Canada and Polio

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CraigBaird

During the first half of the 20th century, one of the most feared diseases for parents was polio. While polio could strike anyone, at any age, it was the children under the age of five who were most at risk. From 1910 to 1955, polio upended lives and changed Canada in many ways. Today, I look at that period of time when polio was a mysterious and sometimes deadly disease in our country.

A brief description of polio before we get down to its history worldwide and in Canada. Polio is caused by the poliovirus and typically most people recover from it fully. Unfortunately, in .5 per cent of the cases, the virus moves from the gut to attack the central nervous system and cause muscle weakness. This can happen within hours. Typically, muscle weakness occurs in the legs. Of those infected, 70 per cent have no symptoms, 25 per cent have minor symptoms and five percent have a headache or neck stiffness. Roughly two to five per cent of children die, while 15 to 30 per cent of adults die if the virus moves to the central nervous system. It is typically spread through infected fecal matter entering the mouth but can also spread by food or water that has been contaminated by human feces.

Polio has existed for centuries, with Ancient Egyptian paintings and carvings showing healthy people with withered limbs and children using canes. It is also believed that the Roman Emperor Claudius had it as a child, resulting in a limp for the rest of his life.

Until the before the 20th century though, major polio epidemics were unknown. Localized polio epidemics began to appear in the 19th century, with reports of multiple polio cases in a localized area first appearing in 1841 in Louisiana. It would be another 50 years before another cluster would occur. By the 20th century though, cases were increasing quickly. In 1907, 2,500 cases were reported in New York City and by 1916, 27,000 cases were reported, with 2,000 deaths in New York City.

Today, the disease is completely preventable through the polio vaccine, but I will get to that later. Throughout this episode, I will relate some of the stories of regular Canadians who dealt with polio.

In Canada, the first known outbreak occurred in 1910 when a little girl was taken to a Hamilton hospital with the belief, she had rabies. In fact, it was polio but that was only discovered after she had sadly passed away.

This would be the beginning of the polio epidemics in Canada. From here, the polio epidemics would become larger, more severe and impact older children and youth. It would also hit adults, including future president of the United States, Franklin Delano Roosevelt, who contracted it while vacationing off the coast of New Brunswick

No one at the time understood what was causing polio, or how it spread. Provincial health departments would close schools, restrict children from traveling or attending the movies, while also quarantining the sick. As time went on, it would become clearer that this did not help stop the spread of polio.

In 1912, Lewis Thompson came to Froude, Saskatchewan with his father after being a victim of polio. While he survived the disease, it left him with a foot that turned outwards and was mostly useless.

In the 1920s, Peter Friesen of Rosthern, Saskatchewan, who was a local teacher, became ill with polio and loss the use of the muscles in one leg. He bought an electric shock apparatus and exercised constantly to overcome the loss of the muscle in that leg. The leg was left thin and shorter than the other, but Peter was happy that he was able to walk once again.

Polio epidemics would strike British Columbia and Alberta in 1927, Manitoba in 1928, Ontario in 1929 and 1930 and Quebec in 1931 and 1932. In the Manitoba 1928 epidemic, there were 434 cases and 37 deaths. The epidemics then hit again, larger this time, reaching Manitoba again in 1936 and Ontario in 1937. After Manitoba was hit again, the province took a stronger approach to polio. An epidemiologist was appointed to work in the hardest hit areas, and he was given the power to insist on rigid observation of quarantine regulations, while also acting as a diagnostic consultant.

Glen Strong of Rossburn, Manitoba contracted polio at the age of 15 in 1935. He would go through two operations to improve the strength in his legs at the Children’s Hospital in Winnipeg. Unfortunately, the operations were not successful, but Glen was still able to walk around but if he fell, he needed to crawl on his hands and knees until he could get to something that he could pull himself up on.

Manitoba was especially hard hit by polio, with epidemics hitting in 1928, 1936, 1941, 1947 and 1952. In the 1928 epidemic, 434 cases were confirmed with most of the cases being children under the age of five. In the 1941 epidemic, 969 Manitobans were impacted.

