Polio and Non-Polio Flaccid Paralysis- What is Going On?

DDT2Everyone knows that polio is horrible, right? We all recall images of iron lung machines and children with paralysis walking with crutches from the 1940’s and 1950’s right? I haven’t seen any polio the past 30 years that I have been a pediatrician. ZERO CASES. We had our last case of wild polio acquired in the USA in 1979. I wasn’t even in medical school yet! During my early years as a pediatrician we were using the live oral polio vaccine. It turns out that was causing polio. About 8 cases a year in the USA, so we switched to the injectable IPV vaccine in 2000. So what about the rest of the world? India has struggled with the eradication of polio and made a huge effort this past decade with a massive immunization campaign. During the epidemic years, anything with acute flaccid paralysis (AFP) would have been called polio. In the USA, after the introduction of the polio vaccines, physicians were instructed to diagnose polio only if proven to be caused by the polio virus, thus many of the AFP cases were no longer identified as polio. Of course the rate of polio plummeted once the definitions were changed. It is interesting that India is undergoing the same shift in definitions.

“India has been polio-free for a year, there has been a huge increase in non-polio acute flaccid paralysis (NPAFP). In 2011, there were an extra 47,500 new cases of NPAFP. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of NPAFP was directly proportional to doses of oral polio received. Though this data was collected within the polio surveillance system, it was not investigated. The principle of primum-non-nocere was violated.” You can read more on this here… Are we somehow doing more harm than good with our polio eradication efforts? To the extent that we are still using pesticides like DDT and similar neurotoxic and immunesystem-toxic pesticides, I suspect we are doing more harm that good with our efforts.

A look back at our own history with the flaccid paralysis (polio) in the US and we have some troubling years where it appears our use of DDT (pesticides) may have set the stage for the rise of these enteroviral infections. “As the DDT campaign proceeded, the incidence of polio began to sharply rise in the U.S. The number of reported cases of polio in the country in 1946 hit 25,191—nearly twice the number as in the previous year. In 1947, the number of cases dropped to 10,737 (580 deaths), but then rose again to 27,680 (2,140 deaths) in 1948. The number of cases remained high during 1949-1951, with a total of 103,719, or an annual average of 34,573. In 1952, the number of polio cases peaked at 52,879, and then began to decline to 35,592 in 1953, 38,476 in 1954 and 28,985 in 1955. The rates of polio were already well on a downward trend by the time the Salk vaccine was licensed in 1955 and began to be used on a mass scale.” You can read more about this here…

“India, which manufactures and uses the most DDT, was declared free of polio in 2011, but cases of AFP have skyrocketed. The Ministry of Health & Family Welfare (MoHFW) made a big announcement in June of 2015 that, ‘India is polio-free.’ The country reported its last case of wild poliovirus in 2011. After three consecutive polio-free years, the South-East Asia Region of WHO, comprising of 11 countries (including India), was certified polio-free on 27 March 2014. Learn more about this certification here…

This year I had my first case of what I might have diagnosed as polio had I been a pediatrician several decades ago. A school-age girl comes into my office with a walker, clearly weak and barely able to get onto the exam table.   She thankfully gets better after a month or so. Her diagnosis? Acute flaccid myelitis might fit the best. What is causing this? I suspected Enterovirus D68 but that test came back negative. We had case reports this past year that it was Enterovirus D68 causing the polio-like paralysis in the USA. Then reports came that other enteroviruses could do this. The CDC has issued the following definition of acute flaccid myelitis:

  • Patients with acute onset of focal limb weakness, and
  • MRI showing a spinal cord lesion largely restricted to gray matter, or cerebrospinal fluid (CSF) with pleocytosis, and
  • Without another apparent cause (such as, but not limited to, Guillain-Barré syndrome, transverse myelitis, trauma, or toxic neuropathy).

You can read more about those CDC definitions here…

Clearly, when we require an MRI to make the diagnosis of AFP or acute flaccid myelitis, we will reduce the number of cases to less than 1% of the cases out there. Less than 1% of enteroviral infections, like polio, reach the level of paralysis. For most, it’s a minor cold, upper respiratory, and/or loose stool diarrhea event. Most of these infections get better on their own as my patient did.

The family of viruses that causes AFP belongs to the enterovirus (EV) family, but the immune system has to be compromised for them to wreak havoc on the nervous system; otherwise, they just remain a relatively benign family of viruses. Consider the possibility that the infamous “polio” epidemic was a man-made environmental catastrophe where a relatively benign family of viruses opportunistically took advantage of those with a compromised immune system because their bodies were subclinically poisoned with pesticides. You can learn more here…

The key to all of this, if your goal is to stay healthy, is to avoid environmental toxins, especially the neurotoxins (pesticides, herbicides, mercury, aluminum, lead, PCB’s, PBDE’s, etc.). Eat healthy organic food. Drink filtered water. Consider supplementing micronutrients when you have nutritional deficiencies.

More than ever, staying healthy is as much about having a healthy immune system as anything else. Vaccines + toxins does not equal an healthy immune system. I’m not against vaccines, just pointing out that it is your healthy immune system that will protect you from the thousands of viral infections for which there are no vaccines.

 

 

Dr. Paul

 

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