Or is this the year we'll get a new vaccine that will make poliomyelitis a dreaded disease of the past?
This year may mark the turning point, but in the meantime, here are factual answers to questions that can trouble you in the months ahead
There were more than 55,000 cases of polio in the United States in 1952, the worst year in polio history. What is the prospect for 1953?
As a result of tests sponsored last year by the National Foundation for Infantile Paralysis in Houston (Texas) and Sioux City (Iowa) gamma globulin-a high-sounding medical term that became a household word overnight-seemed to promise new hope for partial protection against the paralysis of polio. Early this year, there was another optimistic note in news reports of progress in research that indicated a vaccine would probably be produced in the near future. To Americans keenly conscious of miracle drugs of the past and who assume that the first conservative announcement by researchers is a sure sign of wonders soon to follow, there is the danger of disillusionment in the coming polio season. Just as surely as the summer months will bring an increase in-the incidence of the disease, those stricken or threatened with polio will ask: Where is that much-talked-about gamina globulin, or that new vaccine we read about?
That will be a hard question for the doctors and for the National Foundation. to answer. The answer will be still harder to take if you are unprepared for the sober facts. To know just where we stand against polio this year, it's necessary to have clear ideas about recent antipolio developments. To begin with, you should have the facts or gamma globulin.
What is gamma globulin?
Gamma globulin (also called immune-serum globulin) is that part of human blood that contains antibodies-small protein particles-that have been built up in the blood stream as a result of the body's fight against disease. Antibodies remain in the blood stream and can be separated from whole blood and concentrated for injection into patients exposed to various diseases.
What is gamma globulin used for?
Prior to its use against polio, gamma globulin was chiefly used in the prevention of measles and treatment of infectious hepatitis. Wide use of gamma globulin for measles began in 1944; in two years it halved the death rate from the disease. In infectious hepatitis-an infection of the liver-gamma globulin has modified the disease in those who have been exposed. The recent Provo (Utah), Houston (Texas), and Sioux City (Iowa) experiments, demonstrated that gamma globulin can temporarily halt or lessen the paralysis of polio.
How successful was gamma globulin in last year's tests?
A total of about 55,000 children between the ages of 1 and 11 received injections in the Utah, Texas, and Iowa field tests of gamma globulin. Of these, one half got gamma globulin, the other half were given an injection of harmless gelatin. In a 30 day follow-up of a total of 90 paralytic polio cases occurring in these children, there were 64 cases of paralytic polio in the group that did not receive gamma globulin and 26 cases among those who had received gamma globulin. Paralysis was reduced but not completely eliminated.
How long does gamma globulin give protection?
Dr. Harry M. Weaver, research director of the National Foundation for Infantile Paralysis says:
"The field trials demonstrated quite conclusively that an injection of a sufficient quanity of gamma globulin will confer significant protection against the disease. However, the duration of effectiveness in the dosages we used was limited to about six weeks. During the first and last weeks of this period, paralysis appeared to be lessened in severity, rather than prevented."
How much gamma globulin is given in an injection?
Dosage varies, depending on the weight of the person injected. In experiments, the average dose was seven cubic centimeters about one-fourth ounce for a 50-pound child or a little more than three teaspoonfuls.
How much blood is required to make one dose of gamma globulin?
It takes slightly more than one pint of whole blood to make the average, dose of gamma globulin.
Will gamma globulin be available this year?
Yes, gamma globulin will be available but in limited supply. The potential demand for the serum will far exceed all that was produced, since.last year's tests proved the effectiveness of gamma globulin. Despite every effort of the National Foundation for Infantile Paralysis, the American Red Cross, and government authorities, gamma globulin can be given. to fewer than 1,000,000 children out of a population of 46,000,000 in the most susceptible age groups. Although processors have been working at full capacity seven days a week, 24 hours a day to produce gamma globulin for 1953 and 1954, production will fall short of the total quantity needed in epidemic areas in 1953.There are only four processing laboratories in this country producing gamma globulin from whole blood or plasma. In addition, there are three commercial firms producing small amounts of gamma globulin from placentas.
How will gamma globulin be distributed?
Gamma globulin will be distributed early this month to each state health department by the U.S. Office of Defense Mobilization. It will be distributed on the basis of each states average number of polio cases over the last several years. State health departments will be the distributing agencies within each state. Distribution methods may vary from state to state, but will probably follow this general pattern:
1. To members of a family where one or more persons have polio.
2. To school children in a classroom where two or more children have polio.
3. To residents in areas where the number of cases appears to be reaching epidemic proportions.
In the event of a polio epidemic in any state, the national agency will, if possible, make a second allotment of gamma globulin to meet the emergency.
What are considered "epidemic proportions?"
Some years ago, 20 cases per 100,000 was considered epidemic. Last year in Sioux City, Iowa, the ratio was 512 per 100,000. This indicates the problem authorities will face in being unable to supply sufficient gamma globulin to many communities that feel they have been hit hard by the disease.
Is gamma globulin just a temporary measure?
Gamma globulin is not and can never be the final answer to the polio problem. To be effective, gamma globulin must be administered shortly before or while the virus is still in the blood stream; before the polio virus has attacked the nerve cells in the central nervous system. It is very difficult to determine whether a person has been exposed to the disease; hence mass inoculations may either be unnecessary or too late.
What's more, if gamma globulin production were expanded, enormous quantities of blood would be required. This would probably prove unfeasible on a long-term basis. Moreover, there is evidence that an effective vaccine may be made available in a relatively short time. For these reasons gamma globulin is admittedly a temporary preventative.
Is gamma globulin, then, a "blind alley?"
Gamma globulin itself is not the final answer, but the gamma