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THE EPIDEMIOLOGY OF POLIOMYELITIS: Title and subTitle BreakProblems at Home and Among the Armed Forces Abroad FREE

ALBERT B. SABIN, M.D.
[+] Author Affiliations

Read at the Rocky Mountain Conference on Infantile Paralysis, sponsored by the University of Colorado School of Medicine and Hospitals and the National Foundation for Infantile Paralysis. Inc., Dec. 16, 1946.


Cincinnati

From the Children's Hospital Research Foundation and Department of Pediatrics, University of Cincinnati College of Medicine.


JAMA. 1947;134(9):749-756. doi:10.1001/jama.1947.02880260007003
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One of the most important and difficult jobs in science is to ask the right question of nature. The right question leads to the design of those experiments or tests which yield the pieces that are required to make a logical pattern out of an incomprehensible jigsaw puzzle. My paper will present more questions than answers, and I hope that among the many that have been asked those questions may be selected that will guide physicians to what must be learned in the future if the origin and evolution of epidemics of poliomyelitis is to be understood and if physicians are ultimately to know what, if anything, can be done to prevent them. From the point of view of public health the chief importance of poliomyelitis as a disease lies in its paralytic manifestations, and the main problem in the epidemiology of poliomyelitis concerns the cause or causes of the

REFERENCES

 Poliomyelitis , Report of International Committee for Study of Infantile Paralysis , Baltimore, Williams & Wilkins Company, 1932;.
Dauer, C. C.:  Poliomyelitis in the United States in 1942, and a Summary of Its Prevalence from 1933 to 1942 Inclusive , Pub. Health Rep. 58: 937 ( (June 18) ) 1943;.
Aycock, W. L.:  Susceptibility to Paralysis in Poliomyelitis , Illinois M. J. 80: 231 ( (Sept.) ) 1941;.
Sabin, A. B., and Ward, R.:  The Natural History of Human Poliomyelitis: Distribution of Virus in Nervous and Non-Nervous Tissues , J. Exper. Med. 73:771 ( (June) ) 1941;.
Sabin, A. B.:  Studies on the Natural History of Poliomyelitis (Béla Schick Lecture) , J. Mt. Sinai Hosp. 11:185 ( (Nov.) -Dec.) 1944;.
Ward, R.; Horstmann, D. M., and Melnick, J. L.:  The Isolation of Poliomyelitis Virus from Human Extraneural Sources: IV. Search for Virus in the Blood of Patients , J. Clin. Investigation 25:284 ( (March) ) 1946;.
Footnote deleted by author.
Howe, H. A.; Wenner, H. A.; Bodian, D., and Maxcy, K. F.:  Poliomyelitis Virus in the Human Oropharynx , Proc. Soc. Exper. Biol. & Med. 56: 171 ( (June) ) 1944;.
Howe, H. A.; Bodian, D., and Wenner, H. A.:  Further Observations on the Presence of Poliomyelitis Virus in the Human Oropharynx , Bull. Johns Hopkins Hosp. 76: 19 ( (Jan.) ) 1945;.
Horstmann, D. M.; Melnick, J. L., and Wenner, H. A.:  The Isolation of Poliomyelitis Virus from Human Extraneural Sources: I. Comparison of Virus Content of Pharyngeal Swabs, Oropharyngeal Washings, and Stools of Patients , J. Clin. Investigation 25:270 ( (March) ) 1946;.
Horstmann, D. M.; Ward, R., and Melnick, J. L.:  The Isolation of Poliomyelitis Virus from Human Extraneural Sources: III. Persistence of Virus in Stools After Acute Infection , J. Clin. Investigation 25:278 ( (March) ) 1946;.
Lépine, P.; Sedallian, P., and Sautter, V.:  Sur la présence du virus poliomyélitique dans les matières fécales et sa longue durée d'elimination chez un porteur sain , Bull. Acad. de méd., Paris 122: 141, 1939;.
Sabin, A. B., and Ward, R.:  The Natural History of Human Poliomyelitis: Elimination of the Virus , J. Exper. Med. 74: 519 ( (Dec.) ) 1941;.
Ward, R., and Walters, B.:  The Elimination of Poliomyelitis Virus from the Human Mouth or Nose , Bull. Johns Hopkins Hosp. , to be published.
