POLIO: ROOSEVELT AND THE MARCH OF DIMESDR ROD AMOS — 8th MAY 2017

Dr Rod Amos, a retired con­sult­ant rheum­at­o­lo­gist at the Royal Hallamshire and Sheffield Children’s Hospital who last spoke to us in January 2014 on Changing Concepts of Medicine (from Sorcery to Science), returned with a fas­cin­at­ing account of the almost total erad­ic­a­tion of polio­my­el­itis.

Specifically, his talk centred on the involve­ment in fun­drais­ing of Franklin D Roosevelt, the 32nd President of the United States, who was him­self struck down with a para­lytic ill­ness (there is some debate as to whether it was actu­ally polio)  in 1921, at the age of 39.

Roosevelt, who would sub­sequently be elec­ted to the first of his record four terms as pres­id­ent in November 1932, was the only child of a rich and polit­ical family, and was at his hol­i­day home at Campobello Island, a pop­u­lar summer retreat for wealthy Canadians and Americans, when he was taken ill with exhaus­tion, deep muscle aching and fever­ish­ness. Within a day he was show­ing signs of para­lysis which even­tu­ally left him unable to walk or even stand without some kind of sup­port.

President Franklin D Roosevelt in 1944

He was crippled, as Rod poin­ted out, at a time when such a dis­ab­il­ity was a major prob­lem to someone who wanted to be prom­in­ent in public life. He labor­i­ously taught him­self to walk very short dis­tances while wear­ing cum­ber­some iron braces on his hips and legs by swiv­el­ling his torso and sup­port­ing him­self with a cane, and he was care­ful never to be seen using his wheel­chair in public.

Although his ill­ness was gen­er­ally known, the extent of his para­lysis was kept from public view, helpedby a gentlemen’s agree­ment with the Press that there would be no pho­to­graphs or cari­ca­tures reveal­ing his dis­ab­il­ity, and he would often stand for two or three hours while making speeches at public meet­ings, his leg irons and hip brace locked in pos­i­tion but con­cealed by a spe­cially con­struc­ted three-sided podium.

A rare pho­to­graph of FDR in a wheel­chair, 1941

Roosevelt tried a wide range of rem­ed­ies, and par­tic­u­larly favoured hydro­ther­apy. He believed that swim­ming in the warm, buoy­ant min­eral water of the Warms Springs resort in Georgia was bene­fi­cial. “Franklin Roosevelt will swim to health,” pro­claimed one news­pa­per head­line of the day. He became obsessed with it, to the extent that in 1926 he bought Warm Springs and turned it from a resort to an insti­tute for polio rehab­il­it­a­tion, set­ting up a non-profit organ­isa­tion able to bene­fit from tax-free gifts and char­it­able dona­tions.

The Georgia Warm Springs Foundation was renamed the National Foundation for Infantile Paralysis in 1927 and Keith Morgan, a suc­cess­ful insur­ance sales­man, was brought in to sell the idea to pro­spect­ive wealthy pat­rons, a busi­ness plan which fell victim to the Wall Street crash of 1929. Carl Byoir, a PR expert, was hired to raise the foundation’s pro­file and sug­ges­ted a nation­wide party to cel­eb­rate FDR’s birth­day in 1934, organ­ising 3,000 ‘birth­day balls’ around the coun­try. This became an annual event from which 70 per cent of the profits were retained by local com­munit­ies to provide care for polio vic­tims and 30 per cent went to the found­a­tion.

The name March of Dimes – a play on the title of a con­tem­por­ary American radio and news­reel series, The March of Time – was coined by Eddie Cantor, who was a radio show host as well as a pop­u­lar singer, comedian and screen star. The found­a­tion had decided at Byoir’s sug­ges­tion on a nation­wide fun­drais­ing cam­paign which would encour­age large num­bers of small dona­tions rather than a few large bequests, and Cantor inspired a fun­drais­ing cam­paign in the week before President Roosevelt’s birth­day on January 30, 1938.

Lapel pins were sold at ten cents (a dime) each, and thou­sands of people mailed cards and let­ters, each con­tain­ing a dime, to the White House. On the first day 30,000 dimes were received, on the second day 50,000 and on the third day 150,000. Along with the pro­ceeds from spe­cial events held by nightclubs and cab­arets, and spe­cial fea­tures pro­duced by motion pic­ture stu­dios and the radio industry, Cantor’s appeal raised more than $85,000 in what the Press called ‘a silver tide which actu­ally swamped the White House.’ Over the years, half a bil­lion dol­lars would be raised in the fight against polio.

The word polio­my­el­itis comes from the Greek words polios, mean­ing grey, and meulos or myelós, mean­ing marrow or spinal cord. It would often cause res­pir­at­ory para­lysis and Rod, who was born in 1948, struck a note with many in the audi­ence when he said: “In my early child­hood, when polio was men­tioned, the image which came into my mind was the iron lung.”

An iron lung ward in an American hos­pital

The big break­through in the erad­ic­a­tion of polio came in the period 1951 to 1953 when Dr Jonas Salk, a med­ical researcher and vir­o­lo­gist, was given more than $1 mil­lion in fund­ing by the National Foundation for Infantile Paralysis in his quest to find a cure, and the Salk Vaccine was intro­duced in 1955. Salk’s ‘killed’ vac­cine was effect­ive in elim­in­at­ing most of the com­plic­a­tions of polio, but did not pre­vent the ini­tial intest­inal infec­tion.

But in late 1954, Salk’s rival Dr Albert Sabin had tested his ‘live’ atten­u­ated oral vac­cine, and between 1955 and 1961 the oral ver­sion was tri­alled on at least 100 mil­lion people in the USSR and other coun­tries. This provided the impetus for large-scale clin­ical trials of the oral vac­cine in the US, in the face of con­sid­er­able oppos­i­tion from the National Foundation for Infantile Paralysis.

Dr Jonas Salk (1914–1995)

Salk and Sabin hated each other,” Rod revealed. “There was a lot of rivalry. Many sci­ent­ists had long thought that a live, oral ver­sion made more logical sense, but the National Foundation wouldn’t sup­port the cost of another massive vac­cin­a­tion pro­ject before the Salk vac­cine was up and run­ning,”

However, from 1962 onwards the USA and much of the world switched to the Sabin ver­sion.