We’re so close to eradicating it, but here’s the block: Superstition, suspicion—and the C.I.A.
By Leigh Cowart
Jennifer Brodersen was just over two when she contracted polio, the paralytic scourge of the 20th century, after picking up the virus — most likely, from a contaminated drinking fountain at a Sunday church picnic near her Chicago home in 1956. “The Salk vaccine had come out the year before, but erring on the side of caution, the pediatrician had waited a season to administer the vaccine,” she says. She and her sister were vaccinated two days after the picnic, but no one yet knew that Brodersen herself was sick.
A week later, she woke up from her daily nap unable to stand up or move her legs.
Her father, a doctor himself, went to his briefcase and gave each member of her family a shot of gamma globulin in a last-ditch effort to boost their immune responses with protective antibodies. Brodersen was the only one in the family to get sick. She was in isolation for six days.
“Only about one in 200 people who had polio experienced paralysis, and many mistook it for a horrible case of the flu,” she says. “It is a truly vicious disease.”
The paralysis rate is roughly the same today; and of those afflicted with immobilization, five to 10 percent will die when then their breathing muscles fall silent. “One evening my chest muscles were failing and an iron lung was put beside me, ready and waiting,” Brodersen says.
But polio doesn’t just leave its mark on early childhood. “Most of my muscles came back, but not some of the ones in one leg, torso, and back,” Broderson says. “I did learn to walk again with a limp. I had seven surgeries between the ages of about three to 16, including spinal fusion.” Broderson also had to wear a Milwaukee brace for a year — “a medieval device designed to straighten curved spines by stretching your head up from your hips” — and even now suffers from post-polio syndrome (PPS), which can be a painful and debilitating condition that can strike years after the acute infection resolves.
“Mercifully, there are only three things I remember about that time,” Brodersen says. “Two out-of-body experiences, and going home.”
She’s not alone in a hazy memory of life with polio. It’s a disease that has been relegated to our collective history with astonishing speed — so fast, in fact, that it no longer frightens us. “When I tell someone I had polio, there’s often a bit of a distant look as they search for something to connect it to,” Broderson says. “Many had a relative or neighbor at one time. Really young people have no idea what it is or means.”
It’s probably time that we change that. You should know polio. Its story is horrifying and magnificent, a testament to both the capacity of humanity to work together for good, and mankind’s relationship with the killers among us. We are so close to wiping it from the planet — an end goal that no one even dared to ponder when the vaccine was created. But there are pockets of resistance where polio is exploiting political strife and sowing the seeds of its own resurgence. With an outbreak brewing fresh in Pakistan, the stakes are enormously high. We have watched polio emerge, rise to ubiquity, and fall dramatically; we have seen everything but its final breath. And we would be remiss to welcome it back through ignorance and apathy.
It’s not a new relationship, us and poliovirus: One Egyptian carving dating to 1400 BC features a man with the characteristic leg deformities. But the disease didn’t really hit the bigs until the 1900s, thanks to our shift away from tainted water.
Here’s what experts think happened: In the pre-epidemic era, shit-related diseases like polio were so common that most babies contracted an infection before their first birthday. And, since they were at an age when they were likely to be breastfeeding, most babies received passive immunity from their moms.
With improvements in sanitation came less contact with other people’s poop. Circumstantial evidence suggests this delays baby’s first enteric infection, because yeah, less poop around means less shit-related disease. But an older, weaned child with polio wasn’t getting dosed with mother’s helpers; as such, their immune systems didn’t have tools robust enough to put up the fight necessary to keep polio in the gastrointestinal tract and out of the nervous system. Meaning more kids get sicker, later, and polio gets a foothold in society.
After polio exploded, there was a terrible epidemic in the summer of 1916 that left 2,400 dead in New York City. That same year, polio would kill 6,000 across the whole of the U.S. We had a little luck fighting the worst symptoms in the 1920s with the development of the iron lung — those formidable metal coffins they stuck children in so that technology could breathe on their behalf — but by the advent of Jonas Salk’s vaccine, polio was everywhere.
In 1955, the United States began to protect its citizens from polio using the vaccine that Salk famously declined to patent (“Could you patent the sun?” he explained). Six years later Albert Sabin created an oral vaccine, too. The resulting campaign sought to immunize 80 to 90 percent of the country’s children, widely considered to be a best-case scenario for compliance. In a time when this fecal-transmitted enterovirus was contracted by virtually every single child, eradication was never considered a possibility. And yet!
With the introduction of the vaccine, cases of polio began to fall exponentially. From the mid-’70s onward, mankind went after polio without mercy. In fact, the disease disappeared so quickly that the date of the last wild-caught, wild-type polio virus case in the U.S. is unknown — and it was definitely gone by the late 1970s.
