Science and Nature

Polio Makes Its U.S. Debut in Vermont’s Otter Creek Valley in 1894

In June of 1894, a strange nervous disease attacked several children in Vermont’s Otter Creek Valley. It started as a summer cold, but then it paralyzed its unlucky victims. After a few weeks, people in the valley began hearing about deaths from the mysterious ailment. By the end of July, the valley filled with dread as the disease took victim after victim, seemingly at random. Then finally a 37-year-old country doctor figured out what afflicted Otter Creek Valley: polio

Charles Caverly was the right person in the right place at the right time to diagnose the disease that would maim and kill tens of thousands of U.S. children over the next half century.

 

Otter Creek

Summer after summer, polio returned in great waves, striking first in the Northeast and then moving westward. It struck randomly – in the city, in the country, among rich and poor, healthy and sickly.  Like AIDS in the second half of the 20th century, polio in the first half was lethal, incurable and favored a specific group of victims – children.

It would take six decades before Jonas Salk developed the first safe vaccine against polio. But the process of eradicating the disease began with Charles Caverly and the large body of data he collected in Vermont.

Charles Caverly

He was born in Troy, N.H., on Sept. 30, 1856, to an old New England family. His great-great-grandfather, Philip Caverly, served as a soldier in the American Revolution.

He went to local high schools, prepped for college at Kimball Union Academy in Meriden, N.H., and graduated from Dartmouth in 1878. He then attended the University of Vermont School of Medicine, and then studied for 18 months at the College of Physicians and Surgeons in New York.

Charles Caverly

Caverly began practice in Rutland in 1883, in association with Dr. Middleton Goldsmith.

“He was a quiet, cultivated man, with a singleness of purpose which was striking, a lack of pretense which was always charming, and an ability which was perfectly evident,” wrote Robert W. Lovett, who knew him.

But Caverly was more than a country doctor. He had a passion for public health, and by 1897 he served as president of the Vermont State Board of Health. He also taught hygiene and preventive medicine at the University of Vermont College of Medicine.

Polio Strikes the Otter Creek Valley

The first polio cases appeared in the middle of June in Rutland and nearby Wallingford. Until mid-July, it prevailed in Rutland, then other nearby towns began reporting cases.

Caverly sensed the new disease had created a feeling of uneasiness among Vermonters. In late July he decided to investigate the outbreak systematically. He reached out to all the physicians in the area who had patients affected by the disease. Caverly identified 123 cases from June 17 to September 1. All but six were within the Otter Creek Valley, which was only 15 miles wide and 30 miles long.

The investigation, he wrote, “soon convinced me that this region had been affected by an epidemic of nervous disease very rarely observed.”

Some Polio Cases

Caverly then described some of the cases he’d seen.

The first case was a three-year-old American boy, healthy, active and strong. He grew feverish and cranky and had stomachache. After three days he lost the use of his legs. At the end of 10 days, he began to walk by holding on to chairs. Then in three weeks, he could walk again.

The second case was similar: A sturdy, 3-1/2-year-old Irish boy had a high fever and incontinence. On the third day, his legs were paralyzed. One leg improved, the other not so much, and after 10 weeks he could walk, but had spinal curvature.

Case 93, a two-year-old American boy, got stomachache, fever and rash. After a few days, his legs were paralyzed. He didn’t improve much after two months, Caverly reported.

Case four was a six-year-old boy taken with convulsions while playing in the street. They lasted nine hours, along with a fever, vomiting and excessive sensitivity of his extremities. The boy died after six days.

Polio died out in September, but not after 132 people, mostly children, had come down with it, and 18 had died.

Caverly Figures It Out

Caverly took careful note of the strange disease. Boys, for example, were more likely to get it than girls. Some died early, some recovered with no paralysis and some were permanently disabled. He saw a 70-year-old man with polio. He saw it in horses, dogs and chickens.

Caverly decided the mysterious disease had to be one of two things: cerebro-spinal meningitis or poliomyelitis. He sent the brain and spinal cord of a chicken to doctors in New York. One said it was cerebro-spinal meningitis, but two others said it was polio. Polio it was.

History of Polio

Polio was not unknown before it ravaged Otter Creek Valley. Sir Walter Scott, born in 1771, contracted it as a child and walked with a limp for the rest of his life.

Sir Walter Scott. Note the cane.

In 1789, British doctor Michael Underwood came up with the first clinical description of polio. He noted “the debilitations of the lower limbs” in children. Doctors called it “teething paralysis” or “infantile paralysis.” They would occasionally see isolated cases.

But because polio didn’t reach epidemic proportions, doctors, including Charles Caverly, didn’t think it contagious.

Polio, actually, is extremely contagious. A virus, it enters the body through the digestive system by droplets from the nose and mouth and by contact with contaminated feces. But the overwhelming majority of people who get it – 98 percent – don’t show symptoms.

