◎ Science and Technology Daily reporter Zhang Jiaxing
"At the hospital, the doctor took him away from us soon. I never saw my son again. He died alone like that. We had no chance to say goodbye to him at all. Now there is only his wardrobe and tropical fish …"
The grief and separation described in the father’s intermittent gibberish in the novel Nemesis really and frequently occurred in North America, Europe and other places in the first half of last century.
The source of all tragedies is a virus called poliovirus. Thousands of infants and young children developed fever and inflammation for unknown reasons at first, and then suddenly they could not breathe spontaneously, were paralyzed and even died. In the classroom full of children’s voices in the past, several seats are vacant every day, some because of isolation, some because of illness, and no one knows which day "you at the same table" will disappear. Historical pictures show that in 1944, a sixth-grade classroom in Milwaukee, the largest city in Wisconsin, USA, was almost empty on the first day of school, and a teacher only taught one student. This scene is embarrassing.
On the other side of the city, the huge cylinder "iron lung" has "eaten" more and more children to help them breathe. Some people walk out of the "iron lung", some people fail to walk out alive, and some people spend the rest of their lives in the "iron lung", with their limbs and bodies in jars, only showing their heads to eat, drink and breathe …
Image source: vision china
According to records, on June 17th, 1916, new york officially announced the existence of epidemic polio infection. That year, the first polio epidemic broke out in new york, with more than 9,000 cases and 2,343 deaths. The polio epidemic in 1952 was by far the worst, with 57,628 cases reported in the United States alone.
Searching for "patient zero" thousands of years ago.
Who was the first "patient zero" infected with polio virus?
The most famous origin comes from the lithographs in ancient Egypt. A lithograph of the 18th dynasty in ancient Egypt (1403 -1365 BC) depicts a person with muscular atrophy in his right leg, which is regarded as the earliest verifiable document reflecting the pathological state of polio.
There are also manifestations of clinical manifestations of poliomyelitis in TCM books. The earliest record is found in Huangdi Neijing, such as Su Wen Wei Lun, which says, "The five internal organs are hot, which can make people sick and flaccid, and the cover is hot inside and flaccid outside."
Patients with polio sequelae in ancient Egyptian lithographs. Image source: shell
People know that the existence of poliovirus is only a short hundred years, but poliovirus has accompanied the evolution of human society like a ghost. The age is so long that the pursuit of polio virus zero infection is meaningless.
It can’t be traced back to the first "intruder" in the whole human society, but in some parts of human society, either because of the fear brought by the unknown, it is necessary to find an outlet to vent, or because of unspeakable political purposes, people will offend each other and even fight for who is the "patient zero" who brought it.
Gao Xi, a professor of history at Fudan University, pointed out in a speech that in the dark European Middle Ages, the scale, duration, coverage, number of deaths and variety of diseases that ravaged the European continent were unprecedented. Infectious diseases, including typhoid fever, smallpox, polio and scarlet fever, spread from one country to another and soon spread in Europe.
Countries go to war and blame each other for this. Among the people, rumors spread everywhere. Witches, Jews and children … Any group that is considered to be different may cause public anger at any time because of a rumor and be pushed into the painful abyss of publicly offending.
"At that time, a more common and excusable statement was that Columbus and his companions brought diseases from the New World to Europe and then spread them all over the world." Gao Wei said.
Ignorance leads to rumors and conviction. The haze of the virus enveloped the European continent at that time, and at the same time, human ignorance made the disaster spread like a virus.
Draw a circle and search for the cause of disease for a hundred years.
At first, people couldn’t relate the figurative and mechanized symptoms of sudden muscle paralysis and limb paralysis to a tiny microorganism, which is why polio has another name: polio.
At one time, polio was considered to be congenital and acquired. There was a secular view that children with polio had problems during embryo gestation, and even it was attributed to ghosts and gods. As a result, generations of polio patients had argued about their rights to get married and have children as adults for nearly half a century.
