Carriers and Abortive Cases in a Rural Poliomyelitis Outbreak

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Abstract
The author reports an explosive outbreak of poliomyelitis in a small rural area in Albany Co., New York. The study presented indicated the extent to which carriers in unrecognized cases may develop among the intimate contacts of paralytic cases in a rural community, in which a previous case had not been reported for 19 years. Out of the group of 27 contacts examined, 84.5% of the children under 19 years and 50% of the adults were carriers. Half of the contacts remained well. Only 1 of them had sufficient symptoms to meet commonly accepted criteria for typical abortive poliomyelitis. Thus a variety of symptoms must be considered to be suspicious, and of these gastrointestinal symptoms appear to be more suggestive than respiratory. In this series, however, it has been impossible to differentiate clinically between cases with and without virus in their stools. Spread of infection through personal contact appears to be the most reasonable hypothesis by which to account for this outbreak. The high proportion of individuals shown to harbor the virus must have offered many opportunities for spread from person to person, both among children and adults. The finding of the virus in the feces by no means implies that the disease was transmitted by water, milk, or food contaminated with such discharges. The extent to which the infection was present throughout the community was not determined.