In the fictional North Carolina mountain town at the heart of Gail Godwin's Flora, a 1945 polio scare takes the life of one child and paralyzes another while the community scrambles to contain the disease. These tragedies, which form part of the cultural fabric of Godwin's fictional world, echo real events that took place in rural North Carolina in the 1940s, when the polio epidemic was peaking there. In 1944, the mountain town of Hickory, NC, experienced a devastating polio outbreak. When local facilities were not adequate to house the stricken, most of whom were children, residents mobilized. They repurposed a rustic health camp that had been built the year before for children recovering from tuberculosis, and built a new hospital on the spot. Tent wards were erected, and the one stone building on the site held the worst cases. Water, electrical, and phone service were brought in, and beds and equipment collected. Medical staff, in short supply during wartime, came from all over the country to help. The hospital opened to patients just 54 hours after the outbreak began, a feat which went down in history as the "Miracle of Hickory."
People who grew up in the environs of Hickory remember being kept indoors in summer when the polio epidemic was raging, as Helen is in Flora. Children were especially susceptible to infection, although polio can strike at any age. President Franklin Delano Roosevelt, one of the most high-profile American survivors of polio, was 39 when he was infected.
Poliomyeletis is an ancient disease, but its increasing prevalence in the late nineteenth and early twentieth centuries is thought to be related to improvements in water supply and sanitation. The virus is transmitted through fecal-oral routes, primarily in contaminated water, and before sanitation the germ was everywhere. Constant exposure from infancy created a certain degree of immunity, and most cases of illness occurred in babies and toddlers. Under cleaner conditions, children didn't encounter polio until they were older and more at risk for developing a more severe form of the disease. Complications from paralytic polio, which affects the central nervous system, could lead to skeletal deformities. Many polio victims suffered muscle paralysis affecting their breathing; for some it was permanent but for others it was possible to treat the disease and get a partial/complete recovery, so long as the lungs could be kept going through the paralysis by external means. The negative pressure ventilator, or "iron lung" used for this purpose, and developed in America in the 1920s, became a familiar symbol of polio and the forerunner of the kind of medical support we now know as "Intensive Care."
Polio vaccines began to emerge in the early fifties as the epidemic continued to spread, and it was Jonas Salk's 1955 vaccine, used to mass inoculate school children, that began to stem the spread of the disease. Today polio is the target of a massive eradication program. The Global Polio Eradication Initiative lists three countries where polio is still endemic Afghanistan, Nigeria, and Pakistan. India was declared polio free in 2012.
Pictures from National Museum of American History
This article was originally published in June 2013, and has been updated for the
March 2014 paperback release.
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