Talk:Polio

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Here is the featured topics project that focuses around poliomyelitis. Any interested editors are welcome to join the project and help us get the first medical featured topic up and running! —[[::User:Cyclonenim|Cyclonenim]] ([[::User talk:Cyclonenim|talk]] · [[::Special:Contributions/Cyclonenim|contribs]]) 00:11, 22 August 2008 (UTC)

What was the first polio vaccine?

I'm confused. Don't the following contradict each other? :

Two polio vaccines are used throughout the world to combat poliomyelitis (or polio). The first was developed by Jonas Salk and first tested in 1952. It was announced to the world by Salk on April 12, 1955. http://en.wikipedia.org/wiki/Polio_vaccine

The first polio vaccine was developed in 1950 by Hilary Koprowski. The second one was developed by Salk also at the University of Pittsburgh, and announced to the world on April 12, 1955. http://en.wikipedia.org/wiki/Polio#Vaccine —Preceding unsigned comment added by Intelliot (talk • contribs) 00:15, 23 November 2008 (UTC)

In your prognosis paragraph, you should change the word abortive to an easier word to understand; such as, ineffective. I think it will help with understanding the paragraph better. —Preceding unsigned comment added by Paula bean7 (talk • contribs) 22:56, 11 February 2009 (UTC)

Due to the dates, the first one was the one of Koprowski (1950), the second one of Salk (1952) and the third one of Sabin (Sabin was basing on the materials given by Koprowski). The doubt might surge from the fact, that Koprowski's (and Sabin's) vaccine was a live one, and the Salk's was a killed one. So the first vaccine ever was developed by Koprowski, but the first vaccine based on killed viruses came from Salk.Lamignat(talk) 09:10, 15 December 2009 (UTC),

I've reverted the change that introduced the following paragraph:

The first effective polio vaccine, based on live but weakened (attenuated) virus, was invented by the Polish virologist and immunologist, Hilary Koprowski. Koprowski's vaccine was served for the first time on February 27th, 1950, but weren't commonly used until the 1958, when massive vaccinations in Kongo were performed.

The text is unsourced. All content added must meet our verifibiliy policy and use reliable sources. We need a reliable source that this vaccine saw clinical use (i.e. not just the large-scale experiments). It does appear to have been in-development earlier than the others but failed to complete development before the others. Has the efficacy of Koprowski's vaccine been proven? Note that we mention Koprowski in the lead so he deserves a mention in the body too, while keeping within WP:WEIGHT. Colin°^Talk 11:35, 16 December 2009 (UTC)

I reverted again, adding two sources - I guess the information is totally objective and correct now (?).

Why:

Let's distinguish an invention of a vaccine and a readiness for a massive production. As a date of developement of Salk's vaccine the year 1952 is given, while all the tests and experiments were finished by 1955, when this vaccine was "announced" to the world and went to the market. So in order to keep the consistency it should be mentioned, that the invention of vaccines starts with the live one of Koprowski (1950), followed by the dead one of Salk (1952) and then, modified live vaccine of Sabin. If we're talking about a massive usage, the order changes, as the Salk's vaccine was in common use since 1955, and the Koprowski's since 1958. But this is quite understandable, as the Koprowski's vaccine was based on a live virus and generated a fear against vaccination. Salk's one came soon after and, being based on dead viruses, generated no fear and immediately started to by used. This can be found in several sources, although the english ones are not so numerous. I find it in many polish publications - which is quite normal, although Salk was also born on a polish territory of today, in Białystok). I found it also in french, on Sanofi Pasteur page dedicated to Polio - what i linked in previous modification: http://www.polio-vaccine.com/fr/histoire/vaccins_oral.html

I see that DO11.10 found this source in english, so I now linked this one in the text. I also linked a bullettin of National Sanitary Inspection in Poland:

http://www.wsse.krakow.pl/Files/Attachments/phpIoa3ar_G_Historia%20odkryc%20szczepionek%20i%20rozwoju%20szczepien.doc

The rough translation is the following (supported by babelfish - sorry...):

"1950: Polish immunologist and microbiologist, Hilary Koprowski, working since world war II in USA, serves as first an effective vaccine against Polio disease.It was a vaccine with a live, but weakened virus.