Hamburger, M., Jr.; Green, M. J., and Hamburger, V. G.:  The Problem of the "Dangerous Carrier" of Hemolytic Streptococci: I. Number of Hemolytic Streptococci Expelled by Carriers with Positive and Negative Nose Cultures , J. Infect. Dis. 77:68 ( (July) -Aug.) 1945;
 II. Spread of Infection by Individuals with Strongly Positive Nose Cultures Who Expelled Large Numbers of Hemolytic Streptococci , HamburgerJ. Infect. Dis. 77:96 ( (Sept.) -Oct.) 1945;
 IV. Observations upon the Role of the Hands, of Blowing the Nose, of Sneezing, and of Coughing in the Dispersal of These Microorganisms , HamburgerJ. Infect. Dis. 79:33 ( (July) -Aug.) 1946;.
Howe, H. A., and Bodian, D.:  Portals of Entry of Poliomyelitis Virus in the Chimpanzee , Proc. Soc. Exper. Biol. & Med. 43:718 ( (April) ) 1940;.
Burnet, F. M.; Jackson, A. V., and Robertson, E. G.:  Poliomyelitis: Use of Macacus Cynomolgus as an Experimental Animal , Australian J. Exper. Biol. & M. Sc. 17: 375 ( (Dec.) ) 1939;.
Sabin, A. B., and Ward, R.:  Behavior of Poliomyelitis Virus in Cynomolgus Monkeys Infected by the Oral Route , abstracted, J. Bact. 43:86 ( (Jan.) ) 1942;.
Sabin.4b
Sabin and Ward.14b Sabin.4b
Paul, J. R., and Trask, J. D.:  Occurrence and Recovery of Virus of Infantile Paralysis from Sewage , Am. J. Pub. Health 32:235 ( (March) ) 1942;.
Trask, J. D., and Paul, J. R.:  Periodic Examination of Sewage for the Virus of Poliomyelitis , J. Exper. Med. 75: 1 ( (Jan.) ) 1942;.
Paul, J. R.; Trask, J. D.; Bishop, M. B.; Melnick, J. L., and Casey, A. E.:  Detection of Poliomyelitis Virus in Flies , Science 94:395 ( (Oct. 24) ) 1941;.
Trask, J. D.; Paul, J. R., and Melnick, J. L.:  Detection of Poliomyelitis Virus in Flies Collected During Epidemics of Poliomyelitis: Methods, Results, and Types of Flies Involved , J. Exper. Med. 77:531 ( (June) ) 1943;.
Trask, J. D., and Paul, J. R.:  Detection of Poliomyelitis Virus in Flies Collected During Epidemics of Poliomyelitis: Clinical Circumstances Under Which Flies Were Collected , J. Exper. Med. 77:545 ( (June) ) 1943;.
Sabin, A. B., and Ward, R.:  Flies as Carriers of Poliomyelitis Virus in Urban Epidemics , Science 94:590 ( (Dec. 19) ) 1941;
 Insects and Epidemiology of Poliomyelitis , WardScience 95: 169 ( (Feb. 13) ) 1942;.
Ward, R.; Melnick, J. L., and Horstmann, D. M.:  Poliomyelitis Virus in Fly-Contaminated Food Collected at an Epidemic , Science 101: 491 ( (May 11) ) 1945;.
Ward, R., and Sabin, A. B.:  The Presence of Poliomyelitis Virus in Human Cases and Carriers During the Winter , Yale J. Biol. & Med. 16: 451 ( (May) ) 1944;.
Paul, J. R.: Personal communication to the author.
Kling, C.; Olin, G.; Fahraeus, J., and Norlin, G.:  II. Studies on the Conditions of Life of Poliomyelitis Virus Outside the Human Organism , Acta med. Scandinav. 112:2501942;.
Evans, C. A., and Osterud, K. L.:  The Failure of Poliomyelitis Virus to Grow in Certain Protozoa of Sewage , Science 104: 51-53 ( (July 19) ) 1946;.
Kling. C., Olin. G.. and Fahraeus. T.:  Zur Frage der Übertragung der Epidemischen Poliomyelitis durch Trinkwasser und der dabei Entstandenen Immunität , Acta path, et microbiol. Scandinav. 54:499, 1944;.
Maxcy, K. F.:  Hypothetical Relationship of Water Supplies to Poliomyelitis , Am. J. Pub. Health 33:41 ( (Jan.) ) 1943;.
