Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698077617859.pdf (Guyana)
Epidemic Interim of Poliomyelitis in British Report of the Honourable Labour, Health and Housing.

Guiana.

of Minister I Introduction: Poliomyelitis is a disease three types, '!

'ype I, 'l'ype are varied ranging disease illness.

Most persons However, paralysis types may be classified: II and 'l'ype caused by a virus of which there are III., The manifestations of the to a severe paralytic illness from an inapparent show no symptoms infected or a transient illness.

occurs as an infrequent complication .


'!

'he clinical (a)Inapparent infection symptoms.

'!

'hese examinations, virus or an increase without i.e.

finding cases are diagnosed in antibody by laboratory level in the blood.

(b)Abortive Poliomyelitis -in which there is fever, headache , sore loss of appetite, throat, may last 24 -48 hours and is comr:1oner in children be diagnosed but only by laboratory constipation clinically te�ts.

and pain in muscles.

'!

'he illness .

'!


'hese cases cannot (c) Non-paralytic signs of involvement illness.

'!

'he non-paralytic illness severe with paralysis of the central developing poliomyelitis Sl{S� in addition nervous to the minor may clear up in 4 to 7 days or become -in which there are symptoms and • .

(d)Spinal paralytic poliomy�litis illnesso '!


'he muscles -Paralysis develops are pc;1.ralysed, after 1 -4 but not usually usually paralysed' are those of the legs, anns, days of non-paralytic symmetrically .

'!

'he muscles back, thorax and diaphragm.

Paralysis of muscles may occur.

of respiration (e)Bulbar paralytic of the muscles eye.

Paralysis Acute deaths follow bulbar involveme of the soft palate, poliomyelitis.

pharynx, and circulatory nt.

In this form, there is paralysis of the face, ton.


:ue, may occur.

centres of the respiratory jaw and (f)Enre;,hali tic manifestations with with coma may occur together paralysis of muscles.

'l'he virus enters through the mouth and infection occurs in the throat and in the rest of alimentary of throat secretions and faeces through' average incubation as 30 days.

cpntamination of the hands.

'!

'he is two weeks, but may be as long period of the disease trp.ct.

'!
'!

'he virus is sp1ead by transfer usual for the virus to be found in other members If a case of poliomyelitis occurs in a member of a family, it is they appear well.

although In tropical countries , where the standard the virus is disseminated of living is poor and among the children and they up than those brought mild infection earlier also the sanitation, through acquire under good conditions.

protection Outbreak: '!

'he The first cases at the Georgetown Hospital 1.


On the 4th, there were two more cases, on the 5th, 3 cases, were admitted on December on the 6th12 and on the 7th one case.

'!

'hereafter in the hospital.

cases continued to arri,e Material Laboratory from patients collected and sent t0 the 'l'rinidad and the results were p• epaned at the Central Regional Virus Laboratory promptly as 'l'ype I Polio reported examination, for Medical virological Virus.
Up to 9th January this year, there had been 269 cases of paralytic of which 266 have been studied carefully .

It is possible poliomyelitis, that the epidemic difficult to say at this time how the epidemic its peak on about 26th December, .

curve will continue reached but it is '!

'here exclude "non-polio" deaths" have been 16 deaths, but all have not yet been analysed to /l'he cases •• .. - 2 - .
.. f' The cases have occurred table gives the number in various parts of the country and tl and rate per 1001000 persons as on January following 9, l963.

T./1..BLE I.

No.

and Case Rate Per 100,000 persons.

Area Area Georgetown Greater Earl Demerara West Bemerara Essequibo(excl�ding Leguan Wakenaam Berbice islands) (:IJ 69 66 17 13 lD 9 Rate 4o.5 65.4 116.2 59.5 198.o 149.0 6.3 incidence The highest Berbice.

No cases have been reported District.


Mackenzie There have been four cases in the Bartica and 13 in the New J\..msterdam Hospital.

has been in Leguan, and the lowest in the county of in the Rupununi and'the North West , 22 in the ,Hospital Hospital The age distribution of the di::;ease of the cases analysed is set out below - 'l'l\.BIE II.

of Cases.