[here some technical data on virus passages, rat's brains etc]

First massive vaccination with Koprowski's vaccine took placein Kongo in 1958 when within merely six weeks over 250 thousand child were vaccinated.

[here some historical data on vaccinations with Koprowski's vaccine (9 million doses) that took place in Poland, starting in 1959]

It has to be mentioned here an error committed in the majority of textbooks of the history of medicine. It's told there, that the discoverer of the vaccine was Salk, relatively Sabin. There is a falsehood, because first time Koprowski gave his vaccine to a child, Salk wass still performing experiments with monkeys, while Sabin was only starting his work."

By the way - I wonder why in the header, the names and dates are not following the chronological order (1952-1950-1962)? Lamignat (talk) 13:41, 16 December 2009 (UTC)

OK. I've read some more on the vaccine story. The source you used from Sanofi appears to be a reasonably balanced account. Having read some of the papers by those researchers I don't trust any of them to document their part in the history with any fairness. Was the single-strain "vaccine" that Koprowski tried in 1950 was effective (it produced antibodies but did it protect the community to a sufficient degree) or safe (lots of trouble with the live vaccine strains becoming more virulent). By the time of the large-scale trial in Congo and the use in Poland, it wasn't the same product at all (in 1950 it was PV2 but the later ones were PV1 and PV3). It would appear that Koprowski lost out on several points (some politics perhaps) but including the fact that Sabin's vaccine protected against three strains and met the requirements for safe attenuation (though Sabin had a hand in drafting those requirements:-). Ultimately, Koprowski's vaccine did not feature in the global fight against polio. The standards (ethical and clinical) of those early trials is rather shocking. Colin°^Talk 19:44, 16 December 2009 (UTC)

Collin - I do not agree.

By effective vaccine we mean the one that works - protects against the viruses in it.

Let's take for example Streptococcus pneumoniae or Neisseria meningitidis. Following your approach to Polio, we should agree theere is still no vaccine against it - 'cause none of the ones being currently in use protects against all of the types. The same with Hepatitis (there is a vaccine against A and B, but not against C).

The vaccine of Koprowski served in 1950 was based on PV2 and was totally effective:

"His results were excellent. The virus was found in the stools of everyone who received the vaccine, which indicated it had reproduced in their digestive systems and triggered the production of antibodies. When the immunized children received the vaccine a second time, they were not re-infected, evidence that they were protected. The findings were so spectacular that when Koprowski presented them to a meeting of the NFIP's Immunization Committee, the committee members greeted them with skepticism."

(I read somewhere that the one convincing the others, that the results are great and skepticism was stupid was... Salk)

Then, we got this information:

"In 1951, Koprowski tested a prototype of the vaccine containing attenuated strains of types 1 and 2 on a group of 61 children in Sonoma State Home, an institute for mentally retarded children."

So, summarizing the info gathered:

The first effective vaccine ever: Koprowski, 1950, live virus PV2, OPV.

The first vaccine against PV1: Koprowski, 1951, live virus, OPV.

The first trivalent vaccine: Salk, 1952, dead virus, IPV

The first one to have invented vaccines for all 3 types of virus: Koprowski (1950 PV2, 1951 PV1. I miss the date for PV3, but this one since 1958 was already in massive use in Congo, Germany and Poland. So he had to invent it before).

The first trivalent OPV vaccine: Sabin, 1962.

Each one of them invented sth for the first time, but it is obvious for me, that the expression "the first effective vaccine" should be linked with Koprowski.

I get, that Sabin is the most important for the "western world" (that's why, I guess, his "the face" of the first vaccine), as he invented sth safe and complete. But, on the other hand, for the 3rd world this vaccine was almost totally useless - imagine massive vaccinations with IPV in Africa (!). For the 3rd world far more important was the oral vaccine, and, even if it weren't covering the 3 serotypes, it was invented already in 1950 and it was the first one giving an immunity against Polio (represented by PV2).