Pearson, H. E., and Rendtorff, R. C.:  Studies on the Distribution of Poliomyelitis Virus: I. In the Environment of Sporadic Cases , Am. J. Hyg. 41:164 ( (March) ) 1945;
 II. In a Small Town , RendtorffAm. J. Hyg. 41:179 ( (March) ) 1945;.
Pearson, H. E.; Brown, G. C.; Rendtorff, R. C.; Ridenour, G. M., and Francis, T., Jr.:  III. In an Urban Area During an Epidemic , Am. J. Hyg. 41:188 ( (March) ) 1945;.
Toomey, J. A.; Takacs, W. S., and Tischer, L. A.:  Attempts to Find Poliomyelitis Virus in Fish , Proc. Soc. Exper. Biol. & Med. 58: 152 ( (Feb.) ) 1945;.
Olitsky, P. K.:  A Transmissible Agent (Theiler's Virus)in the Intestines of Normal Mice , J. Exper. Med. 72: 113 ( (Aug.) ) 1940;.
Theiler, M.:  Studies on Poliomyelitis (DeLamar Lecture) , Medicine 20: 443 ( (Dec.) ) 1941;.
Burnet, F. M., and Macnamara, J.:  Immunological Differences Between Strains of Poliomyelitis Virus , Brit. J. Exper. Path. 12:57 ( (April) ) 1931;.
Weyer, E. R.:  Immunological Differences Between a Strain of Monkey Virus and Human Poliomyelitis Virus , Proc. Soc. Exper. Biol. & Med. 29:289 ( (Dec.) ) 1931;.
Harmon, P. H., and Harkins, H. N.:  The Significance of Neutralizing Substances in Resistance and Recovery from Poliomyelitis , J. A. M. A. 107:552 ( (Aug. 22) ) 1936;.
Lennette, E. H., and Hudson, N. P.:  Neutralization of Poliomyelitis Virus by the Serum of Native Chinese of Peiping , Proc. Soc. Exper. Biol. & Med. 30:449 ( (Jan.) ) 1933;.
Jungeblut, C. W.:  The Power of Normal Human Sera to Inactivate the Virus of Poliomyelitis in Relation to Blood Grouping and Exposure , J. Immunol. 24:157 ( (Feb.) ) 1933;.
Aycock, W. L.:  Immunity to Poliomyelitis: Heterologous Strains and Discrepant Neutralization Tests , Am. J. M. Sc. 204:455 ( (Sept.) ) 1942;.
Hudson, N. P., and Lennette, E. H.:  The Neutralization of Poliomyelitis Virus by the Serum of Liberian Negroes , Am. J. Hyg. 17: 581 ( (May) ) 1933;
 Incidence of Poliocidal Sera in Regions Where Poliomyelitis Epidemics Are Infrequent , Am. J. Trop. Med. 18: 35 ( (Jan.) ) 1938;.
Burnet, F. M., and Jackson, A. V.:  Poliomyelitis: Significance of Neutralizing Antibodies in Human Sera , Australian J. Exper. Biol. & M. Sc. 17:261 ( (Sept.) ) 1939;.
Haas, V. H., and Armstrong, C.:  Immunity to the Lansing Strain of Poliomyelitis as Revealed by the Protection Test in White Mice , Pub. Health Rep. 55:1061 ( (June 14) ) 1940;.
Turner, T. B., and Young, L. E.:  Mouse-Adapted Lansing Strain of Poliomyelitis Virus: Study of Neutralizing Antibodies in Acute and Convalescent Serum of Poliomyelitis Patients , Am. J. Hyg. 37:67 ( (Jan.) ) 1943;.
Turner, T. B.; Young, L. E., and Maxwell, E. S.:  The Mouse-Adapted Lansing Strain of Poliomyelitis Virus: IV. Neutralizing Antibodies in the Serum of Healthy Children , Am. J. Hyg. 42: 119-127 ( (Sept.) ) 1945;.
Paul, J. R., and Trask, J. D.:  Comparative Study of Recently Isolated Human Strains and Passage Strain of Poliomyelitis Virus , J. Exper. Med. 58: 513 ( (Nov.) ) 1933;
 Neutralization Test in Poliomyelitis: Comparative Results with Four Strains of Virus , TraskJ. Exper. Med. 61:447 ( (April) ) 1935;.
Trask, J. D., and Paul, J. R.:  Neutralizing Antibodies in Abortive Poliomyelitis , J. Exper. Med. 58:531 ( (Nov.) ) 1933;.
