PA. Polio Survivors NetworkInformation and Inspiration

for All Polio Survivors and Their Families

Serving the Keystone State and Beyond

www.papolionetwork.org

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December 2019

Our Mission: To Be in Service Providing Information to Polio Survivors, Post Polio Support Groups,

Survivor's Families and their Caregivers.

Whether you are in the US or Abroad,

everyone is aware that it is the Holiday Season !This month, both Dr. Richard Bruno, HD, PhD and Dr. William DeMayo, MD are addressing PPS

issues that can affect polio survivors any time, but especially during the holidays.

Dr. Bruno helps us with the relationship between the feelings of depression and PPS.

Dr. DeMayo shared his annual holiday message about managing fatigue during these times –

and how we can rethink our behaviors so that we enjoy ourselves to the fullest.

The holiday season is about kindness and compassion towards others.This message speaks to us as we see first hand, the thoughtful generosity of the survivors, our

families and the friends in our network. Team Survivor has now raised enough funds to protect

an est. 51,000 children against the polio virus !

The worldwide effort to eradicate this disease is truly greater than we can imagine.

THAT is something to be joyful about.

As we celebrate our 5th Birthday, we are grateful for your support, your kind words,

your thoughtful donations and the truly generous articles and advice

from our professional contributors. When we began, we were determined to follow a mission that would serve YOU, by being a

credible resource for information that can help you help yourself. We had no idea five years ago

that our numbers would be so large and that we would be seen all over the US and abroad.

Thank you survivor Jim Smith for this beautiful poem.

Jim has been a special part of our team since we began.

So often, he’s the one that is just “there”, just “listening” and just being a friend to us all.

A Friend that Just Stands By

When trouble comes your soul to try, you love the friend who just stands by.

Perhaps there is nothing he can do, the thing is strictly up to you.

For there are troubles all your own, and paths the soul must tread alone.

Times when love cannot smooth the road, nor friendship lift the heavy load.

But just to know you have a friend, who will stand by until the end.

Whose sympathy through all endures, whose arm handclasp is always yours.

It helps someway to pull you through, although there is nothing he can do.

And so with fervent heat you cry, God bless the friend who just stands by !

Author Unknown

We wish you a warm, wonderful holiday season.

As Dr. Bruno loves to tell us – Be Well.

Bruno Bytes

By: Dr. Richard Bruno, HD, PhD

Director, International Centre for Polio Education

www.postpolioinfo.com

On the topic of PPS and Depression

Question: Could you tell me whether depression can result from PPS?

Dr. Bruno’s Response - Depression is not a PPS symptom. Sure polio survivors can become

clinically depressed. Our research on more than 1,100 polio survivors found no more Major

Depressive Episodes than in the general population...actually there were fewer...but much

more Adjustment Disorder with Depressed Mood that did not need antidepressants to treat,

just psycho therapy. See - https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t19/

and the following:

Long-standing Poliomyelitis and Psychological Health.

Posted by Dr. Richard Bruno from Disabil Rehabil. 2015 Feb 27:1-5. Shiri S, al. e*trade

There are no big surprises here, but it is an interesting article . . .

Objective: To compare the psychological health of the individuals with long-standing

poliomyelitis, with or without post-polio sequelae (PPS), to the general population and to

identify the role of work as well as other variables with regard to their psychological health.

Subjects: One hundred and ninety-five polio patients attending post-polio clinic in Jerusalem.

Methods: Emotional distress (ED) was measured using the general health questionnaire

(GHQ-12). Demographic, medical, social and functional data were recorded using a specific

structured questionnaire. Each polio patient was compared to four age- and sex-matched

controls.

Results:

1) Emotional Distress was higher in the polio population as compared to the general

population.

2) Within the polio population Emotional Distress was higher in those who were not

working

3) There was no relationship between Emotional Distress and the functional level of

polio participants and no difference was found in general health between polio

participants with or without post-polio sequelae.