Ironically, polio emerged at a time when advances in public health had gotten diseases such as typhoid, tuberculosis and diphtheria under control. Many scientists believed improvements in cleanliness and hygiene had succeeded too well. In dirtier times, they thought, infants developed mild infections but fought them off with the help of maternal antibodies. That immunized them against more severe attacks of the disease. But improved sanitation delayed children’s exposure to it, leaving them more vulnerable to the severest form of polio.

Polio Returns Every Summer

After Otter Creek, polio appeared in Europe. In the Northeast United States, it began to return every summer, at first sporadically and then with a vengeance. By 1905, the medical community realized the contagiousness of the disease. Public health authorities closed swimming pools, canceled county fairs and tacked quarantine signs on homes where the disease had struck.

In the summer of 1910, a severe epidemic of polio hit North America, killing 2,500. It hit Massachusetts hard, especially in Springfield. Another terrible outbreak struck Vermont in 1914, concentrated in the northern half of the state. The mortality rate neared 25 percent, and 226 victims were left with varying degrees of paralysis.  The state Board of Health realized it had to do something. Charles Caverly persuaded an anonymous benefactor to make a generous donation for the prevention and care of polio.

Children at a polio clinic in France. Courtesy NARA.

The state decided to hold free public clinics in the infected areas where victims could go for treatment and care.

Robert Lovett, a doctor engaged in that effort, described how patients were given braces and crutches. Therapists helped train their muscles, exercised their withered limbs and gave them massages. Family members were taught how to massage and exercise polio victims.

“Thus it happened that from being the first state in which the disease occurred in epidemic form, Vermont also became the first to undertake on a statewide scale the after-care of the victims of infantile paralysis,” wrote Lovett.

The 1916 Outbreak

The worst was yet to come. In 1916, a wave of polio struck without warning a Brooklyn neighborhood called Pigtown. Twenty-four hundred people died in New York City, 80 percent of them children under five years old.

Courtesy March of Dimes

As the terrifying disease traveled beyond New York, cities and towns in the Northeast began to bar outsiders. Armed policemen patrolled train stations and roads to make sure no strangers crossed the borders. Parents told their children not to play with anyone they didn’t know, share their ice cream cone or go swimming. In New York, people blamed dogs and cats for spreading polio. They killed 72,000 cats and 8,000 dogs.

In Vermont, Charles Caverly continued to monitor the polio outbreaks. He wrote reports loaded with data about polio outbreaks in his state. They included the distribution and timing of cases, ages of victims, type of house they lived in, the soil around the house, quality of the sewer facilities, water supply, family history, the number of cases in railroad towns.

But then in 1918 polio took a back seat to another disease – influenza. Among the many thousands killed by the flu pandemic was Charles Caverly.

Lovett credited Caverly with first seeing the need to understand polio. “Dr. Caverly did not live to see the disease against which he had fought so long and so untiringly really conquered and the fear of future epidemics removed,” wrote Lovett. “[B]ut he did live to see many of the victims of infantile paralysis in Vermont well on the road to happy, useful, and in some cases normal lives, and to know that real contributions to the knowledge of the disease had been made by those working in cooperation with the State Board of Health under his presidency.”

FDR

In 1921, a wealthy, influential 39-year-old named Franklin Roosevelt contracted polio. Five years later he founded the Georgia Warm Springs Foundation, after the waters he’d taken for therapy. Later it was renamed the National Foundation for Infantile Paralysis (NFIP).

Franklin Roosevelt taking a therapeutic plunge in Warm Springs, Ga.

Then in 1938, five years into his presidency, Roosevelt kicked off the NFIP’s March of Dimes campaign to raise money for polio research. The public sent 2,680,000 dimes to the White House.

Many scientists had already started work on a vaccine or a cure for polio. In the United States, scientists conducted research at Harvard, Yale, Johns Hopkins, the Rockefeller Institute for Medical Research, the University of Michigan, the University of Pittsburgh and the University of Cincinnati.

During the mid-1950s, Dr. Jonas Salk at the University of Pittsburgh tested a polio vaccine. In April 1955, banner headlines announced the great news: tests had proven Salk’s vaccine successful.  The government then mobilized a massive public health effort to vaccinate every child in America. By 1991, polio was eradicated in the Western Hemisphere.

Polio, The Beginning of the End

Sara Jones had gotten the disease at two years old, one of the first Otter Creek Valley victims in 1894. Polio had paralyzed her legs. For the next 20 years she dragged herself around her North Ira farm. Finally, a doctor operated on her feet so she could wear shoes. The next year she got her first pair of crutches, and in 1955 she got her first wheelchair.

On Jan. 5, 1956, Sara Jones attended the NFIP’s kickoff of its national fundraising campaign on the side of Mt. Mansfield in Vermont. The Dartmouth Outing Club built a snow sculpture of Dr. Jonas Salk, and Olympic gold medalist Tenley Albright figure-skated for attendees. At night, a torchlight parade was held, and a monument shaped like a dime was dedicated to those first 132 victims.

With thanks to The “New Disease” strikes the Otter Creek Valley by Edward Neuert and to Infantile Paralysis in Vermont.

Images: Otter Creek By Chumash11 – Own work, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=73732544.

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