Polio and its Survivors in Twentieth-Century Belfast

by Hannah Brown, Ulster University

Poliomyelitis merges three Greek words, ‘polio,’ ‘myelo,’ and ‘itis,’ which translates respectively to ‘grey matter’, ‘spinal cord’ and ‘swelling’.[1] Poliomyelitis is often referred to as polio or infantile paralysis. The highly contagious disease is spread faecal-orally and is caused by a wild-type polio virus type 1, 2 or 3.[2] Polio attacks a person’s nervous system, with the potential to cause paralysis or even death. However, it presents in many people as a series of mild symptoms, including fever, sore throat, fatigue or intestinal issues. In most cases, the patient will be asymptomatic.[3]

The history of polio can be charted back at least to Ancient Egypt.[4] Michael Underwood, a British doctor, in 1789, was the first to describe polio as the ‘debility of the lower extremities in children’.[5] French doctors Jean-Martin Charcot and Alix Joffroy identified the pathology of polio as a wasting of the anterior horns of the spinal cord grey matter. In 1891, polio was first reported, in an epidemic proportion, by Swedish doctor Oskar Medin.[6] Moreover, another Swedish doctor Ivar Wickman, published reports in 1907 and 1911, developing a better sense of the epidemiology of polio. Wickman noted the seasonal variations of polio, commenting that infection rates rose during the summer months and that the virus spread among healthy children.[7]  

Polio in Belfast

In 1951, Belfast was a typical industrial hub with a bustling population of 443,680. Manufacturing provided employment opportunities for fifty per cent of the working population. The largest industries were ship building and textiles.[8] The linen trade fell into decline in the 1950s; ship building met a similar fate in the 1960s.[9] The improvement of sanitation measures in the twentieth century, in response to problems that emerged due to nineteenth-century industrialisation, had catastrophic consequences for childhood immunity to polio. Improved hygiene diminished infant exposure to the virus, thus creating a hotbed for polio infections to thrive.[10] Epidemics of polio became commonplace. Between 1940 and 1950, there was widespread panic relating to polio.[11] Trepidation ran high; affluent and low-income areas were defenceless against polio.[12] 

In 1913, the north of Ireland recorded its first case of polio. From 1947, in Ireland and Britain, the highly contagious disease devastated in an epidemic proportion.[13] There were only sporadic incidences between 1914 to 1946 in the north. The first case in Belfast was identified in 1923.[14] The prevalence of polio in Belfast, increased steadily from 1947, with 61 notified cases.[15] The largest outbreaks in the north were in 1947 (208 cases), 1950 (272 cases), 1953 (290 cases) and 1957 (297 cases).[16]

There were no major outbreaks in Belfast until a swell in 1957, when the largest outbreak of polio occurred. It was estimated that there were 171 cases of type 1 polio.[17] There were three features of the 1957 epidemic, firstly ninety per cent of those paralysed were children under the age of six. Secondly, there were nine incidences of multiple cases in one household. Finally, most of the cases were in children under twelve months old. Eddie McCory, now a retired civil servant and Jim Bailey, now a retired IT tutor, both became infected with polio during the 1957 Belfast outbreak. Jim was only a small infant when he contracted polio, respectively, Eddie was five years old.[18] Both are now members of the Northern Ireland Polio Fellowship, which was initially called the Northern Ireland Branch of the Infantile Paralysis Fellowship.

Image: Jim Bailey and his mother, 1957. Courtesy of the Bailey family.

