Monday, March 23, 2020

Remembering Polio


As we struggle with Coronavirus (COVID-19) some may remember another epidemic disease – infantile paralysis, better known as polio.  It spread through the feces of someone who was infected. In areas of poor sanitation it could get into water or, by touch, into food. It was highly contagious. It could attack a person of any age, but children were most susceptible. In the hot days of summer before air conditioning the young often headed to public swimming pools, lakes, streams, rivers and the ocean to cool down, but these bodies of water could also be a source of the disease. Our parents and grandparents were terrified that infantile paralysis might strike one of their own; for my own family it did when a cousin was diagnosed with polio, unable to breathe after the virus paralyzed muscles in the chest. He was placed in an iron lung, with everyone praying for young Billy B.

           Poliomyelitis has been with mankind since the dawn of history, but it wasn't until the 20th century that major polio epidemics occurred.  The disease first struck Southern California in 1912. In one week, twenty-one cases were reported and one death.  Long Beach, which was free of the disease, suffered $100,000 ($2.6 million today) in lost revenues because of rumors of outbreaks in the city. On the morning of August 13th, city health officials, trying to keep the disease out of Long Beach, passed an ordinance prohibiting youngsters under fifteen years of age from congregating together in one area.  This was disastrous for business, coming in the midst of the tourist season, but it undoubtedly helped curtail the spread of the disease.  Theater owners were particularly hard hit and suffered large economic losses.  Pike merry-go-round entrepreneur Charles Looff was so upset he decided to disobey the new law and was arrested.  Because of the success of the quarantine, Long Beach did not suffer a single case of infantile paralysis, something city health officials were proud of.  Businessmen, however, viewed the quarantine as extreme, considering there was not a single case of the disease reported in Long Beach.  Because of public pressure, the ordinance was repealed on September 5th, and Looff's case dropped. (Daily Telegram 9/5/1912) 


       One of the worst outbreaks occurred as the world was trying to recover from World War II. Fathers recently returned from battle, who had fought for a better world for their families, were now witnessing their children suffer from a disease that had no cure. Would their youngsters, if they survived, still be able to enjoy life without permanent physical disabilities? Such thoughts raced through Long Beach parents' minds as they witnessed an epidemic in the making. Polio cases in the city had jumped from a mere 28 in 1947 to 275 in 1948. (Press Telegram 1/1/1949) 

        The epidemic was not just happening in Long Beach but nationwide as more and more children experienced headaches, nausea, upset stomachs, sore muscles and unexplained fevers, all symptoms of infantile paralysis. In 1949, the number nationwide for polio outbreaks set record numbers, soaring to 41,173 with 2,720 deaths.  In Muncie, Indiana, the infection was so bad the city was forced to ban public gatherings, including funeral services.  The outbreak was not as severe in Long Beach, the number dropping to 111 cases from the city's record of 275 the previous year. Perhaps this was due to city health officials asking residents to avoid crowds and close contact with other people.  Also to be avoided was swimming in polluted water, over exertion and sudden chilling.  Residents were also asked to observe strict personal cleanliness, keep food safe from flies and make sure lids on garbage cans were tightly covered.
An iron lung ward for the young

            The polio virus operated by attacking  nerve cells of the brain and spinal cord, often causing paralysis.  The virus got into the body through the nose and mouth and into the intestines.  The infection then traveled along nerve fibers or through the blood to the central nervous system.  There the virus entered a nerve cell, multiplying so rapidly it killed the cell.  Paralysis resulted when the majority of the nerve cells were destroyed.  Surprisingly, some people who became infected by the virus did not always get the disease.
            Doctors believed fatigue made the disease more severe.  Complete bed rest and simple treatments such as a hot, moist bandage was recommended to relieve pain.  When the fever abated it was important to start gently moving the limbs.  If this didn’t happen deformities and painful tightening of the muscles could occur.  Splints, braces and crutches were needed by some patients, though exercises helped strengthen and retain the muscles.  Often breathing muscles became paralyzed and doctors put the patient on a respirator called an iron lung to help with oxygen intake.  With the help of a respirator two-thirds of patients would eventually recover their natural breathing. Sometimes as little as two weeks in an iron lung was needed for treatment, in other cases it lasted a lifetime.

           Can you imagine placing a young child in an iron lung, trying to keep the frightened child calm? There wasn't much for youngsters to do but keep still.  There was a mirror in front so they could see what was going on behind. There was a frame over the top where they could put a book or a newspaper, but they had to have someone to turn the pages. There was the radio they could listen to, but no television. That was still being developed. Patients could only be let out for about 15 minutes several times a day, gradually increasing as the lungs began to work again on their own. 
            Hospitals such as the Adelaide Tichenor Orthopedic Clinic in Long Beach helped children, who were most susceptible to the disease, regain the use of their limbs.  The Tichenor Clinic was supported by endowments, fees and donations and was available for children up to the age of 18 with orthopedic complaints whose parents could not afford the needed care. In 1948 the clinic treated 511 children, half of whom were victims of polio. (Press Telegram 1/2/1949).

