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Childhood Polio Infection May Cause
Chronic Fatigue Syndrome in Baby-Boomers
A childhood poliovirus infection may cause chronic fatigue in
baby-boomers concludes a paper published in the January, 11,
2000, issue of the American Journal of Physical Medicine and
Rehabilitation "Paralytic Versus 'Non-Paralytic' Polio: A
Distinction without a Difference," by Dr. Richard L. Bruno,
director of The Post-Polio Institute at New Jersey's Englewood
Hospital and Medical Center and chairperson of the International
Post-Polio Task Force.
Bruno reviewed the personal laboratory notebooks, publications
and private correspondence of Dr. Albert Sabin, developer of the
oral polio vaccine, regarding a 1947, Cincinnati, Ohio outbreak
of the "summer Grippe," a flu-like disease that affected more
than 10,000 children. Because Summer Grippe was associated with
a stiff neck – a hallmark symptom of polio – Sabin hospitalized
and studied a dozen children. "Sabin concluded that Summer
Grippe was caused by a mild form of the Type 2 poliovirus which
caused a flu-like illness even though it did not cause
paralysis," said Dr. Bruno. However, when Sabin infected monkeys
with poliovirus from the Summer Grippe children, spinal cord and
brain stem neurons were killed just as they would have been by a
paralytic poliovirus. "Both the Summer Grippe and paralytic
polioviruses damage the brain stem," Dr. Bruno continued. "Sabin
showed us that even a 'mild' poliovirus infection could cause
neuron damage that, although not apparent in terms of causing
polio-like symptoms, was very real."
However, Dr. Bruno reports that another "mild" poliovirus
outbreak did cause symptoms. In the very next year, 1948, over
1,000 Icelanders became ill with a flu-like illness causing
stiff neck, some muscle weakness, and fatigue. While many of
those with "Iceland Disease" recovered, some who became ill in
1948 still have fatigue today. "Iceland Disease was also
apparently caused by a relatively mild Type 2 poliovirus," said
Dr. Bruno, "but one that did more severe and therefore more
apparent damage to the brain stem – damage that caused chronic
fatigue." Fifteen years of research at The Post-Polio Institute
has found evidence of brain stem damage in polio survivors who
have fatigue associated with Post-Polio Syndrome, including
lesions on MRI of the brain, attention deficits on
neuropsychologic testing, reduced levels of brain activating
hormones, and brain wave slowing. "These abnormalities are
evidence of damage to the brain stem neurons that activate the
brain – the brain activating system that keeps the brain awake
and focuses attention – and they are identical to abnormalities
seen in patients with Chronic Fatigue Syndrome (CFS)," said Dr.
Bruno. "We believe that brain activating system damage causes
fatigue in both polio survivors and those with CFS."
Between 1934 and 1954, the year
the polio vaccine was developed, nine outbreaks of CFS occurred
either at the same time as polio epidemics or affected the staff
at polio hospitals. "In fact, the first CFS outbreak was in
1934, sickening the staff at the Los Angeles County polio
hospital," said Dr. Bruno. And, just as in Iceland, some who
became fatigued in L.A. in 1934 remained fatigued for decades.
"The symptoms of polio and CFS were so similar," said Dr. Bruno,
"that 48% of the patients in the CFS outbreaks between 1934 and
1954 were thought initially to have had non-paralytic polio."
Sabin's Summer Grippe, Iceland Disease and the long association
between polio and CFS have important implications for those
diagnosed with Post-Polio Syndrome and CFS today," according to
Bruno. Englewood Hospital and Medical Center's The Post-Polio
Institute treats many middle-aged adults with fatigue who had
non-paralytic polio as children. "Albert Sabin showed us that
even a mild poliovirus infection can damage the brain activating
system setting the stage for fatigue to develop later in life,"
said Dr. Bruno. The Post-Polio Institute's experience is
supported by the 1987 U.S. National Health Interview Survey
which found that 21\% of those who had had non-paralytic polio
report fatigue in mid-life. "The one million North Americans who
had non-paralytic polio must be assertive," said Bruno, "telling
their doctors that both paralytic and non-paralytic polio
survivors develop late-onset fatigue."
An epidemiological study by Dr.
Leonard Jason, published in the October 11, 1999, issue of the
Archives of Internal Medicine, found that half of the estimated
836,000 Americans with CFS are at least 40 years old. Jason
concluded that baby-boomers may be at greater risk for CFS.
"Potentially half of those diagnosed today with CFS may in fact
have had Summer Grippe or undiagnosed non-paralytic polio as
children in the years before the polio vaccine became
available," said Dr. Bruno. "They may also have brain activating
system damage that causes chronic fatigue."
"There is no question that neither the naturally-occurring
poliovirus nor the Sabin oral polio vaccine causes CFS today,"
said Dr. Bruno. "But the possibility of a non-paralytic
poliovirus infection in childhood causing chronic fatigue in
middle-aged baby-boomers is a reason for hope." The Post-Polio
Institute's research has found that conserving energy, daytime
rests breaks, stopping activities before fatigue starts, and a
higher-protein diet significantly reduce symptoms of fatigue."
The Post-Polio Institute,
Englewood Hospital and Medical Center. Contact Claudie Benjamin
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