Summaries of the advances in our knowledge of infantile paralysis have just appeared in several medical journals. These represent largely the experience gained in the widespread epidemic of last year.
The year 1932 was not a very bad one for infantile paralysis. Some parts of the country, notably Pennsylvania, suffered severely, but in general the country was fairly free of the disease.
It is a disease of summer and fall.
Early diagnosis is important because the prevention of paralysis by treatment depends on the introduction of the serum before paralysis occurs. This early diagnosis depends upon two things: one is a strong suspicion, founded on facts, that the child has acquired the disease, and the other is to call the doctor immediately in order to have a test of the spinal fluid.
The facts on which the suspicion should be founded are that there is infantile paralysis in the neighborhood and that the child has a fever with headache, nausea and stiffness of the neck. Common movements, such as bending over a wash bowl or putting the head on the pillow, may reveal a tendency to favor the spine and neck muscles.
If the physician agrees with the parents’ suspicions, he will employ lumbar puncture to obtain spinal fluid, which shows characteristic changes very easily.
Many cases of exposure occur without any resulting disease. Five little guests went to a birthday party and 24 hours later the birthday child came down with infantile paralysis, but none of the guests developed the disease.
In fact, their exposure probably created immunity which protected them for life. This sort of immunizing process is going on all year ’round, not only in fall during the seasonal period of the disease. It accounts for the fact that nearly all adults are immune to the disease, and that infantile paralysis is only one hundredth as common as diphtheria.