Few reports have been published concerning the sources of the initial cases of poliomyelitis in a large and widespread epidemic, although many investigators have demonstrated the radial spread of the disease from established epidemic areas. Wickman1 focused attention on a parish school as the possible common source of some of the early cases in the Swedish epidemic of 1905, but he offered no suggestion as to how the infection entered the school prior to the first clinical case. In 1911 Kling and Levaditi2 reported that an immune carrier was probably responsible for the introduction of the disease into two small islands off the coast of Sweden. However, in view of present day knowledge, this circumstance is probably not significant since at that time the incubation period of poliomyelitis was erroneously thought to be from two to three days.3 The 1916 epidemic in New York City and environs
SMITH ML, BRIDGE EM, UNDERWOOD HE, DALE GE. A STUDY OF THE ORIGIN OF AN EPIDEMIC OF POLIOMYELITIS. JAMA. 1945;129(17):1150–1156. doi:10.1001/jama.1945.02860510016004
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