Age Distribution Under 1 year 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9- 10 '" Data incomplete.

No.

28 87 55 43 14 9 6 8 4 0 7 Perc;enta�e 10.5 32.


7 20.7 16.2 5.3 3.4 2.3 3.0 1.5 0 2.6 It will be observed 89% of the cases.

that children some under the age of 6 years comprised There is no significant difference, so it appears in the incidence among the races.

'!

'able III sets out the incidence.

TABIE III.

Racial Inoidence of the Disease.

Race East Indian African Mixed Data incomplete.

No.
No.

140 81 28 Rate /100,000 50 43 42.5 Assistance Early in December as soon as the first cases were diagnosed from the U.S.A. was sent to WH0/PAH0 Washington for assistance.

WHO/ a request the U.S.A. Government .

clinically, PAHO consulted of the Ministry, perienced Communicable arrived 200,000 doses of Sabin'u Vaccine, in Epidemic the U.S.A. Government Poliomyelitis, on December 21st in MilitaI"J Center, Atlanta, Disease sent a team of four doctors under Dr. H.M.

Gelfand., M.D.

i'rom Georgia, '!


'ransport to assist us.

'!

'he team 'Plane bringing with tbem ex­ as well as equipnent and supplies.

At through A.I.D.

and with thE approval /the request ••••• .. -3- .

.. ,.

a second Unit" of the request of the Ministry, from the:·•Rehabilitation on December arrived nurses and a medical .A..I.D.

has secured eight "iron lungs11•• It should be pointed medical since the facilities 27.
'l'he team included student teams go to the assistance of local hospitals for our use, further I3aylor University, team under Dr. G.M.

Harrison, M.D.

Houston, 'l'exas, erapists, two with Poliomyelitis • two physioth in dealing all experienced equipment, and supplies including out that in the U.S.A. such of communities stricken with Poliomyelitis are severely taxed in epidemics.

Care of Patients '!
Care of Patients '!

'he Children's in Hospital (Georgetown): Medical Ward was converted into a Poliomyelitis Room in the Lady '!

'hompson Ward, and Ward 2 into a Ward for convalescent Lecture Ward were converted of the 'l'eclmical Branch of the Red Cross -linen, etc.

was provided.

'!here were also helpers.

voluntary into wards for "non-polio" block as well as three rooms in that cots were made and with the help of the local patients.

'!

'he Nurses' Institute, cases.


With the assistance assisted Dr. Harrison • s Ward, in setting in breathing of Children difficulty be brought into the Georgetown Hospital from other was brought from Bartica Dr. Walter Singh, the Physician Unit for children with up a Respiratory to for all very ill patients and one from Mackenzie hospitals.

One patient and it was arranged Hospital in charge Hospital.

'l'he American Physiotherapists of paralysed children ists.
In addition , treating the /unerican to both nurses and doctors the condition the local have Nurses and Dr. Harrison and have been recording them, and teaching in the care of patients of muscles physiotherap given instructions the use of the iron lungs.

Additional Nursing to the staff and other staff were allocated wards •• Children's Children Clinic.

A special of a house in the Hospital who had recovered physiotherapy Compound.
were sent home to return to the Polio was established by conversion department Arrangements were made with the local Branch of the Red Cross at first convalescent to receive accept convalescent at the Red Cross Convalescent polio children "non-polio" children .

Many children and recently ml¥ have to be kept to Home for a short or long period of time.

At the aentral Medical Laboratory , a virology unit was set up.
Rehabilitation: It is anticipated that some fifty (5o) children may need special care and attention will be need for additional to make appliances.

At a later stage, the advice of an Orthopaedic will be required.

of paralysis.

In order to assist them, there physiotherapists, because two to three, and a technician Surgeon With the assistance of the local Red Cross it will be possible to make arrangements for convalescent children .
Control Apart from taking routlne public health measures, of the Outbreak: arranger.ents were made to vaccinate Ministry received Messrs. Burroughs attached to the Children's specially persons island of Leguan were exposed all children five years of age and under.

'!