4) Emotional Distress in the general population was related more to subjects’ subjective

perception of physical health than among polio survivors.

Conclusions: Long-standing poliomyelitis is associated with decreased psychological health as

compared to the general population. Yet, the resilience of polio survivors is seen by their ability

to stop additional decline of psychological health in spite of deterioration in their physical

health. Work appears to be a significant source of resilience in the post-polio population.

Implications for Rehabilitation: Polio survivors often suffer from high emotional distress and

may benefit from psychotherapy aimed at reducing distress. As active employment status is

associated with increased mental health among polio survivors, encouraging participation at

work needs to be a significant component of psychotherapeutic programs.

Polio survivors, although physically disabled, are resilient as their mental health is less

affected by physical impairments. This and other expressions of resilience may serve as a

platform for increasing personal growth among them by implementing hope-oriented

psychotherapy.

Check out The Encyclopedia of Polio and Post-Polio Sequelae on our website.

It contains all of Dr. Richard Bruno’s newly published and updated: articles, monographs,

commentaries, videos and “Bruno Bytes” (Q & A articles) and links to his book.

You can easily access it from Dr. Bruno’s website as well: www.postpolioinfo.com 2

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World Polio Day Showcases Great Progress In Eliminating PolioJudy Stone, Senior Contributor

Oct 24, 2019

Those of us of a certain age recall classmates with braces and a withered limb, or parents

keeping their children from swimming pools, afraid they would contract polio.

I’m astonished at the progress made in eradicating polio over the past few years since I last

wrote about disease. How has that been accomplished?

Rotary International has been a leader in working globally to eliminate polio. In their work over

the past decade, I’m particularly impressed at how they are overcoming mistrust of health care

workers and vaccines. Mind you, some mistrust is still there, particularly in Pakistan. As I

wrote two years ago, vaccine workers were murdered there with some regularity by the Taliban,

which had also banned immunizations.

Now the United Arab Emirates is also helping to turn the tide of vaccine hesitancy and

providing funding to combat polio. The Islamic Advisory Group, a consortium including “Al

Azhar Al Sharif, the IIFA, the Organisation of Islamic Cooperation (OIC) and the Islamic

Development Bank (IsDB), along with other religious scholars and technical experts” has

endorsed the immunization efforts. Nonetheless, in part due to a strong anti-vax community,

vocal on social media, polio is increasing in some areas.

Progress in Polio

The Global Polio Eradication Initiative (GPEI) is “a public-private partnership led by national

governments with five partners – the World Health Organization (WHO), Rotary International,

the US Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund

(UNICEF) and the Bill & Melinda Gates Foundation.” Working together, they have reduced polio

cases by more than 99.9% worldwide in the last 31 years. Rotary and its >1 million members

have contributed $2 billion and countless volunteer hours to help immunize 2.5 billion

children and eradicate polio in 122 countries, and Rotary is the top private sector contributor.

Except for Pakistan and Afghanistan, the news about polio has improved. In particular, Nigeria

has just achieved three years without any case of wild polio. This is especially remarkable

since less than ten years ago, Nigeria accounted for more than half of the total polio cases

globally. Prior to that time, there was wariness about western medicine due to fallout from the

deaths on Pfizer’s Trovan (Trovafloxacin) meningitis trial in 1996. [I was a US investigator on

other Trovan trials, had some sympathy for Pfizer in this case, and wrote a perspective piece.]

Then the Iraq War fueled mistrust of Western vaccines and led to a boycott of immunizations.

After much back and forth, WHO and UNICEF met with traditional chiefs and Muslim clerics,

tested vaccines in Indonesia, which was a trusted partner, and ultimately resumed effective

immunization campaigns, leading to this current success.

Current Status of Polio

This year ProMed Mail reports Pakistan having 66 cases so far vs. 12 cases in 2018 and 8

cases in 2017. Afghanistan has had 16 cases of wild-type polio cases, which are great

improvements.

