Polio Particles - Issue 6

Mary Westbrook

Parking violators sentenced to wheelchairs

Since November last year able-bodied people in San Angelo, Texas, who park in disabled parking spaces could end up doing time in a wheelchair (Associated Press). A first offence of parking without a permit results in a fine of $265. A second offence leads to a higher fine or serving 21 hours in a wheelchair. The 21 hours must be completed within three working days with a minimum of seven consecutive hours being spent in the wheelchair each day. The West Texas Rehabilitation Centre provides the wheelchairs. Each chair has a sign on the back stating that the user has broken the law. A toll-free number is listed to call if the chair is found empty. As violators do not have a valid disabled parking permit they cannot use disabled parking spaces while doing time.

Polio reappears in a polio free zone

In the last Newsletter I reported the concern that if vaccination ceases after the eradication of polio then the mild virus associated with the Sabin vaccine might mutate and infect non-vaccinated people. Such a mutation or change of the Sabin virus recently occurred in the Caribbean. In 1991 the Western Hemisphere was declared polio free after the last case of polio caused by wild-type polio virus was recorded (in Peru). However the Washington Post (1/1/01) reports that in the second half of last year there were 45 cases of polio or suspected polio in the Caribbean; 35 in the Dominican Republic and 10 across the border in Haiti. After the cases were diagnosed as polio, health officials there were swamped by people wanting to be vaccinated. A report by Associated Press focuses on the individual cases asking, Will 3-year old Erika Pimental, who now drags herself across the floor on her hands, ever be able to run around the neighbourhood? How will 6-year old Alejandrina Arismendy, now unable to stand on her own, make it down the steep hill outside her home to school? Sandy Torres, who is described as now using a wheelchair because his body is forever damaged, told the reporter, I ask God when I will be able to walk again, and if I can continue playing baseball? All the cases in the Caribbean were either unvaccinated or incompletely vaccinated. CDC (Centers for Disease Control) in the USA conducted a genetic analysis of the viruses obtained from patients. This revealed that the viruses were related and all were derived from the weakened virus used in the Sabin vaccine. Apparently the virus had mutated and spread from person to person among the 50% of people in the two areas who have not been vaccinated against polio. CDC estimates that it took about two years for the Caribbean Sabin virus to mutate as it spread. In a fully immunised population the vaccine virus dies off quickly. This is known from research in Cuba where the Sabin vaccine is only given twice a year on nationwide immunisation days and at no other times. Samples of sewage in Cuba contain no polio virus three months after immunisation days. As relatively few cases occurred in the Caribbean epidemiologists believe that this mutated virus strain is not as transmissible or dangerous as wild-type polio virus. Echoing the point made in the last Newsletter, Walter Orenstein, director of CDC's immunisation program said that the outbreak highlights the importance of maintaining a high level of suspicion for polio, and for ensuring that our vaccination coverage is maintained. Or as the Washington Post put it, Even if the tiger you're holding by the tail is mortally wounded, is it ever truly safe to let it go?

Legacies of the WHO Polio Eradication Program

The Bulletin of the World Health Organisation (Volume 79(3), 2000) had polio eradication as its special theme. These are some tidbits I extracted from its many articles.

• The greatest challenge to the eradication program has been war in countries such as Angola, Congo and Afghanistan where polio is endemic. However sometimes immunisation days had a peace-building impact. In part of Sri Lanka the process of arranging ceasefire days for immunisation enabled negotiations leading to the restoration of electricity to the region. In Somalia the demand from the local population for immunisation led local leaders to de-mine roads.
• In the 11 years since WHO resolved to eradicate polio, the estimated number of paralytic cases has fallen from over 400,000 a year to fewer than 20,000. The number of known or suspected polio-endemic countries has fallen from over 120 to fewer than 50. India now accounts for over 50% of reported cases of polio.
• In many developing countries the polio immunisation programs have helped develop better public health systems. Many countries have now established measles and malaria surveillance and eradication programs based on the polio programs. Polio immunisation days are being used to provide vitamin A supplements. Vitamin A is essential for the functioning of the immune system and healthy growth and development. Vitamin A deficiency is a major factor in causing 1-3 million child deaths and blindness in a quarter to half a million children per year.
• Many experts believe there are too many gaps in our knowledge to stop polio vaccination yet. Vincent Racaniello, Professor of Microbiology at Columbia University asks, Are we willing to take the chance that infants and children will once again be paralysed and sent to iron lungs by a disease that can be prevented by vaccination? Even if some people are, who is willing to take responsibility for taking that chance by deciding to stop vaccinating?

How many Australians have disabilities?