'he of Sabin's a free gift of 2,000 doses Wellcane of London.

From that supply, the nursing staff wards was vaccinated.

At th.

:: same time, those Vaccine from were also given vaccine.
Th(; children in the vaecinated on the 18th -20th December.

On December 22, the mass immunisation programme was commenced /t..rea.

On that date, a supply of 5o,ooo doses for use in remote areas was received on an ormer in the Greater of vaccine suitable placed by the Ministry Georgetown .

Ministry It should be mentioned to disc ss the outbreak conferences that regular and to make arrangeMents were held at tlr to deal with it.

•••• /rhc Medical .. ,, .. -4 -- '!


'he Medical of the British a fonner ·Senior Physician Officers Guiana Sugar Producers' at the Georgeto.-m Association Hospital, and Dr. F .M.

Willi -J attended meetinge.

of the City of GcorgetoWilJ the· Chief Medical Offii'"'"r .

.,. "

In order to advise people and encourage them to make use of the vaccine, radio broadcasts Minister of Labour_.
Health and Housing members George.town and in other ways in making the programme o,f the i\me·rican were ai,raneed ais well' as His Worship the Mayor greatly Officer assisted.

of Heal th, in publicity te .. s took part.

'I'he Medical by the G.I.S.

The Honourable and various member� of the staff and a successful one in Georgetown .

.
.

Vaccine has been riven to children in all parts of the couhtry of certain very remote interior.areas is beinf sent into the rivers Islands in the Essequibo -Upper Mazaruni, of the North West .

All the .

Vaccine the Pomcroon, with the exception Upper Eissequibo· District, figures received covered.

It is interesting Georgetown are not y�t available, the vaccine Area, the response and certain and they represent have but it is known that 94,121 children 79% of the children in the are!.
that in the Georgeto,m to observe and Greater has been exceedingly good.

G�neral Since the outbreak of 1956-1957 Comments: when there were 100 cases of Poliomyelitis, very few cases have been reported were children under the age of five years of age.

Pro­ then at Yale, studied of the patients fessor J.L.

Melnick, 'Iype I and 'Iype II Polio virus were responsible.
He ex�ined &od specimens in the Gcorsetown areas and found that few age of four lacked antibodies, and by the age of fifteen persons liad antibodi from the J\.merindian es.

Specimens Rupununi above the years almost all in the children also showed antibociies.

.
.

In that outbreak, the outbreak and found that and coastal children 83% Quite recently Dr. Mauricio Martins the use of Sabin's da Silva of WHO/P.llsIO vaccine to replace the Salk vi�ited and diwcusseri the Ministry -vaccine of the Polio-immunisation oral vaccine immunisation early in 1963 and to continue of infantis.

Programme.

It was planned the prograrrane to use the with the annual On account of the outbreak, the Ministry used the vaccine earlier.
\ containing 'I'here the three types of the virus should produce is need for a second dose.

'I'he use of the trivalent good immunity.

vaccine In order to detennine the efficacy, laboratory before and after the studies will be use of the vaccin::;.

made of blood specimens In that way, it will be known how effective the use of the _vaccine from the country.

collected it is hoped that Poliomyelitis will be eradicated has been the programme.
With Thanks: Sincere thanks go to WHO/PAHO and the United States of J\.merica Govertrne:nt who offered of the West Indies.

for their assistance help -including in our time of need and to the countries Cuba and the University the United Kingdom, Our thanks also go to the hundreds assisted or offered and in the immunisation st. John•s.
to assist in various programme and especially of volunteers ways in the Georgetown and others who Hospital to the local Red Cross and of Labour, Health and Housing, Ministry Brickdarn, Georgetown.

10th January, 1963.

.. ADD E ND UM.

NO'l'E, ., ,.

It should be explained that there will be cases of Poliomyelitis in children myelitis had entered their bodies before the vaccine was taken.

who have had the oral vaccine, because the virus of Polio­ 'l'herefore, to occur for several weeks.
after the vaccination programme, cases will continue ooOoo .. '\ Epidemic of Poliomyelitis Interim Report of the Honourable in British Guiana.

Minister of Housing.