          Many "boomers" may remember the March of Dimes drives to raise money for polio research and treatment. The dimes collected helped aid victims and search for a cure for this much feared disease. It was estimated that just one polio case a year cost $3415 to treat with more money needed for continued therapy. (Press Telegram 1/1/1949).  Often the money collected through the March of Dimes was not enough to cover local expenditures. In 1949, for instance, the March of Dimes spent $102,750 to treat Long Beach polio victims, but just $56,831 had been raised through city donations. (Press Telegram 1/18/1950)
            From 1912 onward a polio epidemic appeared each summer in at least one area of the county. Research continued, resulting in the invention of the iron lung in 1927. In September 1949, Dr. Harvey E. Billig Jr. on the staff of Community Hospital gave a glimmer of hope to sufferers of the disease.  Dr. Billig had experimented by injecting glandular secretions into muscles.  These steroid injections, he claimed, caused the ligaments to relax.  His research showed that when this treatment was used in the first stages of the disease it worked miracles.  The down side of his research, however, showed some glands failed to recover and the use of artificial steroids had to be continued. (Press Telegram 1/15/1949)
Lining up for the Salk vaccine
             Despite years of  research it wouldn’t be until 1955 that a partial cure would be found. That year anxious parents rushed to have their children immunized with the Salk polio vaccine.  Free mass polio immunization got underway in Long Beach on April 18, 1955.  Eleven thousand first and second grade students lined up for the first of three injections.  Following the first shot a second shot was given two to four weeks later, and a third, or booster shot given seven months to a year later.  The series of shots provided three years protection from the paralyzing virus.  But all was not well. Within a few days of the injections reports appeared stating that some of the Salk vaccine manufactured by Cutter Laboratories was unsafe.  One Pocatello Idaho girl died one week after being vaccinated.  The vaccine was recalled and inoculations halted; despite this precaution several Long Beach youngsters suffered polio attacks after being given the Cutter produced vaccine.  All, however, recovered.
Given on a sugar cube it tasted fine
            Salk’s vaccine was only partially effective. It did not prevent the initial intestinal infection. In the 1960s the Sabin oral vaccine was released by Albert Sabin, who refused to patent his vaccine so the low price would guarantee coverage for all. The Sabin vaccine blocked the chain of transmission the Salk vaccine did not, effectively obstructing the polio virus from entering the bloodstream.

            Infantile paralysis didn’t just strike the young, it infected adults as well. Perhaps the most well-known instance is that of Franklin D. Roosevelt who contracted the disease in 1921.  A lesser known case is that of Long Beach's Don Hornsby, a tremendously gifted concert pianist and composer who performed at the Jack Lasley Cafe in Belmont Shore. Here he combined his piano artistry with song parodies, magic tricks, unusual facial expressions and hilarious ad lib comic. His talents were recognized by NBC who signed Hornsby to a five-year television contract to present a late-night show out of New York. Broadway Open House was network television's first late night comedy variety show.  It was televised live on NBC from May 29, 1950 to August 24, 1951, airing weeknights from 11 pm to midnight.  It went on to become the Tonight Show. Unfortunately Hornsby did not even get to perform one show...he died May 22, 1950. His name would most likely have been as well-known as Steve Allen, Jack Parr, Johnny Carson and Jay Leno if death brought on by polio hadn't overtaken the 26-year-old Long Beach comedian. 


            For the younger audience reading this, which never experienced the battle against polio and fear of epidemics, rest assured. We have been through similar times before, as my last article Coronavirus vs. 1918 Influenza pointed out.  The United States has been polio-free since 1979, though it still exists in underdeveloped parts of the world. We have also developed vaccines to help combat other diseases and will do so with the Coronavirus. Oh yes, my cousin Billy B. survived polio after six months in an iron lung, followed by physical therapy, with no ill effects and is still enjoying life today.


Thursday, March 12, 2020

Coronavirus vs 1918 Influenza




            “Council Should Act on 700 Citizens’ Request for Mask Ordinance.” “Individual Quarantine Should be Made Permanent in Fighting Influenza.” “New Flu Law Enacted for Quarantine Emergency: Guards to be placed if ordinance is disregarded.” “Deaths by Influenza Top War Casualties.”
            Such were the headlines in the Los Angeles Herald from the fall of 1918 to the spring of 1919.  There were many similarities to the Coronavirus (COVID-19) we are now experiencing. Read for yourself what was happening during the epidemic that struck the world more than a 100 years ago and make your own comparisons with what is transpiring today.  