‘Dreaded Complication’

The 1952 Report of the Medical Officer of Health for Belfast stated that mild symptoms of polio could be managed at home with the support of a local physician.[19] Purdsyburn Fever Hospital in Belfast treated those with critical polio in the 1950s, under the care of Dr Fred Kane.[20] If the patient’s condition advanced further, they would be transferred to the Royal Victoria Hospital.[21] Eddie reveals that he spent six weeks in isolation and was then hospitalised for ten months at Greenisland Orthopaedic Hospital. Similarly, Jim was hospitalised at Greenisland for eighteen months.[22]

In 1953, physician Dr F. Lenore J. Robinson, from Purdsyburn Fever Hospital, stated that ‘the most dreaded complication’ of polio was respiratory paralysis.[23] The Royal Victoria Hospital housed a device called the ‘iron lung’. The iron lung was a cylinder device that enclosed the body and stimulated breathing. It must be noted, that although polio largely infected children, it did occur in adults. Dr Robinson describes a case of a ‘iron lung’ dependant, 28-year-old man as follows: ‘He was then gradually weaned from the mechanical lung until at the end of eight months he could do without artificial aid’.[24] Other courses of treatment for polio included plaster casts on limbs, splints, or physical therapy. Patients also, exercised in a warm pool, and received light massage. To manage pain, surgery was sometimes suggested.[25] Jim and Eddie, respectively, underwent surgery to manage the symptoms of polio. Jim had a leg lengthening surgery and a subsequent amputation. Eddie wore a body brace and calipers. After two years, these devices were deemed unnecessary. At age twelve, Eddie was diagnosed with lumbar scoliosis and subsequently refused to undergo corrective surgery.[26]

In 1957, the Belfast Telegraph revealed that those who suffered polio believed in ‘swimming to recovery’ at Belfast’s Ormeau Baths. Swimming was cited as the best exercise to strengthen limbs. Jim and Eddie shared that they have fond memories of swimming.[27] The activity was set-up by the Northern Ireland Branch of the Infantile Paralysis Fellowship. In 1957, the membership of the group exceeded 300. The group intended to purchase a hall for a weekly club for support as ‘a physiotherapist cannot help him’.[28] Eddie has tender memories of ‘polio house’, he learnt ‘not to lie down’. Patients often did not receive counselling to cope with their psychological trauma of contracting polio.[29] Both Jimmy and Eddie stated they were not offered counselling, following their polio diagnosis yet were satisfied with the medical care they obtained.

The Arrival of a Vaccine       

Polish doctor Hilary Koprowski, was the first to create a potential polio vaccine in 1948.[30] Koprowski received a letter from the Micro-Biology department, led by G. W. A. Dick at Queen’s University, to trial the vaccine in Belfast.[31] Members of the Koprowski team departed to Belfast with types I and II of the vaccine. Dick carried out clinical trials, including trials on colleagues, medical students, and family members. Polio was not present in the participants. Yet, when the virus was extracted from the stool of vaccinated children and given to monkeys, it caused paralysis. The virus was more infectious than when the vaccine was initially ingested. Dick recommended that trials be abandoned.[32]

Koprowski’s findings were eclipsed by the successes of Jonas Salk and Albert Sabin.[33] In 1952, Salk, of the University of Pittsburgh, began experimental tests on children who had suffered polio or another disability. He reported his findings to the Committee on Immunisation in 1953. By 1954, a large-scale trial on 1.8 million American children between the ages of 6 and 9 was in motion.[34] In 1955, the vaccine was deemed safe. Manufacturing commenced in the United States. However, a problem emerged known as the ‘cutter incident’. The Cutter Laboratories in California, accidently produced vaccines contaminated with polio. The accident caused 40,000 cases of polio and ten deaths.[35] Sabin developed an oral vaccine from the live poliovirus. Sabin’s oral vaccine halted the epidemic spread of polio and was favoured from 1962.[36]

In May 1957, the first 100 children from Belfast received the polio vaccine, the same vaccine taken by Prince Charles.[37] The 1957 Report of the Medical Officer of Health for Belfast detailed that the vaccines received an apathetic reception. In Belfast, parents questioned its safety.[38] Both Jim and Eddie recall that their parents favoured the polio vaccine and had intended for them to receive their first vaccination. Sadly, both boys contracted the virus prior to receiving the vaccine. By February 1958, over 2000 inoculations a week were being administered. Adverse reactions to the vaccine were closely monitored; however, these reactions were minimal.[39] There were only ten cases of polio in Belfast in 1959. In all these cases, the child was unvaccinated. In 1960, there were three cases of polio in Belfast. The re-emergence of cases, led to a rise in demand in Belfast for the vaccine.[40]

Image: Eddie McCory. c.1960s. Courtesy of the McCory family.

