October 13, 2004

Poliomyelitis in the United StatesThe Final Chapter?

Author Affiliations

Author Affiliations: Dartmouth Medical School and Children’s Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

JAMA. 2004;292(14):1749-1751. doi:10.1001/jama.292.14.1749

Epidemic poliomyelitis is a disease that both appeared and disappeared in the United States during the last century. The first recorded outbreak of paralytic disease in the United States occurred near Rutland, Vt, in 1894.1 Within a decade, thousands of infants and young children were permanently crippled during summertime epidemics that swept through cities on the East Coast and, later, throughout the country.2 The likely explanation for the dramatic emergence of epidemic polio during this era lies in the paradox of improved standards of hygiene, particularly the invention of the flush toilet, which reduced exposure to polioviruses in feces and delayed infection until the protective effect of passively acquired maternal antibodies had waned.3

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