Wild poliovirus type 2 was declared eliminated in 2015. This World Polio Day, the Global

Commission for the Certification of Poliomyelitis Eradication (GCC) is anticipated to officially

declare the wild polio type 3 strain as also globally eradicated. Update since article publication.

We will need to remain vigilant, as this video explains. See “Surveillance” video, in the Polio

Vaccine Video Library on our website.*

(continued . . . .)

Forbes – World Polio Day (continued . . . )

What is a bit worrisome is that there are cases of vaccine-derived Type 2 polio cropping up in

Africa, Myanmar, and the Philippines. Update since article published.

Such cases are rare, but can crop up and can spread especially where vaccination rates are

low. This map shows such pockets, often in conflict zones. The GPEI is planning to fully

eliminate the threat of vaccine-derived polio through the phased removal of OPV, which will

occur after WPV eradication has been certified.

The few cases of vaccine-derived polio will need to be treated with more rounds of

immunizations to keep it from spreading. Here is a brief explanation of how this happens. See

“WHO – Vaccine Derived Poliovirus” video, in the Polio Vaccine Video Library on our website.*

How Is The Work To Eradicate Polio Being Done?

The GPEI is using smart strategies that could be helpful across a wide range of diseases and

countries—they are enlisting women as religious support persons (RSP). Carol Pandak, EdD,

the longtime director of PolioPlus, Rotary’s global polio eradication effort, outlined some of their

strategies to me. A smart strategy is using “voluntary community mobilizers” along with more

traditional leaders. They are not limited to polio immunization. Instead, they are integral,

“trusted members of the community.” Each woman works with a relatively small number

(<150) of households, and are “in the community all the time…Tracking newborns, providing

health information, prenatal care, and other health interventions” such as providing Vitamin A

and clean water. “The women are usually attached to the local clinic that has the capacity to

deal with more complicated issues.” Pandak also stressed that they work closely with religious

leaders and ulema (scholars) “who will speak about it at Friday prayers.” The women

ulema use their religious training to shape discussions with mothers.

I found two of Pandak’s strategies particularly clever. In the first, in Nigeria, polio survivors

were given hand-operated tricycles, so they could travel around and graphically explain the

need for immunization.

The “Roots of Peace” adaptation particularly piqued my interest. In an agreement with the

National Emergency Operations Center for polio eradication in the Ministry of Health in

Afghanistan, Roots of Peace will pilot programs in two areas of Afghanistan that have higher

levels of vaccine refusal. Working with NGOs, the program will provide an incentive like plants

and saplings to communities and parents who participate in the polio immunization program. I

like this idea as it gives an award that will be sustainable and provide continued, tangible

benefit.

One barrier to immunizing children is finding them. In tracking TB infections in India, an

unexpected (to me) barrier was that there were no maps of these remote villages in the

mountains of Himachal Pradesh. Our team used GPS units to make our own maps both from

established roads and from health care workers hiking into villages, dropping GIS (geographic

information system) points along the way. (Thank you, ESRI!). We could then better identify

patterns of infection. Similar problems are encountered with providing immunizations as

workers are having to map the communities they are visiting. Using cell phones to collect

data is more efficient and complete as well. The challenges of reaching a very mobile

population are well-described for polio here.

One other new approach from GPEI is a focus on gender equality and addressing gender-

specific barriers.

Other Vaccine Preventable Diseases

The GPEI model has achieved great success with polio. Their sprawling infrastructure reaches

globally, but rationally focuses on areas of greatest risk. In addition to polio, health workers in

this network provide other immunizations and health education.4

Forbes – World Polio Day (continued . . . )

Due to the spread of anti-vaccine misinformation, measles has been increasing in Europe and

the US. The US almost lost its measles elimination status because of a long-running outbreak

in New York. Hundreds were infected, mostly within ultra-orthodox Jewish communities.

Ultimately, the city had to order mandatory vaccinations.