Labour, Healtlr and .

...... • Introduction: • Poliomyelitis is a disease caused by a virus of which there are three.

types, 'l'ype I, 'l'ype II and 'l'ype IIL '!


'he manifestations disease are varied ranging illnel}s. Most persons infected show no symptoms or a transient Howev�r, paralysis occurs as an infrequent types.may be classifiedi from an inapparent complication of the .

'!

'he clinical illness.

illness to a severe paralytic ( a) Inapparent infection by laboratory.

examinations, level in the blood.

without symptoms.

'l'hese cases are diagnosed i.e.


finding virus or an increase in antibody (b)Abortive Poliomyelitis sore - in which there is fever, headache, throat, loss of appetite, may last 24 - 48 hours and is commoner in children.

'l'hese oases cannot be diagnosed and pain in muscles.

'!

'he illness but only by laboratory constipation clinically tests.

( c) Non-paralytic poliomyelitis -in which there are symptoms and signs of involvement illness.

'!

'he non-paralytic severe with paralysis developing.
of· tJ1e_ central nervous S)lstem in addition to the minor i'i'iness may clear up in 4 to 7 days or become (d)Spinal paralytic poliomyelitis - Paralysis develops after 1 - 4 day.s of non-paralytic illness.

'!

'he muscles are paralysed, symmetrically.

'l'he muscles usually pnralysed back, thorax and diaphragm.

are those of the legs, arms, but not usually Paralysis of muscles of respiration may occur.-· (e) Bulbar paralytic poliomyelitis .
In this form, there is para]ysis of the muscles of the soft palate, pharynx, of the face,· tongue, jaw and eye.

Paralysis of the respiratory Acute deaths follow bulbar involvement.

and circulatory centres may occur.

(f)Enre;ihali tic manifestations with coma may occur together with paralysis of muscles.

'!

'he virus enters through the mouth and infection occurs in the throat and in the rest of alimentary of throat secretions average incubation as 30 days.

and faeces through contamination of the hands.


'!

'he period of the disease is two weeks, but may be as long tract.

'!

'he virus is spread by transfer occurs in a member of a family, it is usual for the virus to be found in other members although they appear well.

If a ·case of poliomyelitis In tropical countries ., where the standard of living is poor and also the sanitation, acquire protection under good conditions.
the virus is disseminated among the children and they through mild infection earlier than those brought up '!

'he Outbreak: The first cases at the Georgetown December 10 On the 4th, t:1ere WE;lre two more on the 6th,2 and on the 7th one case.

'l'hereafter in the hospital.


Hospital were admitted on cases, on the 5th, 3 cases, cases continued to arri, e Material Laboratory from patients were collected and sent t0 the '1.rinidad Regj_onal p"epared at the Central Virus Laboratory fo:r examination, as 'l'ype I Polio and the results reported promptly Medical virological Virus.

Up to 9th January this year, there had been 269 C'1ses of paralytic of which 266 have been studied carefully.
It is possible poliomyelitis, that the epidemic reached its peak on about 26th December, difficult but it is to say at this time how the epidemic curve will continue.

'!

'here have been 16 deaths, but all have not yet been analysed to exclude "non-polio" deathso /l.

'he cases o.

- , .. ' - 2 - .

.,_ fr The cases have occurred in various eives the numbe:r_: and rate per 1001000 persons parts of the _country and the as on January following table 9, 1963.

TJ\.BLE I.

No.
TJ\.BLE I.

No.

and Case Rate Per 1001 000 persons.

Area Area Greater Georgetown Eavt Dernerara West llemerara Essequibo(excluding Leguan Wakenaarn Berbice islands) (:/) 69 66 17 13 lD 9 Rate 4o.5 65.4 116.2 59.5.

198.o 149.0 6.3 incidence The highest Berbice.

No cases have been reported District.

There have been four cases in the Bartica Mackenzie Hospital.
has been in Leguan, and the lowest in the county of in the Rupununi andithe North West , 22 in the Hospital and 13 in the New 1'..msterdarn Hospital The age distribution of the disease of the cases analysed is set out below - '1'.11.BIE II.