Example: Although Koprowski's vaccine was not trivalent, it helped to reduce the nO of cases from 6k in 1958 to 30 in 1963.

I think you are mixing the words "invent" and "effective" with "prepare for a masive production" and "comprehensive"

Now - your comment to "Polio Vaccine" article:

"Sabin's vaccine contained several serotypes so it is an oversimplification to say that it came from Koprowski)"

It doesn't consider the fact, that already in 1951 Koprowski had at least 2 serotypes, including the most "popular" PV1. The fact that Sabin used the viruses from Koprowski is also not questionnable (?). Nobody says he just took viruses and did nothing with them later on. It was supposed to be an exchange of Scientific material in order to reach the common "target".

Lamignat (talk) 21:19, 16 December 2009 (UTC)

• I think the balance of the article on this topic is acceptable and probably close to the best that can be achieved with the available, reliable sources. The problem, as I see it, is that none of these scientists discovered vaccination or were the first to develop vaccines. The hepatitis example given above is not helpful at all; hepatitis A, B and C are caused by three completely different viruses. I cannot see the point of debating who was the first to develop the first effective polio vaccine. Effectiveness, or efficacy is impossible to determine without evidence from large scale clinical trials—antibody production alone is not a marker of efficacy, the antibodies have to be produced to levels that confer protection against all three serotypes and cell-mediated immunity is also important. Koprowski's first candidate vaccine was never tested for efficacy and safety. Without this data it remains that; a candidate vaccine. Koprowski's role is given due weight, let's leave it as it is, otherwise we will come close to contravening WP:NOR and WP:NPOV. Graham Colm ^Talk 21:48, 16 December 2009 (UTC)

• There are different ways of spinning this for sure. Note that your 1962 for Sabin is wrong for how could the 1958 NIH select his vaccine (all three serotypes) if it wasn't available then. Regardless, it doesn't really matter what your or my interpretation of the primary research facts is. What is needed is an independent published source of high quality to arbitrate on that. The Sanofi source repeatedly calls Koprowski's vaccine a "prototype". Ultimately, mass producing a vaccine to government standards of safety and consistency is part of the "development" process and the other guys got there first. At present, Koprowski gets about the same amount of article text as Salk, who arguably should have more.

I don't buy the "western world" argument. All the guys were working in the US, all were Jewish and two were from Poland. I think the current text is reasonable: Koprowski was first to research, first to small clinical trials but he was not first to actually produce a workable vaccine accepted for clinical use. Ultimately, for whatever reason, his vaccine wasn't considered as good as Sabin's and lost the beauty contest. Agree with Graham that we are in danger of original research here. Colin°^Talk 21:54, 16 December 2009 (UTC)

Ok, I won't argue much more. As to 1958/1962 of Sabin, I think it was not the vaccine that was chosen, but the virus (which was later on used in a final vaccine). "Western world" - you don't have to buy, it's just my interpretation ;) Neither I referred to the nationality and/or origin of the guys mentioned in the article - my deduction was taken looking from the point of view of the addressees of the vaccine.

I can agree the text in this section is acceptable as it is right now. Anyway, as the vaccines of Koprowski was in a massive usage by the time the Sabin's one went to market, I think the header should have a shape similar to the one before:

"The polio vaccines developed by Jonas Salk in 1952, Hilary Koprowski in 1950 and Albert Sabin in 1962 are credited with reducing the global number of polio cases per year from many hundreds of thousands to around a thousand"

I'd suggest a change to:

"The polio vaccines developed by Hilary Koprowski in 1950 and 1951, Jonas Salk in 1952, and Albert Sabin in 1962 are credited with reducing the global number of polio cases per year from many hundreds of thousands to around a thousand"

If you insist on distinguishing the Koprowski's one from the others due to its discontinuation or mono/duo(not tri-)valency, it can be written e.g. like this:

