JAM Vol. 12, Nr 4 The poliomyelitis epidemic in Holland in September - December 1992 attracted a great deal of attention, as the disease was thought to have been eliminated in developed countries.

Holland 1992

What happened in Holland? Between September and December 1992 52 cases were reported, ranging from one patient less than 1 year old to one aged 40 (40 paralytic, 10 non-paralytic). 6 required artificial respiration. A 4-week old infant died. In all cases polio type 3 was isolated and/or spe- cific IgM antibodies identified. The epidemic strain, also found in sewage in different parts of Holland, was closely related with a strain isolated in South-East Asia. All those who contracted poliomyelitis belonged to a religious sect which refuses vaccination. They live in closed communities in different provinces of the country. The sect has about 30,000 members. An epidemic had occurred in the same population group in 1978, when 100 people contracted the disease (80 paralytic), and type 1 was isolated.(1,2)

It is worth noting that the Salk vaccine, that is, an inactivated vaccine, is largely used in the Netherlands, whereas in Germany and all Eastern European countries the oral method is used.(3) This was introduced in 1962, thanks to considerable personal engagement on the part of Prof. Joppich (Goettingen). Prior to this, epidemics occurred at 4 or 5 year intervals, with numbers gradually rising from the early part of the century (1925 c. 4/1000,000 = c. 2,400 in Ger- many) to the early 1950's (18/ 100,000 = c. 10,800), after which the disease almost disappeared with the introduction of the oral vaccine. There were still 296 cases in 1962, but only 14 in 1986-1990, most of them brought in from abroad.(4)

Epidemiology in Germany

1992 also seems to have been a subliminal epidemic year in Germany. It was the year I saw the first case of polio following vaccination (short- term paresis of legs after second vaccination: type 3) in a young child at nursery school.

At the highly efficient virus laboratory of Prof. Enders, Stuttgart, a case of paralytic polio was identified for the first time after many years in 1992 (male aged 46, immigrant, unvaccinated, type 1) and 9 cases of complications following oral vaccination were recorded (3 short-term pareses, 4 cases of post-vaccination fever, 1 "encephalitis" - a boy of 5 with respiratory failure). Viruses of different serotypes were found in all cases. The fact that different viruses have been found in Germany (Enders laboratory) suggests an epidemic situation that makes use of existing pathogens (cosmic influences? nutrition? weather? soil?) and is not due to a single virus strain or vaccine.(5)

R. Steiner spoke of cosmic influences on diseases and epidemics; these are communicated to the Earth, passed on via the food, which, of course, depends on the soil, and influence the course of an epidemic.(6,8)

Scientific research has shown that sugar consumption favors an epidemic, and/or that reactive hypoglycemia may lead to disease becoming manifest.(9)

"Disease entity" When a disease entity rears its head after enforced dormancy to show the disease still exists we consider what the nature of this entity may be. Can we recognize it in individuals who have overcome the disease but nevertheless bear the marks of it for the rest of their lives, or in those who have died from it?

The 12-year-old girl, top of the class, was celebrated as a winner at the Federal Youth Games. Soon after she was tetraplegic, needed artificial respiration, and finally died of poliomyelitis.

A boy of about 6 developed quadraplegia, needing artificial respiration, and from then on had to depend on a respirator. He was permanently in hospital and became the soul and moral heart of the hospital. He had to be on his respirator throughout his school years. Nurses and physicians came and went, he remained. The first person to go and see when one had been away for years was this boy. He knew every- thing that was going on, was pleased to have a visit, and you left feeling all the richer for having seen him. Years later he got a place in the Pfennigparade (Penny Parade) institution in Munich. Many of our older colleagues will know of similar cases.

In the first case we see prior damage during the incubation period, and what might have been a harmless influenza-type illness turned into a fatal illness. In the second case the patient survived. He developed special human and social powers that probably only could develop because of this stroke of destiny. I have repeatedly seen similar qualities in people who have had poliomyelitis in the past. (Could Roosevelt have been one of them?)

Prior damage suggests something "getting through" by way of karma. The development of special qualities makes one think that the disease seeks to achieve a metanoia, an inner change of direction. (The idea may be taken further, for instance, also asking which disease does this disease heal? I am not going to do so, as this may justifiably be called speculation.)

Historical aspects

The disease was first described by Heine, an orthopedic surgeon in Cannstatt, Germany, in 1938. In 1860, Medin, a Swede, realized it was an infectious disease occurring in rhythms during late Summer and in the Fall, its incidence rising. In 1909 transmission was demonstrated in animal experiments (primates) by Landstein. Since then it has been possible to "experiment" with the disease. That year may also be considered to mark the beginning of the disease being "tamed." Finally 3 serotypes of the virus were identified, chemically analyzed and their morphology described (electron microscope, RNA virus).

From 1949, the virus could be grown in tissue cultures in vitro (Enders, Nobel Prize) and not only via animals. These technological advances made it possible to develop vaccines, which were needed as people were helpless in the face of rising incidence. Young mothers also contracted the disease. It became not only a personal and family, but also a social, problem.

