The Spatial Dynamics of Poliomyelitis in the United States: From Epidemic Emergence to Vaccine-Induced Retreat, 1910-1971.

This article seeks to advance an understanding of the spatial dynamics of one of the great emergent viral diseases of the twentieth century-poliomyelitis. From an apparently rare clinical condition occurring only sporadically or in small outbreaks before the late nineteenth century, poliomyelitis had, by the early 1950s, developed into a globally distributed epidemic disease. But, from 1955, continued growth was suddenly and dramatically reversed by the mass administration of inactivated (killed) and live (attenuated) poliovirus vaccines.

The spatial structure of epidemic emergence: geographical aspects of poliomyelitis in north-eastern USA, July-October 1916.

The great epidemic of poliomyelitis which swept New York City and surrounding territory in the summer of 1916 eclipsed all previous global experience of the disease. We draw on epidemiological information that is included in the seminal US Public Health Bulletin 91, 'Epidemiologic studies of poliomyelitis in New York City and the northeastern United States during the year 1916' (Washington DC, 1918), to re-examine the spatial structure of the epidemic. For the main phase of transmission of the epidemic, July-October 1916, it is shown that the maximum concentration of activity of poliomyelitis occurred within a 128-km radius of New York City.