Polio Prevention

As the annual summer epidemic of infantile paralysis was about to break upon the country last week, expert prophylactic teams deployed over the nation to prevent it by spraying the noses of children with zinc sulphate. This is a new but thoroughly tested method of preventing a disease which has crippled thousands of people of the U. S., including the President.

Overtures to this preventive campaign appeared in last week's Journal of the American Medical Association. Bacteriologist Edwin William Schultz of Stanford University recalled Medicine's halting; progress against infantile paralysis. Serum from the blood of people who suffered from the disease failed to immunize children. Vaccines made from the spines of infected monkeys failed.

Presuming that the virus entered the body only through the nerves of smell, Epidemiologist Charles Armstrong of the U. S. Public Health Service, tried coating the tips of those nerves with spray containing alum. This procedure protected some children exposed to the disease but not all.

Dr. Max Minor Peet, ebullient neurosurgeon of the University of Michigan whom

President Roosevelt appointed to help Dr. Armstrong, found that the occasional failures were due to faulty spraying. While he, with Assistants Dean H. Echols and Harry J. Richter experimented on methods of completely covering the olfactory nerve ends, Dr. Schultz, with help of Chemist L. P. Gebhardt, sought chemicals which might be more effective than alum. They decided on a solution of 1% zinc sulphate, 0.5% sodium chloride and 1% pontocaine, hydrochloride (a local anesthetic) in distilled water.

Last week Dr. Peet prescribed the method of administering this: "The subject is seated and an attendant holds the head tilted backward about 45DEG. This is the usual position for a nasal examination. A speculum is introduced into the nostril and under direct vision the spray tip is inserted upward along the septum until definitely past the middle turbinate. If it impinges on the roof of the nose it is slightly withdrawn. The bulb is squeezed the number of times required to introduce ice. of solution. This amount completely covers the olfactory area. A similar procedure is then carried out on the opposite side of the nose."

The zinc sulphate spraying should be repeated for three consecutive days, then once every two weeks while danger of infantile paralysis prevails in the community. The treatment destroys the sense of smell for a few days and may cause headaches, but is otherwise undisturbing.

Prophylactic teams, each composed of a specially trained doctor, a nurse and a clerk, will work under Dr. Armstrong's general supervision. They started in the South where infantile first breaks out each summer and will rapidly work north.

Dr. Schultz last week took pains to warn: "The application of a prophylactic measure such as this must be kept entirely in the hands of those who are fully competent to apply it properly. It is not a prophylactic measure which can be turned over to the public for self administration."

Dr. Peet warned: "To offer a child the only protection now known for the prevention of infantile paralysis, the spray solution must be actually applied to the olfactory area. . . . It is not a procedure which can be applied by the parents or by a physician not familiar with intranasal work."

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