boston.com Arts and Entertainment your connection to The Boston Globe
BOOK REVIEW

'Solution' provides shot of adrenaline in retelling of polio vaccine race

Splendid Solution: Jonas Salk and the Conquest of Polio, By Jeffrey Kluger, Putnam, 373 pp., illustrated, $25.95

Fifty years after the first successful polio vaccine, it is all but impossible to imagine the terror and tragedies generated by the virus. In the first half of the 20th century, the disease killed or crippled countless infants, children, and adults. In one record-breaking polio season, the summer of 1952, almost 58,000 Americans contracted polio.

The initial symptoms of polio mimic those of a cold or a mild flu. Days later, the victim would be battling fever, or would be unable to get out of bed, or even sit up. In this brief time, the polio virus would have swiftly and permanently damaged the spinal column, withering the strength of arms, legs, and sometimes lungs.

It's a small wonder, then, that the announcement of the first safe and effective vaccine against this dread disease, on April 12, 1955, set off worldwide celebrations and made its creator, Dr. Jonas Salk, an international celebrity.

The quest for a polio vaccine spanned three decades, from the 1930s through the 1950s and involved a sizable cast of characters from government, science, and the media. Sometimes the different groups worked together toward a common goal; sometimes they competed fiercely for information, prestige, and funding.

To tell this tale, Jeffrey Kluger has pulled intricate scientific concepts from remote lab shelves and has shone a readable, engaging light on them. ''Splendid Solution" is meticulously reported and gracefully told, with medical, social, and political factors made equal parts of a very large equation. Kluger is an award-winning senior writer for Time magazine, specializing in science. He is also the coauthor of ''Lost Moon: The Perilous Voyage of Apollo 13" (the book was the basis for the 1995 movie ''Apollo 13").

Polio was also known as infantile paralysis, since it often struck the very young. The virus thrives in hot weather: Spring signaled the beginning of a polio season, and outbreaks continued until the cooler fall weather.

Salk, who came to know the mechanics of the polio virus better than anyone else of his time, was born in 1914 in New York City. He became an inquisitive young man who ''would listen more than he spoke." When he did speak, Kluger writes, ''he would seem to refract everything that had been said so far through an odd prism of his own, casting new . . . insights on whatever was being discussed."

With an analytical mind and a strong desire to make a difference in the world, Salk entered the City College of New York in 1934, with the idea of becoming a lawyer and ultimately a congressman. But a required freshman course in chemistry, which he loved for its logic and ''orderliness," convinced him that medicine was where he wanted to be.

While Salk was in college, the country was deep in the Great Depression. President Franklin D. Roosevelt was combating economic woes, creating Social Security, and mounting an increasingly organized campaign against polio.

''Splendid Solution" is told in chronological order, alternating medical events with worldly ones. Kluger's fine organization keeps a crowded story from collapsing in on itself.

The disease that had struck down countless children had afflicted Roosevelt in 1921, when he was 39. In his 50s and at the helm of the country, Roosevelt found numerous ways to motivate Americans to fund polio research. The most famous of these was the creation of the national fund-raising group March of Dimes and the National Foundation for Infantile Paralysis, which distributed funds to labs and universities across the country.

Kluger clearly explains how a vaccine ''wakes up" the body's immune system to fight a given disease. Historically, the challenge for scientists had been to create a vaccine using as weak a virus as possible, so it would trigger an immune response without giving the recipient the full-blown disease.

The danger had always been that in any batch of vaccine serum, one or two viruses might not be as diluted as others and could ''muster the muscle to mutate back" and fully infect an ''unfortunate few" of the vaccine recipients.

Since he was an undergraduate, Salk had disagreed with the thesis that a live virus was the only basis for a vaccine. He wondered why a person couldn't be shielded from an illness by being given just a ''scrap" of a virus. A killed-virus vaccine would be safer, but would a body's immune system learn enough from it to be effective?

In World War II, Salk had a chance to prove his theory on a grand scale. Working for the US military, he and Dr. Thomas Rivers cocreated the first successful flu vaccine, using a killed virus. Their methods were lauded as revolutionary.

The question of live vs. killed virus heated up as the 1940s edged toward the 1950s, and as more labs around the country focused their efforts on a polio vaccine. Salk was head of the University of Pittsburgh lab and was concentrating on developing a polio vaccine with a killed virus. His fiercest opponent in this medical debate was Dr. Albert Sabin of Cincinnati Children's Hospital. Sabin, who had a ''profoundly sharp medical mind, and an equally sharp way of expressing it," was convinced that the only effective polio vaccine was one made with a live virus. Their research efforts would parallel each other into the 1950s.

''Splendid Solution" indirectly highlights the importance of being first in a major endeavor. In 1962, Sabin's live-virus polio vaccine would begin to be distributed to schoolchildren across the country. Many baby boomers probably remember getting this style of inoculation, taken orally by sugar cube rather than by an injection in the arm, yet it is Salk who is most noted in school history books.

Kluger brings you right into the daily workings of Salk's lab as his team edges toward its ultimate goal, from Salk's national success in 1949, when he became the first scientist to define the three major types of polio, right through the ''Polio Pioneer" national vaccine trials of 1954.

The narrative also provides a media's-eye view of the country's response to these efforts. With polio plagues raging nearly every year, the vaccine research could not be kept secret. Newspaper and magazine reporters clamored for bits of medical news for an anxious public. Salk gave multiple print interviews and national radio addresses, the most notable one in 1954, to calm fears about a manufacturing problem at one of the companies that was producing vaccines for the national trials. Salk handled the media as deliberately and skillfully as he maneuvered through the inner world of the science community.

Intentionally or not, Salk is portrayed as more interesting at work than at home. He seems fully engaged with his peers, with patients of all ages, even with the lab monkeys that had to endure test versions of the vaccine. In domestic scenes, Salk is often described as distracted or exhausted. His wife, Donna, seems unwaveringly supportive, dispatching all domestic and family details for their three sons so Jonas can concentrate on his investigations.

The results would amount to a permanent barrier against this disease for millions of young Americans. Fifty years later, we have Kluger's compassionate account to remind us of how the world used to be, and how it was changed at this magnificent milestone.

SEARCH THE ARCHIVES
 
Today (free)
Yesterday (free)
Past 30 days
Last 12 months
 Advanced search / Historic Archives