Jonas Salk’s 100th Birthday
Google today is commemorating Jonas Salk’s birthday with a Google doodle. Salk was the developer of the first vaccine against polio, a disease which affected 58,000 people in 1952 in the United States alone, leading to over 3000 deaths and over 20,000 people with permanent levels of paralysis from the disease. Polio is a viral disease, and is passed from individual to individual via contaminated drinking water, and until the development of a vaccine it was essentially impossible to control. Previous attempts at creating vaccines generally used a strategy of attenuating pathogens, a method of laboriously reducing the virulence of the pathogen in the laboratory, with the hope that non-virulent organisms might still provide protection against the more virulent pathogens in the wild. Salk’s innovation was to pursue inactivated pathogens; virus that had been grown in the lab, and then was partially denatured so that it was then physically unable to cause disease. Fortunately, this approach worked for Salk, and in 1955 the first polio vaccine came to market worldwide. By 1962, the number of polio cases in the US had dropped to under 1000, and the last case of natural transmission domestically occurred in 1979 during an outbreak among several Amish communities.
Salk was hailed as a hero when the wide availability of the vaccine was announced. The Google doodle above is based on an actual photograph from 1955–I think that people today have little understanding how terrifying many infectious diseases were to society as a whole. Salk was recognized with many honors during his career, however he did not receive the Nobel Prize even though he was nominated during the late 1950’s. Vincent Racaniello at the Virology Blog suggests that the prevailing opinion among the community at the time was that Salk’s procedure didn’t really involve true innovation, which is an important component of the Nobel Prize. The 1954 Nobel Prize was awarded to a trio of polio researchers (John Enders, Thomas Weller, and Frederick Robbins) who discovered a method to grow polio virus in the laboratory. Indeed, without this innovation, Salk would have never been able to produce his vaccine.
I came across a second item about polio this morning as I went through my Twitter feed, linked to by @popehat, a politics/news site that helps me to get outside my political comfort zone on occasion. In this Boston Globe article detailing what is hopefully the final days of polio here on Planet Earth, the intrusion of world politics clearly is complicating global eradication efforts. Most recent outbreaks have been limited to a small geographic area in sub-Saharan Africa, however Pakistan is currently experiencing an epidemic, whereas neighboring India has been certified “polio-free” effective this year. The problems in Pakistan have been complicated by US anti-terror efforts in the region. Currently, Taliban leaders regard legitimate polio aid efforts as suspect, with vaccination efforts as an American plot to deliberately infect children or to gather intelligence information. The latter suspicion is not off base, as in 2011 CIA operatives used a vaccination program around Abbottabad near Osama bin Laden’s compound to collect DNA samples in hopes of confirming that bin Laden was there. Following exposure of the CIA’s involvement, later vaccination aid efforts were stymied, and aid workers have been threatened.
Global polio eradication will eventually occur, and like smallpox, within a generation the only place polio virus will be found will be in laboratories. Smallpox required an almost 200-year concerted effort to eliminate; polio by contrast has essentially disappeared within two generations. This story however is important to remind us that seemingly disconnected events (the war on terror, global public health measures) are in fact tightly intertwined. Unfortunately, the messy intrusion of politics into polio eradication has created a mistrust of the importance of public health measures outside of this county. I fear that this same mistrust is also at work with public health measures here at home.