Conclusion

We have to remain ever vigilant to keep up immunization levels. In the US, measles was once

eliminated, and recently there have been new outbreaks due to loss of group (herd) immunity

from parents refusing vaccinations. Polio could be similarly reintroduced here or elsewhere and

again spread rapidly through unprotected children.

Judy Stone I am an Infectious Disease specialist and author of Resilience: One Family's Story of Hope

and Triumph over Evil and of Conducting Clinical Research, the essential guide to the topic.

https://www.forbes.com/sites/judystone/2019/10/24/world-polio-day-showcases-great-progress-in-

eliminating-polio/?fbclid=IwAR0-

a93w4SekvzQdzfOFLFWYPNpxzoVCOIGYRW7F3Vy_ZywmmO9oDHD9ajU#794742904ac7

A Message about Winter Wellness and Energy ConservationFrom Dr. William DeMayo, MD.

DeMayo’s Q&A Clinic

“Winter Wellness” begins with "Deciding what you really Want to do and holding off of the

things that you want to do (w = impulse or desire, but not a decision)." I believe that words

that we use in our head have power over us and so deciding what we Want vs what we want

can be an important factor in changing our decisions. Many people do this already with their

finances and purchases but have not thought to apply the same language to their activity and

health. Another set of similar words that can have power in influencing our behavior and

health include: "need to", "have to", and "should".

The holidays are a particularly difficult time when it comes to these activity decisions. In

order to avoid chronic overuse activities, some helpful questions to consider this holiday

season may include:

• Do I want to continue to push myself to prepare the big family dinner

(and risk creating pain and exhaustion) or do I Want to put my

relationships with family first and preserve my energy by asking for help?

• Do I need to climb that ladder to put up decorations despite the

obvious risk?

• Do I have to bake 12 dozen cookies or do I Want to avoid overdoing

it and dial it back a bit and ask for help?

•Should “shop ‘til I drop” or do I Want to be a better example to

my kids and grandkids by purchasing or even making one

special gift.

All these questions center around individual values, desires,

and goals. It is my hope, especially during the holiday season,

and the cold winter months, that we can all focus on our real

Wants and be less driven by passing desires/wants, “have to”,

“need to”, and a “should” mentality.

The holistic model of wellness applies to us all, especially during this time of year.

Be kind to Yourself with the gift of wellness.

Warm wishes for a happy, healthy Holiday Season. Dr. DeMayo 5

Team Survivor 2019

We are more than thrilled to be able to announce that Team Survivor

(a means by which members of our PA Polio Survivor’s Network can participate in

the eradication of Polio) has exceeded our goal. In addition to monetary

donations, survivors in our network were actively engaged in World Polio Day

activities this year.

At the end of last year, we had raised enough funds to vaccinate an est.

32,000 children. Our goal for this year was to take it to the 42,000 number.

With gratitude to the Gates Foundation turning every dollar you’ve donated into

$3, your generous gifts to the Rotary Foundation for the Polio Plus eradication

effort will enable the GPEI (Global Polio Eradication Initiative) to vaccinate an est.

51,000 children . . . children who won’t get Polio because of the kindness and

generosity of the survivors, our families and friends who participated !

Team Survivor

Together, we are

making a difference.

Spreading KindnessBy Noor Phillips

Bucks County Courier Times

Kindness is something that is common in many

religions.

In Buddhism, Bohdi Day is a day to celebrate the

foundation upon which the religions has been built

upon for the last 2,500 years. It is a day on which

followers can renew their dedication to Buddhism, and reaffirm themselves to enlightenment,

compassion, and kindness to other living creatures.

Earlier this week a friend sent me a “Random Acts of Kindness” Advent calendar. It is mostly

for children, sharing with them what things they can do for another person — reading a story,

sending a little note, and the list goes on.

