The most widely accepted theory concerning the mode of spread of poliomyelitis is that of direct contact through the upper respiratory passages. This theory, brought out by Wickman, has received experimental support in the detection of the virus in the upper respiratory passages in active cases, abortive cases and healthy contacts, and in the infection of animals through the nasal mucosa. However, epidemiologic evidence of direct contact is scant. The proportion of cases ascribed to direct contact, made up largely of multiple cases in families, has been stated at around 5 per cent. It has been observed that the onsets of multiple cases in families as a rule so nearly coincide that they probably represent in the majority of instances simultaneous infection.1 When allowance is made for this, the proportion of direct contact cases is reduced to an extremely small figure.
The apparent discrepancy between the theory of spread
AYCOCK WL. THE EPIDEMIOLOGY OF POLIOMYELITIS: WITH REFERENCE TO ITS MODE OF SPREAD. JAMA. 1926;87(2):75–79. doi:10.1001/jama.1926.02680020003002
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