"The polio vaccines developed by Hilary Koprowski in 1950 and 1951, Jonas Salk in 1952, and Albert Sabin in 1962 (this one replaced Koprowski's vaccines), are credited with reducing the global number of polio cases per year from many hundreds of thousands to around a thousand"

Lamignat (talk) 23:52, 16 December 2009 (UTC)

• I offer, for discussion, a more neutral: "Developed in the 1950s, polio vaccines are credited with reducing the global number of polio cases per year from many hundreds of thousands to around a thousand". Subject to the citation supporting this. Graham Colm ^Talk 00:09, 17 December 2009 (UTC)

Fine with me - kinda compromise. Lamignat (talk) 00:18, 17 December 2009 (UTC)

I still have a major problem with including Koprowski here because, besides mentioning the developer and year of release, the vaccine section of this article is meant to be a very brief and pointed outline of the vaccines currently in use to prevent polio. Since Koprowski's vaccine is no longer used, and because specific information about the development of the other vaccines is not discussed here, it is confusing to the reader to have this information in this section. [Or rather, they were not initially included, although I suspect Colin's recent additions were meant to balance this point out]. I thought the best and most obvious place for the historical information about his vaccine was the polio vaccine article, which is why I moved it, corrected it and properly sourced it there. WRT the Polish article used as a reference there are two problems, it is in Polish and it is a Word document neither aspect lends the reference the verifiability these statements require. Surely English sources, whether web or texts, exist for this information. Finally, please keep in mind that the intention of Wikipedia is and should be to inform, not to "right the wrongs".

Trivalent OPV was "released" in 1962 and is the version of OPV that is currently used.

Per the introduction: I !vote for Graham's neutral version.--DO11.10 (talk) 00:41, 17 December 2009 (UTC)

• Bloody edit conflict (life is too short):-

Not really a compromise—it's an attempt to achieve consensus, which is not quite the same thing. It has been very thought provoking and interesting to discuss this and I thank you. I suggest not making the change until other involved editors have had the chance to read and comment on this discussion. Graham Colm ^Talk 00:47, 17 December 2009 (UTC)

PS, lets take a break and take time to reflect. Knowing Colin, he will probably be in the bathtub or in bed. It will do no harm to leave the article as it is for a few hours. Graham Colm ^Talk 01:03, 17 December 2009 (UTC)

At 1am? In bed, fast asleep. Colin°^Talk 10:02, 17 December 2009 (UTC)

If the vaccine section is intended to discuss only the current versions of the vaccines then it probably shouldn't mention people's names at all. We like mentioning names in history sections because it puts a face to the discoveries, but really these were team efforts and the vaccines are now manufactured by big drug companies, not labs headed by famous figures. According to that Sanofi article, the current OPV now contains a new strain of type 3 so OPV is not longer just Sabin's vaccine strains (a point that is currently missing from the polio vaccine article).

The problem with just discussing the vaccines from a technical rather than personal or historical POV is that I think it would leave this article failing to be "comprehensive". The names of the polio vaccine researchers, and the fact there was a race with winners and losers, are well known aspects of polio. I'm fully in agreement that we shouldn't be trying to "right the wrongs" here, which is why our sources on this should be articles/reviews that comprehensively and independently tell the story (not Koprowski or Sabin's own papers, which are biased). There is probably a better source than the Sanofi article but it tells me that if we mention Salk and Sabin then we should mention Koprowski too -- being first at something is a notable fact even if ultimately he lost the race.

I support Graham's suggestion for the lead. Colin°^Talk 10:02, 17 December 2009 (UTC)

I have edited the Lead accordingly. Graham Colm ^Talk 10:45, 17 December 2009 (UTC)

Well I guess can't argue with your comprehensiveness argument, and I think that what you've added is as neutral and properly weighted as can be. I totally agree about the bias issue, both of them make it seem like they worked in a bubble tirelessly researching (i.e. injecting their prototypes into scores or retarded children, without so much as a whisper of "consent") with no help or input from anyone else. I just didn't want that type of slanted POV ending up here, and especially without the proper context. In any event, I think you've done a great job keeping the cruft out, so to speak. I do now remember reading something in some book about the change of the type 3 vaccine, but I can't seem to find it again. I'll keep looking and update the vaccine article accordingly. --DO11.10 (talk) 22:44, 23 December 2009 (UTC)