In Ontario in 1937, the Ontario Society for Crippled Children predicted a significant outbreak that year and they devoted their June issue of their magazine to articles on polio. They were able to predict the disease moving to Ontario because of the trend of polio to move from west to east in the country over the years.

By 1934, half of the disabled population of Canada could have their disabilities traced to polio.

In 1930, Canada would begin using its first iron lung, which was brought from Boston to Toronto and installed at The Hospital for Sick Children. These devices were huge metal cylinders that would regulate the breathing of people whose polio had caused issues with their ability to breathe. While the hospital waited for its first iron lung to arrive, a wooden iron lung was built with materials on hand. John Gordon, a three-year-old, was the first child to use it and he thankfully stabilized. His mother would do an interview with the Toronto Star, begging the wealthy to donate money so hospitals could build more lumber lungs to save lives. The one iron lung that arrived in 1930 would remain the only one in Canada for the next seven years.

In 1937, a severe outbreak pushed the Ontario government to get more iron lungs, with 27 bought and built in only six weeks. Each of those lungs was bought by the province at a cost of $650 to $700. In that epidemic year, 63 polio cases were treated in iron lungs, with 40 of the children not surviving, 12 recovering and 11 remaining in respirators by March 1938.

During that outbreak, the Ontario Ministry of Health published a large ad describing the signs and symptoms of polio, which were of little help, and suggested parents keep their children in their own yard.

Amidst the epidemic, the Ministry of Health spokesperson Gordon Jackson stated that he felt there would be no great outbreak of polio and he suggested that the new nasal spray convalescent serum be used whenever possible, despite no proof of its value. He would say quote:

“It can do no harm.”

That nasal spray was designed to block the polio virus from entering the body. It was used on 5,000 Toronto children but after two rounds of treatment, it was abandoned as it did not prevent polio and instead caused children to lose their sense of smell. Even with the vaccine doing nothing to help, many parents demanded sprays from their doctors, and some even tried to make their own.

In 1937, Canada saw 4,000 cases of the virus, including 2,500 in Ontario alone. Numerous schools were shut down amid a public health panic in the province. One child who was hit with polio during that epidemic was Gordon Jackson. Only four-years-old, the disease paralyzed his limbs and resulted in difficulty breathing. There was only one iron lung at the hospital at the time, so he had to wait a few weeks for another to arrive. His breathing was getting worse and an experimental respirator designed for infants was used after a carpenter built a larger wooden cabinet for him in five hours. Almost blue from lack of oxygen, within two hours of using the wooden lung his breathing had improved. Eventually, he had a portable respiratory jacket. Nine months later, he was free of any devices to help him breathe but he was still in the hospital.

R.H. Saunders, a city alderman with Toronto City Hall, was the only member of the board of health to propose that the Canadian National Exhibition cancel its upcoming Children’s Day. Mayor William Robbins responded with quote:

“Do you want to kill the Exhibition?”

Saunders responded, quote:

“Of course, I don’t want to kill the Exhibition, but I don’t want to kill children.”

In the end, Children’s Day continued on, but the baby contest was cancelled. Many felt this was an odd choice by the municipal government because they had closed pools, public parks, schools, theatres and churches to children, but there seemed to be no problem with 200,000 children mingling freely on Children’s Day. The Canadian National Exhibition was also expected to be large, with 1937 being the Coronation Year of King George VI. That year, Children’s Day saw a 78,000 decrease in the number of children attending, but there were still 200,000 people there for the day.

To deal with the pandemic, the Ontario government spent $197,000 in 1937. That is a huge jump from the $4,000 it had spent on average to deal with polio prior to that year.

In 1939, the Manitoba Medical Association Review stated, quote:

“There is no disease over which the public is more apprehensive and in which both the laity and the medical profession feel so helpless than the Epidemic Poliomyelitis.”

During this period of time, running from the 1920s to the 1950s, no disease created such a strong response from Canadian governments than polio.

In 1940, Sister Elizabeth Kenny would come to North America and make several trips into Canada to instruct nurses on her methods. Her methods to help treat polio included hot packs to relieve pain and passive movement of affected limbs. These methods were quickly adopted by most of the governments in Canada.

In 1941, Manitoba and New Brunswick were both hit hard by another polio epidemic.