Trask, J. D.; Paul, J. R.; Beebe, A. R., and German, W. J.:  Viruses of Poliomyelitis: Immunologic Comparison of Six Strains , J. Exper. Med. 65:687 ( (May) ) 1937;.
Howitt, B. F.:  Poliomyelitis: Further Studies on the Immunization of Sheep to the Virus of Poliomyelitis, with a Comparison of Neutralization Tests, Using the Old and a Recent Strain of Virus , J. Infect. Dis. 53:145 ( (Sept.) -Oct.) 1933;.
Sabin, A. B., and Ward, R.:  Poliomyelitis in a Laboratory Worker Exposed to the Virus , Science 94: 113 ( (Aug. 1) ) 1941;
Paul, J. R.; Havens, W. P., and Van Rooyen, C. E.:  Poliomyelitis in British and American Troops in the Middle East: Isolation of Virus from Human Feces , Brit. M. J. 1:841 ( (June 24) ) 1944;.
Personal Observations While Serving in the Far East as Field Director of the Commission on Virus and Rickettsial Diseases, Army Epidemiological Board, Office of the Surgeon General United States Army.
McAlpine, D.:  Epidemiology of Acute Poliomyelitis in India Command , Lancet 2:130-133 ( (Aug. 4) ) 1945;.
Seddon, A. J.; Agius, T.; Bernstein, H. G. G., and Tunbridge, R. E.:  The Poliomyelitis Epidemic in Malta 1942-1943 , Quart. J. Med. 14: 1 ( (Jan.) ) 1945;.
Hillman, C. C.:  Poliomyelitis in the Philippine Islands , Mil. Surgeon 79:48 ( (July) ) 1936;.
Hernando, E., and Alomia, A.:  Epidemiological Aspects of Acute Anterior Poliomyelitis or Heine-Medin Disease in Manila , Rev. filipina de med. y farmacol. 25: 529 ( (Nov.) ) 1934;.
Doull, J. A.; Hudson, N. P., and Hahn, R. C.:  Note on Poliomyelitis, Diphtheria, and Scarlet Fever Antibodies in Serum from the Philippines , Am. J. Hyg. 21:540 ( (May) ) 1935;.
Zia. S. H.:  The Occurrence of Acute Poliomyelitis in North China , Nat. M. J. China 16: 135 ( (April) -June) 1930;.
Yen, C. H., and Hsu, Y. K.:  Isolation of Virus from Case of Acute Poliomyelitis in Peiping, with Histopathological Studies , Chinese M. J. 60: 199 ( (Sept.) ) 1941;.
Scott, A. V.:  Anterior Poliomyelitis in China , Chinese M. J. 54: 442 ( (Nov.) ) 1938;.
Burnet, F. M.: Virus as Organism: Evolutionary and Ecological Aspects of Some Human Virus Diseases , Cambridge, Mass., Harvard University Press, 1945;.

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Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

 Poliomyelitis , Report of International Committee for Study of Infantile Paralysis , Baltimore, Williams & Wilkins Company, 1932;.
Dauer, C. C.:  Poliomyelitis in the United States in 1942, and a Summary of Its Prevalence from 1933 to 1942 Inclusive , Pub. Health Rep. 58: 937 ( (June 18) ) 1943;.
Aycock, W. L.:  Susceptibility to Paralysis in Poliomyelitis , Illinois M. J. 80: 231 ( (Sept.) ) 1941;.
Sabin, A. B., and Ward, R.:  The Natural History of Human Poliomyelitis: Distribution of Virus in Nervous and Non-Nervous Tissues , J. Exper. Med. 73:771 ( (June) ) 1941;.
Sabin, A. B.:  Studies on the Natural History of Poliomyelitis (Béla Schick Lecture) , J. Mt. Sinai Hosp. 11:185 ( (Nov.) -Dec.) 1944;.
Ward, R.; Horstmann, D. M., and Melnick, J. L.:  The Isolation of Poliomyelitis Virus from Human Extraneural Sources: IV. Search for Virus in the Blood of Patients , J. Clin. Investigation 25:284 ( (March) ) 1946;.
Footnote deleted by author.
Howe, H. A.; Wenner, H. A.; Bodian, D., and Maxcy, K. F.:  Poliomyelitis Virus in the Human Oropharynx , Proc. Soc. Exper. Biol. & Med. 56: 171 ( (June) ) 1944;.
