The Battle to Beat Polio

PUBLIC HEALTH FILM:

'You've never seen me but I'm sure you've seen my shadow.'

This programme contains some scenes some viewers may find upsetting.

100 years ago, a mysterious new epidemic took hold in Britain and America.

There was no vaccine to prevent it and no cure.

'I specialise in grotesques, twisting and deforming human bodies.'

It was every bit as terrifying as the AIDS epidemic in the 1980s -

except the victims of this cruel plague were mainly children.

And its symbol was a calliper.

ARCHIVE: 'A thick fear fell over the city. Polio running wild, choking hospitals.'

I know about polio

because my own dad caught the disease in the navy during the war.

Polio put him in a wheelchair from the age of 21.

It was also a large part of the reason why

he never lived to see me grow up.

The battle to beat polio tested medical science,

particularly here in America, to the limit.

It's a story of decades of battling between good

and bad science and giant scientific egos - brilliant men who often

seemed more focused on defeating each other than defeating polio.

ARCHIVE: 'Someday, says Dr Salk,

'the vaccine may completely eradicate the menace of polio.'

Sort of celebrity scientist, Jonas Salk,

this white knight in a lab coat who was always talking in front of cameras.

There was tremendous jealousy.

Albert Sabin really attacked Salk mercilessly

because he was a bastard, frankly.

The race for a vaccine saw scientists

embarking on the riskiest types of testing.

About 120,000 children were inadvertently inoculated with

live deadly polio virus.

It was probably the worst biological disaster in United States' history.

But if it hadn't been for all that,

it turns out we might have had a polio vaccine years earlier.

Hundreds of thousands of people, maybe even my dad,

might have been spared.

Hello, good evening.

We had quite a business getting up here from the Haymarket.

Swann offered to push me up.

I'd forgotten it was November 5th tomorrow -

he got one and sixpence! LAUGHTER

My father became a world-famous entertainer in the singing duo

Flanders and Swann in the 1950s.

He wheeled himself into the spotlight,

20 years after contracting polio.

Polio paralysed him completely for the first six months, withered

his muscles and then put him in a wheelchair for the rest of his life.

I was only six-and-a-half when dad died

so my memories are glimpses, really.

# Mud, mud, glorious mud...

# Nothing quite like it for... #

One of the memories I do have is something that was related

to his disability cos I remember being able to sit on his lap

and drive the car, because he had a specially-adapted car

where the accelerator actually just involved squeezing

with your hand rather than having to use your feet.

A disabled driver's badge seems to act like an L-plate to most other

drivers - they want to get past you at all costs.

They think you're going to blow up or something.

My father died in 1975, when he was only 53,

from medical problems partly brought on by a long life with polio.

ARCHIVE: 'He looks well enough, but there's something wrong with him.

'Infantile paralysis or to give it its proper name - poliomyelitis.

'It left his limbs limp and powerless.'

We know now that polio is a virus that enters the gut

and attacks the central nervous system.

But in Bristol back in 1909,

when the first children in Britain became ill, no-one knew any of that.

They just knew that children were being paralysed by a terrifying new disease.

This was pretty standard if you had a leg affected

so you can lock the leg straight for walking because the leg would

otherwise be so weak that it would just buckle under your weight.

It wasn't perfect but it did get people mobile.

Parents and doctors alike had no understanding of what was

attacking the children - could only try to cope with the symptoms.

This was an immobilising plaster cast. A child would have had

a paralysed right arm and the arm would have been splinted up

like that with this back slab and held up with that support.

And how long would they be in something like that?

Um, usually some months.

It was an attempt to rest the arm

so that the paralysis could run its course and hopefully recover.

The big problem with this, of course, is that

if you splint a limb in a position, then all the muscles lose power

and they don't synthesise protein.

So if there was any chance that these children were going to get

some use back in his arms this would make sure that wouldn't happen.

This would be a really good way

-of preventing that from happening.

-Oh, God.

The patient simply had to lie paralysed waiting

and hoping for the worst phase of the disease to subside.

These are dolls that were used to show children who were

going into an orthopaedic hospital what they might expect.

And this is the child's prison, effectively,

so the child would have been stuck in that bed for weeks or months.

But there is worse to come.

In the worst cases, polio would paralyse the child's diaphragm

till they couldn't breathe at all.

Here we have the iron lung if there was a risk that their respiratory

muscles might be paralysed.

And so if you couldn't breathe, you would go into this.

If you couldn't breathe, you would go into this.

The mortality rate was about 70%.

It looked like a coffin and it effectively was a coffin.

Three quarters of people put into this actually died in the machine.

A year before the Bristol epidemic,

science had made its first foray against the disease.

Most infections of the time were caused by bacteria,

and a Viennese professor of pathology, Karl Landsteiner,

had gone looking for the bacteria that he assumed caused polio,

and found out something important.

They put an extract of infected spinal cord from a boy who had

died of polio in Vienna...

They ran this through a filter that held back all bacteria.

But that extract which had been filtered out to take out

the bacteria still was able to transmit paralysis to a monkey

when it was injected into a monkey.

So that proved that whatever caused the paralysis was actually smaller

than a bacterium and that's where they proved that it was a virus.