1840 vs 1842

There was no basis for changing the year from 1840 to 1842 in revision 377333698 by 98.66.160.54 (talk). Although Citation 5 Paul JR (1971), A History of Poliomyelitis is not viewable online, other sources such as Merritt's Neurology Page 158 and The Founders of child neurology by Stephen Ashwal (1990) confirm that poliomyelitis was first recognized as a distinct condition by Jakob Heine in 1840. --Dan Dassow (talk) 18:09, 5 August 2010 (UTC)

Recent vandalism

I've reverted the article back to the last stable version on 13:59, December 10, 2010 by user:GrahamColm. IP users 41.209.88.67, 41.209.92.181, 41.209.90.217, and 41.209.93.27 vandalised article within a short period of time. --Dan Dassow (talk) 08:57, 12 December 2010 (UTC)

polio

how many people did poliomyelitis kill? --72.130.113.173 (talk) 05:32, 29 January 2011 (UTC)--72.130.113.173 (talk) 05:32, 29 January 2011 (UTC)--72.130.113.173 (talk) 05:32, 29 January 2011 (UTC)--72.130.113.173 (talk) 05:32, 29 January 2011 (UTC)

"Polio - Fact Sheet". Connecticut Department of Public Health. Retrieved January 29, 2011.

How common is polio in the United States?
Before a polio vaccine was developed, polio epidemics were common in the United States. For example, in the immediate pre-vaccine era (early 1950s), there were 13,000 – 20,000 paralytic cases and 1,000 polio-related deaths each year in the United States.

After the development of the inactivated (Salk) vaccine in 1955 and the live (Sabin) vaccine in 1961, the number of polio cases dropped dramatically. In 1960, there were 2,525 paralytic cases reported, but by 1965 this number had fallen to 61.

"Number of Inhabitants: Table 1 - Population of the United States, Territories, Possessions, 1790 to 1950". US Census Bureau. Retrieved January 29, 2011.

The US population in 1950 was approximately 154 million. This translates to a 0.00065% chance of dying from polio in 1950.

I will leave it to another editor to determine whether number of deaths should be included in the article.

--Dan Dassow (talk) 14:47, 29 January 2011 (UTC)

12th edition of Pink Book now available

The Pink Book (Citation 4) is cited extensively in this article. The 12th edition of the Pink Book is now available.

Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson W, Wolfe S, Hamborsky J, eds. 12th ed. Washington DC: Public Health Foundation, 2011.

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio.pdf --Dan Dassow (talk) 13:27, 16 April 2011 (UTC)

Add video ?

http://www.youtube.com/watch?v=19KkFCQz8WQ It's up to you guys. 81.241.103.106 (talk) 10:41, 26 May 2011 (UTC)

The video would be more appropriate for Poliomyelitis eradication. A better link is bruce_aylward_how_we_ll_stop_polio.html.

Bruce Aylward: How we'll stop polio for good
About this talk

Polio is almost completely eradicated. But as Bruce Aylward says: Almost isn't good enough with a disease this terrifying. Aylward lays out the plan to continue the scientific miracle that ended polio in most of the world -- and to snuff it out everywhere, forever.

About Bruce Aylward

Bruce Aylward is a Canadian physician and epidemiologist who heads the polio eradication programme at WHO, the Global Polio Eradication Initiative (GPEI).

--Dan Dassow (talk) 15:54, 26 May 2011 (UTC)

File:Womanonsideinlung.jpg Nominated for Deletion

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Polio Outbreak in China

http://www.bbc.co.uk/news/world-asia-pacific-14997307 Not sure how this will factor into the broad picture, but being here in China made me curious about how often this happens crossing nearby countries. There is a bit under "Eradication" that could be updated or elaborated? Springfinger (talk)