New Polio

In the summers of 1934 and 1935, more than 300 women nurses in Los Angeles County Hospital fell ill with a mysterious, hideously painful disease.* A few more became ill in 1936 and 1937. The disease was first diagnosed as poliomyelitis (infantile paralysis). It was not. The Los Angeles press howled. Doctors were accused of incompetence, hospital officials of carelessness. Grand juries investigated. The county shouldered the bill for the care of the victims, which has now reached about $1,000,000. One newspaper charged that there was nothing really the matter with the patients except "weak muscles."

Meanwhile a committee of doctors appointed by county authorities undertook to study the epidemic. Last week the committee submitted its report, written by Neurologist Edmund Thorwald Remmen. The report was, in effect, a description of a new disease, at least of one never previously reported in medical literature. It is called polio-encephalitis.

Poliomyelitis is transmitted by a virus. Polio-encephalitis appears to be caused by a streptococcus. Dr. Edward Carl Rose-now of the Mayo Foundation cultured streptococci from inflamed muscles, injected the culture into monkeys, reproduced the disease in them. In infantile paralysis, the affected muscles are withered and flaccid; in polio-encephalitis they are not--but they are so acutely inflamed and painful that spasms often occur and any movement is impossible. Furthermore, the seat of infantile paralysis is in the spinal cord, whereas the seat of polio-encephalitis is in the brain.

Very few of the polio-encephalitis victims died. Some were only mildly and briefly affected, returned to work. Others were desperately ill and still are. Still others, after apparently getting well, suffered sudden relapses, as though a built-up immunity had succumbed to a fresh onslaught of the disease.

The typical polio-encephalitis victim had blinding, excruciating headaches, accompanied by nausea and vomiting so severe that artificial feeding was sometimes necessary. About ten patients suffered bladder paralysis, necessitating the constant and painful use of catheters. Two developed arthritis. Many women had sharp abdominal pains, due to attacks by the germ on the ovaries. Such a diseased ovary, when exposed for surgical treatment, looked "like a sac of pale blue cellophane stuffed with tapioca pudding." The ovaries of a few patients were entirely destroyed and typical menopause symptoms followed. Endocrine disturbances snowed themselves in increased obesity and growth of body hair.

Most of the patients were hypersensitive to light, noise and excitement, emotionally unstable, restless and irritable. One nurse, during an attack of headache, changed hospitals three times in three days, finally came back to the first.

In the face of this new mystery, doctors tried every kind of treatment that offered faint promise. None was wholly satisfactory. Blood transfusions were the most beneficial, but failed in some cases. Vaccines made from the streptococcus and sera from the blood of recovered victims and inoculated monkeys helped only a few mildly affected patients.

The committee of doctors concluded last week's report by recommending that they be authorized to continue to keep tabs on polio-encephalitis and its remaining victims.

* About ten male nurses, doctors and internes were stricken, but their cases were less serious than those of the women.

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