50 years ago, Rhode Island suffered through its last -- and worst -- polio epidemic

02:34 PM EDT on Sunday, September 25, 2005

BY ARTHUR GREGG SULZBERGER
Journal Staff Writer

1955 was an unusually hot summer.

Journal file photo

Fifty years ago, Rhode Island suffered through its last -- and worst -- polio epidemic,.

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The Long family, as always, was enjoying a quiet retreat on Jamestown, serene and wonderfully inaccessible in the cool waters of Narragansett Bay. Their small summer cottage had no running water, no television and no phone. An outhouse presided over the backyard.

Shirley Long watched over her four sons and the baby girl who was beginning to make her presence known on Shirley's slender physique, while her husband commuted to work in Pawtucket. The Longs only left their island refuge once, for a short visit to nearby Narragansett.

As September approached, the youngest of the boys, 2-year-old David, became sick with what appeared to be a nagging cold. A doctor gave the boy some medicine and assured his worried mother he'd be fine. Several days later, his arms stopped moving and David was rushed to the hospital.

Shirley was next. It started with a headache, an upset stomach, then paralysis. "It was like somebody had fingers on every muscle of your back, pulling you up."

A week later, 9-year-old Stephen Long collapsed. "I couldn't feel my legs . . . the next morning, I couldn't move my arms; the next morning, I couldn't move at all."

Stephen didn't walk again for nine months.

Polio was spreading throughout the state, even as a new vaccine, released months earlier, promised to end the disease that killed and crippled thousands of children across the country each year.

That summer, 50 years ago, Rhode Island suffered its last polio epidemic.

It was also the worst.

In Rhode Island, 421 people, including Shirley, Stephen and David Long, were hospitalized because of the disease, which for half a century had terrorized parents and children during the summer months when polio was most prevalent.

As the scale of the epidemic became clear, state officials turned Providence's Charles V. Chapin Hospital for communicable diseases into one large polio ward. Even there, the Longs stood out.

"[David and Stephen] were among our worst cases when they came here," Dr. Edward J. West, clinical director for Chapin hospital told The Journal several months after the brothers arrived. "They couldn't move a finger between them."

Poliomyelitis wasn't the most common, or most deadly disease of its time, but the ruthlessness with which it targeted children made it, perhaps, the most feared. More than half of polio's victims were under 3 years old. It was so widespread that nearly 80 percent of Americans had acquired immunity to the disease by age 15.

Spread through contact with fecal material, the virus, which has three strains of varying potency, incubates for more than a week before the onset of symptoms, often allowing it to spread widely before being detected. Most people contracting the virus never knew because there were no symptons, and others just thought they had a cold. But, in some cases the virus destroyed the nerve cells that activate muscles, causing paralysis in affected areas. The muscles, then the bones, atrophied, leaving arms and legs weak and brittle and often requiring the support of metal braces.

In the worst cases, polio would also paralyze the breathing muscles, forcing its victims into "iron lungs" -- huge metal chambers that regulated breathing and spawned nightmares for a generation of children who would see pictures of victims trapped motionless in the devices.

THERE IS no cure for polio.

Efforts to defeat the virus, from the beginning of the 20th century, focused on prevention -- finding a way to keep it from taking hold.

On April 12, 1955, the nation learned that a massive trial of an experimental polio vaccine had exceeded all expectations. The date of the announcement fell on the 10th anniversary of the death of polio's most famous victim, President Franklin Delano Roosevelt.

The vaccine, which used dead polio virus (30 billion viruses in a single shot) to produce antibodies, was 90 percent effective, possibly more. Three doses within a year's time would protect against polio for life.

The national mood was celebratory. The vaccine's creator, Pittsburgh scientist Jonas Salk, was immediately hailed as a national hero. President Dwight D. Eisenhower magnanimously offered the recipe for the vaccine to the rest of the world, even to "Russia and the other Red countries."

The Providence Journal editorial page heralded the "promise of a speedy end to the annual season of dread that has darkened the summer thoughts of every mother and father of young children."

Polio, which was paralyzing and killing an average of 40,000 Americans annually in the early 1950s, with a high of 58,000 in 1952, appeared ready to join typhoid fever, malaria, cholera, plague, smallpox and diphtheria on the list of feared scourges that medical science had solved.

In hopeful anticipation of the positive trial results, the National Infantile Paralysis Foundation had ordered vaccine for 9 million children nationwide, just enough for the country's first and second graders. Rhode Island prepared to administer its share -- inoculations for about 36,000 children.