The Australian Bureau of Statistics (ABS) recently released the findings of its 1998 survey titled Disability and Long Term Health Conditions. A nation-wide sample of 42,667 (selected to be representative of Australians) were interviewed by trained personnel. The survey concluded that 3.6 million (19%) Australians have a disability (long term health condition or impairment that interferes with their daily living activities) and another 3.1 million (17%) have a long-term health condition or impairment that is not disabling. The ABS used the World Health Organisation's definition of disability: any restriction or lack of ability to perform an action in the manner or within the range considered normal for a human being. To be counted as disabled in the survey a person had to have had the condition for at least six months or be likely to have it for at least six months and be restricted in their ability to perform at least one everyday activity such as self care, mobility or communication.

Mobility restriction is the disability most frequently found among polio survivors. For the purpose of the ABS survey, mobility was considered to comprise the following tasks: getting into or out of a bed or chair, moving about your usual place of residence, getting to or from places away from your home, walking 200 metres, walking up and down stairs without a handrail, bending and picking up an object from the floor, and using public transport. Disabilities were classified from mild to profound depending on how difficult/ impossible tasks were for the person and how much help from others was needed to carry out tasks. The most common type of disabilities were caused by physical impairments (2.6 million or 14% of Australians) followed by sensory impairments/speech loss (1.2 million or 6% of Australians). Intellectual impairments, psychological impairments and head injuries/stroke/brain damage were much less common but were more likely to result in severe or profound disability than were mobility or sensory impairments. The survey collected information on disabled people's living arrangements, type of assistance they needed and received, and their formal and informal care providers. The disabilities of men and women and people of different ages were compared. Examples of ABS findings were that industrial deafness and intellectual disorders are commoner among males.

How many people with disabilities worldwide?

A billion people with disabilities by 2000 is the title of an article by Art Blaser in the US journal Electric Edge (July 1998). (The American definition of a billion is a thousand million). The author admits that his estimate is a guess but argues that the 'one in ten people are disabled' figure usually cited in calculating the number of disabled people in a population is too low. As the above Particle revealed, the Australian figures are almost double this. Blaser says that some factors are reducing the population of people with disabilities: some may not be born because they have been aborted; some will join the non-disabled as a result of medical science; the death of some may be hastened when they are chosen not to receive scarce food supplies; some may become the subjects of euthanasia, whether voluntary or involuntary. However the total disabled population is increasing. People are not dying like they used to. Although many of the causes of death - automobiles, workplace hazards, and unclean water - are still with us, they now more often disable people than kill them. Many disabilities are easily preventable, but that does not mean that they are being prevented. Examples are blindness, famine and land mines. A high rate of disability may be the result of a society's success. Examples are Alzheimer's and people with AIDS who are surviving longer but have disabilities. Often so-called cures for disabilities lessen their effects rather than eliminating them. Blaser concludes: We are left with the question of whether the certain increase in people with disabilities is good news or bad news. I say it's good news. The challenge for society is to raise the quality of life for all of us, many of whom will be people with disabilities.

Polio survivor invented teddy bears

Margarete Steiff was born in Germany in 1847. She contracted polio when she was two and used a wheelchair for the rest of her life. After attending school, where the janitor carried her up stairs, she took sewing lessons and opened a dress shop in her parents' home. This grew to several shops. Margarete began using scraps left over from sewing to make toys. These were so successful that she abandoned dressmaking and with her brother opened the Steiff Toy Company. The building was wheelchair accessible with long sloping ramps and wide spaces. By the 20th century according to an article in Mainstream Magazine (12/95) the name 'Steiff' on a stuffed animal or doll was comparable to the word 'sterling' on silver. Margarete wanted to create a stuffed toy animal that would compete with dolls in popularity. The animal had to one appeal to both sexes and be able to dressed liked a doll. After a visit to the zoo her brother suggested a bear. Their factory manufactured a toy bear made of wool plush and cotton fabric called mohair to give the bear a furry, cuddly appearance. Wooden discs were placed at the neck, shoulders, and hips to allow the bear to be posed in different positions. Shoe buttons were used for eyes and silk thread for nose, mouth and claws. The first bear was exhibited at the Leipzig Toy Fair but there was only one order. This was from a New York department store that placed a large order for 3000 bears. When the bears arrived in the US Theodore (Teddy) Roosevelt was the popular president who loved hunting. On a recent hunting trip he had shot nothing so his aides put a bear cub in his path. Roosevelt refused to shoot the bear. The picture of him with the cub captured Americans' imagination. The name 'Teddy' was attached to the Steiff bears and the world's love affair with teddy bears began. When Margarete died in 1909 her company was exporting hundreds of thousands of bears and it still produces them.