The Salk vaccine became avail- able in 1956. It contains inactivated virus with adsorbents and has to be given by injection. Complications were relatively common and not ac- cepted in the German Federal Republic so that this vaccine had no influence on the epidemiology in that country (personal experience).

Sabin's oral vaccine was only generally accepted from 1962. Licensing was delayed due to fears that the viruses might turn "wild" again. Sabin had attenuated the wild virus in repeated animal passages, so that inoculation was not followed by reactions or paralysis. Taken orally, the whole immunization process - with infection, incubation, symptoms such as enteritis and catarrhal changes - runs its course, except that the phenomena such as viremia, meningismus and paralysis developing are drastically reduced. The recorded frequency of complications is 1:10" - 1:3.5 xl0/4.

Immunization process, vaccination method

In the process, the organism conies to terms with the virus, acquiring all phases of immunity via IgM/IgG antibodies (complement binding reaction and neutralizing antibodies) and local immunity as a specific secretory IgA develops. The latter phenomenon cannot be achieved with inactivated vaccine. This method is therefore much more "stable" and confers better immunity than the Salk vaccine. Oral vaccination given during an epidemic has brought this to a stop. It only allows the disease to develop to the level it would normally develop with natural, wild infection, for the disease may be seen as a complication - occurring in 1 of 1,000 cases - of a harmless throat and intestinal infection.

The virus is, however, eliminated by vaccinated individuals for a limited period (c. 2 weeks), and they are therefore infectious for that period, "silently" vaccinating "their environment." As a result, the danger of an epidemic developing is much less in areas where the oral vaccine is used, and gaps can be much larger than in areas where the Salk vaccine is used. The wild virus disappears with this measure and only the vaccination virus circulates among the population.(4)

The method of vaccination comes as close as possible to the natural process, essentially returning to the method used with the first vaccination ever, which was for smallpox. The choice of time is the only arbitrary element compared to the natural process.

Initial resistance to the oral vaccine had to do with concern over the safety. A virus deriving from a person who had developed paralysis was attenuated in animal passages so that its virulence was reduced, apparently due to mutation. The gesture of the method indicates alienation from the human being. The process is, however, reversible, and work is in progress on the problem. The strategy of vaccinating each successive generation serves to protect from reverse mutation.

The vaccination virus' ability to immunize and its ability to mutate back are unequal. This is the reason for further development work on the established oral vaccine. The problems concern:

1 the quantitative relationship between the three serotypes and, hence: the individual power of each to confer immunity;

2 serotype 3 appears to present a particular risk of reverse mutation, and work is in progress to develop a safer strain.(4)

Other aspects

So far we have mainly considered aspects to be taken into account with immunization against polio. They concern the infectious agent and not the host.

We have seen that the infectious agent is merely an indicator for the host's situation and consider it important to keep the host in mind - his karma, life situation and constitution.

We do not know how far immunization intervenes in the karma of the individual, maintaining life situations that karma demands should be changed. Thus immunization, and particularly mass immunization, influences the individual in terms of a uniform collective.(10,11)

Apart from this there is always the question of whether vaccination makes people healthier. The answer may be said to be in the negative, except for a certain immunostimulation which is a "health factor."

In my view, immunization against polio has no adverse effect on the constitution. If we take the abovementioned immunostimulation to the constitution a health factor, it may even have a strengthening effect. The processes initiated in the metabolic sphere no doubt contribute to this.

Final comment

The history of vaccination began with smallpox vaccination. It became a legal requirement, for the disease was known to be more than individual destiny. Society, the State, felt that the disease threatened its stability, as evident from the high incidence of the disease, the suffering it caused and the powerlessness experienced in the face of it.

TB and diphtheria immunization, both intended to limit the disastrous consequences of these diseases, were of public interest as well as helping to reduce personal suffering. Again, the State recommended immunization from the point of view that "personal suffering is the suffering of society as a whole." With tetanus, the situation is somewhat different. Immunization was initially developed for military reasons - to save the soldiers for the State. With pertussis vaccination we see the focus change more to the child again. It was followed by polio, measles, mumps and rubella vaccination in that order. Poliomyelitis vaccination was the first to combat a dreaded complication of a disease; the same applied to measles. With rubella, the indication became more diffuse. In this case, it is not the patient who is protected from the disease and its consequences, but the next generation. With mumps we are even further removed from the individual and the disease. The main motive is to maintain procreative capacity, i.e. not protecting the patient but possibly only his ability to create the next generation. This ranking order in time for vaccination and the motives behind it shows a growing distance from disease and patient, from coming to terms with the disease entity and preventing suffering.

The question of the meaning of illness arises if the vaccinated individual is included in our considerations of the vaccination process. It appears that the answer to this background question is always in the negative.

Kaspar Mittelstrass, MD

Filderklinik

Im Haberschlai 7

D-70794 Filderstadt-Bonlanden Germany

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