            In the fall of 1918 a deadly disease began to sweep across the United States--influenza. In October, the epidemic reached Long Beach.  Years later it was determined that it probably started on a pig farm in Iowa.  After the annual Iowa Cedar Rapids Swine Show in September 1917, a mysterious ailment gripped its pigs.  Millions of hogs fell ill and thousands died.  At the same time the pigs got sick, Canadian hunters found moose and elk with flu.  The pig virus also hit bison and sheep and eventually humans.  Doctors didn't recognize the epidemic potential until American troops had already introduced the flu to war-weary Europe.  Coughing Germans called it the "Blitz Kartarrh" while feverish English solders named it "Flanders Grippe." American troops added to the confusion by calling it the "Spanish Flu" or "Spanish Lady."
            In September 1918 the flu overwhelmed Camp Devens outside of Boston.  The overcrowded military camp housed 45,000 men where only 35,000 were intended.  The first case appeared on the first of September and by the eighteenth had multiplied to 6,674 cases.  Many of the soldiers, men in the prime of health, turned blue, bled from the nose and died in forty-eight hours, struggling for air.  In the book the Fourth Horseman by Andrew Nikiforuk, one physician called it the most vicious type of pneumonia he had ever seen, and reported that "mahogany spots" spread over the face "until it was hard to distinguish the colored man from the white." In one day 90 men died.
            Having had no previous experience with the 1918 swine flu strain, the adult immune system overreacted.  All of the inflammation and water in the body allowed wandering bacteria to deliver lung dissolving infections.  Crowded barracks, fetid trenches and sealed troop ships guaranteed that there was no shortage of meningitis of staphylococci to stalk soldiers.  By the end of October, one in five U.S. servicemen had the flu.
            The Southern California epidemic started with the arrival of an infected ship in the San Pedro harbor.  On October 11th, following the lead of Los Angeles County health officials, Long Beach city commissioners ordered all schools, churches, theaters, dance halls, bath houses and fraternal lodge houses closed.  Public meetings were forbidden.
            Other ways were tried to stop the spread of the virus.  One small town in Arizona made it a criminal offense to shake hands.  Every morning the army forced its recruits to gargle with salt and water, the men then drilled twenty yards apart.  In many places, people seized upon the imagined flu-fighting properties of vegetables; some tied cucumbers to their ankles while others put a potato in each pocket.  One Oregon mother even buried her four-year-old daughter neck-high in onions.  The more scientific-minded added sulfur to the soles of their shoes.

            Perhaps the most popular protection against the flu was a white cotton mask.  In San Francisco, public health officials started a cotton craze by passing an ordinance that forbid people from appearing in public places without a mask over their nose and mouth.  The only place people didn't have to wear masks was at home or in a restaurant while eating.  At the beginning of the epidemic, the mask had such appeal that even frightened newlyweds wore gauze when they made love.
            Despite all the precautions the influenza spread.  In the first two weeks of October between 400 and 500 cases of influenza had been reported in Long Beach and five deaths had occurred.
            The disease itself resembled a very contagious kind of cold.  It was accompanied by a fever, pains in the head, eyes, ears, back or other parts of the body. In most cases the symptoms disappeared after three or four days; some patients, however, developed pneumonia or meningitis and died.  Nurses and others were warned to guard against breathing in the germs by wearing a fold of gauze or mask while near a patient.  Some, such as Doctor William J. Cook, physician at Seaside Hospital, caught the disease despite taking all the necessary precautions.  Doctor Cook died of influenza on October 26, 1918.
            Tragic stories were everyday reading in the obituary section of the local newspapers. On October 16, 1918, death invaded the Harry Poor home for the second time in two weeks.  First Poor, a mining engineer, passed away from influenza.  Two weeks later his son Allen, aged 3 was buried at Sunnyside Cemetery.  Twenty-year-old Pearl Phillips pleaded that her husband George not be buried until she recovered from the flu.  Instead she joined her husband in the same grave when she died a few weeks later – both victims of influenza.  Second Lieutenant Edward Stout survived the war, only to become a victim of the flu.  One month after his arrival home, his death notice appeared in the February 2, 1919, Daily Telegram.  His son had just been born five days earlier.
            On November 23, 1918, the ban on public gatherings in Long Beach was lifted.  On December 9th, schools reopened.  However, a second influenza epidemic hit the City in January 1919.  Schools, theaters and other places where the public gathered were again closed for ten days, but not before Detective E. V. Denney of the Long Beach police force had a curse put on him.
            Denney was in the process of arresting a young Gypsy fortune teller who was plying her trade on the Pike without a license when she told him he was under “a spell of death.”  According to the comely fortune teller Denney would soon be attacked by influenza.  Only by wearing a coffee strainer over his face, and thereby appearing ridiculous, could death be avoided.  Denney didn’t believe a word of it!
            2437 Long Beach men and women had gone to war; 50 of them did not return.  In comparison, 9000 cases of influenza were reported in Long Beach between October 1, 1918 and February 1, 1919; 148 Long Beach residents died.
                The flu buried more than 50 million people throughout the world in eighteen months.  The death rate stunned physicians.  It took the battlefields of France four years to kill 15 million men but the flu did the same work in much less time.  In the United States alone more people died of the flu (550,000 adults) in 1918 than the U.S. military lost to combat in both World Wars, Korea and Vietnam.  In Alaska, whole Indian villages disappeared while India lost more than 12 million people.  Adults with flu finished a poker game or army drill one minute, only to drop dead the next.  Although the epidemic initiated the biggest plague die-off in world history, it is remembered, when it is remembered at all, as no more than a bad outbreak of "the flu."