Back in the 20th century, before the Russian pathologist ivanovski discovered the virus, people knew nothing about this microorganism that could not be seen through the optical microscope. At that time, the disease was called: tooth paralysis, infantile spinal paralysis, primary paralysis of children, degenerative paralysis, anterior horn myelitis, early morning paralysis, etc., and it had no "half a cent" relationship with the virus.
In 1789, a British doctor named Michael Underwood made a clinical description of polio, which he called "weakness of lower limbs".
In 1840, Jacob von Heine, a German orthopedic surgeon, first separated the paralysis caused by polio from other forms of paralysis, calling it polio.
In 1887, Karl Oskar Medin, a Swedish scholar, went out to study individuals and regarded them as epidemics. He recorded an epidemic situation in Stockholm from an epidemiological point of view, and reported the epidemiological characteristics and nervous system complications of polio for the first time.
It was not until 1908, 10 years after the concept of Virus was accepted, that Austrian-born doctors Karl·Landsteiner and Erwin·Popper obtained samples from the central nervous system tissues of patients after death, and then isolated the virus by inoculating monkeys, finally associating paralysis and paralysis with the virus, and drew a closed-loop "circle" in finding the cause.
However, up to now, the closed-loop "circle" of polio caused by virus still can’t erase the prejudice brought by this terrible disease, especially the mutilation it brings is clearly visible, which will make people wonder whether it may be inherited in future generations or associated with "bad luck" regardless of scientific objectivity.
Together, NATO and Warsaw Pact are both healthy covenants.
In the summer of 1921, a cluster of small particles of poliovirus with a size of only 20 nanometers and a icosahedron swam in the water near Campobello Island on the Atlantic Ocean. Small particles drift with the tide, and their surrounding environment is as leisurely and quiet as the earth in ancient times.
A 38-year-old man dived into the water to enjoy the beauty of nature. A small wave came, and the small particles trapped by the sea water entered the man’s mouth and nose.
In just one day, the virus reached the man’s local lymphoid tissue, such as tonsils and other places to multiply and grow; Then the virus further invaded the blood stream, and on the third day, it reached various non-nerve tissues, such as heart, kidney, liver and pancreas, and propagated. The antibodies in the man’s body didn’t have time to stop this powerful offensive of the virus, and watched the virus break through the "blood-brain barrier" and go straight to the central nervous system.
After this trip, the man began to have incontinence, fever and facial paralysis. The paralyzed part began to spread from the hip, and gradually his legs were completely paralyzed, and then his waist … He was franklin roosevelt, who was later elected president of the United States. He was paralyzed for life from the waist down because of polio virus.
His infection and illness brought panic about this virus in the United States in the short term, but in the long run it sounded the "assembly number" for fighting polio virus.
With the emergence of vaccinia to contain smallpox, vaccines have become the "killer" for human beings to deal with viruses. Vaccine makers start with real viruses and try to eliminate their toxicity, so as to produce vaccines.
In 1953, the swimming pool in Elmira, New York, had a sign indicating that it was closed due to polio. Image source: shell
At the American Public Health Association conference in 1935, two groups of researchers reported their experiments on polio vaccine. In the first group of about 10 thousand children vaccinated, five died of polio and ten were paralyzed. There was no control group in this group of experiments, but John Ke Ermo, who led the experiment, said that the infection rate would be higher without vaccination. Such speculation without factual data made the scene in an uproar.
The second group is Maurice Brodie of new york University. One of the 7500 people vaccinated with the vaccine he developed was infected with polio; One of the 900 people vaccinated in the control group was infected with polio. Although the data is statistically significant, when the audience learned that the infection in the vaccinated population was caused by the vaccine, they all condemned Brody’s research for making healthy people suffer from polio.
Shortly after the report, Brody lost his position at new york University and was found to have committed suicide at home.
