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The Journal of Experimental Medicine logoLink to The Journal of Experimental Medicine
. 1914 Feb 1;19(2):195–204. doi: 10.1084/jem.19.2.195

A CONTRIBUTION TO THE EPIDEMIOLOGY OF POLIOMYELITIS

Simon Flexner 1, Paul F Clark 1, Harold L Amoss 1
PMCID: PMC2125154  PMID: 19867758

Abstract

A strain of the poliomyelitic virus was propagated in monkeys for four years, during which time it displayed three distinct phases of virulence. The several phases covered different periods of time. At the outset the virulence was low, but by animal passages it quickly rose to a maximum; this maximum was maintained for about three years, when, without known changes in the external conditions, a diminution set in and increased until at the expiration of a few months the degree of virulence about equalled that present at the beginning of the passages in monkeys. The cycle of changes in virulence is correlated with the wave-like fluctuation in epidemics of disease which also consist of a rise, temporary maximum, and fall in the number of cases prevailing. And an explanation of epidemics of disease is inferred in variations or mutations among the microörganismal causes of disease affecting chiefly the quality of their virulence.

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