Pseudopolio

With the onset of cooler weather, 1952's record-breaking polio epidemic was on the wane all across the country. Nevertheless, scattered here & there were hundreds of new cases that looked like poliomyelitis. Patients, mostly youngsters, who had headaches, fever, nausea, stiff neck or muscular difficulties were rushed to hospitals, and their cases were entered in the polio records. The truth was that many of the new patients did not have polio at all. There was good reason to believe that the season was producing an unusually large number of virus infections that only seemed to be polio.

During an epidemic, if a patient shows the standard combination of polio symptoms, including localized paralysis, the chances are that the doctors are right in calling the disease polio. In any case, the patient still gets good care and usually does not suffer, even if the diagnosis is wrong. But during every epidemic there are many cases called polio in which there is no paralysis, or only a short-lived muscle weakness. And some doctors suspect that there is a higher proportion of these among the scattered cases which crop up after the epidemic season is past.

Rough & Ready. Research doctors are now trying desperately to find ways & means of telling the true polio cases from the false. In at least three U.S. cities, they are working with tissue cultures from pieces of human organs or monkey testicle, on which polio virus grows and has a destructive effect. This way, they are able to tell in about a week whether the patient has had polio or not. But this technique is not generally available to physicians or even large hospitals; it is still in the research stage.

Until three years ago, when a team headed by Boston's Dr. John F. Enders reported that these test-tube cultures provided a test for the presence of polio and similar viruses, it used to take a monkey a month to confirm a single diagnosis of polio. That was impractical. Many physicians relied (and still do) on a microscopic examination of a droplet of fluid taken by puncture from the patient's spinal column. In normal, healthy fluid, there are few or no cells--not more than eight to the cubic millimeter. In victims of virus diseases like polio there may be 500 cells or more. This is still only a rough & ready test; half a dozen known viruses will produce the same result, and recent researches have turned up several viruses that seem to be new.

Three Unknowns. In 24 virus specimens taken from supposed polio patients and studied by other researchers at Yale, the diagnosis was confirmed in only 19 cases. The researchers had trouble with the other five. Only two behaved like Coxsackie virus (TIME, Sept. 17, 1951), which causes symptoms easily mistaken for polio. What the three others were is still a mystery.

The diseases most likely to be confused with polio are caused by the viruses of encephalitis (at least three forms) and mumps. Even the lowly, and usually harmless, virus of the fever blister can, like these, occasionally cause a severe inflammation of the central nervous system with widespread paralysis, or even death. At the Children's Medical Center in Boston, Dr. Enders and his colleagues are now busy screening cultures from 150 of this year's "polio" patients. Their results should be a big addition to medicine's slim store of knowledge about pseudopolio.

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