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Fifty years ago, children everywhere could once again play outside without worrying about ending up in a hospital, caged in an iron lung. The date was April 12, 1955, when the polio vaccine, developed by Pitt’s Jonas Salk and his team of researchers, was declared “safe, effective, and potent.”

The Anniversary of
Making Medical History

Meghan Holohan

Dr. Jonas Salk (Photo © Getty Images)

It was late one night at Charleroi-Monessen Hospital when the intern first noticed the young patient struggling to breathe. Alarmed, he called the boy’s family doctor, who said the problem was diphtheria. The doctor in training, Fred McAlpine, didn’t think so, because the boy had overall muscle weakness. McAlpine remembered reading about polio and wondered if that should be the diagnosis. Within a few hours, the child died, and McAlpine told the parents he suspected polio.

See a timeline of the polio vaccine’s development

A couple of weeks later, the boy’s sister became ill and her parents, remembering McAlpine’s concern, took her to Children’s Hospital in Pittsburgh. Doctors there confirmed that the young patient had polio and began treatment that saved her life

This first glimpse of polio for McAlpine occurred in 1952. It wasn’t his last. In 1955, McAlpine (MED ’54), who had become a navy physician, started a civilian residency in anesthesiology at Massachusetts General Hospital, just as the polio epidemic hit Boston. All elective surgery was canceled so that the hospital staff could treat polio patients.

Dozens and dozens of iron lungs lined the wards. McAlpine’s ward treated mostly teenagers. The whirring was constant, making the ward sound more like a textile factory than a hospital. Heads stuck out of the long, metal tubes. The patients, wrapped in iron, could only look at the ceiling or at themselves through mirrors that were attached to their machines. Apart from a slew of physicians and nurses, these polio patients had little contact with the outside world. They weren’t able to breathe on their own, so the iron lungs kept them alive by alternating positive then negative pressure on their lungs, simulating breathing.

Regularly, they needed to be washed and given clean bedding, so they had to be pulled out of their machines. McAlpine and other physicians would then “manually” breathe for each patient, squeezing a bag that forced air into the patient’s lungs, while nurses attended to the teens and their machines.

The epidemic required the mobilization of healthcare workers, and volunteers came from across the nation. But McAlpine still had to work 16-hour shifts or longer.

No wonder. Between 1950 and 1954, an average of nearly 39,000 cases of polio were diagnosed yearly among Americans, according to the U.S. Public Health Service. Some died, and those who lived were often left paralyzed or required lifelong medical support.

Polio was an enigma. Polio was indiscriminate. Polio infected anyone. Maybe one night a mother put her baby to bed, and the next day the baby couldn’t move, couldn’t breathe. Maybe it happened like it did to Bill Kirkpatrick. He was a sophomore hoping to play high school football. After running laps one evening to get in better shape, he felt an overwhelming sense of exhaustion. When he fell asleep, he was feverish. The next morning, he couldn’t move. But that didn’t stop the pain. Pain that crawled up his spine. Pain so intense it felt like his spine would shatter. Soon he was in Oakland Municipal Hospital, which was becoming a polio treatment hospital.

Youngner, center, received an honorary Doctor of Public Service degree during February’s Honors Convocation. Provost James V. Maher, right, helped bestow the academic hood, while Youngner shakes hands with Chancellor Mark A. Nordenberg.

Municipal Hospital housed more than iron lungs. It was where Jonas Salk and Julius Youngner labored over what would become one of the most important scientific developments of the 20th century. (The University of Pittsburgh has just hosted a 50th anniversary celebration to commemorate the landmark breakthrough.)

After a few weeks in Municipal, Kirkpatrick was sent to the D.T. Watson Home for Crippled Children to start his yearlong rehabilitation.

Sure, parents forced their children to stay away from the cool waters of public pools during the hot polio summers. Stay away from the puddles, too, parents warned. And many children couldn’t go to the movie theaters—maybe that’s where polio was spread.

As soon as a child got queasy, the panic started. This could be it. This could be polio. It was just as bad if there was joint pain. Muscle soreness—that, too, could be polio.

Every June, the newspapers would start running the polio count, says David Oshinsky, a historian at the University of Texas at Austin, who says he is motivated to write about events that affected his generation. Then there were the pictures of children in iron lungs. It was the pictures, the visual aspect of this disease, that caused such fear in every parent in the United States, Oshinsky explains. Everyone knew who the polio patients were—they were in iron lungs, they were wearing leg braces, they were in wheelchairs. Oshinsky’s book, Polio: An American Story, has just been published by Oxford University Press. The book chronicles the search for the polio vaccine. Oshinsky remembers rolling up his sleeve as a child and receiving the polio shot for the first time. He remembers the long line, the large number of volunteers trying to organize all the kids.

The story of finding a vaccine for polio means many things in scientific history. The search for the polio vaccine elevated a young, unknown researcher, Jonas Salk. And it helped the University become a leader in biomedical science, with support from the Pittsburgh community. The polio vaccine also showed how the pharmaceutical industry mobilized to mass-produce a vaccine and prevent a terrifying disease. And a whole country banded together to donate dimes to the March of Dimes to fund this research, showing what large-scale medical funding can accomplish.

