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

Hip

Senior Member
Messages
17,824
Very interesting @halcyon.

In a similar vein, I came across this study, which examines the link between coxsackievirus B and beta-cell autoimmunity (a first step to type 1 diabetes). Testing positive for coxsackievirus B1 was found to be associated with an increased risk of beta-cell autoimmunity.

But interestingly, testing positive for coxsackieviruses B3 or B6 was associated with a reduced risk of beta-cell autoimmunity, which the authors suggested was the result of CVB3 and CVB6 providing immunological cross-protection against the ill effects of CVB1.

I found that paper very interesting, because it occurred to me that this might help explain why some people develop ME/CFS after catching a coxsackievirus B infection, but others who catch the same virus do not get ME/CFS. One reason might be because some people have prior coxsackievirus B infections in their body which provide cross-protection against the ME/CFS-triggering coxsackievirus.



I am also wondering whether in cases of virally-triggered ME/CFS spontaneously going into remission after several years, could that remission in fact be caused by the patient catching another virus which provides cross-immunity that targets the both the first and second virus?

So let's say for example that someone's ME/CFS is caused by a chronic smoldering coxsackievirus B3 infection, which their immune system cannot clear. But then by chance, several years later, that ME/CFS patient catches coxsackievirus B6, and this new virus induces a cross-protective immune response, which serves to fight off both the new CVB6 virus and the original CVB3, thereby curing their ME/CFS.

It's always something of a mystery how ME/CFS can sometimes spontaneously clear up, but I wonder if a scenario like this might potentially explain it.
 

barbc56

Senior Member
Messages
3,657
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 I read about the possible beneficial effect of natural polio infection on an archived page of Dr Myhill's website; but presumably this idea has an older history, and someone must have originated it

You have got to be kidding! She should lose her license over saying such unscientific speculation. Oh wait...... :D

Is this still on her website? If I lived in England, I would definitely report this.

Tell this to all the kids who died or ended up paralyzed, I barely remember this era but people were scared and a lot of people had their lives ruined by polio.

I vaguely remember that time. I remember my sister and I had to rest every day. We weren't allowed to go to the community swimming pool. I remember all the pictures of kids in iron lungs. Actually, that may have been later.

Look at the countries where polio has been eradicated.

ME has been around for centuries. They didn't know what me/cfs was. Therefore it wasn't diagnosed as such.

In my opinion, I see nothing herr but spurious correlations, misuse of statistics and conspiracy theories. Certainly not critical thinking.

I am going to have to leave this thread beforeI I say something I regret. Or start crying . I don't even know why I started reading it.

Edit. I see this was seen on an archive page. I wonder if Myhill took it down herself or was ordered to by the court.
 
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Hip

Senior Member
Messages
17,824
@barbc56, your post is incoherent and a non sequitur. "Tell this to all the kids who died or ended up paralyzed" you say? Tell me what has that got to do with the speculation that poliovirus infection may confer cross-protection to other enteroviruses?
 
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Chrisb

Senior Member
Messages
1,051
Given the often reported hypothesis from the Iceland cases that, as I recall, the area in which the ME epidemic occurred avoided the effects of a later polio epidemic, the question raised by the thread is entirely valid.

I think it might help to change the language of "the possible beneficial effect of natural polio infection". It is possible to misinterpret it in its current form.
 

SamanthaJ

Senior Member
Messages
219
I think it might help to change the language of "the possible beneficial effect of natural polio infection". It is possible to misinterpret it in its current form.
As a relative of a disabled polio survivor, I heartily agree. I mean, I do understand the theories being discussed, and I'm hoping no one intends to trivialise polio.
 
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Hip

Senior Member
Messages
17,824
As a relative of a disabled polio survivor, I heartily agree. I mean, I do understand the theories being discussed, and I'm hoping no one intends to trivialise polio.

That is certainly not the intention, and that's why the very first sentence of this thread details how many children were killed by polio before widespread polio vaccination — to make it clear what a menace poliomyelitis used to be.

The introduction of the poliovirus vaccine was undoubtedly a good move, as it has pretty much eliminated poliomyelitis as a disease in countries where this vaccination is given.

However, if there is this inadvertent adverse effect from the polio vaccination program, that in the absence of wild poliovirus allows other enteroviruses greater scope to cause disease (diseases such as ME/CFS and type 1 diabetes), then this adverse effect should be investigated.