A problem surfaced almost immediately when a batch of vaccine contaminated by live polio viruses infected a number of children in Idaho, reviving concerns about its safety and fueling opposition by rival scientists. State and health officials moved quickly to reassure a nervous public. In Rhode Island and most of the nation, participation was fairly widespread: more than 76 percent of eligible Providence children received vaccinations, and 88 percent in Warwick.

Amidst the celebration, Surgeon General Leonard A. Scheele offered a prophetic warning: "Experience indicates . . .that there will be some scattered local epidemics and some may be severe."

AS THE SUMMER heat peaked and communities began administering the second of the series of three shots to first and second graders, polio cases began trickling into Chapin hospital.

By Aug. 12, the number of cases had nearly quadrupled from the previous year, from 13 to 50. Soon, all seven wards at Chapin hospital were filled with infected children and adults.

When Mary Picard, 20 years old and just out of nursing school, called Chapin at the onset of the epidemic, she was hired over the phone.

She remembers the red-brick buildings packed with patients, supervisors begging the nurses to take on extra shifts, the parents who had to watch their immobilized children from doorways because they weren't allowed to enter the rooms, the lines of iron lungs releasing the swish, swish, swish of artificial breath, and the man who killed himself one night after realizing the physical toll the disease had taken on him.

"It was a terrible time," says Picard of Greenville, now 70. "Everyone was afraid."

By September it became clear that Rhode Island was suffering the worst polio epidemic in its history. Parents kept their children inside. The start of school was postponed for two weeks in Providence and several other communities. In Pawtucket, it was postponed indefinitely.

The 421 who suffered from the disease in 1955, most of whom lived in the northern part of the state along the Massachusetts border, easily topped the previous high of 346 cases in 1935, and gave Rhode Island the third-highest rate in the nation, behind Massachusetts and Wisconsin. The virus also hit particularly hard that year, paralyzing over half its victims and killing 20 in Rhode Island.

Critics here and elsewhere blamed the outbreak on the vaccine. But state Health Director Edward A. McLaughlin pushed to maintain the vaccination program, a move that would be vindicated in December, when a state study showed unvaccinated children were more than 10 times as likely to catch the virus.

"We feel this is the beginning of the end as far as large epidemics are concerned," said Dr. Raymond F. McAteer, chief of Rhode Island's Division of Communicable Diseases, after the epidemic had passed. "We believe the vaccine program will eliminate future epidemics and will bring about the final conquering of paralytic polio. And it has come just in time."

In the next couple of years the disease was virtually eliminated in America.

By 1956, more than 150,000 Rhode Island children were inoculated, more than 90 percent of those eligible. Only nine cases of polio were reported that year. The next year there were none. Aside from a brief resurgence in 1960, when complacency about vaccinations had left a new generation of children vulnerable, the scourge of polio had been defeated.

Polio and all the tragic and noble imagery associated with it: the child imprisoned in an iron lung asking for ice cream, the posters of a young girl with crutches and a brace, the mothers marching through communities requesting a dime's worth of help faded, too. The most feared disease of the first half of the 20th century quickly became an anachronism.

But for the victims of the last epidemic, the knowledge that a vaccine that could have prevented a lifetime of physical suffering eluded them is an added burden.

"You ask the question, 'Why me?' You ask the question 'What the hell happened?' when you understand that the vaccine came out in April, but we got [polio] in August and September," says Stephen Long. "What went on?"

EARLIER THIS summer the Long brothers, Stephen, 59, and David, 52, both crippled from their bouts with polio and the seemingly endless surgeries that followed, gathered to talk about polio at their mother's Jamestown house, just blocks from the cottage where the disease struck 50 years ago.

As happened in many families, polio eventually became a silent presence among the Longs. During the conversation, David, who was only 2 when it hit, heard for the first time many of the details of his family's struggles. .

Anna G. Rubin, who interviewed hundreds of polio survivors for the Polio Oral History Project, says the silence was typical of many polio survivors.

"There was so much fear, it was such a dreaded disease that it was something [many families] never, ever talked about in the home again."

David had been aware that he was probably the first to get the virus -- while attending a birthday party thrown by a next-door neighbor -- and brought it home, infecting his mother and eventually his older brother.

But he didn't know that soon after being admitted to the hospital doctors said he was likely to die, or that his mother, hospitalized in one room, could hear Stephen down the hall screamming in pain as the virus attacked his nervous system.

After nine months of near immobility, the Long brothers were released from Chapin Hospital and returned to their home in Cranston, relying on metal braces for support where their muscles had withered and their bones had begun to shrink.

But it wasn't over. In the coming years, Stephen would have more than 15 surgeries; at age 11, David had a series of three spinal-fusion operations that immobilized him again, this time for more than a year.