Howe, H. A.; Bodian, D., and Wenner, H. A.:  Further Observations on the Presence of Poliomyelitis Virus in the Human Oropharynx , Bull. Johns Hopkins Hosp. 76: 19 ( (Jan.) ) 1945;.
Horstmann, D. M.; Melnick, J. L., and Wenner, H. A.:  The Isolation of Poliomyelitis Virus from Human Extraneural Sources: I. Comparison of Virus Content of Pharyngeal Swabs, Oropharyngeal Washings, and Stools of Patients , J. Clin. Investigation 25:270 ( (March) ) 1946;.
Horstmann, D. M.; Ward, R., and Melnick, J. L.:  The Isolation of Poliomyelitis Virus from Human Extraneural Sources: III. Persistence of Virus in Stools After Acute Infection , J. Clin. Investigation 25:278 ( (March) ) 1946;.
Lépine, P.; Sedallian, P., and Sautter, V.:  Sur la présence du virus poliomyélitique dans les matières fécales et sa longue durée d'elimination chez un porteur sain , Bull. Acad. de méd., Paris 122: 141, 1939;.
Sabin, A. B., and Ward, R.:  The Natural History of Human Poliomyelitis: Elimination of the Virus , J. Exper. Med. 74: 519 ( (Dec.) ) 1941;.
Ward, R., and Walters, B.:  The Elimination of Poliomyelitis Virus from the Human Mouth or Nose , Bull. Johns Hopkins Hosp. , to be published.
Hamburger, M., Jr.; Green, M. J., and Hamburger, V. G.:  The Problem of the "Dangerous Carrier" of Hemolytic Streptococci: I. Number of Hemolytic Streptococci Expelled by Carriers with Positive and Negative Nose Cultures , J. Infect. Dis. 77:68 ( (July) -Aug.) 1945;
 II. Spread of Infection by Individuals with Strongly Positive Nose Cultures Who Expelled Large Numbers of Hemolytic Streptococci , HamburgerJ. Infect. Dis. 77:96 ( (Sept.) -Oct.) 1945;
 IV. Observations upon the Role of the Hands, of Blowing the Nose, of Sneezing, and of Coughing in the Dispersal of These Microorganisms , HamburgerJ. Infect. Dis. 79:33 ( (July) -Aug.) 1946;.
Howe, H. A., and Bodian, D.:  Portals of Entry of Poliomyelitis Virus in the Chimpanzee , Proc. Soc. Exper. Biol. & Med. 43:718 ( (April) ) 1940;.
Burnet, F. M.; Jackson, A. V., and Robertson, E. G.:  Poliomyelitis: Use of Macacus Cynomolgus as an Experimental Animal , Australian J. Exper. Biol. & M. Sc. 17: 375 ( (Dec.) ) 1939;.
Sabin, A. B., and Ward, R.:  Behavior of Poliomyelitis Virus in Cynomolgus Monkeys Infected by the Oral Route , abstracted, J. Bact. 43:86 ( (Jan.) ) 1942;.
Sabin.4b
Sabin and Ward.14b Sabin.4b
Paul, J. R., and Trask, J. D.:  Occurrence and Recovery of Virus of Infantile Paralysis from Sewage , Am. J. Pub. Health 32:235 ( (March) ) 1942;.
Trask, J. D., and Paul, J. R.:  Periodic Examination of Sewage for the Virus of Poliomyelitis , J. Exper. Med. 75: 1 ( (Jan.) ) 1942;.
Paul, J. R.; Trask, J. D.; Bishop, M. B.; Melnick, J. L., and Casey, A. E.:  Detection of Poliomyelitis Virus in Flies , Science 94:395 ( (Oct. 24) ) 1941;.
Trask, J. D.; Paul, J. R., and Melnick, J. L.:  Detection of Poliomyelitis Virus in Flies Collected During Epidemics of Poliomyelitis: Methods, Results, and Types of Flies Involved , J. Exper. Med. 77:531 ( (June) ) 1943;.
Trask, J. D., and Paul, J. R.:  Detection of Poliomyelitis Virus in Flies Collected During Epidemics of Poliomyelitis: Clinical Circumstances Under Which Flies Were Collected , J. Exper. Med. 77:545 ( (June) ) 1943;.
Sabin, A. B., and Ward, R.:  Flies as Carriers of Poliomyelitis Virus in Urban Epidemics , Science 94:590 ( (Dec. 19) ) 1941;
 Insects and Epidemiology of Poliomyelitis , WardScience 95: 169 ( (Feb. 13) ) 1942;.
