The recent polio epidemic in Syria has Martha Ann Lillard of Oklahoma very worried. Lillard has spent 60 years depending on an iron lung to sustain her life.1 She was paralyzed by polio in 1953 at 5 years old from a sore throat that spiraled into the dreaded disease that changed her life.
Many people today have never experienced the kind of widespread fear that was provoked by simply mentioning polio in the late 1940s and early 1950s. In addition, the majority of healthcare professionals in the United States today have never treated a patient with an acute polio infection. When 5-year-old Lillard became ill, vaccines for polio were not available; otherwise, she is certain her mother would have consented to her receiving the vaccine.
With the licensing of the Salk polio vaccine in 1955 and the Sabin vaccine in 1960, new cases of polio began to decline dramatically in the United States. I knew children who had polio, but luckily, none of them needed to use an iron lung. I remember waiting in long lines in the school cafeteria to receive the oral vaccine, a new, red, sweet tasting (we were assured) medicine that was going to keep us healthy. The vaccine held great promise, and in 1979, officials declared to the world that polio had been eradicated in the United States through intensive vaccination efforts and vigilant surveillance.
The Global Polio Eradication Initiative
The World Health Organization (WHO) states that polio cases have decreased by 99% since 1988, when there were an estimated 350,000 cases worldwide. In 2012, there were only 223 reported cases worldwide. This dramatic decrease can in part be attributed to the Global Polio Eradication Initiative, “a public-private partnership led by national governments and spearheaded by the WHO, Rotary International, the U.S. Centers for Disease Control and Prevention (CDC), and the United Nations Children's Fund (UNICEF).” (www.polioeradication.org/AboutUs.aspx.)
There are 200 countries involved, and 2.5 billion children have been immunized during its 25-year history. The goal is a polio-free world. Former South African President Nelson Mandela was a spokesperson for the initiative during his lifetime. Today, polio is endemic in only three countries: Pakistan, Afghanistan, and Nigeria; however, it is still actively transmitted in five other countries: Syria, Kenya, Somalia, Ethiopia, and Cameroon.2,3 India is on the verge of declaring eradication.
April 23 to 30 was World Immunization Week, and April 26 to May 3 is National Infant Immunization Week. This is an opportunity for nurse practitioners to raise awareness among their patients–especially adults–about preventive immunizations.
In my clinic, we offer travel medicine services; a polio booster is recommended for adults before international travel, assuming the patient received the primary series as a child. In many states, parents have the right to decline having their children immunized based on a medical or religious exemption rule. These children, however, are at risk for contracting and transmitting a highly contagious, preventable infectious disease should they be exposed.
Lillard is a strong and persistent advocate for immunization. She owns her own 800 lb (362.9 kg) iron lung, which was built in the 1940s, and prefers it over modern devices. “It feels wonderful, actually, if you're not breathing well...When I was first put into it, it was such a relief. It makes all the difference when you are not breathing.”1 Lillard has a message for everyone: Children should be vaccinated, and adults should choose to be vaccinated as well. You can prevent the alternative.
I end with wishing nurses everywhere a Happy Nurses' Day as the world celebrates us this month!
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, DPNAP