Industry Insights

two scientists performing pressure decay testing

Pressure Decay Testing and Why It is Important in BSL-4 Laboratory Annual Verification Testing

What is Pressure Decay Testing? Pressure decay testing is a systematic procedure to validate room construction to determine if the laboratory’s containment barrier defined by walls, floors, ceilings, penetrations, and other construction features meet the required integrity to prevent leakage of unfiltered air from the BSL-4 containment space. Pressure decay testing is the most reliable method to prove that a BSL-4 laboratory room’s envelope is airtight. The National Institutes of Health, which oversees the operation of the BSL-4 laboratories located in Fort Detrick, Maryland, and Hamilton, Montana, indicates that the standard BSL-4 pressure testing method is to negatively pressurize the room to 2 InH2O, and then measure the pressure decay. The requirement for a BSL-4 laboratory is to maintain a pressure higher than 1 InH2O after 20 minutes (Memarzadeh, 2009). This quantifiable test can pinpoint issues with critical equipment in a BSL-4 laboratory including: Air distribution valves Isolation dampers and actuators Isolation dampers bioseals APR doors gaskets Barrier autoclaves gaskets and seals Breathing air system lines Laboratory vents Why is Pressure Decay Testing Important? Pressure decay testing provides an acceptable level of quality for annual verification testing of BSL-3 Ag and BSL-4 laboratories. The complex design and operation of these facilities minimize the potential risk of an aerosolized pathogen to staff, the general population, and the surrounding environment. The pressure decay test verifies that there is no air leakage. Air leakage can compromise research studies through cross-contamination of multiple pathogens. How to Prepare for Pressure Decay Testing? The following steps must occur before conducting a pressure decay test: Verify the facility’s HVAC system is operational and commissioned. Verify the building automation system (BAS) is operational. Provisions for setting up testing equipment are available (pressure transducer enclosures, decontamination ports, etc.) Use either testing vacuum pump or exhaust system to negatively pressurize the system up to 2.00 InH2O. Check all potential sources of leakage for audible or identifiable leakage. To the extent practical, eliminate/minimize potential sources of heat generation so that the space stays at a relatively constant temperature throughout the testing (lights, freezers, motors, etc.) Isolate the affected areas from pressure fluctuations that will affect the testing. Monitor room Differential Pressures (DP) with static conditions (no airflow or pressurization air) to ensure that there are no external effects that will invalidate the results. All plumbing fixtures and floor drain traps are filled with water. If previously identified, all construction deficiencies have been rectified and completed. Ensure no visible damage is apparent to the room under test. All conduit, wiring, and electrical boxes have been epoxy-sealed. All epoxy coatings (if epoxy coatings are present) are in place and free of visible defects. Seamless flooring is in place and free of visible defects. Check valves and isolation valves are in place and operational. Dunk tanks (if installed) are filled. Autoclaves are operational and have their seal barriers in place. APR doors are functional and interface to BAS, and door access control systems are operational. Room temperatures are measured and data logged. Changes in temperature cause changes in pressure. Atmospheric pressure is measured using an instrument with an accuracy of 0.01 In. Hg. which is equivalent to 33.86 Pa or .136 InH2O. A pressure decay test form has been generated. It has been confirmed that room and general laboratory conditions are acceptable for testing the laboratory. The subject test area should be isolated and then allowed to stand for 20 minutes before commencing the test. Acceptance Criteria The room passes the pressure decay test if the residual pressure at the end of the 20-minute period is -1.00 InH2O or more negative (50% of the initial room’s pressure value) under steady state conditions for temperature and barometric pressure. Each pressure zone within maximum containment (BSL-4) must pass two consecutive pressure decay tests. If Pressure Decay Testing Is Not Feasible If annual pressure decay testing is not feasible for some rooms, then another option would be conducting a smoke saturation test. A smoke saturation test is a qualitative test, but it will help the users to identify possible issues with the containment envelope. The maximum containment engineering/maintenance team will need to command the laboratory into maintenance or decontamination mode. The surrounding areas will be more negative; therefore, if there is a leak or issue during the testing, the maximum containment team will be able to identify it. The challenge with this method is that it is only recommended if the rooms are decontaminated. Another option (a little bit messy and more time-consuming) is the use of a soap solution on critical areas. This test is the least accurate option because it will only test perimeter barrier components. The laboratory will require decontamination prior to testing. “Light Pressure Decay Test” If there is a decontamination or maintenance mode for the facility, you can run what we call a “light pressure decay test.” Before a decontamination process begins, you need to make sure the laboratory is airtight. The light pressure decay test is typically conducted from the BAS for testing and running trends. No additional testing equipment is used. This is a non-invasive procedure. What About BSL-3 Laboratories? BSL-3 laboratories can be pressure decay tested depending on the laboratory’s envelope construction system, calculated room’s leakage rate, and room’s isolation capabilities. Pressure decay testing on BSL-3 laboratories is more challenging since, by concept, these types of laboratories are considered “leaky labs” (infiltration of air is required). However, with the implementation of good room isolation standard operating procedures, the pressure decay test can be achieved with no issues. Recommendations Pressure decay testing is a team effort. Our recommendations to have a successful pressure decay test include: Make sure to get involved with experienced staff and a third-party consultant such as World BioHazTec from the beginning. Pressure decay testing is a critical testing procedure that requires experience and knowledge of BSL-4 and BSL-3 laboratories. Pressure decay testing should not be rushed. It requires coordination and is a team effort that involves the biosafety officer, Responsible Official, Alternate Responsible Official, facility director, facility personnel, and contractors. Differential pressure meters and test equipment calibration must be current and traceable to NIST. Check and double-check items which could inadvertently affect the testing outcome. If room or atmospheric conditions are not stable, such as a thunderstorm, do not hesitate to reschedule the test. If you would like to learn more about pressure decay testing, contact World BioHazTec for a free consultation or send us an email. Works Cited Farhad Memarzadeh (2009, September 15). Pressure and Temperature Correction for BSL4-Pressure Decay Test. (O. o. National Institutes of Health, Producer) Retrieved 2023, from Pressure and Temperature Correction for BSL4-Pressure Decay Test: https://orf.od.nih.gov/TechnicalResources/Bioenvironmental/Documents/PressureandTemperatureCorrectionforBSL4_508.pdf