‘Polio could Strike’

The British inactive poliomyelitis vaccine (IPV) began in 1956 and was eventually phased out in favour of the oral vaccine in 1962. Initially the IPV was offered only to infants and children. The eligibility was then widened to embrace those under the age of 40.[41] The polio vaccination campaign was unlike any other vaccine campaign, as previous ones were specifically for parents to vaccinate their infants. The polio campaign had to adapt to target various cohorts of people. Therefore, promotional material had to consider the emotions and perceptions of those groups.[42] ‘Polio Could Strike’ was a series of posters which sought to ensure all eligible groups were vaccinated. These posters were uncomplicated and emotive to encourage support of the vaccine.[43] 1963 was the first year in two decades in which no incidences of polio occurred, due to the success of the oral vaccine.[44] The 1963 Report of the Medical Officer of Health for Belfast stated that ‘immunisation against diphtheria, tetanus, whooping cough, poliomyelitis and smallpox is available at special clinics, many health clinics and in schools and is also done by general practitioners’. By then, vaccines were readily available in Belfast. Professor Dick attempted to combine vaccines to reduce the number of injections. However, these trials proved unsuccessful.[45] The Belfast Telegraph revealed that in 1977, only 60% of children were vaccinated. An anonymous Belfast doctor stated that it was partly down to complacency and confusion with the whopping cough vaccine.[46]

In 1982, polio returned to Belfast, a two-year-old boy became infected.[47] Polio had not been detected in the city for five years and was dubbed the ‘new polio shock’. Officials once again urged parents in Belfast to vaccinate their children.[48] In response to the outbreak, surplus vaccinations were flown in from London. Belfast undertook a citywide vaccination program. The Irish Press in 1982, commented that even with the wonders of modern medicine, polio continues to pose a threat.[49] The last case of natural polio in the United Kingdom occurred in 1984. In 1988, the Global Polio Eradication Initiative sought to increase vaccine availability and establish campaigns to promote the vaccine.[50]

Image: Wellcome Polio vaccine dropped on to sugar lump for child patient. Wellcome Collection. Attribution 4.0 International (CC BY 4.0).

‘A Very Full Life’

Eddy and Jim encountered complications as a result of contracting polio and still suffer from post-polio syndrome. Jim continues to be in pain and needs a double hip replacement. Eddie states that post-polio syndrome makes you ‘tired and sore’. However, Jim states that he was ‘obviously never going to become a footballer’ but despite this he had a ‘very full social life, very full married life’. Eddie concurs that he has had a ‘very full life’ with children and grandchildren. Jim and Eddie are active in spreading awareness about polio. In 2017, a 60th anniversary event of the 1957 outbreak, was held by Rotary International and the Last Punch Campaign.[51] In 2019, the United Kingdom pledged £400 million to the Global Polio Eradication Initiative. Jim travelled to Pakistan to see the aid and vaccination program.[52] The Global Polio Eradication Initiative is at the forefront in the eradication of polio. When compared to 30 years prior, the rates of polio in 2020 have diminished by 99%. Currently, Pakistan and Afghanistan are the only countries that continue to have a polio presence.[53]

© The Author(s) 2021. Published by the Epidemic Belfast team on behalf of Ulster University. Any unauthorised broadcasting, public performance, copying or re-recording will constitute an infringement of copyright.

[1] Frederick C. Robbins and Elena O. Nightingale, ‘Selective Primary Health Care: Strategies for Control of Disease in the Developing World. IX. Poliomyelitis’, Reviews of Infectious Disease, 5:5 (1983), pp. 957-968; Jun Li, Erawady Mitrabhakdi, Richard A. Lewis, et. al., ‘Neuromuscular Complications of Infectious Disease’, AAEM 51st Annual Scientific Meeting (Rochester, NY: American Association of Electrodiagnostic Medicine, 2004), pp. 1-37.