Salk came to the University of Pittsburgh in 1947. Previously, he was a researcher at the University of Michigan, where he worked on developing an influenza vaccine. He continued his research here with another faculty member, Julius Youngner, who became the second in command in Salk’s lab. At 28, Youngner was an experienced researcher who had worked as a scientist with the Manhattan Project while in the army during World War II. Following his service in the armed forces, he worked at the National Cancer Institute. In 1949, he arrived at Pitt to do cell culture research with viruses and soon was working in Salk’s lab, with its focus on polio. More than 50 years later, Youngner is still at the University as a distinguished service professor emeritus of molecular genetics and biochemistry in the School of Medicine. He continues to investigate new approaches and more effective vaccines against various flu strains.

Shortly after Salk came to the medical school, the March of Dimes offered him a research opportunity—typing strains of polio. This tedious work, essential for developing a polio vaccine, wouldn’t normally be something a well-established researcher would bother doing. But Salk knew that characterizing the number of strains of polio would be key to developing the vaccine.

Salk took the money from the March of Dimes and invested it in hiring dozens of talented young researchers. In 1948, not long after 34-year-old Salk first came to the University, John Enders of Harvard discovered how to grow polio on non-nerve tissue in a test tube. Meanwhile, Salk and his team identified that there were three stains of the disease-producing virus, and they were also cultivating the virus at a faster rate than other research groups. Youngner figured out a way to kill the virus with formaldehyde, which increased the production of antibodies against the disease. “There was always big excitement,” Youngner says. “We were excited because we were getting closer and closer [to a vaccine].”

The two men worked every day in the basement of Municipal Hospital, now Salk Hall and home to the Schools of Pharmacy and Dental Medicine. Throughout the years, Municipal was an infectious diseases hospital, and the third floor was home to the metal beasts, the iron lungs. Seeing the long cylinders, with children’s heads sticking out, gave Youngner and the others in Salk’s lab a greater sense of urgency for developing a polio vaccine.

In the polio research community, most people doubted that any killed virus would work. Salk, though, believed it would, especially because he helped develop an effective killed-virus flu vaccine for the army.

While Youngner was in the lab, Salk was in the public arena, fighting the establishment, championing the killed- virus vaccine. Alfred Sabin, a physician in Cincinnati, argued loudest that this kind of vaccine could never work. Sabin always felt that Salk was too young, too inexperienced. Sabin thought that the job of typing polio was perfect for Salk.

But Salk’s lab already had a first batch of the vaccine. In the days before institutional review boards, or IRBs, which now closely monitor all research involving human subjects, the researchers were unsure of how best to test the potential vaccine.

“We had done enough testing in monkeys,” Youngner says, sitting in front of his office window that looks over upper campus in Oakland, right across the street from where his lab was in Municipal. “We could protect the monkeys.”

After the vaccine’s animal testing, Salk and his team believed it was safe for humans. Salk drew the vaccine into hypodermic needles, injecting himself, his family, his lab staff, and many of their family members.

There are various accounts of who was vaccinated. Youngner says with conviction that the lab staff was vaccinated, too. It wasn’t just the Salk family that made the sacrifice. Later, all the lab staff tested their blood to see whether there were polio antibodies. There were, just as Salk and his team expected.

Bill Kirkpatrick was in the D.T. Watson Home when Salk took the vaccine there to test it on patients who already had polio. Kirkpatrick was the first person outside of the lab to receive the vaccine. These tests revealed that the vaccine produced antibodies against all three of the infectious polio strains.

A larger field trial, with more than 1.8 million children, followed the Pittsburgh trial. “The field trial was one of the biggest of its kind,” Youngner says.

The development of the polio vaccine is “important to remember, because it became our scientific future,” says Margaret McDonald, associate vice chancellor for academic affairs in the health sciences at the University. She planned the 50th anniversary celebration of the polio vaccine held this spring.

“Polio was absolutely feared and dreaded; children were kept in their houses during the summer polio season as this was so feared,” McDonald says. “Pittsburghers were the real pioneers, because a sample of Pittsburghers received the vaccine before any other trials took place. It’s a proud moment in the city and the region’s history. And it changed the course of biomedical science.”

The polio vaccine showed how funding, in this case through the March of Dimes nationally and the Sarah Mellon Scaife Foundation regionally, enriched biomedical research, making cures more feasible. McDonald also notes that the pharmaceutical industry mass-produced the vaccine, showing what is possible with such mobilization.

Speakers at the anniversary celebration included Pitt’s Youngner; Charles Rinaldo, a professor of pathology and assistant director of the clinical virology lab; and Tara O’Toole, chief executive officer and director of the Center for Biosecurity of the University of Pittsburgh Medical Center. Representatives from the Salk family and the Centers for Disease Control and Prevention talked about vaccines internationally. Sebastiao Salgado’s photographs of the international efforts to eradicate polio from the few nations still suffering from the disease were exhibited at the Carnegie Museum in Oakland.

Chancellor Mark A. Nordenberg gives some perspective on the medical breakthrough. In dedicating the Salk vaccine display in the School of Pharmacy, he noted that the Association of American Universities, as part of its centennial events, prepared “a public salute” promoting the value of university research during the last century—it began with three examples: the computer revolution, U.S. space exploration, and the Salk polio vaccine.

“Think about it,” remarked Chancellor Nordenberg. “The third, the development of the Salk polio vaccine, essentially occurred here—in Pittsburgh and in this building, which appropriately bears Dr. Salk’s name.”

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