With Landsteiner's discovery came

the realisation that there would be no cure.

There aren't any particularly good medicines

against viruses once you've got the infection,

so, in general terms, the best way of dealing with a viral

infection is to try and prevent it rather than treat it or cure.

By the start of the 20th century, science had already developed

successful vaccines for two deadly viral diseases - smallpox and rabies.

But polio turned out to be much, much, trickier.

All viruses are small, but the polio virus was tiny.

It was so small you could fit 20,000 of them on a printed full stop.

They didn't invent a microscope powerful enough to see them for another 20 years.

Right from those early days, British scientists shied

away from even trying to solve the problem of polio.

There simply wasn't the money, the will,

or the expertise to investigate the condition in this country.

But across the Atlantic, philanthropists made rich

by industry were funding scientists to do exactly that.

If you wanted to do serious medical research in America

in the first part of the 20th century, you wanted to do it here.

The Rockefeller Institute basically set the course for research

into polio for nearly 30 years - not always in the right direction.

In fact, the first attempts in 1910, by the Institute's

illustrious director Simon Flexner, would turn out to be disastrous.

To discover how the virus took hold in the body, Flexner began

swabbing the noses of his lab monkeys with the live polio virus.

His monkeys soon became paralysed.

Flexner's conclusion was that polio virus was inhaled through

the nose, went into the brain,

and into the central nervous system causing paralysis.

The problem, as Flexner saw it,

was that polio virus never entered the bloodstream.

If that was true, it was very bad news.

Vaccines work by creating antibodies in the blood,

so if the polio virus never passed through the bloodstream,

a vaccine would be impossible.

But Flexner, it turned out, had made a fundamental mistake.

He never tested any other kinds of monkeys to see

if there was any other way that you could catch polio.

Had he done so, he would have found out that most monkeys become

infected through the mouth -

ingesting the virus through the gut and into the bloodstream,

so a vaccine would have been possible after all.

But Flexner wasn't just wrong...

He was incredibly powerful.

He was right at the top of the tree in American medicine.

He was regarded as the most powerful man in polio research

on the planet, and he concluded that if he couldn't make it work,

then nobody could make it work -

so he single-handedly effectively killed off research into polio

vaccines for another 20 years after that.

And the need for a vaccination was about to become even more urgent.

In June 1916, right on Flexner's doorstep, the largest polio epidemic

the world had ever seen erupted right in the heart of New York.

It would paralyse or kill as many as 27,000 people

in the next three months.

The health authorities were baffled and set out to find the source.

Infectious diseases, like cholera and TB, were a huge problem

in New York in the 1870s and '80s, when the population was exploding.

By the turn of the century, the number of cases had gone down dramatically.

They thought they'd got on top of the problem

with better sanitation and better health standards.

So the outbreak of polio came as a real shock.

They blamed the foreigners -

particularly the Italian immigrants who were coming in with their

"deadly germs" and living in Brooklyn.

Thousands of Italian immigrants who'd fled the war in Europe

were now flooding into New York.

Most settled in Pigtown, as this area of Brooklyn was known.

Little did they know they were moving into another war zone -

the epicentre of the polio epidemic.

It affects hundreds of children,

they come down with high fevers, paralysis.

The parents do not know what to do.

They begin to send workers around to these various immigrant

tenements to look at the children

and very quickly these neighbourhoods are quarantined

meaning that parents cannot go in and see their children.

But quarantine officials on Ellis Island soon found out that

though the disease had originated in that Italian neighbourhood,

there wasn't any evidence of it coming in with the refugees.

And before long, the disease itself began to spiral outwards.

It starts in Brooklyn, it moves to Manhattan,

it moves into the areas north and west of New York City,

and the authorities don't know what to do.

The public health authorities kill tens of thousands of cats

believing that cats and dogs spread the disease.

They begin killing horses, they begin trying to figure out

is this a disease that comes from animals to humans?

Where has it come from?

Towns outside of New York begin to have police at the borders

saying that no-one who does not live in this town will be allowed in.

When the epidemic finally burns itself out three months later,

the authorities make an astonishing discovery.

Nine out of ten of the victims

hadn't come from Pigtown or other ghettos,

but from the wealthier suburbs.

You have to understand that the great polio epidemics

occur in the 20th century - the belief being that polio is

a disease of cleanliness, and as societies become more

antiseptic they are more likely to have certain kinds of diseases.

And polio virus is apparently very susceptible in that area.

The reality was that no-one was safe.

As a rising star of American politics,

Franklin D Roosevelt would contract polio five years later in 1921.

It would leave him paralysed from the waist down

for the rest of his life.

Despite that, he went on to become the only man

ever elected president four times.

I, Franklin Delano Roosevelt, do solemnly swear that

I will faithfully execute the office of President of the United States.

In office, he made the fight against polio not just his own

personal crusade, but a spur for all of America to embrace the cause.

For 25 years, Simon Flexner's failed experiment had made sure that

nothing had happened in the world of polio research.

But with this new president,

the search for a vaccine was back on the agenda.

What you do have by the 1930s are other people beginning to work.