[2] Man Mohan Mehndiratta, Prachi Mehndiratta and Renuka Pande, ‘Historical Facts, Epidemiology, and Current Challenges in Eradication’, Neurohospitalist, 4 (2014), pp. 223–9.

[3] https://bestpractice.bmj.com/topics/en-gb/902. Accessed 9 July 2021.

[4] The history of polio can be traced to around, 1500 BCE. One of the first depictions was a priest, who had one leg shorter than the other. See Francesco M. Galassi, Michael E. Habicht and Frank J. Ruhli, ‘Poliomyelitis in Ancient Egypt?’, Seminars in Paediatric Infectious Diseases, 11 (2000), pp. 280-286.

[5] Micheal Underwood, A Treatise on the Diseases of Children (London: J. Mathews, 1789), p. 506.

[6] J.M.S. Pearce, ‘Poliomyelitis (Heine-Medin disease)’, Journal of Neurology, Neurosurgery and Psychiatry, 76 (2003), 128; Anda Baicus, ‘History of Polio Vaccination’, World Journal of Virology, 1 (2021), pp. 108-114.

[7] Hans J. Eggers, ‘Milestones in Early Poliomyelitis Research (1840 to 1949)’, Journal of Virology, 73 (1999), 4533-5.

[7] H.G. Schwick, ‘Poliomyelitis in Landsteiner’s Time and Today’, Wiener Klinische Wochenschrift,103 (1991), pp. 136-40.

[8] Morgan D. Thomas, ‘Manufacturing Industry in Belfast, Northern Ireland’, Annals of the Association of American Geographers, 46 (1956), pp. 175-96.

[9] Frederick Boal, Enduring City: Belfast the Twentieth Century (Belfast: Blackstaff Press, 2006).

[10] Gemma Lien and David L. Heymann, ‘The Problems with Polio: Toward Eradication’, Infectious Diseases and Therapy, 2 (2013), 167-74.

[11] ‘Poliomyelitis Precautions’, British Medical Journal, ii (1949), p. 323. 

[12] Hannah J. Elizabeth, Gareth Millward & Alex Mold, ‘Injections While You Dance’: Press Advertisement and Poster Promotion of the Polio Vaccine to British Publics, 1956–1962’, Cultural and Social History, 16 (2019), pp. 315-36.

[13] Gareth Millward, ‘‘A Matter of Common-Sense’: The Coventry Poliomyelitis Epidemic 1957 and the British Public’, Contemporary British History, 3 (2017), pp. 384-406.

[14] ‘The 1957 Epidemic of Poliomyelitis in Belfast’, Ulster Medical Journal, 29 (1960), pp. 14-21.

[15] Report of the Medical Officer of Health for Belfast, 1947.

[16] Northern Ireland Polio Fellowship (polio-ni.org) Accessed 10 September 2021.

[17] The figures do vary, from 142 to 171 cases. See Report of the Medical Officer of Health for Belfast, 1957; ‘1957 Epidemic of Poliomyelitis in Belfast’.

[18] Belfast Newsletter (2 December 2017).

[19] Report of the Medical Officer of Health for Belfast, 1952.

[20] Richard Samuel and Jessop Clarke, The Royal Victoria Hospital, Belfast A History, 1797-1997 (Belfast: Blackstaff Press, 1997), p. 214.

[21] Samuel and Clarke, Royal Victoria Hospital, p. 214.

[22] Belfast Newsletter (2 December 2017).

[23] F. Lenore and J. Robinson, ‘A Report on the Cases of Acute Poliomyelitis treated in the Nor/thern Ireland Fever Hospital’, Ulster Medical Journal, 22 (1953), pp. 138-143.  

[24] Lenore and Robinson, ‘Report on Cases of Acute Poliomyelitis’.

[25] R. Clayton Rounds, ‘The Treatment of Poliomyelitis’, American Journal of Nursing, 40 (1940), pp. 617-623; Laurence Geary, ‘The 1956 Polio Epidemic in Cork’, History Ireland, 14 (2006), pp. 34-7.

