‘How polio has returned to haunt its victims in old age’, Daily Mail, 9 August 2011

From the Daily Mail, 9 August 2011 (story by Lois Rogers)

Valerie Brewster contracted polio at the age of eight — one of dozens of children affected by an outbreak at a municipal paddling pool in Leeds.

She had the classic symptoms of the disease — nausea, muscle stiffness and high fever. But a year later her school doctor told her she’d made a good recovery.

So when she developed muscle weakness at the age of 61 and had to walk with a stick, she had no idea it could have been linked to that childhood illness.

But in fact she was suffering from post-polio syndrome — a condition where the virus, which lies dormant in the bodies of polio sufferers for many years, becomes active and starts triggering symptoms.

Epidemics of polio swept through Britain’s schools and playgrounds for much of the 20th century, leaving many facing a slow death from paralysis or a lifetime marred by deformity.

Although by the mid-Sixties the disease was believed to have been wiped out by vaccination, the virus is returning to haunt the estimated 120,000 polio survivors living in the UK.

And, as with tuberculosis, there is also a renewed threat of polio as people travel to Britain from countries where it was never successfully eradicated.

Polio is caused by a virus which attacks nerve cells in the brain and spinal cord. It is spread via human faeces and leads to muscle weakness and painful spasms, followed by paralysis and sometimes death when the lungs are affected.

Post-polio syndrome is believed to affect at least eight out of ten of the survivors. Although the syndrome was first described by doctors in the Eighties, the scale of the problem is only just emerging, as more polio survivors live long enough to develop it.

Doctors are divided about whether this is the result of a sudden reactivation of the dormant virus in their bodies, or a consequence of abnormal re-growth of nerves damaged by the original infection.

Whatever the cause, the result is a cruel return of symptoms, meaning that many who battled the effects of withered limbs with leg irons and built-up shoes face the possibility of life in a wheelchair or, in the worst cases, reliance on ventilators to supply oxygen to damaged lungs.

‘It is a disaster for many of these people — a tragedy,’ says Carolyn Young, professor of neurology at The Walton Centre in Liverpool, who is leading the first research project on the syndrome, in more than 200 people aged 50 and over.

It is hoped to find out which treatment or medications might best reduce symptoms.

Polio has not been reported in Britain since the mid-Sixties, but there are a number of celebrity survivors, including actors Mia Farrow and Donald Sutherland, film director Francis Ford Coppola, celebrity academic David Starkey, and singers Judy Collins and Neil Young.

All are at risk from this re-emergence of symptoms, for which there is no recognisable trigger, no diagnostic test, and no cure.

Professor Young’s results are being presented at an international conference in Copenhagen this summer, which will discuss ways of helping the 700,000 people across Europe at risk from the syndrome.

Many doctors are too young to remember the polio outbreaks of the Sixties and do not put two and two together with their patients’ symptoms. Some think it down to ageing, or other conditions such as chronic fatigue syndrome.

Professor Young says: ‘It takes many years to get a diagnosis.

‘Our patients say GPs are completely unaware of its existence, and it is a sad fact that people who have a history of these kinds of symptom often do not get the same level of interest or attention if they complain of new ones.’

She believes post-polio syndrome is only now starting to emerge because polio victims, like the rest of the population, are surviving to greater ages — long enough for the ravaging effects of the virus to re-assert themselves.

When Valerie Brewster first contracted polio, she spent the whole of that year’s school summer holiday in bed with severe neck pain. The family doctor dismissed her as ‘lazy’ and insisted she had ‘summer flu’.

It was only after she had returned to school that a sharp-eyed school doctor noticed telltale signs of residual muscle weakness and fatigue. He concluded she had been an unnoticed victim among that year’s other cases.

Like many polio sufferers, Valerie received no specific treatment.

Only in the most severe cases were patients put into an ‘iron lung’ machine to aid breathing.

Pressure would be raised in the machine to force air into the victim’s semi-paralysed lungs, and then lowered so it would flow out again. It saved thousands of lives.

Now 67, Valerie who lives in Scarborough, North Yorkshire, with her retired fireman husband Colin, 71, says she remained chronically tired for the whole of the school autumn term, but a year later she was considered to have made a good recovery.

She left school at 16 and started work as a secretary. But although she married at 19 and had three children, she has experienced a variety of intermittent problems.

‘By the time I was 20, I started getting really bad back pain,’ she says.

‘Ten years went by and eventually I went to see an osteopath who said I had scoliosis — curvature of the spine — and one leg half-an-inch shorter than the other.

‘I was told I would need to walk with a stick, but there was never any mention of the after-effects of polio. It is like a silent disease in this country. No one thinks of it or talks about it.’

Six years ago new pain emerged in her legs, a result, she was told, of sciatica. It was only in 2009 that she happened to read a magazine article about the new diagnosis of post-polio syndrome.

‘It took me two or three weeks to pluck up the courage to ring the doctor, because I knew I would be told that these problems would get worse.’

She was finally diagnosed by a neurologist in Sheffield, who relayed the grim news that walking would become progressively harder. Ironing, cooking and other domestic chores are also difficult because of the muscle fatigue they cause.

Although physiotherapy or muscle-relaxing drugs may help people like Valerie, specialists are unsure about exactly what sort of treatment might work best.

The British Polio Fellowship, which supports the research project at the Walton Centre, is concerned that despite The World Health Organisation’s international vaccination programme, the disease has never been eradicated and continues to attack children in India, Nepal and Afghanistan.

It has also re-appeared in Nigeria because of malicious rumours that the Western-donated vaccine is harmful, while a renewed threat to Britain has emerged from our growing contact with Eastern Europe.

‘We can never be complacent about this, even with vaccination,’ says Professor Young.

‘We thought tuberculosis had been dealt with, but that has re-emerged in new treatment-resistant strains. That is why it is vital that we try to understand how this disease works and how we can treat its effects.’


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