They're not sure how polio virus enters the system,

but they are willing to move forward in terms of a vaccine -

what we will try to do is to produce some antibody reaction.

It's worked in the past with smallpox,

and a smallpox vaccine, it's worked with rabies and a rabies vaccine,

these are both viruses, let us try to move in that direction.

What quickly develops are two very different approaches.

Here in Philadelphia, the director of the city's medical

research institute, John Kolmer, following in the footsteps of Edward

Jenner's success with smallpox,

began work on a live virus vaccine.

That's a very tricky vaccine because basically you have to

weaken it to the point where it causes a very infinitesimally

minor case of polio, but it also produces immunity.

In other words, it will produce antibodies that will give you

a lifetime of immunity against the virus itself.

That is very hard because you have to keep attenuating the vaccine

and make sure that it does not have enough live virus in it

to give you polio.

But there was a rival team.

Here in New York, the city's head of public health, William Park,

had brought in a brilliant young researcher, Maurice Brodie,

who had very different ideas on how to create a vaccine.

Brodie had decided to follow the method used by Louis Pasteur

in his discovery of a vaccine to fight rabies.

We will take polio virus and we will kill it with formaldehyde.

And we will inject it into your body and see what happens, OK?

The beauty of that kind of vaccine is that

if you fully kill the polio virus, the vaccine itself can never

cause polio in the person who is getting the injection.

The question is, how well will it work?

Two lines of attack should have been better than one, and yet these two

illustrious men turned a scientific endeavour into a dangerous race.

William F Park and Maurice Brodie thought

they could basically take their time but they found out very quickly that

in Philadelphia, 90 miles away, John Kolmer, was testing on children.

What this did was to increase the pressure on Park and Brodie

to also begin testing on children

and what you had was a kind of scientific race.

Who would get the vaccine out first, who was going to test the most,

what the results were going to be, who would be more successful?

When you're doing vaccine work in the 1930s,

almost no-one, in a regulatory way, is looking over your shoulder.

You are on your own - you're a buccaneer, you're a pioneer,

and you are doing what you think must be done.

Paul Offit knows all about pioneering vaccines.

He helped create the rotavirus vaccine against diarrhoea

which still kills more children in the developing world than

almost anything else.

I wouldn't say cutting corners was the right thing,

you do it because you want to get there as quickly as you can.

Polio was a devastating disease.

It would, you know, it would affect children

and it would cause them to be permanently paralysed and worse,

they had a complete realisation what was happening to them.

It affected their spinal cord far more than it affected their brain

so they were fully aware of the fact

that they may have had this iron lung that

helped them breathe or that they were going to be crippled for life.

It was a devastating infection and a very emotional infection.

So there was a lot of interest in trying to make a vaccine to prevent it -

to do whatever you could to make a vaccine to prevent it.

What came out of that pressure was a willingness to take risks.

Brodie thought injecting a mere 20 monkeys would be enough to

prove his vaccine worked.

Kolmer thought it OK to give his virtually untested live virus

vaccine to hundreds of doctors who injected

it into thousands of children.

In November 1935,

Brodie and Kolmer's results were publicly unveiled

at the country's top medical conference in St Louis, Missouri.

Both men were confident they had a vaccine that worked,

and was safe to use.

Looking back now, these papers, there's a lot that's wrong.

Kolmer makes the point that his vaccine, in particular, is safe.

Out of the 10,000 who were immunised,

there are ten cases here of children who developed

what looked very much like paralytic polio after being vaccinated.

And five of those died.

And when Kolmer wrote the first draft of this paper

he didn't include this. It looks awfully like a cover-up.

One of their fellow scientists at the meeting was damning.

He presented the clinical evidence to the effect that the Kolmer

live virus vaccine caused several deaths in children

and then point blank accused Kolmer of being a murderer.

And then in the end, they all turned on him

and he then said, Kolmer said,

"Gentlemen, this is one time I wish the floor would open up and swallow me."

In fact, his rival Brodie had also been

responsible for paralysing children.

The formaldehyde he used hadn't killed all the virus in his vaccine.

And it's Maurice Brodie that I really feel very sorry for

because he was young, he was only 30, and died not very many years

later at the age of 39 and there were rumours that he killed himself

because he couldn't cope with this.

The National Medical Conference concluded that both Brodie

and Kolmer's vaccines were dangerous and should be banned immediately.

I don't blame Kolmer and Brodie.

I think they were trying to do the best they could to prevent a disease

that was paralysing and killing children. For the 20 years

until we had the next polio vaccine, think about how many children,

how many thousands of children, would be paralysed or killed by that

virus while we were waiting to figure this out.

I find that whole episode in the '30s really frustrating.

If it's true that it put back the search for a vaccine by 20

years, well, that was the 20 years when my dad got polio.

But Britain had never been part of any scientific race to find a vaccine.

Here the response seemed to be damage limitation.

-ARCHIVE:

-'Usually severe paralysis means imperfect recovery

'and you may have to help the patient with a mechanical aid.

'In the iron lung he looks happy.'

We didn't have a president to lead the campaign

but we did have our own rich philanthropist.