Ward, R.; Melnick, J. L., and Horstmann, D. M.:  Poliomyelitis Virus in Fly-Contaminated Food Collected at an Epidemic , Science 101: 491 ( (May 11) ) 1945;.
Ward, R., and Sabin, A. B.:  The Presence of Poliomyelitis Virus in Human Cases and Carriers During the Winter , Yale J. Biol. & Med. 16: 451 ( (May) ) 1944;.
Paul, J. R.: Personal communication to the author.
Kling, C.; Olin, G.; Fahraeus, J., and Norlin, G.:  II. Studies on the Conditions of Life of Poliomyelitis Virus Outside the Human Organism , Acta med. Scandinav. 112:2501942;.
Evans, C. A., and Osterud, K. L.:  The Failure of Poliomyelitis Virus to Grow in Certain Protozoa of Sewage , Science 104: 51-53 ( (July 19) ) 1946;.
Kling. C., Olin. G.. and Fahraeus. T.:  Zur Frage der Übertragung der Epidemischen Poliomyelitis durch Trinkwasser und der dabei Entstandenen Immunität , Acta path, et microbiol. Scandinav. 54:499, 1944;.
Maxcy, K. F.:  Hypothetical Relationship of Water Supplies to Poliomyelitis , Am. J. Pub. Health 33:41 ( (Jan.) ) 1943;.
Pearson, H. E., and Rendtorff, R. C.:  Studies on the Distribution of Poliomyelitis Virus: I. In the Environment of Sporadic Cases , Am. J. Hyg. 41:164 ( (March) ) 1945;
 II. In a Small Town , RendtorffAm. J. Hyg. 41:179 ( (March) ) 1945;.
Pearson, H. E.; Brown, G. C.; Rendtorff, R. C.; Ridenour, G. M., and Francis, T., Jr.:  III. In an Urban Area During an Epidemic , Am. J. Hyg. 41:188 ( (March) ) 1945;.
Toomey, J. A.; Takacs, W. S., and Tischer, L. A.:  Attempts to Find Poliomyelitis Virus in Fish , Proc. Soc. Exper. Biol. & Med. 58: 152 ( (Feb.) ) 1945;.
Olitsky, P. K.:  A Transmissible Agent (Theiler's Virus)in the Intestines of Normal Mice , J. Exper. Med. 72: 113 ( (Aug.) ) 1940;.
Theiler, M.:  Studies on Poliomyelitis (DeLamar Lecture) , Medicine 20: 443 ( (Dec.) ) 1941;.
Burnet, F. M., and Macnamara, J.:  Immunological Differences Between Strains of Poliomyelitis Virus , Brit. J. Exper. Path. 12:57 ( (April) ) 1931;.
Weyer, E. R.:  Immunological Differences Between a Strain of Monkey Virus and Human Poliomyelitis Virus , Proc. Soc. Exper. Biol. & Med. 29:289 ( (Dec.) ) 1931;.
Harmon, P. H., and Harkins, H. N.:  The Significance of Neutralizing Substances in Resistance and Recovery from Poliomyelitis , J. A. M. A. 107:552 ( (Aug. 22) ) 1936;.
Lennette, E. H., and Hudson, N. P.:  Neutralization of Poliomyelitis Virus by the Serum of Native Chinese of Peiping , Proc. Soc. Exper. Biol. & Med. 30:449 ( (Jan.) ) 1933;.
Jungeblut, C. W.:  The Power of Normal Human Sera to Inactivate the Virus of Poliomyelitis in Relation to Blood Grouping and Exposure , J. Immunol. 24:157 ( (Feb.) ) 1933;.
Aycock, W. L.:  Immunity to Poliomyelitis: Heterologous Strains and Discrepant Neutralization Tests , Am. J. M. Sc. 204:455 ( (Sept.) ) 1942;.
Hudson, N. P., and Lennette, E. H.:  The Neutralization of Poliomyelitis Virus by the Serum of Liberian Negroes , Am. J. Hyg. 17: 581 ( (May) ) 1933;
 Incidence of Poliocidal Sera in Regions Where Poliomyelitis Epidemics Are Infrequent , Am. J. Trop. Med. 18: 35 ( (Jan.) ) 1938;.
Burnet, F. M., and Jackson, A. V.:  Poliomyelitis: Significance of Neutralizing Antibodies in Human Sera , Australian J. Exper. Biol. & M. Sc. 17:261 ( (Sept.) ) 1939;.
