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Did the introduction of the polio vaccine cause the massive rise in ME/CFS incidence in the 1980s?

Discussion in 'General ME/CFS Discussion' started by Hip, Apr 10, 2017.

  1. Hip

    Hip Senior Member

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    Before the introduction of the polio vaccine in the late 1950s, most children naturally caught poliovirus. Around 70% of poliovirus infections were completely asymptomatic and resulted in no long-term problems; but around 0.5% of infections caused paralysis, and out of that 0.5%, around 1 in 30 cases were fatal (ref: 1).

    Thus the introduction of the poliovirus vaccine undoubtedly saved numerous lives and prevented numerous disabilities. However, in spite of these considerable benefits, it is possible that poliovirus vaccine may also have a dark side, and may have inadvertently created some major health negatives.

    It has been suggested that natural infection from wild poliovirus conferred some cross-immunity against the ill effects of other enteroviruses such as coxsackievirus B and echovirus — two viruses linked to ME/CFS.

    But poliovirus vaccine may not confer the same cross-immunity as natural poliovirus infection, and so individuals who were vaccinated and never caught poliovirus as a child may have reduced immunity to coxsackievirus B and echovirus.

    Decades later in life, when those vaccinated individuals catch coxsackievirus B or echovirus, their immune system may thus have more trouble fending off these infections, and this conceivably could increase the chances of developing ME/CFS from the infection.

    So the introduction of the poliovirus vaccine in the late 1950s might potentially be the cause of the explosive international increase in the incidence of ME/CFS that appeared to occur some two decades later, in the 1980s.



    Prior infection with poliovirus most likely does provide immunological cross-protection against coxsackievirus B, as this paper from Estonia talks about the differences between Estonian children immunized with the live attenuated polio vaccine, versus Finnish children immunized with the inactivated polio vaccine.

    It was found that the Estonian children given the live vaccine have a stronger T-cell responses against coxsackievirus B4, which the authors suggest may explain why type 1 diabetes (linked to coxsackievirus B4) is 3 times lower in Estonia compared to its neighbor Finland.

    So even with the two types of polio vaccine, the live virus vaccine seems to ramp up T-cell immune responses against other enteroviruses like coxsackievirus B more than the inactivated virus vaccine does. Presumably then, natural wild poliovirus infections in childhood will provide even stronger T-cell responses against other enteroviruses later in life.



    It is a fascinating possibility that the introduction of the polio vaccine could have inadvertently led to a subsequent rise in the incidence of ME/CFS, because natural poliovirus infections in children were providing cross-immunity to the ME/CFS-triggering enteroviruses.

    To test this theory, it would be interesting to compare the prevalence of ME/CFS in individuals given the live attenuated polio vaccine (Sabin vaccine) as a child, versus the ME/CFS prevalence in those given the inactivated polio vaccine (Salk vaccine). That paper perhaps suggests that ME/CFS would be more prevalent among those give the inactivated polio vaccine.

    The Sabin live polio vaccine is given orally on a sugar cube; the Salk inactivated vaccine is given by injection.



    If it turned out to be true that the introduction of the polio vaccine has weakened our immunity to other enteroviruses, then this would only reinforce the need to develop a coxsackievirus B and echovirus vaccine with urgency, to be added to the vaccine schedule. More info about the rationale for this here: Coxsackievirus B vaccine appears feasible, and might conceivably abolish ME/CFS in future



    Some keywords useful for Google searching on this topic: cross-immunity | cross-protection | cross-reactivity | cross-neutralization
     
    Last edited: May 22, 2017
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  2. Mary

    Mary Senior Member

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    Very interesting @Hip. But, FWIW, I had the sugar cube Sabin live vaccine as a child and still had high Cocksackie B viral titers, as well as a couple of echoviruses.
     
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  3. lansbergen

    lansbergen Senior Member

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    Wild poliovirus did not disappear straight away when the vaccination program was started. .Anyway. I was exposed to the wild virus soon after I was vacinated.
     
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  4. CCC

    CCC Senior Member

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    It's an interesting thought.

    I could be annoying and point out that smallpox vaccinations dropped out at around the same time.

    That we had little ME/CFS pre-vaccination might have as much to do with the rise and rise of antibiotics at the same time, which allowed people to survive childhood who otherwise wouldn't have. A few on PR have noted this about themselves.
     