-ARCHIVE:

-'Once again Lord Nuffield comes forward as Britain's premier philanthropist.

'He watches a demonstration of the new iron lung which he's mass

'producing at Cowley for presentation to hospitals all over Britain and the Empire.'

The millionaire industrialist, Lord Nuffield,

turned over half his shop floor to producing not cars, but iron lungs.

This instrument is vital for the treatment of children whose

respiratory organs had been impaired by infantile paralysis and a special

staff, trained in its correct use, is always available day or night.

The Royal Berkshire Hospital was given one of those iron lungs.

He offered to build, and supply free of charge,

an iron lung to every hospital in the British Empire

which is an extraordinary philanthropic gesture...

-So they were shipped off around the world...

-Yes, absolutely.

-Amazing!

I sincerely hope that my gift

will be the means of saving many valuable lives.

Lord Nuffield's generosity reached as far as the Flanders family.

When Dad caught polio, out at sea in the navy,

it was so severe he quickly needed an iron lung to survive.

For the first six months, he was in it for 24 hours a day.

With the war still raging, there were frequent power cuts

when his nurses had to pump it by hand to keep him breathing.

-ARCHIVE:

-'The patient is made to breathe by a regular alteration of air pressure.

'The air presses on the patient's diaphragm

'and thus brings about an involuntary emptying and filling of the lungs.'

Just stopped you dying of respiratory failure

in the early stages, and then not everyone did recover.

Um, it really bought you time.

I had to go down a mine once.

I had a terrible claustrophobia attack

and I'm starting to feel slightly the same way.

So this is a normal one and I'm finding it too short

so I don't know what my dad would have done.

Urgh... God!

-Do not be alarmed!

-Urgh!

-God!

-Excellent.

All this clanking around!

And then there'd be a rubber seal around your neck to stop any leaks.

Completely trapped!

Everything had to be done for you.

You were dependent on nursing staff completely.

-I'm not sure this is going to be...

-So this is...

-..great on the dignity front.

-..a feeding cup.

Mm-hm.

Hmm.

Very tasty. Gosh, that's the only way you can drink anything.

Horrible feeling, isn't it, to be so dependent?

It's true that anyone in hospital feels a bit like that,

but this is extreme.

My dad, eventually, was able to breathe again on his own,

but some patients spent 50 years in this horizontal prison.

In 1938, the same year that Nuffield was sending iron lungs

across the world, President Roosevelt was doing

all in his power to make polio research America's national cause.

And he found a very American way to raise money for it, using the power

of Hollywood - bringing in stars like Judy Garland and Mickey Rooney.

Judy, when I spent a dime on myself for some little luxury

like this, I always think about those unfortunate kids -

how far just a dime will go toward helping.

And that's what every good American should do - join the March of Dimes.

Send yours to President Franklin Roosevelt in the White House.

Like a battle-ready general, he founded the March of Dimes - a polio

charity that would "lead the fight on every phase of the sickness".

Over the next 20 years, The March of Dimes would turn

the traditional model of fundraising on its head.

It wasn't looking for big donations from the few,

but tiny ones from the very many.

He raised hundreds of millions of dollars.

The dimes weren't forthcoming within the first two days

and then indeed there was a deluge.

And the joke was that the White House had to

increase its mailroom staff in order to manage the volume of mail.

He wanted to take this fight nationally and to really unify

the fight against this disease and that's what he did.

And that was our mantra at the time, to unify,

lead and direct the fight against polio.

ARCHIVE: 'March of Dimes headquarters in Washington.

'Mrs Roosevelt accepts a cheque from Bobby Ridgio of Brooklyn.

'And here it is. 500,000 dimes!'

The campaign was also before its time in the way it used

the media to scare the population into action.

PUBLIC HEALTH FILM ARCHIVE: 'My name is Virus Poliomyelitis.

'I cause a disease which you call infantile paralysis.

'Ah, here we are - this is what I've been looking for...'

I mean, now it's quite hard to watch that because it does

look like scaremongering - I mean, it's a horror movie.

But this would have been playing in movie theatres across the country?

It was shown in theatres, yeah.

It does seem like a precursor to The Twilight Zone, I like to think.

Infantile paralysis.

The way it's designed. It's trying to grab people, to scare them.

Just the physical presence of disabled children in hospitals,

in homes in the public was fearful enough.

Infantile paralysis.

That might have been me or your little boy or girl.

It strikes the poor and the rich.

No-one is safe from infantile paralysis,

no matter who you are or what kind of home you live in.

With all my money, what could I have done for my child?

By the late 1940s, they'd proved that polio was absorbed

into the bloodstream through the gut, and Hilary Koprowski, a Polish

emigre working for a commercial lab in New York, realised this discovery

could pave the way to a pioneering new method of vaccination.

Hilary Koprowski was being funded by private industry

and therefore Hilary Koprowski had fewer restrictions on what

he could and could not do.

And he was, in many ways, the great scientific buccaneer.

He was going to give patients a vaccine they could drink.

That would offer faster

and more effective protection than a vaccine injected by syringe.

But it would also be more risky, because he chose a live virus method

as the building block for the vaccine.