This meant the possibility of completely eliminating the disease was tantalizing and within reach. Since 1988, when the Global Polio Eradication Initiative began, cases worldwide have decreased by 99 percent, falling from around 350,000 cases to 416 in 2013, thanks in huge part to support from the Bill & Melinda Gates Foundation.
We’ve watched polio grow from an epidemic fearmonger to a virtual Ozymandias of infectious disease. We’ve learned its tactics and systematically dismantled its grip on the future. Because of global public health efforts, there are an estimated 10 million people walking around who would have been paralyzed by polio. Simply put, kids today just don’t get fucking polio.
Well, that is, most kids. In three countries — Afghanistan, Nigeria, and Pakistan — polio remains endemic. Why? Since the CIA used a vaccination campaign as cover for its attempts to locate Osama bin Laden by way of his children’s DNA, our triumphant march to the end of polio has been sidelined.
“In September, as a result of a CIA sham vaccination campaign used to hunt for Osama bin Laden in Pakistan, Save the Children was forced by the Government of Pakistan (GoP) to withdraw all foreign national staff… This past month, seven or more United Nations health workers who were vaccinating Pakistani children against polio were gunned down in unforgivable acts of terrorism. While political and security agendas may by necessity induce collateral damage, we as a society set boundaries on these damages, and we believe this sham vaccination campaign exceeded those boundaries.” — excerpt from a letter to President Obama, January 6th, 2013, from 12 deans of public health at major U.S. institutions
Because of the sham vaccination campaign, it’s no longer safe to vaccinate in certain areas of Pakistan.
“The story of polio’s persistence in Pakistan is one of terrible culture, archaic government machinery, and lack of political will,” says Yousuf Sajjad, a journalist in Karachi. “The culture is a bit stupid, with women being locked away in a lot of families from the outside world to protect them and make them hard to get to. The children are with them. Women and children’s medical treatment can sometimes be restricted by the fathers in the family. The fathers of a lot of rural or Pashtun kids think that polio drops will make their children sterile.”
The CIA stopped using vaccination campaigns as cover in August 2013, but the damage has been done: Suspicion is as endemic as the disease itself, and religious extremists are fueling the rumors about sterilization as a way of enforcing their authority. The World Health Organization has noticed. It warned that if we fail to wipe polio from its last bastions of infectivity, we face as many as 200,000 cases of children paralyzed from polio each year within the decade. And, according to its website, “As long as a single child remains infected, children in all countries are at risk of contracting polio.”
Authorities in Pakistan are not taking that threat lightly: More than 500 parents who refused polio vaccination for their kids were recently arrested jailed in a rare, widespread crackdown. Will it help?
Although such government action suggests it’s possible, the immediate future looks grim. “Unfortunately we do not feel that eradication will happen close enough for anybody’s comfort,” says Sajjad. “What we seem to be heading for is containment of the disease. We feel like there is a lot more ground that will have to be covered at best to first reduce the incidence of polio. After that, we will have to continue dealing with the threat of drive-by shootings of health workers administering polio drops or of the policemen guarding them.”
The unlikely goal of global eradication is threatening to slip through our fingers, but it doesn’t have to.
The curious thing about vaccines — other than being a safe and effective way to prevent suffering — is not that they require compassion to work; it’s that the compassion required for the vaccine to protect us is, incredibly, abundantly present. Every day, thousands of parents make a choice that says I want to keep our children safe. And with human-only diseases, the vaccines we take today are also on behalf of future generations, such that they will not need to know the names of monsters we’ve felled before their time.
And oh, how we have been busy. In 1920 there were almost 500,000 cases of measles reported in the U.S.; in 2013 there were under 200. Whooping cough fell from over 250,000 cases in 1934 to less than 30,000 in 2014. We’ve dramatically reduced the percentage of population at risk for scurvy today, and we’ve almost eradicated polio. Still, though, they linger on and see occasional spikes.
The WHO and Centers for Disease Control and Prevention have done their jobs so well that we’ve just forgotten how to be scared of diseases, forgotten that we should bask in the awe we once felt as mankind began to claim victory against giants like rabies, tetanus, syphilis, and black plague. But although they are no longer the menace they once were, these infectious titans are still among us.
A strange bat in the daytime. A rusty nail. An unsafe drunken hookup. Rats in the deserts outside Las Vegas. These are the homes of our monsters. They’re all out there, right along side measles, scurvy, whooping cough, and polio; it’s just now they no longer scare us. Because now we know we can win.
But let’s not get too smug about that.
A portion of the research for this series was crowdfunded on Inkshares.