Khesed is an important Jewish value and a character trait that is very heavily emphasized

within Judaism. For example, in Pirkei Avot (“Sayings of Our Forefathers”) it is taught that

Rabbi Shimon the Righteous used to say that the world stands on three things, one of which is

acts of loving-kindness.

There is a popular story that states a person who lived next to Prophet Muhammed (peace be

upon him) along with putting trash on his door stoop, she would spit at him when he passed

and called him names. When Prophet Muhammed did not see her trash on his stoop for three

days, the Prophet became very concerned and went there to ask if she needed help. Most of us

seem to not have this much compassion.

On the website Islamicity.com it states: “God Almighty is Kind, and the Prophet imitated

Allah’s example in its perfection by showing kindness to His servants and all creatures without

any regard for their beliefs, color or nationality. The Prophet said: ‘God is kind and likes

kindness in all things.’ (Bukhari, 6601).”

“Another person said to the Prophet: ‘0 Messenger of Allah! My relatives are such that although

I cooperate with them, they cut me off; I am kind to them, but they ill treat me.’ The Prophet

said this in reply: ‘So long as you continue as you are, God will always help you and He will

protect you against their mischief’ (Muslim, 4640).”

Kindness is not always an easy way to answer another’s actions. It can, however, change the

tone and actions of others.

Kindness is a fundamental part of many religions. This season, perhaps starting off

conversations, meetings, and all greeting with kindness just might help others with their mood,

pick up their spirit, and start the meeting, the greeting, your time with others positively and

with a smile.

Leave with kindness and may that feeling continue long after the initial kindness. That

secondary kindness can last a long time.

To all of you: remember you are a wonderful being, go and let that shine through and be proud

of the true you!

Noor Phillips is a member of the Zubaida Foundation in Lower Makefield. From a Faith Perspective is a

weekly column written by members of the local faith communities.

https://www.buckscountycouriertimes.com/lifestyle/20191208/faith-spreading-kindness

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Some Additional News

The article from Forbes Magazine was published for World

Polio Day on October 24. Sadly, the numbers have gone up

since that time. The GPEI is NOT giving up the fight to

eradicate Polio. The latest information is HERE

Note: WPV=Wild Polio Virus

cVDPV=circulating Vaccine Derived Polio Virus

In addition, There are two videos cited in the article, they are

easily available in the “Polio Vaccine Video Library” Section of

our website.

The article also speaks about the United Emirates commitment to fund the eradication

effort. Rehabilitative physician, Dr. William DeMayo (who is temporarily living and working in

Abu Dhabi) sent us his “local” newspaper when global leaders met at a forum titled ”Reaching

the Last Mile”. https://gulfnews.com/uae/global-leaders-pledge-26b-to-eradicate-polio-

1.67937184

Just a little Humor with our Best Wishes for a Warm, Wonderful Holiday

WHO – Vaccine Derived Polio Virus Surveillance

Praying For Gifts

Two young boys were spending the night at their grandparents the week before Christmas. At

bedtime, the two boys knelt beside their beds to say their prayers when the youngest one began

praying at the top of his lungs.

"I PRAY FOR A NEW BICYCLE..."

"I PRAY FOR A NEW NINTENDO..."

"I PRAY FOR A NEW VCR..."

His older brother leaned over and nudged the younger

brother and said, "Why are you shouting your prayers?

God isn't deaf."

To which the little brother replied, "No, but Grandma is!“

Holiday Riddles

Question: What’s a parents favorite Christmas carol?

Answer: Silent night.

Question: When does New Year’s Day come before Christmas Day?

Answer: Every year.

Always feel free to contact us.

Unless noted with the article, feel free to copy and share what you see. Always give credit to

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and email us a copy of what you “share”. THANKS.

9Contact us: Email: papolionetwork@gmail.com Phone: 215-858-4643

PO Box 557, Doylestown, Pa. 18901We are a Registered 501C3 organization

Thank you for your kind words and thoughtful donations.

Together, we can and ARE making a difference.We will be publishing our list of 2019 contributors in early January.