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Provocation of poliomyelitis by multiple injections.

H V Wyatt

    Transactions of the Royal Society of Tropical Medicine and Hygiene
    |January 1, 1985
    PubMed
    Summary

    Multiple childhood injections, particularly in the tropics, may provoke paralytic poliomyelitis. This study links historical epidemics to injections, suggesting a significant causal role for multiple inoculations in polio cases.

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    Area of Science:

    • Epidemiology
    • Infectious Diseases
    • Public Health

    Background:

    • Injections, including vaccines, have been linked to provoking paralytic poliomyelitis in children.
    • The impact of multiple injections on polio risk, especially in tropical regions with high inoculation rates, has been underrecognized.
    • Historical epidemics of poliomyelitis (1914-1962) in children treated for congenital syphilis or yaws with arsenicals or penicillin suggest a potential link.

    Purpose of the Study:

    • To investigate the potential causal relationship between injections and paralytic poliomyelitis.
    • To highlight the previously unrecognized risk associated with multiple injections in polio provocation.
    • To examine historical polio epidemics for evidence of injection-provoked cases, particularly in tropical contexts.

    Main Methods:

    • Review of historical poliomyelitis epidemics (1914-1962).
    • Analysis of case data linking polio paralysis to prior treatments involving injections (arsenicals, penicillin).
    • Epidemiological assessment of paralysis rates in relation to injection frequency and historical disease outbreaks.

    Main Results:

    • Injections were observed to provoke paralytic poliomyelitis in children.
    • During epidemics, paralysis rates reached up to 25% in affected children.
    • In non-epidemic periods, susceptibility to polio paralysis increased approximately 25-fold following injections.
    • A strong correlation was found between multiple injections and high rates of polio paralysis, particularly in tropical settings.

    Conclusions:

    • Multiple injections represent a significant, previously unrecognized factor in provoking paralytic poliomyelitis.
    • The high incidence of paralysis following multiple injections provides strong evidence for a causal link, especially in tropical regions.
    • While difficult to definitively prove causality in all tropical cases due to potential coincidence, the evidence strongly suggests injections are often causal.

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