Age Distr!

'5ution of Cases.

Under 1 year 1 2 .

3 - 4 - 5 - 6 - 1- 8 - 9 - lD 4- Data incomplete.

No.

28 87 55 43 14 9 6 8 4 0 1 Percentage lD.5 32.

7 20.1 16.2 5.3 3.4 2.3.

3.0 1.5 0 2.6 It will be observed 89% of the cases.
that children some under the age of 6 years comprised '!

'here is no significant difference, so it appears in the incidence among the races.

'!

'able III sets out the incidence.

TABIE III.

Racial Inoidence of the Disease.

Race East Indian African Mixed , Data incomplete.

No.

140 81 28 1000 Rate /100 5o 43 42.5 Assistance Early in December as soon as the first cases were diagnosed from the U.S.A. a request was sent to WHO/PAHO Washington for assistance.

WHO/ the u.s .

.11.. Government the u.s .


.11.. G9vernment through A.I.D.

and with the approval sent a team of four doctors ex­ Disease in Epidemic Poliomyelitis, under Dr. H.¥.. Gelfand, M.D.

from to assist us.

'!

'be team 'Plane bringing with them taI"J '!

'ransport Sabin's Vaccine, as well as equipnent and supplies.
At Center, Atlanta, on December 21st in Mill Georgia, clinically, PARO consulted of the Ministry, perienced .Communicable arrived 2001000 doses of /the request ••••• .. • -3- JI a second tean under Dr. G.M.

Harrison, 11 Unit of Baylor University, Houston, 'I'exas, r.r.D.

.

.,.

.. of the Ministry, the request from the.

:·•Rehabilitation arrived nurses and a mecical .4..I.D.

has secured eight "iron lungs medical since the facilities student for our use, further 11-.

It should be pointed on December 27.


'l'he team included all experienced two physioth in dealing erapists, two with Poliomyelitis • equipment, and supplies including out that in the U.S.A. such teams go to the assistance of communities of local hosoi tals are severely taxed in epidemics.
stncken with Poliomyelitis Care of Patients 1'he Clrildren in Hospital (Georgetown): f s Medical Hard was converted patients Room in the Lady Thompson block as 'Well as three rooms in that Ward, and Ward 2 into a Ward for convalescent Lecture Ward were converted of the 'l'eclmical Branch of the Red Cross -linen, etc.

was provided.

'lhere were also helpers.

voluntary into wards for "non-polio" Ins-ti tute, cots were made and with the help of the local .

'!

'he Nurses' into a Poliomyelitis cases.


With the assistance Dr. Harrison of Children's difficulty in breathing be brought into the Georgetown Hospital was brought from Bartica up a Respiratory for- all from other and one from Mackenzie assisted Dr. Walter Singh, the Physician Unit for chilclren with to and it was arranged Ward, in setting Hospital hospitals Hospital.

very ill patients in charge .


One patient The .American Physiotherapists of muscles physiotherap given instructions the use of the iron lungs.

of paralysed children, treating ists.

In addition the .American to both nurses and doctors have been recording them, and teaching Nurses and Dr. Harrison have the condition the local in the care of pati�nts and Additional Nursing staff and other staff were alloca¾d to the wards •• Children's Children Clinic.
A special of a house in the Hospital who had recovered physiotherapy • Compound were sent home to return to the Polio was established by corrversion department .Arrangements were made with the local Branch of the Red Cross at first convalescent to receive accept convalescent at the Red Cross Convalescent polio children "non-polio" children .

Many children and recently uy have to be kept to Home for a short or long period of time.

1\.t the Gentral Medical Laboratory , a virology unit was set up.
Rehabilitation: It is anticipated care and attention will be need for additional to make appliances will be required.

because that some fifty (.SO) children may need special of paralysis.

In order to assist them, there physiotherapists, two to three, and a technician • .At a later stage, the advice of an Orthopaedic Surgeon With the assistance of the local Red Cross it will be possible to make arrangements for convalescent children .
Control Apart from taking routine of the Outbreak: all children public health measures, five years of age and under.

