The first modern poliomyelitis epidemic in the western world occurred on the island of Saint Helena, a British colony, in 1836. Outbreaks followed in Norway, France, Sweden and America. By March 1955 the World Health Organisation recognised that poliomyelitis was ‘a practically world-wide disease’. In Ireland, poliomyelitis was scarcely known prior to 1940, until the first epidemic hit in 1942. The incidence of the disease fluctuated during the following years, with the worst epidemic wave occurring in 1956 when approximately 500 cases were notified nationwide. Yet, with the exception of Geary’s short overview of the epidemic in Cork, poliomyelitis has been largely ignored in Irish history. An exploration of poliomyelitis in Ireland will provide a new lens through which to critique public health legislation in the mid-twentieth century and uncover Irish lay and medical understandings of disease. It will contribute to the literature on the epidemiology of diseases, eradication programmes and public health policies, which, to date, has focused primarily on the Irish experience of tuberculosis.
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| Group of poliomyletis and arthitic patients on the sundeck, USA, undated photograph. Courtesy of the National Library of Medicine, Images from the History of Medicine Collection. A015237 |
The project is divided into three thematic sections:
1. What was the geographic and demographic distribution of poliomyelitis?
This section of the project maps the incidence of the poliomyelitis epidemic at a regional level with a view to revealing the topography of the disease. While the impact of the 1956 epidemic upon Cork has received analysis, little is known of poliomyelitis consequences nationally or, indeed, whether its effects varied in urban and rural environments. In addition, the study will provide a demographic profile of its victims in terms of age, sex, marital status, class and outcome. It will also interrogate the types and forms of diagnosis and treatment assigned to sufferers. This data will establish whether the gender, class and age of sufferers impacted on susceptibility to the virus and on access to treatment and vaccination.
2. What were the social and cultural meanings assigned to poliomyelitis and to its victims?
In his study of the American experience of poliomyelitis, David Oshinsky contextualized the outbreak within the increasingly suburban, family-oriented, and hygiene obsessed 1950s, arguing that the nation’s most affected by poliomyelitis were considered to be the most hygienic and least at risk to infectious diseases. The impact these domestic hygienic practices had on Ireland in the 1940s and 1950s is unclear but it would appear that medical research on the epidemiology of the virus in Ireland examined whether the Irish were racially susceptible to the disease; an anti-body survey carried out by the Medical Research Council in 1956 revealed that antibody levels among Irish children were dangerously low. Examining medical research into disease aetiology conducted in Ireland, the study will uncover the social and cultural assumptions underpinning theories of susceptibility to poliomyelitis.
The poliomyelitis epidemic, much like the spectre of the atomic bomb, cast a cloud of terror over daily life. In a contemporary account of the epidemic in Cork, Patrick Cockburn suggested that public fear of the disease outlasted its virulence within society and the possibility of its return terrified communities. Drawing on newspapers, correspondence and memoirs, the study will also look at the social responses to poliomyelitis, especially the widespread fear of the disease and the consequent stigma attached to sufferers and groups who were identified as likely carriers of the virus. It will consider whether ‘fear’ had a negative impact upon public health initiatives, thereby exploring how social histories of diseases can become intertwined with political and policy narratives. Government press releases and publicity campaigns will give insight into the state’s efforts to assuage public terror. By situating the Irish experience within the international context, the study will consider whether there was universality to social reactions to poliomyelitis in the twentieth century.
3. What was the public health response to poliomyelitis in Ireland and how successful was it?
In his pioneering work on the history of public health George Rosen argued that the protection and promotion of public health and welfare was one of the most important functions of the modern state. For Ireland however, it has been demonstrated that ‘few local authorities approached the problem of eradicating infectious disease with determination’ and only belatedly did public health became a matter of major public concern in the 1950s. James Deeney attested to a political disinterest in public health, concluding that in the case of tuberculosis, the government ‘had been hoping the problem would go away’. Did they harbour similar hopes for poliomyelitis? Preliminary research has revealed that Irish health authorities were slow to respond to the threat of poliomyelitis and were pressurised into accepting iron lung respirators from the British Ministry for Health, while specialist centres for treatment were only established fifteen years after the disease had been made notifiable. A Salk vaccination programme was introduced to Ireland in 1957 but this was significantly later than in France, America and Britain.
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| Polio vaccine dropped onto sugar lump for young patients, c.1980. Image courtesy of Wellcome Imagse, WFA WF/M/I/PR/P04 |
This section will examine the public health response to the epidemic at a local and national level revealing the tensions at play that led to delays in implementing vaccination programmes and other initiatives. It will interrogate whether these failings were a result of underdeveloped public health infrastructure, politico-religious conservatism, an inert bureaucracy, economics or other factors. In addition, correspondence between public health bodies, the Medical Research Council and the Department of Health will reveal the factors informing the delivery of the vaccination programme; who was identified as especially vulnerable to the disease and why? The study will then uncover the impact delays in developing a robust public health response had on infection and mortality rates, especially among children, as Dr Noel Browne later lamented. By uncovering a near forgotten epidemic of 1950s Ireland, this project will add greater depth and sophistication to the literature on Irish health policy and infectious disease eradication.
Stephen Bance may be contacted at stephen "dot" bance "at" ucdconnect "dot" ie
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