Thread by @Gurdur

In my last (6th) thread on the #history of polio, we saw how Carl Kling showed physiologically how some people could carry #polio totally asymptomatically, in 1911, five years before they tried useless counter-measures in the NYC epidemic.

https://twitter.com/Gurdur/status/1475550265235365894

2/n Karl Landsteiner, in 1908, Vienna, Austria, discovered the polio virus.
Carl Kling, in 1911, Sweden, showed polio could be asymptomatic, & carried asymptomatically, & showed the route of infection.
Much of the science needed existed, few took notice.

https://twitter.com/Gurdur/status/1475531239411097603

3/n Simon Flexner discovered, in 1911 too, but in NYC, the presence of polio antibodies in the blood of lab monkeys. It was another 30 years till his work was really built upon. Much of the science needed now existed, by 1912, but no-one in authority put the big picture together

4/n Buckle up, folks, the ride gets wild now. I've seen a really odd meme on Twitter, where people sincerely believe that polio vaccines were tested for safety for many years before mass implementation. It simply isn't true. In fact, polio vaccine development was *bumpy*.

5/n There were two separate attempts at the same time to make a polio vaccine. The researchers trying this were building on the work of Jenner, with his inoculation against smallpox, using cowpox. It's from his 1798 paper that we get the derived word 'vaccination'.

6/n Jenner used cowpox. Louis Pasteur took a different approach, w/ rabies viruses from rabbits, subjecting them to a series of levels of drying, so he'd a series of viruses at different stages of incapacitation. In 1885, he used his vaccine for the first time, on Joseph Meister

7/n Bluntly, there were zero safety trials with the 1st rabies vaccine. Louis Pasteur's first human subject for his new anti-rabies vaccine was a 9-year-old boy, Joseph Meister. Except, you know, the boy would have died of rabies if Pasteur hadn't. And Pasteur's vaccine *worked*

8/n Rabies has a 100% death rate. Get infected with rabies, unvaxxed, you DIE. Don't bore me with the 3 people who were saved by massive ICU treatment; they all had bad brain damage forever after. Even today, over 59,000 people die of rabies each year.
cdc.gov/media/releases…

9/n Joseph Meister's mother *begged* Pasteur to save her son after he had been bitten by a mad dog, a known death sentence. Pasteur did a series of totally 'experimental' injections with zero safety trials on the boy, he lived, for another 55 years.

https://twitter.com/Gurdur/status/1479180299967860738

10/n The life and eventual death of Joseph Meister:
historydaily.org/the-life-and-d…
via @LudgerWess

@LudgerWess 11/n It's good to understand that vaccination, using partially deactivated or killed viruses, is actually much, much older, except no-one ever standardized or understood it, & it was an amazingly risky business. Before Jenner & cowpox, there was variolation, using actual smallpox

12/n Practitioners of variolation would take pus or scrapings from a victim of acute smallpox, and (*sometimes*) dry it all out, expose it to sunlight a while, deactivating some of it. You hoped. Variolation had a high death toll, but then, smallpox had a much bigger death-toll

13/n George Washington *ordered* variolation, at the point of a gun 😋, for the entire Continental Army, 1776. Not a popular move; variolation had a high death rate. But if he hadn't done it, he quickly wouldn't have had an army. No variolation, no USA.
health.mil/News/Articles/…

14/n Ironically for all the US antivaxxers, had there been no vaccination, there would be no USA today.
___
In practical terms, variolation as done by a *skilled* practitioner amounted to vaccination. That it was often done by unskilled people made it a very hit-or-miss affair.

15/n The third vaccine to be deliberately made before the first polio vaccines was a vaccine against yellow-fever, developed by Max Theiler & Hugo Smith, in NYC. Y'all have no idea how much of a *terror* epidemic yellow-fever used to be in the States:
history.com/news/yellow-fe…

16/ Jenner used cowpox, i.e. cows & humans for his inoculations. Old-time variolationists used real smallpox, but if you were lucky, they made an attempt to weaken the smallpox virus sample first. Pasteur used rabbits for growing rabies viruses, then deactivated 'em thru drying

17/ Max Theiler & Hugo Smith used chicken-eggs to grow yellow-fever virus in, then deactivated the virus by passing it 200 times through eggs.
___
Except none of these approaches worked with the polio virus. Which made it all very awkward for the first polio vaccine attempts.

18/ The first two attempts at a #polio vaccine were done separately, using monkeys, by John Kolmer, after a bad polio epidemic in Philadelphia, 1932, & by Maurice Brodie. Kolmer used a ricin derivative to deactivate polio viruses; Brodie used formaldehyde.
Spoiler: it went south

19/ At first all went well. Kolmer gave 3 doses of his vaccine to over 10,000 children throughout the USA & Canada. Unfortunately, he didn't bother w/ a control group. Brodie vaccinated 7,000 children, w/ another 4,500 in a control group (i.e. no vaccine)

https://twitter.com/Gurdur/status/1479214747581141008

20/n Brodie reported that 5 out of his control group of 4,500 had contacted polio naturally, in the time allotted; but only 1 out of the 7,000 vaccinated had developed severe disease. Sounds great, right? Wrong.

21/ New (8th) thread:

https://twitter.com/Gurdur/status/1482790546108260361

@threadreaderapp unroll please