Reports and papers on epidemic poliomyelitis.

Date:
1912
Catalogue details

Licence: In copyright

Credit: Reports and papers on epidemic poliomyelitis. Source: Wellcome Collection.

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    The whole of the facts ascertained by Dr. Reece and Dr. Farrar, in connection with the epidemics which they respec- tively investigated, deserve careful study. They wTill be found in many respects closely parallel to observations which have been made in course of some of the foreign epidemics which Dr. Macewen has noted. On the clinical side, stress should be laid upon the great diversity of the symptoms which were met with (dependent on the part of the nervous system attacked, and the intensity of the virus in the indi- vidual case) ; on the appearance of disease among adults as well as in children ; on its considerable fatality ; and on the permanent paralysis often left in those who recovered. On reviewing the circumstances associated with these outbreaks it must be admitted that, while accepting the facts that poliomyelitis has been proved transmissible by inoculation in the laboratory, and that in nature it can on occasion show a very high degree of infectivity, we still do not completely understand the epidemiology of the disease. In particular, explanation is required of the remarkable extent to which poliomyelitis has been found in remote country places and isolated dwellings, and of its intense ability to spread in one house or village while completely failing to infect in the majority of others under seemingly comparable circumstances of population and environment. In both of the epidemics reported on by Drs. Reece and Farrar “ abortive ” cases, in which little or no paralysis resulted, were detected in con- siderable numbers, and it may reasonably be conjectured that such cases play an important part in the dissemination of the virus. In this connection reference should be made to Dr. Reece’s account of an outbreak of illness, associated with paralysis in only one or two instances, which affected nearly every house in the hamlet of Stoke Rivers during the present autumn. If the prevalent illness in this case was true poliomyelitis, it was at once extremely infectious and so slight in its manifestations as hardly to be recognizable. It may be added that both reports contain instances where the circumstantial evidence suggested that the infection was conveyed by an apparently healthy “ carrier.” This has been suspected in some epidemics abroad. It is evident, however, that much further research work is needed, both in the laboratory and by exact and painstaking inquiry into the circumstances of local outbreaks, with a view to the more exact determination of means of communication of this disease and to the discovery of practically available methods of recognising the presence of infection in early cases of sus- pected disease and in contacts with known cases of the disease.
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