In 1943, Clarence Shields of Meskanaw, Saskatchewan would be struck with polio and was taken to Saskatoon by ambulance. He would spend the next seven-and-a-half months in hospital, including three weeks in isolation. In the local history of the community, visits to see him are described as such, quote:

“To visit him, you had to stand on a box to reach a high window through which one tried to carry on a conversation. He was told that he would never walk again. For a time, he was very discouraged but the desire to farm, coupled with a stubborn courageous persistence prompted him to try walking when he was alone. Eventually, Clarence won.”

The worst of the polio outbreaks would occur between 1949 to 1954, possibly as a result of the increased number of children in the generation called The Baby Boomers. In that period of time, 11,000 people in Canada were paralyzed by polio. The Royal Canadian Air Force was used to deliver iron lungs throughout the country.

Several notable Canadians would get polio during that period. Neil Young would contract polio in 1951 when he was five, and Joni Mitchell would contract it in 1952 when she was nine.

In 2000, Joni Mitchell would describe the disease that hit her as a child, saying, quote:

“Polio is the disease that eats muscles. If it eats the muscles in your heart, it kills you. If it eats the muscles that control the flexing of your lungs, you end up in an iron lung. If it eats the muscle of your leg, it withers, or your arm, it withers.”

The disease would peak in Canada in 1953, with 9,000 cases and 500 deaths. This made it the worst epidemic in Canada since the 1918 Spanish Flu. During this peak, Manitoba had 72 iron lungs operating in one single Winnipeg hospital. In Edmonton during an epidemic, a thunderstorm knocked out power to the hospital and nurses manually pumped each iron lung until power returned.

During that peak epidemic, Yvonne Hudson, a 25-year-old mother in Winnipeg, was hit by the virus. She noticed a terrible headache, followed by fever and trouble breathing. Also, eight-months-pregnant, she was admitted to hospital and after five days was put in an iron lung. About 15 hours after entering the iron lung, she gave birth to a healthy baby. She would spend six months in the iron lung.

Stefania Olsen was stricken with polio at the age of 15 while living in the RM of St. Laurent in the 1940s. She would require operations to replace the bones in her back, resulting in a handicap that she would carry for the rest of her life.

In 1947, Kitty Walker of Carbon, Alberta contracted polio and had to learn how to walk again. As a result of this, she saw the need for occupational therapy and an outlet for products for the handicapped. Working with Speed Williams, who had lost both his legs, she helped form the Rehabilitation Association, which helped many people in the area over the years.

The same year that Kitty Walker was stricken, Gordon Tully was out harvesting on the family farm in Manitoba when he was stricken ill. He was taken to hospital in Winnipeg and diagnosed with polio. His hopes of survival for the first few weeks were slim at best but he would pull through and improve. Overall, he would spend 18 months in the hospital and when he returned home, he still required a great deal of care and was confined to a wheelchair for the rest of his life.

By 1948, polio was a significant enough problem that the federal government, thanks to Health Minister Paul Martin St., introduced an annual $30 million Federal Health Grant Program to assist public health work in Canada. This doubled the health budget of the federal government.

In the fall of 1952, Dorothy Fawkes of Strathmore, Alberta contracted polio, resulting in her spending the rest of her life in a wheelchair. Her sister Gwendolyn had contracted the disease a week before Dorothy, and she too would spend the rest of her life in a wheelchair. 

In 1953, Gordon Boyd had just returned home from his honeymoon when he was taken the Calgary General Hospital and diagnosed with polio, putting him in isolation for 15 days with 53 other polio patients. He would have to learn to walk again, and through the use of weights, springs and exercises, he was able to return to normal by the early 1970s with his mobility.

