Poliomyelitis is a disease whose incidence steadily increased during the second half of the twentieth century on both sides of the Atlantic. If in the United States the epidemics which afflicted young children each summer became a major public health issue, in France, polio was considered less pressing than other diseases. This article, based on original archives from the Pasteur and Mérieux institutes, analyses the polio control strategies and policies implemented by France from the mid-1950s to the end of the 1960s. The article examines the role of two key actors and institutions that mobilised the French health authorities against the disease: Pierre Lépine and the Institut Pasteur as well as Charles Mérieux and the Institut Mérieux. Lépine developed an effective injected polio vaccine which was first used before being supplemented with the oral polio vaccine. If the two main protagonists and their institutions worked together, they each implemented different actions and manoeuvres, at different times with the aim to raise awareness of the fight against the disease. The national and international relations of the key French actors were decisive in the development and production of the polio vaccines and their application. This work contributes to understanding processes of polio vaccines choice at the level of national institutions and analyses the political and scientific networks built in support of polio vaccination, to finally move towards compulsory vaccination. Ultimately, this study describes the historical processes by which this disease became conflated with a biotechnology of collective protection in France.

Polio cases due to wild virus are reported by only three countries in the world. Poliovirus type 2 has been globally eradicated and the last detection of poliovirus type 3 dates to November 2012. Poliovirus type 1 remains the only circulating wild strain; between January and September 2016 it caused 26 cases (nine in Afghanistan, 14 in Pakistan, three in Nigeria). The use of oral polio vaccine (OPV) has been the key to success in the eradication effort. However, paradoxically, moving towards global polio eradication, the burden caused by vaccine-derived polioviruses (VDPVs) becomes increasingly important. In this paper circulation of both wild virus and VDPVs is reviewed and implications for the polio eradication endgame are discussed. Between April and May 2016 OPV2 cessation has been implemented globally, in a coordinated switch from trivalent OPV to bivalent OPV. In order to decrease the risk for cVDPV2 re-emergence inactivated polio vaccine (IPV) has been introduced in the routine vaccine schedule of all countries. The likelihood of re-emergence of cVDPVs should markedly decrease with time after OPV cessation, but silent circulation of polioviruses cannot be ruled out even a long time after cessation. For this reason, immunity levels against polioviruses should be kept as high as possible in the population by the use of IPV, and both clinical and environmental surveillance should be maintained at a high level.

Objective: To evaluate the measurement structure of the Taiwanese Version of the Job Satisfaction of Persons with Disabilities Scale (JSPDS). Design: A quantitative descriptive research design using exploratory factor analysis (EFA). Participants: One hundred and thirty-two gainfully employed individuals from Taiwan with poliomyelitis participated in this study. Results: EFA result indicated a three-factor structure accounting for 54.1 per cent of the total variance. The internal consistency reliability coefficients for the integrated work environment, job quality, and alienation factors were 0.91, 0.77, and 0.59, respectively. Only the integrated work environment and job quality factors showed positive correlations with life satisfaction. People with higher educational attainment also reported higher levels of job satisfaction than people with lower educational attainment. Conclusion: The three-factor measurement structure of the JSPDS appears to be parsimonious, psychologically meaningful, and interpretable, and can be used to improve the comprehensiveness of vocational rehabilitation outcome evaluation.

Recent polio outbreaks in Syria and Ukraine, and isolation of poliovirus from asymptomatic carriers in Israel have raised concerns that polio might endanger Europe. We devised a model to calculate the time needed to detect the first case should the disease be imported into Europe, taking the effect of vaccine coverage – both from inactivated and oral polio vaccines, also considering their differences – on the length of silent transmission into account by deriving an ‘effective’ case/infection ratio that is applicable for vaccinated populations. Using vaccine coverage data and the newly developed model, the relationship between this ratio and vaccine coverage is derived theoretically and is also numerically determined for European countries. This shows that unnoticed transmission is longer for countries with higher vaccine coverage and a higher proportion of IPV-vaccinated individuals among those vaccinated. Assuming borderline transmission (R = 1·1), the expected time to detect the first case is between 326 days and 512 days in different countries, with the number of infected individuals between 235 and 1439. Imperfect surveillance further increases these numbers, especially the number of infected until detection. While longer silent transmission does not increase the number of clinical diseases, it can make the application of traditional outbreak response methods more complicated, among others.

The abrupt transition to heightened poliomyelitis epidemicity in England and Wales, 1947–1957, was associated with a profound change in the spatial dynamics of the disease. Drawing on the complete record of poliomyelitis notifications in England and Wales, we use a robust method of spatial epidemiological analysis (swash-backwash model) to evaluate the geographical rate of disease propagation in successive poliomyelitis seasons, 1940–1964. Comparisons with earlier and later time periods show that the period of heightened poliomyelitis epidemicity corresponded with a sudden and pronounced increase in the spatial rate of disease propagation. This change was observed for both urban and rural areas and points to an abrupt enhancement in the propensity for the geographical spread of polioviruses. Competing theories of the epidemic emergence of poliomyelitis in England and Wales should be assessed in the light of this evidence.

Poliomyelitis is a paralytic disease of the motor neurones of the central nervous system, which is caused by poliovirus. The virus is transmitted by the faecal–oral route, and if virus replication is confined to the gut, it is harmless. Poliomyelitis is an ancient human disease, but was rare until the beginning of the 20th century, when children began to be exposed to the virus at older ages and were, therefore, no longer protected by maternal antibody, which had already been lost. Inactivated polio vaccines are increasingly being used in those countries in which poliomyelitis has been brought under control; however, live vaccines are still the most widely used types and the World Health Organization (WHO) have set the goal of using such vaccines to eliminate the wild-type virus throughout the world by the year 2000. Substantial progress has been made to this end; however, the strains of poliovirus that are used as vaccines are able to adapt rapidly to the human gut, losing their attenuated (weakened) character within a few weeks. Currently, there is urgent debate about the best method of stopping vaccination against poliomyelitis once the wild-type poliovirus has been eliminated completely, so that the vaccine-strain virus will also be eliminated. Proposed strategies include the abrupt cessation of vaccination with the live virus worldwide, followed by the optional use of inactivated vaccines for an appropriate period. Further information about both the epidemiology and the pathogenesis of the disease is required before an informed choice can be made. The topics covered in this article include a brief history of studies of the disease, its pathogenesis and its control by vaccination, the molecular biology of the live vaccines, which have been extremely successful in controlling poliomyelitis so far, and the concerns that are raised as the eradication of the wild-type virus approaches.

The temporal bones of a 26-month-old white female with a paralytic syndrome clinically and pathologically identical to poliomyelitis were examined. The aetiological agent was unknown although a non-poliomyelitis enterovirus infection seemed likely.

There was a complete absence of the cochlear neurons and substantially reduced peripheral and central axons with loss of some inner hair cells but preservation of outer hair cells. Scarpa’s ganglion, and the geniculate ganglion were partially atrophied. The saccule and utricle were mildely dilated and Reissner’s membrane of the apical turn was bulging.

In two previous audiological studies a 10-20 dB bilateral sensorineural hearing loss was found in poliomyelitis patients and a neuronal lesion was postulated which is now supported by our findings. This is a rare example of an almost pure neural hearing loss.