The research of vaccine is tortuous, but the scientific spirit and unremitting efforts will inevitably push forward the research and development of vaccine.
On April 12, 1955, the Journal of salk reported an exciting news with a full page: "’s vaccine works! 》（《SALK’S VACCINE WORKS！ 》）
In 1947, jonas salk, an American scholar, set up a three-person research team to jointly overcome the problem of polio. Unlike most researchers who studied live attenuated polio vaccine at that time, salk’s research used inactivated virus as vaccine.
In the United States in 1952, under the threat of epidemic disease, the scale of human trials of vaccine research and development continued to expand. Salk’s vaccine was tested on 1.8 million children, making it the largest medical experiment in human history at that time. Almost the day after the test results were announced, millions of children across the United States were vaccinated against polio.
The debate between "dead" vaccine and "live" vaccine has not stopped because of large-scale vaccination.
Albert Bruce Sabin, who is developing research and development in parallel with salk, insists that only when the live virus enters the human body can the vaccinated people get immunity.
However, Sabin’s "live" vaccine was born a little late. When he developed an attenuated polio vaccine, salk’s vaccine had become the mainstream of the United States, and the government no longer supported his project, so he had to cooperate with other countries.
Disease is not political, and science has no borders. The research and development of attenuated polio vaccine spanned the two political and military camps "North Atlantic Treaty Organization" and "Warsaw Treaty Organization". In 1959, with the support of the Soviet Union, Sabin completed a large-scale clinical trial involving 10 million people, which verified the effectiveness, safety and accessibility of the vaccine.
Ark, leading billions of people away from polio.
In 1950s, poliovirus also occurred from time to time in all parts of China. Even if the weather is sultry, families will let their children stay at home, because there is an invisible and frightening polio virus outside, which will make children disabled after a fever. What is even more frightening is that this virus can be invisible like a "ghost", and healthy people who seem to have no symptoms may also carry it.
At that time, which of the three polio viruses was prevalent in China had not been determined, and the etiology and serology research was almost zero. In 1957, Gu Fangzhou, a scientist from China, led a team to isolate poliovirus from patients’ feces in 12 cities across the east and west, and found that the three types of virus had different characteristics. Through a large number of clinical practice studies, the popular virus types in China were determined, and the laboratory diagnostic criteria of poliovirus were established.
A large number of cases obtained from the investigation made Gu Fangzhou more and more worried. He reported to his superiors that if the incidence of polio was not high, the prevention work could be carried out slowly, but now the incidence is high, and a big outbreak will eventually occur somewhere in a certain year. The outbreak in Berlin in 1947 was a warning, and the pandemics in Nantong in 1955 and Wenzhou in 1956 in China have also sounded the alarm.
In 1959, Gu Fangzhou was ordered to go to the Soviet Union to study the development method and production technology of polio virus vaccine. He found that the existing technology was good, but neither the cost nor the inoculation period was suitable for China at that time. In Gu Fangzhou’s mind, public health should not be "bookish" at all, and any work should be useful and beneficial to the people.
At the international conference on polio vaccine in 1959, Gu Fangzhou, who is good at learning, made it clear that vaccines can be divided into "dead" and "live", and that dead vaccines are safe, but they will not form an immune barrier in human body. Attenuated live vaccines may theoretically restore their virulence, but they can become natural vaccines and form an immune barrier.
With the courage and rational judgment of scientists, Gu Fangzhou made a choice for all the people of China. He wrote to the Ministry of Health at that time, suggesting to choose an attenuated live vaccine that was not proved to be safe and had no mature production process, and personally brought the virus back to China from the Soviet Union.
Gu Fangzhou Image Source: Voice of China
In December, 1959, the polio live vaccine research collaboration group was established with the approval of the former Ministry of Health, with Gu Fangzhou as the team leader. Vaccine research and development started from scratch, and the team overcame the difficulties of material shortage and harsh environment, and finally got a vaccine sample. With the start of clinical trials of vaccines, it becomes a problem who will take them first.