'l'he arrangenents a free gift of 2,000 doses of Sabin's Wellcane of London.

From that Vaccine supply, the nursing stafi' wards was vaccinated.

At the same time, those from were made to vaccinate Ministry received Messrs. Burroughs attached persons island of Leguan were to the Children's specially exposed were also given vaccine.

'!
'!

'he children in the vaecinated on the 18th -20th December.

On December 22, the mass immunisation programme was commenced Georgetown 1\.rea.

On that date, a supply of .5o,OOO doses for use in remote areas was received on an or«er in the Greater of vaccine suitable placed by the Ministry .

Ministry It should be mentioned to disc ss the outbreak that regular and to make arrangeMents conferences were held at tlY to deal with it� •••• /rhe Medical ..

'!
'!

'he Medical ·of the Br� tish Guiana Sugar Producers' a fonner·Senior Physician Officers at the Georgetown of the City of Gcorgetow� Association Hospital, the Chief Medical Officer and Dr. F .M.

Williams, .

attended meetings -4 - .

.. ,.

In order to advise people and encourage them to make use of the broadcast�.

vaccine, radio.

Minister members Georgetown and in other ways in making' the programme of Labour, of the .American Officer as well as His Worship the Mayor greatly assisted teaas took part.
'l'he Medical by the G.I,..S. The Honourable and various members of the staff and of Heal th, in publicity Health and Housing a successful were ai,ranged one in Georgetown.

Vaccine has been-riven of certain very to children remote interior in all parts of the country areas -.Uppsr Mazaruni, .

Vaccine the Pomeroon, with the exception Upper Essequibo District, figures received covered.
It is interesting Georgetown are not yet the vaccine Area, the response is being sent into the -rivers of the North West and certain Islands in the Essequibo .

All the available, and they represent have but it is lmown that 94,121 children 79% of the children that in the Georgetoi,m to observe in the area and Greater has been exceedingly good.

-· .•.
-· .•.

G8neral Since the outbreak of 1956-1957 Connnents: when there were 100 cases of been reported were children Poliomyelitis, very few cases have of the patients fessor J.L.

Melnick, 'lype I and 'l'ype II Polio virus were responsible.

He examined &od specim-.me in the Georgetown age of four lacked antibodies, persons had antibodies.

Specimens from the Amerindian Rupununi areas and found that few children and by the age of fifteen above the years almost all under the age of five years of age.
Pro­ and found that then at Yale, s-tudied .

In that outbreak, also showed antibodi the outbreak and coastal children in the 831 es.

• Quite recently the Ministry vaccine of the Polio-immunisation oral vaccine immunisation early in 1963 and to continue of infants.

Martins the use of Sabin's and discussed Dr. Mauricio da Silva of WHO/PAIIO vaccine to replace the Salk visited Prograr.rrne.
It was planned the programmE to use the with.the annual On account of the outbreak, the Ministry used the vaccine earlier.

containing '!

'here the three types of the virus should produce is need for a second dose.

'l'he use of the trivalent good immunity.

vaccine ' In order to detennine the efficacy, laboratory will be before and after the use of the vaccine.

studies made· of blood specimens In th.at way, it will be koown how effective the use of the vaccine from the country.
collected it is hoped that Poliomyelitis will be eradicated has baen the programme.

With '!

'hanks: Sincere Governme:nt who offered of the West Indies.

thanks go to WHO/PJIJIO and the U�i ted States of .America for their assistance help -including in our time of need and to the ·countries Cuba and the University the United Kingdom, Our thanks also·go assisted or offered and in the immunisation st. John's.
to assist in various to the hundreds of volunteers ways in the Georgetown and others who Hospital programme and especially to the local Red Cross and of Labour, Health and Housing, Ministry Brickdam, Georgetown.

10th January, 1963.

.. ADD E ND UM.

NO'l'E: .,.

,.

It should be explained that there will be cases of Poliomyelitis in children myelitis had entered who have had the oral vaccine, because their bodies before the vaccine was taken.

the virus of Polio­ 'l'herefore, to occur for several weeks.
after the vaccination programme, cases will continue .

·� ooOoo r ..