Poliomyelitis has existed as long as human society, but became a major public health issue in late Victorian times with major epidemics in Europe and the United States. The disease, which causes spinal and respiratory paralysis, can kill and remains incurable but vaccines have assisted in its almost total eradication today.
The disease was given its first clinical description in 1789 by the British physician Michael Underwood, and recognised as a condition by Jakob Heine in 1840.
In 1916, New York experienced the first large epidemic, with more than 9,000 cases and 2,343 deaths. The 1916 toll nationwide was 27,000 cases and 6,000 deaths. Major outbreaks became more frequent during the century: in 1952, the US saw a record 57,628 cases.
In 1928, Philip Drinker and Louie Shaw developed the "iron lung" to save the lives of those left paralysed by polio and unable to breathe. Most patients would spend around two weeks in the device, but those left permanently paralysed faced a lifetime of confinement.
A major breakthrough came in 1952 when Dr Jonas Salk (L) began to develop the first effective vaccine against polio.
In 1961, Albert Sabin (R) pioneered the more easily administered oral polio vaccine (OPV).
By 1988, polio had disappeared from the US, UK, Australia and much of Europe but remained prevalent in more than 125 countries. The same year, the World Health Assembly adopted a resolution to eradicate the disease completely by the year 2000.
The WHO Americas region was certified polio free in 1994, with the last wild case recorded in the Western Pacific region (which includes China) in 1997.
A further landmark came in 2002, when the WHO certified the European region polio-free.
India's vaccination against polio started in 1978 with the Expanded Programme on Immunization (EPI). By 1999, it covered around 60% of infants, giving three doses of OPV to each.
In 1985,the Universal Immunization Programme (UIP) was launched to cover all the districts of the country.
In 2012, Polio remained officially endemic in four countries - Afghanistan, Nigeria, Pakistan and India, which was on the verge of being removed from the list having not had a case since January 2011.
India constituted over 60% of all global polio cases as recently as 2009. However, in 2014, India was officially declared polio-free, along with the rest of the South-East Asia Region.
Despite so much progress, polio remained a risk with the virus from Pakistan re-infecting China in 2011, which had been polio free for more than a decade.
China returned to its polio-free status, with no recorded incidents after 2011.
Africa is free from wild poliovirus, the World Health Organization (WHO) announced on 25 August 2020 — leaving just two countries where the virus remains endemic, Afghanistan and Pakistan.
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