By 1894 an antitoxin with therapeutic qualities had been developed, and two decades later an effective means of immunizing children became available with the introduction of the toxin-antitoxin. Yet the precise role played by both in reducing mortality from diphtheria is ambiguous…There is some evidence that the emergence of a dominant strain of mitis [ Editor’s note: a variant of the bacterium that caused a relatively mild form of the disease] reduced the virulence of the disease. Antitoxin serum may therefore have merely assisted a natural decline of the disease already under way. During the 1920s …immunization campaigns probably led to the eventual disappearance of the disease by World War II (Grob, 2002, pp. 205-6).

Total reported cases From 1951, MMWR separated paralytic and nonparalytic cases. Before 1951, MMWR included both as Total Cases.

Whooping cough (pertussis)

Unfortunate incidents and avoidable errors do occur, but these rare events should not be the basis on which to decide the merit of things like public health programs, as some, including Suzanne Humphries and Roman Bystrianyk in their book Dissolving Illusions, have attempted. Even more egregious is the attempt to take a monumentally significant public health issue like polio and, using “alternative facts”, minimize its significance. In Humphries’ and Bystrianyk’s book, the subject of this article, they even go so far as to claim that polio was an “insignificant” disease. Incidence, mortality, disability, suffering: Comparing apples to oranges The classic symptom of malaria is paroxysm—a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days (tertian fever) in P. vivax and P. ovale infections, and every three days (quartan fever) for P. malariae. P. falciparum infection can cause recurrent fever every 36–48 hours, or a less pronounced and almost continuous fever. Not only those who suffered paralysis, going through often long painful therapies, who appeared to have regained somewhat normal mobility, eventually only to develop post-polio syndrome; but a number of those, who following an acute episode of polio, even those asymptomatic, also developed post-polio syndrome. As discussed by Bruno: Complications of smallpox [variola major] include bacterial infections of the skin and other organs, pneumonia, generalized sepsis, destructive arthritis in young children and arthropathies, corneal ulceration resulting in blindness, keratitis, osteomyelitis, and encephalitis. The latter, present in approximately 1 in 500 cases (Kennedy, 2018, p.1003).

Since Humphries obviously doesn’t approve of the March of Dimes, I wonder how she feels about the Jerry Lewis Telethon and other Associations raising money for a variety of medical conditions? Perhaps, she doesn’t think the public should be contributing to them, given their “low” incidence? Estimates of probability of children permanently paralyzed While the other diseases discussed above were on the decline, polio was on the rise. Trevelyan (2005):In the year 1927, for the first time, no case of variola major was reported in the USA, and apart from an outbreak in 1929 no further cases were notified until 1946. In that year a soldier returning from Japan introduced smallpox into Seattle, Washington, which resulted in an outbreak of 51 cases, with 16 deaths (Palmquist, 1947). In 1947 a man with undiagnosed haemorrhagic smallpox died in a Manhattan, New York, hospital. Twelve other persons were infected.