In the Shadows: Poliomyelitis Epidemics and Nursing Care in Edmonton 1947-1955

By Jaipaul, Joy | Alberta History, Summer 2005 | Go to article overview

In the Shadows: Poliomyelitis Epidemics and Nursing Care in Edmonton 1947-1955


Jaipaul, Joy, Alberta History


Poliomyelitis was the most feared of diseases in the first half of the twentieth century, and for Canadians the fourth wave of epidemics during 1947-1955 was the worst. (1) Epidemics had long been part of the Canadian heritage, but although rapid advances in science and technology had substantially reduced the impact of several other communicable diseases such as smallpox, cholera, typhoid fever, scarlet fever, and tuberculosis, early scientific efforts to minimize poliomyelitis infections were less successful. With no remedy for the disease, Canada's scientific contributions in the development of an effective Salk vaccine at Connaught Laboratories had a significant impact on the international history of poliomyelitis. Ultimately, Salk vaccine mitigated paralytic polio by producing antibodies in the bloodstream of vaccine recipients, while the oral Sabin vaccine effectively controlled poliomyelitis outbreaks by protecting the gastrointestinal system from infection.

The valiant contributions of nurses performing their gruelling work during epidemics of poliomyelitis have not been particularly well documented. (2) Nurses were also conspicuously absent from the five International Poliomyelitis Conferences held every three years, although the purpose of the conferences was to primarily evaluate the social and prevention aspects of scientific progress. (3) While conducting research for a 2004 exhibit at the Provincial Museum of Alberta in Edmonton entitled "Every Mother's Fear: Alberta's Polio Experience," curator Matthew Wrangler interviewed some nurses who worked in Edmonton during the poliomyelitis epidemics. In a brief historical account of poliomyelitis, with particular reference to the 1947-55 epidemics in Edmonton, excerpts from his conversations have been modified and presented here. (4) The predominant focus is describing the nursing care of patients in iron lungs; other aspects of infection like post-polio syndrome are not addressed here.

Poliomyelitis is caused by one of three serotypes of the poliovirus and disease typically presented as a mild, self-limiting viral childhood infection of the gastrointestinal tract with marginal morbidity and mortality. Paralytic poliomyelitis was an uncommon complication, as a consequence of viremia and transportation of the virus to the central nervous system. (5) Although it only replicated in humans fecal-oral transmission was possible through virus excreted in stool, such as might occur when handling soiled diapers. It attacked motor neurons in the brain and spinal cord causing varying degrees of damage.

Previously referred to as "infantile paralysis," it was renamed "poliomyelitis" to more accurately reflect the inflammation of gray matter; "polios" referring to gray and "myelos" being matter. (6) After an incubation period of about two weeks, influenza-like symptoms of fever and muscle aches appeared followed by varying degrees of paralysis relative to the extent of neural involvement. Depending on the serotype, infections resulting in paralysis ranged between less than one in 100 and less than one in 1,000 cases, and more than 90 per cent of infections were either asymptomatic or merely resulted in non-specific fever. (7)

Canada reported its first outbreak of poliomyelitis in 1881. With only 23 cases between 1880 and 1884, the incidence steadily increased to 8,054 cases from 1905 to 1909. (8) Waves of epidemics subsequently ensued in 1927-32, 1935-40, 1941-46, and 1947-55, with annual outbreaks in the early 1950s. The worst epidemic occurred in 1953 with a national case rate of 60 per 100,000 population, which was the highest rate in North America and among the highest in the world. It migrated across the age span, no longer primarily a disease of early childhood. (9)

In 1938 the Alberta legislature enacted the Poliomyelitis Sufferers Act providing free hospital, medical, and surgical care for Albertans afflicted with the disease. …

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