitis Global Eradication Program in 1988. Following the Declaration of a Polio-Free America, the target date for the Declaration of a Poliomyelitis-Free World has been set for 2004. Regional surveillance programs use the quality-control portal of acute flaccid paralysis to monitor every potential clinical case of acute poliomyelitis. In the Western Pacific region, a region of 22 countries with a recent history of significant operational deployments, 15 countries had experienced endemic poliomyelitis before 1990. In this region, the last case of poliomyelitis (in Cambodia) was reported in March 1997. Such audit, together with massive point vaccination programs, many using massive military support, conducted since 1997 hold realistic promise that the world may be declared poliomyelitis-free by 2004. Poliomyelitis will be more difficult to eradicate than smallpox; and the current world campaign will succeed only with the logistic and professional input of the military of many nations.