Boldly, he did test the vaccine on himself by drinking his concoction

of virus grown and weakened in the brain cells of infected animals.

The next step was to find a larger group of human guinea pigs

to try out what was a potentially a lethal cocktail.

This is where Koprowski came to try out his experimental vaccine on humans.

Back then, it was a home for so-called "feeble minded children".

In Letchworth Village in upstate New York, Koprowski found what

he considered to be ideal test subjects -

children who were either abandoned or orphaned, who had no-one

to speak for them, and who were too severely disabled to protest.

Koprowski's biographer has a description of him

arriving here on February 27th 1948 with his colleague, Norton.

"They carried a small cooler containing another batch of

"the polio vaccine that they'd made

"in the blender earlier that morning.

"A boy of six waited.

"His extreme handicap included an inability to feed himself.

"A cubic centimetre of the grey liquid was measured out

"and fed to the boy.

"Koprowski recalls that the boy reacted badly to the taste

"and was given a chocolate milk chaser which he liked."

"It was typical," he writes, "of Koprowski to remember such a detail.

They did it in ways that today we would find abhorrent.

On the other hand, he saw this as absolute progress

and what he saw was that he was getting results

in these young children.

By today's standards, this would be absolutely...

It would be an offence that would send someone to jail.

When Koprowski published his results,

the British journal The Lancet did wonder whether it was right

to call the children here "volunteers".

They wrote, "We may yet read in a scientific journal that

"an experiment was carried out with 20 volunteer mice

"and 20 other mice were used as controls."

Despite the controversy about his methods, the Letchworth

residents developed antibodies which protected them against polio.

Over a five year period, he modified his vaccine and ran more tests,

finding a group in Britain who did give permission for a study.

One of those volunteers happened to be a five-year-old

Gareth Williams, then growing up in Belfast.

Well, here we've got two guinea pigs here - this is actually me and my sister.

We were recruited by the Professor of Microbiology coming up to my dad,

who was Professor of Geology,

in the staff club one lunchtime saying,

"I've got this new vaccine for polio we've got to try it out.

"It's everybody's responsibility,

"I'm looking for volunteers, how about your kids?

"Mine are in already."

To which my father allegedly said, "That's fine, you can have them!"

The trial involved Gareth, and hundreds of others,

drinking Koprowski's oral vaccine.

They were then tested over the next few months to see

if their blood had created antibodies - it had.

The vaccine was safe too - no-one had any side effects.

But the research also discovered something alarming

about the way polio could be passed between human beings.

They discovered that although when you took the vaccine

out of vial was absolutely innocuous -

you could inject it into the brain

of a monkey which was a standard test for the ability to paralyse

at the time - you could do that and the monkey was absolutely fine.

If you collected the vaccine virus from the stools having been

through the kids' bowels and injected that virus into the monkeys' brain

then some of those monkeys became paralysed.

So what this showed was that simply going through the bowels

of ostensibly normal kids in Belfast transformed this innocuous

vaccine virus into something that could regain the power to paralyse.

I don't know if it was my sample's of my sister's, or somebody else's,

but somewhere in that study there was a bowel which altered

the nature of the vaccine virus.

So you risked putting it back in the community

even if it wasn't going to be caught by the person themselves?

Exactly right. This was a significant setback for the Koprowski vaccine.

The head of virology at Belfast University declared that

the vaccine was unsafe, so although he had got tantalisingly close,

the Belfast trials had sent Koprowski back to the drawing board.

At exactly the same time, astonishingly,

rather like the rivalry of the 1930s, two more scientists

came forward to battle it out in the race for a vaccine.

Their approaches were radically different,

one slow and methodical, the other fast and driven.

Albert Sabin was the tortoise -

a professor of paediatrics at Cincinnati Medical School.

He was nothing if not thorough,

having spent 20 years already researching the polio virus.

Albert Sabin was actually one of the great medical research scientists

of the 20th century. He moved slowly and very, very carefully.

And he saw himself as a scientist's scientist.

He saw himself as a guy who worked in the lab, never left,

and made discoveries, one by one using building blocks.

If Sabin was the tortoise,

then the hare in the race was Jonas Salk - a fast-thinking, fast-talking

scientist working at the medical school in Pittsburgh, who'd already

made a successful flu vaccine for the troops during World War II.

He had the backing of The March of Dimes who were eager for results.

He was funded by a group, The March of Dimes,

who wanted to get from point A to point B.

He thought like a pharmaceutical company and Jonas Salk in many ways

acted like a pharmaceutical company and that also

went against what one had as a conception a scientist does.

Sabin and Salk were on opposite sides of the debate

when it came to what the vaccine should be based on.

Salk and Sabin had fundamental differences

about what would be the best vaccine.

Salk thought it would be a virus that would be completely killed,

Sabin thought it would be a virus that would be weakened.

So when there are differences of opinion,

those are very emotional issues.

There was tremendous jealousy.

And so, Sabin really attacked Salk mercilessly because he was

a bastard, frankly, and Salk was a much kinder, gentler man.

'But that funding from The March of Dimes gave Salk a major

'advantage over Sabin.

'In 1949, it allowed Salk to put his lab in the centre of a working

'hospital surrounded by polio patients in Pittsburgh.'