At the risk of possible paralysis, Gu Fangzhou drank a small bottle of vaccine solution, and the rest of the lab joined the experiment.
The vaccine is harmless to adults, but how safe is it for children? "At that time, my son Xiaodong was just under one year old and qualified." Gu Fangzhou’s oral memory history records: "My own children don’t eat, let others eat, which is not very righteous."
With the development of clinical trials of vaccines, the epidemiological data of 2 million children after taking vaccines show that the epidemic peaks in Shanghai, Tianjin and Qingdao have basically disappeared, and domestic vaccines are safe and effective biological products to prevent polio epidemic.
China polio eradication confirmation report signing ceremony. Image source: Voice of China
In Gu Fangzhou’s polio immunization strategy, every child in China cannot be left behind. The oral vaccine rate should reach 95% to form an immune barrier. This means that children who are far away from the Tibetan Plateau, the desert in Xinjiang and the deep mountains in Guizhou must enter the protective barrier without exception. If there is a slight omission, the virus may recur. At that time, there was no cold chain, so it was very difficult for vaccines to circulate effectively in the country in a short period of time. The local method of mixing popsicles with wide-mouthed thermos flask is not very effective.
According to Biography of Gu Fangzhou, Gu Fangzhou, who came home after work, was still thinking about the immunization strategy. His son looked at him. He picked up the candy on the table and shook it in front of his son. His son held out his little hand urgently to make him laugh. Sugar! Gu Fangzhou started the research on vaccine sugar pills. He developed the polio vaccine "Sugar Pill", which made China enter a polio-free era.
In 2000, the World Health Organization announced that polio had been eradicated in the western Pacific, which was closely related to the effective immune barrier formed by polio vaccine in China with a population of more than one billion.
Play around and be alert to the resurgence of sophisticated viruses.
Extinction, doomsday, end …
Since April 8, 1994, when the World Health Organization announced that polio was basically extinct, a large number of reports used similar words to summarize the fate of polio virus.
However, contrary to expectations, polio has never become one of the few infectious diseases that can be eliminated.
In 2000, Cape Verde reported 33 cases of acute polio, including 7 deaths.
In recent years, there have also been cases of infection in Pakistan, and the number of cases has dropped from 306 in 2014 to 54 in 2015, 20 in 2016 and 8 in 2017.
By 2018, less than 30 cases of naturally occurring polio had been reported in Afghanistan and Pakistan.
On March 10th, in Mazar-e-Sharif, the capital of Balkh province in northern Afghanistan, a health department worker vaccinated children against polio. Image source: Xinhuanet
However, according to Science, workers found the virus in a vast area of Pakistan. This disturbing latest discovery shows that it still exists in the environment and is far from disappearing.
Will this virus, which has been dealing with human beings for more than 3000 years, resurface?
As far as the virus itself is concerned, one of the secrets that it has lasted for thousands of years is that more than 90% of the carriers are "secret". These secret infected people have no symptoms, but they provide a secret habitat for the virus to preserve its vitality and wait for the opportunity to revive.
For human beings, rumors can still fuel its "resurgence." For example, rumors that vaccines cause autism are exploited by some religious organizations. Some commentators believe that the resurgence of polio in Nigeria in 2016 after two years of extinction has a lot to do with Boko Haram, an extremist organization in the country. The organization spread rumors among local people, saying that the real purpose of polio vaccine is to sterilize Africans, which led to a large-scale protest in Nigeria, and even several immunization workers were shot dead by extremist organizations.
In the face of ancient viruses, human beings should always remember:
For human tragedies and disputes,
The virus looked on coldly in secret.
For the change and migration of the environment,
The virus "secretly" sees the needle.
Source: Science and Technology Daily
Original title: "Apocalypse of the Great Plague in the World: Polio: After dealing with human beings for more than 3,000 years, what is the" resurgence "of this mysterious virus"
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