In the same year as Gordon Boyd, Edwin Flanders of Brandon, Manitoba was stricken with polio at the age of seven and went into a coma. He was sent to the King George Hospital in Winnipeg by ambulance with an RCMP escort and put into an iron lung, while having an emergency tracheotomy done. He was in a coma for seven days, and when he came out of it, he was completely paralyzed from the neck down. His parents visited him every week when they had time off work, for three months. In 1956, after three years in hospital, the doctors said there was no more they could do for him and he was sent home with an iron lung that he had to sleep in for 12 hours a day. During the day, he came out and would sit in his wheelchair while wearing a corset to keep his spine from curving. At night, his hands and feet were put in casts to keep them from turning inwards. The iron lung was in the dining room and his parents, Virgil and Isabella, slept on a chesterfield. Eventually, his parents devoted their entire life to Edwin, only going where he could go in his wheelchair. Edwin eventually passed away in 1974.

Even the elderly could be stricken with polio. Harold McCausland of Riverside, Manitoba was a former pilot during the First World War, who would be stricken with polio and confined to a wheelchair in 1950, which he remained in until his death in 1978.

The move to develop a vaccine for polio was a strong one with epidemics seeming to grow in severity in North America. In 1908, poliovirus was first isolated, but it could only be cultivated in a living host, and the only susceptible non-human hosts were monkeys. In Connaught Labs at the University of Toronto, Raymond Parker, along with biochemists Joseph Morgan and Helen Morton, developed Medium 199. This was developed while studying cancer cell nutrition and it was the world first purely synthetic nutrient medium for growing cells. Its purity allowed it to precisely measure the nutrients cancer cells required. In 1951, Joseph Morgan suggested to biochemist Arthur Franklin, who had recently joined the polio research team at the university, that they use Medium 199 to grow the poliovirus in monkey kidney cells. This was done and it worked perfectly, which allowed for the cultivation of the virus in a medium that was suitable for a human vaccine. Jonas Salk would request a supply of Medium 199 to work on a vaccine.

In 1952-53, Leonne Farrell, also at the University of Toronto, devised the Toronto Method that grew the poliovirus in fluid cultures using large bottles rocked on custom-built machines, allowing for large scale production of the vaccine. A trial was implemented in this new form of the polio vaccine that would take place across the United States, as well as in Canada and Finland. The experiment would involve 1.8 million people, mostly children in grades two and three. One third would receive the vaccine, another third were given a placebo and the remaining were observed. This is called a triple-blind method in which none of the children or researchers know who received the vaccine, placebo or neither. Connaught produced 3,000 liters of the poliovirus fluids, shipping fluids to two pharmaceutical companies in the United States. In Canada, Connaught prepared the vaccine and monitored its Canadian introduction.

On April 12, 1955, the results were released. The vaccine had been found to be 60 to 90 per cent effective against the three types of poliovirus. It was then licensed for use in Canada and the US. With the vaccine licensed, the American government and Canadian government took different paths to getting it out.

The American commercial producers of the vaccine released the virus with little government control. In contrast, the Canadian government, as well as provincial governments, shared the cost of the vaccine and distributed it free to children.

On April 25, 1955, reports began to appear that some batches of the vaccine produced by Cutter Laboratories in California had not fully activated. A total of 79 cases of polio were tied to the vaccine and the US Surgeon General recalled all of the Cutter vaccine and a new polio surveillance system was set up. In total, 200 children were left paralyzed and 10 would die. On May 7, the United States suspended its vaccine program.

This is where Canada comes in again. There was a great deal of debate about what to do. Prime Minister Louis St-Laurent was resistant to allowing vaccines to continue but his health minister, Paul Martin Sr., decided to continue the program in Canada. Martin was a survivor of polio and had been blinded in one eye from it. Polio also hit his son, future prime minister Paul Martin Jr. Martin chose to continue with the vaccination after getting advice from experts and seeing no cases of polio linked with the Connaught vaccine, which was the only one used in Canada. By not stopping the program, Canada was able to show that the vaccine was safe and effective. Due to this, the United States restarted its polio vaccine program in July of 1955.

Paul Martin Jr. would speak about his memories of polio, which had contracted at age eight in 1945, saying quote:

“What I remember growing up in southwestern Ontario was the polio was an annual affair that took place in the summer. Every kid was warned by his mother and his father about it. You knew it was going to happen. That was a fact of life. It was also, by the way, probably what saved my life.”

Martin woke up one morning and felt strange, telling his mother he had a plate in his stomach. He was then on his way to a hospital in Windsor, where he would stay for a month and a half. He would say quote:

“There was a fellow older than me in the ward, in the bed just down from me, and they brought in an iron lung.”