So this is the original, the old bit of the hospital.

'Jody Zogran was a nurse on that polio ward.'

When was the last time that you were here?

Er, 61 years ago.

61 years ago, you came in here!

Yeah, and our nurses station would have been just about here.

Dr Salk took over the first floor for research.

'The layout of the hospital turned out to be vital to Salk's approach.

'With his labs down below and a ward full of polio patients

'just above, he had a unique and ready source of live virus.'

Polio is contracted by going through the mouth and it

goes down through the GI tract and it settles in the intestine.

Patients that were newly infected with the disease would let out

the polio virus in their stools

but it would only stay alive for a very short time, so Dr Salk

needed the samples delivered to the labs as quickly as possible.

He would rush with the pan to the door, no further.

Sitting outside, there were medical students

and they would stand up, grab the bedpan,

run down the three flights of stairs and give it to someone in the lab.

Waiting there to collect the samples and extract the live virus

was Ethel Bailey, a researcher who worked with Dr Salk.

We had to get enough virus to make a vaccine.

Once we got the virus we used to inoculate the test tubes

and the only way we had to do it was with a pipette so you sucked

it up, hopefully not too far, put your finger on it and then

you could release just the amount you wanted, in each test tube.

So it's like when you're trying to get petrol flowing into a tank

you were basically, you were sucking up, only this was live polio virus.

And you didn't think, "This is a crazy thing for me to be doing"?

I don't know, a time or two I think I did get it in my mouth but you

run to the sink and rinse it out as best you can and hope for the best.

Ethel had to wait two weeks to find out whether she'd contracted polio.

That was just one incident of many for the workers who were

taking those risks in the rush to find a vaccine.

ARCHIVE: 'In New England, a silent visitor crept in - polio.

'It first hit the Boston area.

'July, first week, 15 cases, second week 35, then 50.

'August 370 more. Polio running wild, choking hospitals.'

By the 1950s, epidemics were featuring ever more frequently

in the newsreels, adding to the terror of a population

that felt pretty much helpless in the face of a disease

they could do nothing to prevent.

There was so little known about the way polio was spreading.

Some towns sprayed streets with toxic chemicals.

-ARCHIVE:

-'Today's target for this B-25 is Rockford, Illinois,

'a peacetime mission to spread 500 gallons of DDT, the army's

'miracle insecticide over the city stricken with an infantile paralysis epidemic.

'A bomber turns to the ways of peace, becomes an instrument of science.'

For ordinary people in small towns like Dewitt in upstate New York,

it was hard to know how to go about your daily life.

Jan Nichols grew up here during that period.

Parents were terrified and had a bunch of rules for us -

we had to wash our hands a million times a day,

we couldn't get over tired, we could not swim in a swimming pool,

because they were told that if you swam in a swimming pool

you would get polio. They tried to keep us away from large gatherings.

My college roommate's mom was afraid to have her go to Mass on Sundays.

So you were surrounded by a virus you could not see

and you did your best to protect but you could not completely protect.

So, they were just praying that their family was never hit.

But in 1952, polio did come late to the town and with deadly force.

It happened on Halloween.

In Dewitt School, eight out of 24 of her class got polio,

including her twin brother, Frankie.

He was a typical little active boy, always running, always jumping,

always getting into trouble with the boys

and we were getting ready for Halloween.

Frankie suddenly developed a terrible time breathing so

he was rushed to city hospital and I remember vividly looking out one

of the front windows as they were driving Frankie to the hospital.

He was immediately placed in an iron lung because he could not breathe.

The next night, at 10.25 at night, Frankie died.

Frankie was only six.

By the time he died, Jan had also been rushed to hospital with polio.

Her parents were ordered to burn all of the children's possessions

to prevent the spread of the disease.

They were allowed to keep just two.

They kept these silver juice cups with our names on them

and we had been given these when we were born, so he was just...

Look at those eyes, he's absolutely full of the dickens!

It's great that you can remember him so well, though.

Maybe because he was as twin that you had such strong memories.

I was this age when my dad died and I don't remember him very well -

I don't have vivid memories like that.

It was so important to me that he did not die in my mind.

-ARCHIVE:

-'A thick fear fell over the city.

'Summer ended but schools stayed shut,

'their halls mute evidence to the ever-present epidemic.'

The year that Frankie died, 1952, turned out to be the worst year

for polio in American history with 58,000 victims.

-ARCHIVE:

-'This is polio and it is something for you to remember.

'Polio is not over.

'Polio is not over for this patient.

'Polio is not over for thousands.'

There had never been a greater need for a vaccine.

In 1953, Jonas Salk went public

declaring that his vaccine might be possible within two years.

From his Cincinnati lab, Albert Sabin openly contradicted him.

He looked at Jonas Salk and saw this sort of celebrity scientist being

trotted out by The March Of Dimes, this white knight in a lab coat was

always talking in front of cameras - this, to him, was not real science.

Albert Sabin actually believed and to some degree, correctly,

that he had the better vaccine.

It would take longer but his vaccine would give better immunity

and he believed that if another vaccine came out first

that that would push his vaccine aside and that the world would be left

with a quicker vaccine but an inferior vaccine.

