Opinion

Tom Dillard: Polio eradication didn’t come easily in Arkansas

One of my earliest memories involves standing in a long line to receive a polio vaccination. I was in elementary school at the time, and happy that this vaccination did not involve a needle. Instead I was given a sugar cube slightly discolored by the vaccine.

The sugar cube is what I remember best, because I had never seen one -- and I liked it.

The vaccine protected me from polio, a devastating childhood disease which had periodically terrified parents throughout the nation in the first half of the 20th century. Eliminating polio in Arkansas was a long effort which involved coordinated work by a host of medical, educational and governmental agencies as well as parents.

The virus reproduces in the gut of the victim and is spread through fecal contact; hence many of the victims were under 5 years of age. Though the polio virus has been around since ancient times, it did not make an appearance in the United States until 1894, when children in Vermont came down with a new disease which could kill victims, but more often left them at least partly paralyzed.

Brenda J. Murry, author of the entry on polio in the Encyclopedia of Arkansas, wrote that the first case in Arkansas occurred in 1920, followed by 50 cases in 1927, and "close to 80 in 1930." In 1937, central Arkansas was struck with an epidemic which hospitalized 28 people ranging in age from three months to 58 years, the oldest known Arkansas victim up to that time. Thirteen patients died.

The 1949 polio outbreak sent 266 victims to the hospital by July 15, the majority falling ill within two weeks -- betraying the tendency of outbreaks to occur during the summer. The exact count of infected people requiring some form of intensive care for the year was 992.

The University of Arkansas Hospital received the bulk of patients at first, but soon polio wards were set up at Baptist Hospital, St. Vincent Infirmary and Trinity Hospital. Convalescence centers were set up in Jacksonville and Arkansas Children's Home in Little Rock.

At one time iron lungs, huge contraptions needed to help those with the worst paralysis to breathe, spilled out of UA Hospital into hallways. The American Red Cross recruited nurses with polio experience to Little Rock hospitals. The Army-Navy Hospital in Hot Springs provided care to patients from across the nation.

It was the outbreak of 1949 which really caught the attention of the public as well as the medical community. Newspapers across the state reported extensively on the epidemic, the Arkansas Gazette listing patients by name, age, parents, and residence. "Betty Jane Brickley, 3, daughter of James Brickley of Searcy" was a typical entry. A 9-year-old boy from West Memphis seems to have been the oldest.

In 1950 an Arkansas Polio Planning Committee was created by representatives of the Department of Health, the Crippled Children's Division of the Arkansas Department of Welfare, various hospitals, the local Red Cross and the National Foundation for Infantile Paralysis. Retired public health nurses such as Linnie Beauchamp and Mary Emma Smith helped develop special training for nurses providing polio care.

While Arkansas and other states were developing means of caring for polio victims, researchers were hard at work in search of a vaccine. Dr. Sam Taggart, a retired physician and author of a book on Arkansas public health, described the situation succinctly: "By 1950 Jonas Salk, a researcher funded by the National Foundation for Infantile Paralysis, found what he thought might be the answer: a killed vaccine of poliovirus. One of Salk's leading critics was Dr. Albert Sabin, who was working on a live-attenuated vaccine; he was convinced that Salk's vaccine would be too weak."

Dr. Salk's vaccine was ready for mass randomized testing by the spring of 1954. Of the 1.8 million students to be vaccinated nationally, some 5,029 elementary school students were chosen from five large counties in the state including Pulaski, Sebastian, Mississippi, Jefferson and Craighead. A series of three shots was required.

Almost a year later the results were announced: 70-100 percent effective, and a national inoculation campaign began immediately. Arkansas had 202,000 children ages 5 to 9, the range prioritized in Arkansas, although Dr. J.T. Herron of the Arkansas Board of Health preferred starting with children ages 1 to 5. In part due to limited supplies of the vaccine, only 87,832 children were vaccinated in 1955, most in large school clinics.

Much more progress was made in 1956, with 21,000 inoculations in Mississippi County alone. However, health officials in Mississippi County complained about a general indifference among the young and Blacks.

Nurse Clara Ambrose, a public health nurse in Blytheville, told a local news reporter: "Our Negro population is not taking advantage of the program anyway, not like it should." A flareup in 1959 in Little Rock found most of the victims were Black. The shots were given in school settings, almost all of which were still segregated in 1959.

Most of the opposition to polio vaccination plans came from doctors and the Arkansas Medical Society. In 1956, the AMS's Polio Advisory Sub-Committee expressed opposition "to all forms of government control of distribution and administration of any vaccine or substance that ... circumvents or interferes with the normal supply and demand or supersedes the normal ethical physician-patient relations."

Meanwhile, the Sabin vaccine became available in 1961. Its ease of administration and perceived greater safety made it popular. Dr. Roger Bost, a practicing pediatrician in Fort Smith and new chairman of the Medical Society's Polio Committee, was a steady and effective promoter of vaccination. He organized a statewide series of "Sabin Sundays" where vaccinations were administered in every county.

By 1963, infections were reduced to four patients. Arkansas and America were declared free of polio in 1994. The last known case in the Americas was a Peruvian boy in 1991. Rotary Clubs International has sponsored an amazing worldwide campaign which is on the cusp of eliminating polio from the globe.

In July, a polio case was reported in New York affecting an unvaccinated patient.

Tom Dillard is a historian and retired archivist living in Hot Spring County. Email him at [email protected].

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