a quarter and a half <\/a>of patients develop post-polio syndrome, a lifelong condition. Yet with the advent of highly effective vaccines, doctors who have seen polio cases have become increasingly rare.<\/p>\nArt Caplan was one of the last Americans to get polio in the Boston outbreak in the 1950s. He was seven when his neck and legs began to develop paralysis. He spent six months living at Massachusetts general hospital on a floor devoted to children with polio. Sometimes the other children would transfer downstairs to iron lungs when they could no longer breathe on their own; sometimes they would die from their illness in the beds next to him. After months wondering whether he would be next, Caplan suddenly regained use of his legs for reasons no one has been able to fully explain.<\/p>\n
But even after his miraculous recovery, he spent years in physical therapy learning how to walk again. Now he uses a walker, as his legs have weakened again. Through the decades, he\u2019s seen polio experts leave the field as they aged and retired.<\/p>\n
\u201cThere\u2019s nobody left. They don\u2019t see it,\u201d said Caplan, now a professor of medical ethics at NYU Grossman Medical School.<\/p>\n
Gordon Allan, a surgeon who is the orthopedic residency director and the total joint reconstructive fellowship director at Southern Illinois University School of Medicine, said: \u201cOrthopedics has really changed a lot now from the people who trained me.\u201d<\/p>\n
He learned from the previous generation of doctors how to treat post-polio, but even then, there were fewer patients.<\/p>\n
\u201cNo one practicing has first-hand experience,\u201d Allan said. He is now \u201cat the tail-end\u201d of specialists who know what might be done to alleviate long-term issues, he said, adding: \u201cOrthopedics was quite different because of polio, and all that stuff just faded away.\u201d<\/p>\n
Patients with post-polio have weakening muscles and bones, which affects their ability to walk without mobility aids, and falls can easily lead to broken bones. They may develop scoliosis and other problems. They struggle with extreme joint pain, fatigue, temperature regulation, attention, and secondary complications from paralysis.<\/p>\n
In orthopedics, Allan said, surgeons would perform procedures such as tendon transfers around the hip, knee and ankle to help improve strength. Those procedures are now rarely done on ankles. Allan doesn\u2019t know of anyone doing complex tendon transfers around the hip, he said. \u201cThat\u2019s a lost art.\u201d<\/p>\n
Sometimes post-polio patients develop deformities and angularities in their bones, requiring total knee or hip replacements \u2013 but those procedures are markedly more complicated given poor bone quality, and rehabilitation after surgery is much more complex with muscle weakness. The risks of falling and breaking the replacement joints are also high, Allan said.<\/p>\n
\u201cThe best prevention is: don\u2019t get polio,\u201d he said, highlighting the importance of vaccination.<\/p>\n
Rossow contracted polio as an infant in an Indian orphanage. She was born in 1992, long after the vaccine was developed but before it was administered to most children in India; there are still some challenges to doing so in the country. She first fell ill somewhere between the age of four and nine months. Her left leg is paralyzed; she now uses a wheelchair.<\/p>\n
\u201cI have a great medical team that actually listens to me, and that is one of the barriers to care that I worry future polio survivors will have, because people do not know polio, they do not understand polio. The way I describe polio is: it is the \u2018hold my beer\u2019 of medicine. Anything that you think will actually treat it, will not. Physical therapy makes us worse,\u201d Rossow said.<\/p>\n
\u201cI\u2019ve had neurologists who just don\u2019t know anything about polio because they\u2019ve never seen it \u2013 no fault of their own, not like they\u2019re practicing outside of their scope by any capacity, but they just know nothing about me.\u201d<\/p>\n
The polio vaccine has \u201cabsolutely been a victim of its own success\u201d, Rossow said. \u201cPeople aren\u2019t scared of polio any more,\u201d she said, and they don\u2019t understand the risks. \u201cPeople don\u2019t really see the daily side of living with a vaccine-preventable disease. With polio, you\u2019re never going to fix us, and that\u2019s the problem. The only thing to fix polio is the polio vaccine.\u201d<\/p>\n
For Caplan, the experience \u201cabsolutely\u201d shaped him.<\/p>\n
\u201cIt got me to be very pro-vaccine,\u201d he said.<\/p>\n
When Kirk Milhoan, the chair of the Advisory Committee on Immunization Practices, said the vaccine advisers were reconsidering routine childhood vaccines because the risks of illnesses such as polio had dropped, \u201cthat makes me furious\u201d, Caplan said.<\/p>\n
\u201cIf you could gather up the kids I saw die or become really severely disabled from 50 years ago, they would want you arrested \u2026 It\u2019s horrifying, and the height of irresponsibility to leave the door open even a crack,\u201d he continued.<\/p>\n
As more families choose not to vaccinate, particularly after the US stopped fully recommending several key vaccines, Caplan said: \u201cYou are begging to have a recurrence of the disease.\u201d<\/p>\n
Rossow also warned that those \u201cdeeply religious and antivax families who just do not believe these diseases exist or will harm them\u201d were unfortunately \u201cthe families affected most, due to lack of vaccination, and likely those children will suffer\u201d.<\/p>\n
In insular communities where many people reject immunization, \u201cyou could really get polio under way before anybody realized that it was there\u201d, Caplan said. \u201cPreparation also means having huge reservoirs of vaccine available to rapidly deploy when the inevitable recurrence happens.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"With preventable infectious diseases surging and a top US vaccines adviser saying all vaccine recommendations may be reconsidered,…\n","protected":false},"author":2,"featured_media":499225,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[64,63,137,500],"class_list":["post-499224","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-au","tag-australia","tag-health","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/499224","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=499224"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/499224\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/499225"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=499224"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=499224"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=499224"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}