Martin had polio in his lungs and when he asked what that machine was, he was told it was an iron lung, and that was where he was going to end up. Martin said later, quote:

“I’ve got to tell you, that’s when I suddenly realized what I was in for.”

In March of 1956, a delegation from the Soviet Union arrived at Connaught to inspect the lab’s polio vaccine production facility and to receive instruction on making the vaccine. At the time, the Soviet Union did not have a vaccine. By the middle part of that year, Connaught was delivering 2.3 million doses of the polio vaccine, enough to vaccine the 1.8 million children in Canada under the age of 10, 90 per cent of whom received at least two doses before the summer began that year. It was recommended that three doses be administered for full protection.

By 1957, Connaught Labs had a surplus supply of the vaccine, amounting to 1.3 million doses. At the time, it was decided there would be no exporting of the vaccine out of Canada but since the vaccine had a limited shelf life, the government decided that exporting the vaccine could enhance foreign relations, especially within the British Commonwealth. In April 1957, the export ban was lifted and the polio vaccine out of Connaught was seen as a Canadian prestige item. By June of 1958, 5.5 million doses of the Connaught vaccine were shipped to the United Kingdom, with additional exports to 44 other countries including Czechoslovakia. By the end of 1958, the Connaught Lab had exported 17.3 million doses.

The last polio epidemic in Canadian history would occur in 1959 when 2,000 were paralyzed. This outbreak was unexpected, but it happened because the initial vaccinations had been provided primarily to the most vulnerable population segment, those aged five to eight. Those that were hit in the last polio epidemic in Canada were pre-school children or adults who were not immunized. By the end of that year, 45 per cent of Canadians under the age of 45 had received all three doses of the vaccine.

Connaught Labs would begin to work with Albert Sabin in the late-1950s to develop a polio vaccine that could be taken orally, rather than by needle. Since the Salk vaccine was already in heavy use across the country, a large-scale placebo-controlled field trial could not be done. As a result, the evaluation of this new oral vaccine was conducted through genetic stability studies in Quebec City and Montreal, followed by a larger field demonstration in Prince Albert and two small towns in Nova Scotia. As a result of these Canadian demonstrations, the new oral vaccine was licensed for use in Canada in 1962. The Connaught oral vaccine had the advantage over the American oral vaccines because no export license was required in Canada, allowing Connaught to send its oral vaccine, to countries desperate for production. This included sending three million doses to Japan.

Since 1994, Canada has been considered polio free. Roughly 31,000 people in Canada still live with the aftereffects of polio from decades past.

In 1988, there were 300,000 cases of polio in the world, but by 2020 that number had fallen to only a few dozen. Today, polio only remains endemic in Pakistan and Afghanistan. The last known case of polio in the western hemisphere was in a boy in Peru in 1991, while Europe has been polio-free since 2002.

There is still no cure for polio, but it is believed through the use of the polio vaccine, the disease could be eradicated in the near future. One of the most prominent organizations in the world for helping to eradicate polio is Rotary International. The organization is a Global Polio Eradication Initiative Founding Partner. Since their first project to vaccinate children in 1979, polio cases have fallen 99.9 per cent. In all, Rotary members have contributed $2.1 billion and hundreds of thousands of volunteer hours to help three billion children in 122 countries. Their efforts have also pushed governments around the world to contribute $10 billion towards the efforts. They also established World Polio Day, which commemorates the birth of Jonas Salk on Oct. 24.

Information comes from Canadian Public Health Association, Canadian Encyclopedia, Wikipedia, CTV News, Global News, Museum of Health Care, Museum Of Health Care, the Toronto Star, Health Heritage Research, Connaught Fund, Heritage Manitoba, Meskanaw Its Story and Its People, Trail To Little Corner, Snake Valley A History Of Lake McGregor and Area, Old and New Furrows, Froude and Area History, Carbon our History Our Heritage, Footsteps Through The Years, The Land Between The Lakes, Riverside Heritage, On The Sunny Slope Of The Riding Mountains, Millennium Memories,

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