If this adverse effect does exist, the solution would be not to discontinue poliovirus immunization, but rather to introduce new immunizations that cover a wider range of disease-causing enteroviruses, enteroviruses like coxsackievirus B and echovirus.
 
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Chrisb

Senior Member
Messages
1,051
There is an interesting statistic in the paper to which @halcyon provided a link that the ratio of symptomless carriers to clinical cases is 140 to 1 for Polio 1 and higher for Polio 3.

This might indicate the extent of the protection possibly afforded by the virus.

If the rates were similar and it took 140 cases of virus x to produce one case of ME it is not surprising that there might be difficulty in identifying it.
 

msf

Senior Member
Messages
3,650
Prior to the introduction of the polio vaccine in the late 1950s, most children caught poliovirus, with 70% of infections being asymptomatic (but with 0.5% of infections resulting in paralysis, and out of that 0.5%, around 1 in 30 cases were fatal). Ref: 1

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.

However, polio vaccine may not confer the same cross-immunity as natural poliovirus infection, and so individuals who were vaccinated and never had a natural poliovirus infection 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 this infection, 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.


Surely to make this theory sound credible you would need to show that the incidence of enterovirus infection is much higher for people in their thirties/forties? Do you know of any such evidence? Why wouldn´t it have affected the population straightaway?
 

msf

Senior Member
Messages
3,650
Also, isn´t the increased incidence of ME in the 80s likely to be an artifact of the increased awareness of ME after the outbreaks of that decade (it´s difficult to see how these could be put down to polio vaccines twenty years earlier)?
 

Hip

Senior Member
Messages
17,824
Surely to make this theory sound credible you would need to show that the incidence of enterovirus infection is much higher for people in their thirties/forties? Do you know of any such evidence? Why wouldn´t it have affected the population straightaway?

I have never been able to find any data about the typical age that coxsackievirus B and echovirus are contracted, although for other viruses, data is available. For example, we know that 80% of people pick up HHV-6 before the age of 2 years old; whereas Epstein-Barr virus is typically picked up in childhood or the teenage years (most people will have caught it by 20); and cytomegalovirus tends to be contracted at any stage in life (but the older you are, the more likely you are to have it).

But I am not sure about when enterovirus is typically contracted.

However, the "two age peaks" study on ME/CFS incidence is very informative in this instance, as this study gives a graph of the number of people who develop ME/CFS at each particular age. This graph is shown below:

Number of people who develop ME/CFS at each particular age
12916_2014_167_Fig1_HTML.jpg

Source: here.​

As you can see from that graph, there are two peaks in the incidence of ME/CFS, the first peak at around 15 years old, and the second peak at around 35 years old. Note also that there are few ME/CFS cases before 10 years old, so ME/CFS is not really a disease of childhood.

Although the study does not indicate which viruses were involved, my hunch is that the first peak at 15 years old might involve relatively more cases of Epstein-Barr virus-triggered ME/CFS, as EBV is typically picked up in childhood or the teenage years; and the second peak might involve relatively more cases of enterovirus-triggered ME/CFS.

So we can deduce from that graph that if the newly introduced polio vaccine given in infancy were increasing the risk of ME/CFS, the increased numbers of patients with ME/CFS would not appear until at least around 15 years later, which is the first peak on the graph.
 
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Hip

Senior Member
Messages
17,824
Also, isn´t the increased incidence of ME in the 80s likely to be an artifact of the increased awareness of ME after the outbreaks of that decade (it´s difficult to see how these could be put down to polio vaccines twenty years earlier)?

That is almost making ME/CFS seem psychogenic, as if reading a few articles in the newspapers about ME/CFS could suddenly create a whole wave of people bedbound with this illness.

In any case, the 1984 Incline Village ME/CFS outbreak was in the US, and would not really have featured in the UK media, but the data shows a simultaneous 5- to 8-fold increases in ME/CFS incidence in the UK, Canada and the US in the 1980s.

Also, if this idea of media influence were correct, then the famous 1955 outbreak at the Royal Free Hospital in London would have also led to a big increase in ME/CFS incidence in the UK, but there were no such increases in the 1950s or 1960s.
 

msf

Senior Member
Messages
3,650
Hmm, I guess I should have explained what I meant by that. I meant that the outbreaks probably contributed towards doctors diagnosing people with ME more often, when before they might have been just as ill but not have received any diagnosis.

