No Polio in Amish
Dr. Sherri Tenpenny, DO
On October 14, 2004 the major media outlets shrieked a report of "the first outbreak of polio in the United States in 26 years," occurring in an Amish community in central Minnesota. The specter of hundreds of children in braces and iron lung machines lining the halls of hospitals immediately danced through the air, and directly into the minds of parents who have chosen to not vaccinate their children. More than a month later, phone calls and emails from concerned parents continue to pour in. The fears surrounding this "outbreak" need to be put to rest. First of all, there wasn't an "outbreak of polio." There was only the discovery of an inactivated polio virus in the stool of four children. The first confirmation was in a 7-month old Amish infant, presumably hospitalized, with severe immune deficiency. The "find" prompted screening of other children in the community; four children were confirmed positive. None experienced any type of paralysis.
Part of the panic can be blamed on inaccurate reporting. The virus that was identified was not "wild polio." It was a virus that is found only in the oral polio vaccine (OPV). Oral vaccine-strain viruses are inactivated with formaldehyde and are generally considered by the CDC "too weak" to cause disease. Even though the OPV is still used extensively in Third World countries, it has not been used in the United States since 2000. How did children in an isolated Amish community, with no exposure to foreigners, become exposed to vaccine-strain polio virus? That remains a mystery. The unasked question is why was finding this strain front-page news? My suspicion is that it was because it was an Amish child; a large number of the Amish choose to not vaccinate their children. A confirmation would serve a dual purpose: to make an "example" of the Amish and scare parents into believing polio still being "in circulation," when in fact, it is not.
A review of polio is important to alleviating the fears about the disease. Keep in mind that the last case of "wild type" polio virus in U.S was in 1979; the last case the Western Hemisphere was in the Peru, in 1991. Polioviruses are transient inhabitants of the gastrointestinal tract. Up to 95% of all polio infections are completely asymptomatic. Approximately 5% of polio infections consist of a minor, nonspecific illness consisting of an upper respiratory tract infection (sore throat and fever) and gastrointestinal disturbances (nausea, vomiting, abdominal pain, and diarrhea). This influenza-like illness, clinically indistinguishable from the myriad of other viral illnesses, is characterized by complete recovery in less than a week with resultant life time immunity. Less than 1% of all polio infections result in paralysis. Most importantly, the vast majority of individuals who contract paralytic poliomyelitis recover with complete-or near complete-return of muscle function. Any weakness that is still present 12 months after onset of paralysis is usually considered permanent.
The take home message from the "Amish outbreak" is this:
1. Polio is not a synonym for paralysis.
2. The presence of vaccine-strain polio identified in the stool of 4 asymptomatic children is not a "polio outbreak."
3. There have been no wild polio viruses identified in the Western hemisphere since 1991.
4. The WHO certified the Western hemisphere "polio free" in 1994.
For parents who choose not to vaccinate, assessing the risk of contracting polio, based on the facts of this so-called outbreak and the truth about the disease, needs to be put in perspective. Here are some things to think about:
- In 1997 alone, 112 children died from falls.
- In 1999, in Georgia alone, 53 children died in drowning accidents; 4 drowned at home in a bathtub.
- Would you stop bathing your children or prohibit swimming and playing due to these small risks?
- What is the real risk of contracting polio? Certainly, it is zero from this Amish "outbreak." The entire vaccine industry is based on fear. Learning the facts about polio will dissipate personal fears and so will putting the risks in perspective.