SECOND ATTACKS OF ANTERIOR POLIOMYELITIS

The incidence of second attacks of anterior poliomyelitis assumes considerable importance, both as a possible indication of the immunity which is developed from the disease and in differential considerations for patients who have previously had anterior poliomyelitis. Second attacks of this disease would seem to be extremely rare. Fischer and Stillerman,1 in an analysis of all so-called second attacks of poliomyelitis reported prior to 1938, were able to collect 13 which they considered authentic, to which they added certain others. Although the number of cases reported is remarkably few, even a few cases may be significant considering the low incidence of poliomyelitis in the general population. At the Harvard Infantile Paralysis Commission, while following 6,000 cases of poliomyelitis, we have encountered 4 in which the findings were such as to allow a diagnosis of a second attack of the disease. It is significant that all 4 of the patients in question were under observation before, up to and subsequent to the time of the second attack.