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  5. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    There was a discussion here three years ago about the polio vaccine giving rise to the ME/CFS epidemic in the 1980's: http://forums.phoenixrising.me/inde...been-ill-with-cfs-me-for-over-20-years.29818/

    More here: http://forums.phoenixrising.me/inde...me-for-over-20-years.29818/page-4#post-458478

    There may be a cluster of individuals vaccinated for polio in the late 1950's and early 1960's who later developed ME/CFS.

    http://www.wellwithin1.com/polio.htm
     
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  6. Hip

    Hip Senior Member

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    I am wondering whether this possible enterovirus cross-immunity obtained from wild poliovirus infection, and also perhaps to a lesser extent from the Sabin live attenuated polio vaccine, might have any therapeutic benefits in ME/CFS patients.

    Is the enterovirus cross-immunity only conferred to infants, or might adults given the live polio vaccine also acquire increased immunity against enteroviruses? If it works for adults too, then I wonder if live polio vaccine might be useful for stimulating the immune response against the chronic coxsackievirus B and echovirus infections often found in ME/CFS patients?

    There is some info on enterovirus cross-immunity in this paper:


    You are referring to the SV40 virus that contaminated the early batches of polio vaccine. SV40 though has not been linked to ME/CFS; it may have some link to cancer. And SV40 was already present in the human population prior to the introduction of the polio vaccine.
     
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  7. duncan

    duncan Senior Member

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    In hindsight, the 1980s was a watershed decade for festering disease spread. You had your ME/CFS, HIV, and Lyme - the trifecta in contemporary plagues.
     
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  8. lilpink

    lilpink Senior Member

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    I had the live 'sugar cube' vaccine also. I was aged 9/10 when I developed ME. I believe coxsackie B virus has played a role in my ME over time (though annoyingly notations of this in my GP records are missing ..I haven't checked my hospital records.). I was also given smallpox vaccine when I was 17 months old. I do ponder the effect of that vaccine at such a young age.
     
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  9. Snow Leopard

    Snow Leopard Hibernating

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    Anecdotal, but I became very very ill (acute flaccid paralysis) just a few weeks after the Sabin vaccine, though I had a Diptheria/Tetanus vaccine at the same time, so it is hard to know which was the trigger.

    These days. the Sabin vaccine is the only source of the Polio virus, (vaccine-derived Polio virus infection) in many countries. hence why there is a worldwide shift towards the Salk vaccine, since we want to cut the number of Polio infections down to zero, the live-attenuated vaccine is still a risk compared to the Salk vaccine that has similar efficacy (for preventing Polio).
     
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  10. user9876

    user9876 Senior Member

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    Could there simply be a counting issue. In the past people were diagnosed with post polio syndrome now get an ME diagnosis?
     
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  11. Chrisb

    Chrisb Senior Member

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    I like the sound of the theory, but must add myself to the list of those who took the sugar cube.

    I do have a vague memory of having a short illness after one vaccination, but am almost certain that was for smallpox.
     
  12. Chrisb

    Chrisb Senior Member

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    As an afterthought, if there were validity in the theory, might one expect those with a diagnosis of ME who received the Sabin vaccine to have presented with different aetiology and symptoms to those who received the Salk vaccine?

    Presumably the numbers starting with, say, EBV or CMV might remain fairly constant, with changes in the incidence due to changes in numbers with an enterovirus origin.
     
  13. arewenearlythereyet

    arewenearlythereyet Senior Member

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    I also had the sugar cube

    I wonder how robust the data is to draw these conclusions in terms of instances of me in the 1980s vs any other time period. This could be a factor of population dynamics, I.e the average age of onset vs changes in size of population. The post war baby boomer effect does have a big effect generally.

    The other thing to consider is accurate diagnosis generally. Perhaps the instances were just as high previously but remained undiagnosed. ( e.g smelling salts and the So called "hysterical women" that were ignored before the war) ......this might also be a factor? We do seem to have fairly loose diagnostic criteria even now. A lot has been swept under the carpet due to the suppression of women in the past.
     
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  14. Dufresne

    Dufresne almost there...

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    Byron Hyde suggested this hypothesis to me many years ago, more or less.
     
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  15. HowToEscape?

    HowToEscape? Senior Member

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    It could also be that 50 years back there was no name for this disease, and if you were unable to work either your family took care of you or you work yourself to death.

    We are vastly wealthier than we were a century ago, we expect medicine to fix things rather than just provide an official diagnostic label and some painkillers, and there are fewer people living with chronic, unfixable diseases, so the majority doesn't expect to join them.

    I believe the difference that the change in material wealth has made regarding how sickness is recorded and treated is huge. e.g. In 1917 it wasn't uncommon to be hungry, a 12 hour workday was normal for laborers, and somebody with a bit of brain fog or dizziness was likely to fall off a horse or otherwise expire. Such cases were not recorded as medical events, they were unremarkable, part of the noise of life.