Adjusting was more difficult for Stephen. "I played Little League baseball, I can remember running and playing and riding bikes," he says. "[David] doesn't know what he lost. He was too young to know."

David agrees: "I was a baby so I was without malice. I didn't know a better life . . . . By the time I could have recollections, polio was part of my life."

For Shirley Long, now 80, the legacy was not physical: her bout was mild and she was released from the hospital after seven weeks, 20 pounds lighter but without any major physical problems. Her daughter, Debra, was born healthy.

But with five children, Shirley had a huge load.

Like so many other mothers, Shirley expected her disabled sons to learn to be independent. "Shirley is a polio mom. She's tough as nails," says Stephen, who remembers learning quickly that he, like his healthy brothers, was expected to iron his own clothes, make his own lunch, and pick himself up from the falls that would become a trademark of his childhood.

"You lived in a world with normal people," explains Shirley. "I just knew they had to learn to function by themselves . . . Sometimes I might have been hard, at times maybe too hard, but I did the best I know how."

That tough parenting and a desire not to be limited by polio, helped produce a pair of overachievers, says Stephen.

Stephen, a former athlete, began managing the school's baseball, football and swimming teams and served as president of his high school class. After graduating from the University of Rhode Island, Stephen entered public health, rising through the ranks to a top position in the National Institute of Health as associate director of the Institute of Alcohol Abuse and Alcoholism.

David grew up with a quick wit and a desire to entertain. Dropping out of URI, David joined a rock band. But years later, when his band Facedancer finally received a record deal, David was in a full-body cast recovering from another surgery to repair his fused spine.

In 1986, he moved to Jamestown, where his mother, a widow, now has a year-round home, and eventually got involved in politics. He is now serving his fourth term on the Jamestown Town Council, his second as council president. Recently married, he has twin 17-month-old daughters.

The disease continues to haunt the Long brothers.

In 1998 David started experiencing shortness of breath and weakness in his legs. Stephen found it increasingly difficult to stand up. He had trouble with balance.

These symptoms -- muscle weakness, breathing difficulty, fatigue, and bone and joint problems -- were being reported by polio survivors all over the country.

Initially feared to be a resurgence of the disease in survivors, the symptoms were later derided -- even by such luminaries as Salk and Albert B. Sabin, who invented the oral polio vaccine -- as psychosomatic.

But post-polio syndrome, characterized by further weakening and atrophy of muscles that had been weakened by polio, is now seen as affecting between 25 and 70 percent of the nation's polio survivors, though experts offer differing estimates.

The debilitation, years after survivors had thought themselves safe, is caused by the collapse of nerve cells that worked overtime for decades to compensate for the many killed by polio. Those who suffered the most are now the hardest hit by its effects.

Spared the iron lung as a child, David must now sleep and exercise with the help of an oxygen tank.

"It's like this monster polio that you vanquished 30 years ago, or 40 years ago, something you never thought you'd deal with again, is . . . rearing its head, coming alive again," says David.

THE SAME can be said for polio in the rest of the world.

Though polio was officially eliminated in the United States in 1979 -- thanks in large part to an improved oral vaccine -- it continued to kill and cripple children in much of the third world.

In 1988, the World Health Organization launched a vaccination campaign with the goal of eradicating the disease worldwide, much as had been done years earlier with smallpox. That year, despite being virtually eliminated in the Western world, polio struck 350,000 people from 125 countries.

By 2001, after almost $4 billion in spending, polio had reached an all-time low with just 483 cases reported worldwide.

But in the last two years the disease has made a bit of resurgence. Last year there were 1,255 cases; so far this year, 1,262 cases have been reported, according to data released by the Global Polio Eradication Initiative.

In 2003, rumors started to spread through much of Nigeria, one of just six countries considered to have endemic polio, that vaccine had been purposely contaminated with anti-fertility drugs and HIV. Instead of quashing the rumors, the government suspended immunizations while the vaccine was tested for safety. By the time vaccinations were declared safe the country was in the midst of an outbreak, which moved into neighboring Chad, Sudan, Ethiopia, Saudi Arabia, Yemen and finally Indonesia, some of which are still struggling to tame the virus.

The return of the virus to some countries where it had been eradicated has muted some of the progress made in endemic countries such as India and Pakistan, which experienced all-time lows last year.

The recent outbreaks are small steps back in the massive progress against polio since the release of the Salk vaccine 50 years ago.

Even before that vaccine emerged, Roosevelt, with trademark sweeping language, had established the expectations for the forthcoming battle with the virus.

"Not until we have removed the shadow of the Crippler from the future of every child can we furl the flags of battle and still the trumpets of attack. The fight against infantile paralysis is a fight to the finish, and the terms are unconditional surrender."

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