[26] https://www.polio-ni.org/info/committee/ Accessed 1 September 2021.

[27] https://www.polio-ni.org/info/committee/ Accessed 1 September 2021.

[28] Belfast Telegraph (24 October 1957); Northern Whig (28 October 1957).

[29] Marcia Meldrum, ‘A Calculated Risk”: The Salk Polio Vaccine Field Trials of 1954’, British Medical Journal 317 (1998), pp. 1233-6; Daniel J. Wilson, ‘Psychological Trauma and Its Treatment in the Polio Epidemics’, Bulletin of the History of Medicine, 82 (2008), pp. 848-77.

[30] Belfast Newsletter (20 January 1956).

[31] Irish Times (26 January 1956).

[32] Roger Vaughan, Listen to the Music: The Life of Hilary Koprowski (New York, NY: Springer, 2012), pp. 72-4; Gareth Williams, Paralysed with Fear: The Story of Polio (Basingstoke: Palgrave Macmillan, 2013), pp. 226-7.

[33] Laura Newman, ‘Hilary Koprowski’, British Medical Journal, 347 (2013), p. 27. For further reading, and for international perspectives, see also, among others, David M. Oshinsky, Polio: An American Story (Oxford: Oxford University Press, 2005); Stephen E. Mawdsley, Selling Science: Polio and the Promise of Gamma Globulin (New Brunswick, NJ: Rutgers University Press, 2016); Thomas Abraham, Polio: the Odyssey of Eradication (London: Hurst and Co., 2018); and Dora Vagha, Polio Across the Iron Curtain: Hungary’s Cold War with an Epidemic (Cambridge: Cambridge University Press, 2018).

[34] Belfast Newsletter (24 September 1955); William J Hays, The Burdens of Disease: Epidemics and Human Response in Western History (New Jersey, NJ: Rutgers University Press, 2003), p. 268.

[35] Rolf Zetterström, ‘The Cutter Incident: How America’s First Polio Vaccine led to the Growing Vaccine Crisis’, Acta Paediatrica, 96 (2007), pp. 777-8.

[36] Marc A. Shampo, Robert A. Kyle, David P. Steensma, ‘Albert Sabin: Conqueror of Poliomyelitis’, Mayo Clinic Proceedings, 86 (2011), p. 44.

[37] Belfast Telegraph (15 May 1957).

[38] Report of the Medical Officer of Health for Belfast, 1957.

[39] Report of the Medical Officer of Health for Belfast, 1959. 

[40] Report of the Medical Officer of Health for Belfast, 1960. 

[41] The British Medical Journal states that the parameters were set at between 6 months and 40, this also, included pregnant people. ‘General Issue of Live Polio Vaccine’ British Medical Journal, i (1962), p. 311.

[42] Elizabeth, Millward and Mold, ‘Injections While You Dance’.

[43] Elizabeth, Millward and Mold, ‘Injections While You Dance’.

[44] Report of the Medical Officer of Health for Belfast, 1963.

[45] Report of the Medical Officer of Health for Belfast, 1963.

[46] Belfast Telegraph (17 June 1977).

[47] Belfast Telegraph (14 August 1982).

[48] Belfast Telegraph (14 August 1982).

[49] Irish Press (20 August 1982).

[50] Qanta Ahmed, ‘Polio’s Endgame’, The World Today,70 (2014), pp. 32-4; Oliver Razum, Devi Sridhar, Albrecht Jahn and Shehla Zaidi, ‘Polio: From Eradication to Systematic, Sustained Control’, BMJ Health Global, 4 (2019), pp. 1-4.

[51] Survivors of Belfast Polio Outbreak sought for Anniversary Event. Belfast Live Accessed 31 August 2021.

[52] UK aid to help vaccinate more than 400 million children a year against polio – GOV.UK (www.gov.uk) Accessed 31 August 2021.

[53] UK aid to help vaccinate more than 400 million children a year against polio – GOV.UK (www.gov.uk) Accessed 31 August 2021.