Sabin probably considered himself to be the more accomplished scientist

but Salk was the more single-minded about how to achieve his goal.

He was of the belief that if you give a killed virus that that

could induce lifelong immunity and nobody thought that was true.

At the time, what people thought was there was only two ways

to get lifelong immunity and that was to either be naturally infected

with polio or to be infected with a live weakened form

of the virus like Albert Sabin had done.

But he showed that, in fact, a killed virus could induce a memory response

which is to say something that was likely to induce

lifelong immunity and he was right and no-one believed him

at the time but he stuck by that and he was right.

In May 1953, after almost five years of growing, purifying,

heating and pickling his virus,

Jonas Salk finally believed he'd got his vaccine formula right.

Apparently they used to call it "Dr Salk's germ-free lab".

This is the actual lab. It's amazing.

This is where he did all that work and came up with the vaccine -

the first vaccine that could actually beat polio.

But he needed human guinea pigs to be sure.

So in a display of striking bravado, he injected himself,

his wife and all his sons.

Peter Salk, himself now a medical researcher,

is pretty relaxed about this.

He knows exactly why his dad was prepared to take that risk.

My father was time-driven, he was also being

driven by the National Foundation for Infantile Paralysis who

wanted to see something out as quickly as possible.

He had to be sure that the virus was completely killed

so he was caught between two poles.

One was the pressure to move quickly

and the other was the pressure

to do something in absolutely the right way.

Doctor, you must have had confidence in your vaccine when you tried it on human beings.

What was that confidence based on?

Well, it wasn't confidence, it was a question of having a certain

amount of knowledge and information and, er, the next step, er,

in acquiring more information was to inoculate human subjects.

He had himself inoculated, his wife, Donna, and their three sons,

so they had to wait for about a month to see

if they had built up any antibodies and the only way

they would know is if the blood in that test tube changed colours.

Salk knew he was potentially exposing himself

and his family to polio.

31st day, the lab worker that was responsible for all

the specimens opened up the door to the specimen lab

and she screamed at the top of her voice and it was the first time

Doctor Salk ran out of his office without his lab coat on

and everybody came and everybody was kissing and hugging and screaming.

To know for sure if the vaccine worked,

they needed a much larger trial.

In April 1954, the biggest medical experiment in human history began.

It needed the cooperation of more than 50,000 teachers

across the country, immunising almost two million children.

At her school in Dewitt, Jan Nichols and her school friends

were among those lining up to be guinea pigs for Dr Salk's experimental vaccine.

This is the picture of me actually getting the vaccine.

Well, they told us that we were doing something for our generation

and for all future generations of children.

So I can remember thinking we were really famous kids, you know,

because we were doing something good.

-I did get a card...

-He just found it recently.

A certificate of membership presented for taking

part in the first national test.

Well, that's amazing you still have that.

Do you remember getting your injection?

Actually I do because all of us were lined up and this one boy,

if I dare mention his name, John Hammicon was there,

and kids where getting their shots and John got his shot.

His eyes rolled into his head and down he went.

Oh, and so everyone watching that would have been like, "I'm not getting that!"

We were proud, we were proud kids and you ask anybody who was in

that trial if you're a Polio Pioneer, everybody would raise their hands.

No matter where I talk, all over the country,

and I ask for Polio Pioneers, I'll get hands.

-ARCHIVE:

-Now to the University of Michigan Campus in Ann Arbor

come hundreds of scientists hoping to hear the words that will signal

the end of polio's long and ruthless reign of terror.

Leading the medical men is Dr Jonas Salk whose polio vaccine

has been tested and carefully evaluated.

Copies of the official findings are wheeled in.

The room is electric with expectancy.

Then the historic announcement - the vaccine works.

It is safe, effective and potent.

Reporters press forward to get the results the whole world

is waiting for -

rushing to their typewriters to spread the momentous news.

The triumphant Salk vaccine went into production immediately

on the 12th August 1955.

-ARCHIVE:

-Though some of the youngsters are apprehensive, they learn,

when their turn comes, that the vaccination hardly hurts at all.

But less than two weeks after the release of the vaccine,

there was a major setback.

A number of children in the west and south west of America

had started to get polio from the vaccine itself.

-ARCHIVE:

-At this moment, an ominous chain of events begins in California.

Five polio cases are reported

and each victim has just been given the Salk vaccine.

As the tragic scandal played out, it became clear that almost

all of those who had come down with polio, had been given

vaccine from just one laboratory, the Cutter Labs in California.

We had given polio vaccine to prevent polio

and, in fact, had caused polio in these children,

I think, um, I can't imagine

anything worse and so we shut down the polio vaccine programme for

a couple weeks in this country until we figured out what was going on.

-ARCHIVE:

-As the mystery deepens and still more cases are reported,

the government acts.

Soon after, all other vaccine shipments are temporarily held up -

release of the Salk vaccine seems a gigantic

and tragic blunder only 25 days after

the announcement of success in the field trials.

Jonas Salk was adamant that it wasn't a fault in his vaccine,

but in the way it was being manufactured.

The investigation proved him right.