    It's also possible that this disease has become more prevalent because of some modern phenomena searches exposure to a natural or artificial agent. But first we should look at the simplest explanation which is that when you don't have a name for something you don't look for it, and when you don't look for something you don't find it.
     
    Last edited: Apr 11, 2017
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  16. Hip

    Hip Senior Member

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    Would you have any links to that? I read about the possible beneficial effect of natural polio infection on an archived page of Dr Myhill's website; but presumably this idea has an older history, and someone must have originated it. Perhaps is was Byron Hyde's hypothesis?



    In individual cases, this is neither here nor there. You would have conduct a ME/CFS prevalence study on people who had the sugar cube oral live polio vaccine, and compare the ME/CFS prevalence in that group to people who had the inactivated polio vaccine by injection, to see if there might be any protective effect from the live vaccine, compared to the inactivated vaccine.

    In any case, any protective effect from the live vaccine might be much weaker than the possible protective effect of catching poliovirus naturally, which most children did catch before the introduction of the polio vaccines in the late 1950s.



    Dr John Richardson, a GP in the UK who had a very longstanding interest in enterovirus infection and ME/CFS, kept meticulous records of his patients that date back to 1954, and these records span 4 decades. With Richardson's keen eye and interest in these matters, he was certainly in a good position to observe any surge in the number of ME/CFS patients thoughout the period of 1950 to 2000.

    If you look at the graph in this post, taken from Dr Richardson book, you see that in the 1980s, the number of patients in his GPs surgery experiencing chronic ongoing organ pathology arising after viral infection shot up. So this might be viewed as further corroborating evidence of an explosion of ME/CFS cases in the 1980s.

    This increase in chronic organ pathology from viral infection may be a reflection of a weakened immune response — an immune system which is no longer able to keep regular viral infections fully in check.

    Perhaps once children were no longer being exposed to natural poliovirus infection and the immune boost it may provide, this resulted in the population as a whole becoming weaker in their immune response to viruses, leading to these cases of ongoing viral organ pathology.

    Dr John Richardson's figures for viral organ pathology in his patients are here:
    You can see that from the late 1970s onwards, there was a huge explosion in the number of patients with ongoing viral organ pathology .

    This data from Dr John Richardson's surgery is in addition to the several other sources that found an explosion of the number of new ME/CFS cases in the 1980s — sources detailed in the first post of the thread: Fivefold to eightfold increase in the incidence of ME from 1980 to 1989
     
    Last edited: Apr 11, 2017
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  17. Dufresne

    Dufresne almost there...

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    It was quickly mentioned in conversation in his office, and it was somewhat vague. The gist of it was the vaccine had spared us polio, but maybe left us with a greater incidence of ME. I have his old text at my parents' place and I'll try to remember to look up vaccinations in the index the next time I'm there.
     
  18. arewenearlythereyet

    arewenearlythereyet Senior Member

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    Just thought I would post this to illustrate my earlier point. It would be interesting if there was a control against population for this study so you could see the results per capita. It would also be interesting to see this mapped against average age of ME onset if that exists image.png
     
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  19. Hip

    Hip Senior Member

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    The post-war baby boomers will have increased the percentage of younger people in the populace in the 1980s, which conceivably might have an effect on ME/CFS incidence. However, if it were having an effect, the effect would be relatively small, because the birth rate graph shows around a 25% to 30% rise in birth rate in the baby boomer era (1946 to 1964), compared to the pre-war era in the 1930s.

    Whereas the apparent increase in incidence of ME/CFS in the 1980s is 5 to 8-fold, that is to say, a 500% to 800% increase in incidence. So the baby boomers could not really explain such a large increase in incidence.

    Also, I understand that this huge increase in ME/CFS incidence that began in the 1980s has been maintained in the subsequent decades. Whereas if this increased ME/CFS incidence were due to baby boomers (a two decade phenomenon from 1946 to 1964), you'd expect that increased incidence to drop off after a decade or two, which it didn't.

    So it does not look like the baby boomers could explain this increased ME/CFS incidence in the 1980s, although certainly it is the sort of thing that needs to be taken into account when looking at this data.
     
    Last edited: Apr 11, 2017
  20. halcyon

    halcyon Senior Member

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    @Hip you might find this paper interesting, I found it yesterday while musing about the subject of the thread. Not really sure how it might fit into the hypothesis here, but it was interesting regardless, particularly this part:
     
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