Haas, V. H., and Armstrong, C.:  Immunity to the Lansing Strain of Poliomyelitis as Revealed by the Protection Test in White Mice , Pub. Health Rep. 55:1061 ( (June 14) ) 1940;.
Turner, T. B., and Young, L. E.:  Mouse-Adapted Lansing Strain of Poliomyelitis Virus: Study of Neutralizing Antibodies in Acute and Convalescent Serum of Poliomyelitis Patients , Am. J. Hyg. 37:67 ( (Jan.) ) 1943;.
Turner, T. B.; Young, L. E., and Maxwell, E. S.:  The Mouse-Adapted Lansing Strain of Poliomyelitis Virus: IV. Neutralizing Antibodies in the Serum of Healthy Children , Am. J. Hyg. 42: 119-127 ( (Sept.) ) 1945;.
Paul, J. R., and Trask, J. D.:  Comparative Study of Recently Isolated Human Strains and Passage Strain of Poliomyelitis Virus , J. Exper. Med. 58: 513 ( (Nov.) ) 1933;
 Neutralization Test in Poliomyelitis: Comparative Results with Four Strains of Virus , TraskJ. Exper. Med. 61:447 ( (April) ) 1935;.
Trask, J. D., and Paul, J. R.:  Neutralizing Antibodies in Abortive Poliomyelitis , J. Exper. Med. 58:531 ( (Nov.) ) 1933;.
Trask, J. D.; Paul, J. R.; Beebe, A. R., and German, W. J.:  Viruses of Poliomyelitis: Immunologic Comparison of Six Strains , J. Exper. Med. 65:687 ( (May) ) 1937;.
Howitt, B. F.:  Poliomyelitis: Further Studies on the Immunization of Sheep to the Virus of Poliomyelitis, with a Comparison of Neutralization Tests, Using the Old and a Recent Strain of Virus , J. Infect. Dis. 53:145 ( (Sept.) -Oct.) 1933;.
Sabin, A. B., and Ward, R.:  Poliomyelitis in a Laboratory Worker Exposed to the Virus , Science 94: 113 ( (Aug. 1) ) 1941;
Paul, J. R.; Havens, W. P., and Van Rooyen, C. E.:  Poliomyelitis in British and American Troops in the Middle East: Isolation of Virus from Human Feces , Brit. M. J. 1:841 ( (June 24) ) 1944;.
Personal Observations While Serving in the Far East as Field Director of the Commission on Virus and Rickettsial Diseases, Army Epidemiological Board, Office of the Surgeon General United States Army.
McAlpine, D.:  Epidemiology of Acute Poliomyelitis in India Command , Lancet 2:130-133 ( (Aug. 4) ) 1945;.
Seddon, A. J.; Agius, T.; Bernstein, H. G. G., and Tunbridge, R. E.:  The Poliomyelitis Epidemic in Malta 1942-1943 , Quart. J. Med. 14: 1 ( (Jan.) ) 1945;.
Hillman, C. C.:  Poliomyelitis in the Philippine Islands , Mil. Surgeon 79:48 ( (July) ) 1936;.
Hernando, E., and Alomia, A.:  Epidemiological Aspects of Acute Anterior Poliomyelitis or Heine-Medin Disease in Manila , Rev. filipina de med. y farmacol. 25: 529 ( (Nov.) ) 1934;.
Doull, J. A.; Hudson, N. P., and Hahn, R. C.:  Note on Poliomyelitis, Diphtheria, and Scarlet Fever Antibodies in Serum from the Philippines , Am. J. Hyg. 21:540 ( (May) ) 1935;.
Zia. S. H.:  The Occurrence of Acute Poliomyelitis in North China , Nat. M. J. China 16: 135 ( (April) -June) 1930;.
Yen, C. H., and Hsu, Y. K.:  Isolation of Virus from Case of Acute Poliomyelitis in Peiping, with Histopathological Studies , Chinese M. J. 60: 199 ( (Sept.) ) 1941;.
Scott, A. V.:  Anterior Poliomyelitis in China , Chinese M. J. 54: 442 ( (Nov.) ) 1938;.
Burnet, F. M.: Virus as Organism: Evolutionary and Ecological Aspects of Some Human Virus Diseases , Cambridge, Mass., Harvard University Press, 1945;.
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To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
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NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
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