The Cutter Labs had failed to kill all the virus in the vaccine.

About 120,000 children were inadvertently

inoculated with live, fully virulent, deadly polio virus.

40,000 developed abortive polio which is to say

short-lived paralysis.

About 200 were permanently paralysed and ten were killed.

It was probably the worst biological disaster in the United States' history.

By acting so quickly, the government was able to rebuild Americans'

confidence in the new vaccine.

A programme of mass immunisation across the country went ahead

the following year.

The number of cases of polio recorded fell from 60,000

to 2,000 within a year of Salk's vaccine.

Within a decade, polio in America was all but eradicated.

But in Britain, it was a very different story.

Here the take-up of the vaccine was painfully slow.

And again, my own family were directly affected.

A year after Salk's triumph in America, in 1956, in Ireland,

my Uncle Patrick got polio.

He was only six.

I remember having like flu and I sort of remember everybody looking

rather aghast around - my mother and others were in tears.

And I remember my mother saying, to comfort me, the ambulance

will bleep its horn and everybody would get out of the way.

The sort of thing people say to comfort children

but actually it made me feel worse because I could sort of sense

the sense of panic and anxiety so I screamed more and more.

Patrick was one of 220 children to contract polio that year in Cork,

which was in the throes of a serious epidemic.

You caught polio after the vaccine had been discovered.

Did you ever think about how tantalising that was?

-Do I think I feel real unlucky?

-Real unlucky!

You bet I do, yeah!

Patrick's a journalist and he came back recently to write a book

about his childhood experiences and was surprised to find evidence

in the local newspaper archives suggesting why no vaccine was available to him.

-Oh, right, yeah...

-Yeah, there we go, yeah.

So that's...

"Polio vaccine passes safety test in Britain."

That's over a year after the trials in the US,

it's getting its approval in Britain.

The Cutter incident had cast a long shadow across the Atlantic.

Patrick had missed the chance to be immunised at the height

of what was the last mass epidemic in Europe

because the safety tests here had been so exhaustive.

It wasn't until 1957 that the vaccine finally

arrived in Britain but it wasn't hailed with all the enthusiasm

expected of a life-saving drug.

The doubts cast by Cutter just wouldn't go away in the public's mind.

Has your child been immunised?

-No, she hasn't been done yet.

-You refused?

-Yes.

Why did you refuse?

Well, because there was such a lot of talk in the papers about

the danger of it, you know, that I was a bit afraid of her being done.

Are you terrified of the immunisation?

I don't know, I feel a bit sort of, er,

guilty about immunisation - I want other people to see

how it goes before I give my child to be a guinea pig.

In the end, it was the shock of a celebrity succumbing to the

disease that made the difference.

ARCHIVE: Birmingham's defence have Wembley nerves and are marking badly.

Right back Jeff Hall challenges him.

Jeff Hall was a star player for Birmingham City and England.

He caught polio at the peak of his playing career.

He was playing down at Portsmouth and he wasn't very well

when he came off and one or two

of the Birmingham players said to him, "You don't look very well.

"Just take two...two aspirins and you'll be all right."

Monday morning, he couldn't get out of bed.

He couldn't move his legs.

-So he wasn't vaccinated. Was anyone vaccinated in those days?

-No, no.

Nobody knew anything about it.

It was something out of the blue.

Within a week, Jeff had died,

and suddenly everyone in Britain wanted the vaccine.

Emergency clinics were set up

and extra supplies of the vaccine had to be flown in from America.

The attitude on Britain's streets now was quite different.

I ain't thought nothing about it but I'm now going to have 'em done now.

I haven't been but my mother doesn't really believe in it.

-She doesn't?

-But my father said that I should.

-I see. You believe your father more than your mother?

-Yes!

Thank you very much indeed.

Mass immunisation began in 1959.

By the mid-'60s there were only 70 deaths a year in

Britain from polio, and by 1978, it had been officially eradicated here.

What's really interesting about this success, though,

is that the vaccine most of us remember taking in those years,

wasn't Salk's injected vaccine.

We took Sabin's oral vaccine - on a sugar lump or in a cup.

Albert Sabin had continued to develop methodically his live

vaccine despite Salk's success, believing it to be superior.

Once Albert Sabin began testing his vaccine in the Soviet Union

and came back with great numbers, he went out of his way to make

certain that Jonas Salk's vaccine was pushed right of the picture.

And he did.

By the early '60s, most of the world was using Sabin's vaccine

because it was cheaper and easier to take.

So what looked to me in doing this history like an incredibly costly

rivalry that produced two vaccines rather than one, ironically all

these years later, looks like that rivalry had a purpose after all.

To end polio in the world, and we are close,

you are going to need both vaccines.

You cannot end polio just by using the Sabin vaccine

or just by using the Salk vaccine.

You are going to have to use them together.

And these are two scientists who despised each other -

both of whom believed the other's vaccine was inferior.

Both of whom went to their graves just feeling that they had to

do everything possible to push their own vaccine at the expense

of the other and now we found out that to end polio, you need both.

You can't do it with one.

So the men have been linked in ways that not only could

they not imagine but they would be disgusted with.