[apr]

The history of eradicating polio was clouded by redefinition of what was considered a polio case not once but twice. Early in the day any case of acute flaccid myelitis was considered polio. You have to realize that poliovirus is just one of a few dozen of enteroviruses that can cause similar effects.

Here is a recent case that could have been labeled polio just a few decades ago: http://abc7chicago.com/health/6-year-old-boys-death-linked-t...

I cannot find stats right now but I saw numbers of AFM in India where true polio cases keep going down YoY but the overall numbers of AFM have recently skyrocketed.

Also let's keep things in perspective. The absolute number of people getting infected by polio or other enteroviruses do not actually show any symptoms. It is quite rare for the virus to invade the nervous system which leads to the symptoms we all fear.

[dpark]

Are you simultaneously arguing that the percentage of people who get the "worst scenario" polio is very low and that the number of miscategorized "worst scenario" polio cases is drastically skewing the numbers? It cannot be both. If the percentage of polio infections that cause the "worst case" is low (and it is) then miscategorizing similar "worst cases" from other diseases will not significantly skew the number of total detected polio cases.

[apr]

Why it cannot be both? I agree that me bringing in the argument that the number of "worst case" cases is low compared to the number of people that contract the virus was outside the topic of the discussion. I just obliquely wanted to address the issue that polio is often brought up as an absolutely devastating and dangerous disease, and yet generally speaking it is not so.

Here is a curious link to an article from 1961 with memories still fresh from the polio outbreaks of the middle of the 20th century and shortly after the polio vaccines were introduced.

Note the reserved tone which is so at odds with the current day thinking about the success of the polio vaccine. The whole article is worth a read, I will just provide a quote here that is pertinent to our discussion.

"Evaluating the true effectiveness of the Salk vaccine and the new oral vaccines has been difficult for several reasons. Polio is a relatovely rare disease in the United States. Because so few persons get it in its paralyzing form, success of an immunizing agent is hard to determine. The definition of polio also has changed in the last six or seven years. Several diseases which were often diagnosed as polio are now classified as aseptic meningitis or illnesses caused by one of the Coxsackie or Echo viruses. The number of polio cases in 1961 cannot accurately be compared with those in, say 1952, because the criteria for diagnoses have changed."

http://archives.chicagotribune.com/1961/03/05/page/62/articl...

[dpark]

> Why it cannot be both?

Perhaps this is a misreading on my part. I was equating AFM with the "worst case" paralytic polio, which is fairly rare at ~1%. It's unclear to me what percentage of polio cases result in muscle weakness (which AFM seems to correspond to more closely) that doesn't qualify as paralytic.

> I just obliquely wanted to address the issue that polio is often brought up as an absolutely devastating and dangerous disease, and yet generally speaking it is not so.

This is the case for almost every disease. Paralysis in ~1% of victims is still pretty terrible.

> Note the reserved tone which is so at odds with the current day thinking about the success of the polio vaccine. The whole article is worth a read, I will just provide a quote here that is pertinent to our discussion.

It's an interesting article, but doesn't change the fact that polio vaccines have a huge body of supporting evidence. Ignoring the question of 1952 vs 1961 polio counts, what about 1988 to 2016? It's dropped from 350000 cases to 42 in that time. What about all the trials that have shown the effectiveness of polio vaccines? What about the fact that wild polio is eradicated in North America?

No one says vaccines are perfect. No one claims that drug trials are perfect either. But the overall evidence still seems overwhelming, and nitpicking how polio used to be categorized and pointing to some upswings due to the cyclic nature of infectious diseases is not evidence against the efficacy of vaccines.

This is my problem with anti-vaccine lobbying. There's a distinct lack of evidence in their favor, so they resort mostly to nitpicking minor concerns while ignoring the bigger picture. Meanwhile they'll happily jump on weak and even fraudulent studies that support their claims and ignore their deficiencies.

"Hey, Polio is eradicated in the US and reduced by almost 4 orders of magnitude worldwide. That looks pretty effective."

"Yeah, but we haven't always counted polio cases exactly the same, and there was a brief upswing in polio a few years after the vaccine as introduced. Also vaccines cause autism."

"Uh, so we still managed to eradicate polio after the upswing. And the vaccine-autism link was literally fraud."

"But what if you're wrong?"

"??"