Re: your second point, that presumes that the media covered all outbreaks in the same way, and that doctors would have reacted to the media coverage in the same way - somehow I think epidemics are covered in a somewhat different way today than they were, say, 50 years ago.

Anyway, as I said, the real stumbling block with your theory is that we do not know when people are usually infected by enterovirus. Given it is similar to polio, why wouldn´t people get it early on? I looked at a couple of reports of Enterovirus 71 infection in Asia and it seemed to mainly be affecting children.
 

Jan

Senior Member
Messages
458
Location
Devon UK
Betty (Elizabeth) Dowsett (microbiologist) wrote on this subject, her theory was that 'nature abhors a vacuum', the vacuum left after introduction of the polio vaccine.

I've had a quick search, but I can't find anything online regarding this. I have a typed copy somewhere where Betty discusses this I will try to find it when I have the energy.
 

Chrisb

Senior Member
Messages
1,051
@Jan Is this what you had in mind?http://www.poliosurvivorsnetwork.org.uk/archive/lincolnshire/library/dowsett/lateeffectsme.html
THE LATE EFFECTS OF ME
Can they be distinguished from the Post-polio syndrome?

Dr. E.G. Dowsett MBChB, Dip Bact.
Honorary Consultant Microbiologist
Basildon and Thurrock Hospitals NHS Trust.
Originally a Presentation to the All Party Group of MPs on ME/PPS on 31st January 2001.
This Lincolnshire Post-Polio Library Publication February 2001.

EDIT It probably isn't. Have looked through it again and cannot see the reference. It does however give much useful background information for the topic under discussion.
 
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Hip

Senior Member
Messages
17,824
Anyway, as I said, the real stumbling block with your theory is that we do not know when people are usually infected by enterovirus. Given it is similar to polio, why wouldn´t people get it early on? I looked at a couple of reports of Enterovirus 71 infection in Asia and it seemed to mainly be affecting children.

I don't myself see this as a stumbling block in the theory. The above ME/CFS incidence by age graph sidesteps this issue, because it tells you the ages that people typically get ME/CFS (and ME/CFS is usually triggered by viral infection).

The enteroviruses coxsackievirus B and echovirus have been linked to ME/CFS in numerous studies, and researchers like Dr John Chia believe that these enteroviruses are the major cause of ME/CFS (Dr Chia's letter suggests that enterovirus may be the cause of ME/CFS in around 55% of cases). So one might expect that the bulk of ME/CFS cases in that incidence by age graph are triggered by enterovirus. Thus following Chia's views, that graph indirectly tells you the ages that people typically catch the ME/CFS-associated enterovirus.



We can also approach this from another angle, this consideration of the age when ME/CFS-associated enteroviruses are typically caught:

Although I don't know any published data about the age coxsackievirus B or echovirus are picked up, we can deduce just from the enteroviral test results of patients on this forum that these enteroviruses are in general not picked up early in life, and may be typically be picked up in adulthood.

The test results of patients on this forum typically show that out of the six coxsackievirus B serotypes and the five echovirus serotypes that are detected by the neutralization tests at ARUP lab (one of the only labs in the US capable of detecting chronic enterovirus infections), most ME/CFS adult patients on this forum are usually only seropositive for perhaps one or two, maybe three of these 14 enterovirus infections detected by ARUP lab.

Thus most adults (even adults with ME/CFS) have never caught the majority of this group of enteroviruses. Therefore we know that most of these viruses are not caught early in life, because if they were caught early in life (like HHV-6 and EBV are), then most adults would be seropositive for most of these enteroviruses, which is not the case.
 
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JohnCB

Immoderate
Messages
351
Location
England
Betty (Elizabeth) Dowsett (microbiologist) wrote on this subject, her theory was that 'nature abhors a vacuum', the vacuum left after introduction of the polio vaccine.

I've had a quick search, but I can't find anything online regarding this. I have a typed copy somewhere where Betty discusses this I will try to find it when I have the energy.

I attended a talk by Dr Dowsett in 2002 and I recall her presenting this idea. I hope you can find the written version.