N+1 Redundancy in BSL-3 and ABSL-3 Laboratories

Redundancy is a “must” for BSL-3 and ABSL-3 laboratories. Although the Biosafety in Microbiological and Biomedical Laboratories, 6th Edition (BMBL) and the World Health Organization Biosafety Manual, 4th Edition (WHO) do not specifically mention N+1 critical equipment for BSL-3 or ABSL-3 laboratories (BMBL) or “heightened laboratories” (WHO), they both specify: BMBL: “Loss of directional airflow may compromise safe laboratory operation.” – Page 16 WHO: “Laboratory ventilation where provided…should ensure airflows do not compromise safe working.” – Page 33 What is N+1 Redundancy? N+1 redundancy is a risk reduction strategy used in critical containment environments such as BSL-3, ABSL-3, BSL-3Ag, BSL-4 or ABSL-4 laboratories to ensure operational reliability and containment during failure of system components to reduce risks to personnel, animal health, the public and the environment. Building systems are made up of many components (e.g., fans, pumps, motors, variable frequency drives, control air valves, damper actuators, etc.). “N” refers to the component necessary for the system to operate. For systems that are critical to maintain containment, directional airflow, electrical power, water, fire protection, etc., an engineer provides an additional component N+1, or additional components N+2, etc., to reduce the risk of interruption of the building service serving the laboratory. These redundant components are capable of handling the full load of the building system in the event one of its primary components fails. This means that even if one of the primary components fails “N”, the redundant component “+1” takes over. This is not unique to our industry. For instance, commercial jet airliner engines are redundant. Jet airliners are designed so that if there is a loss of one engine, the other engine takes over (N+1 redundancy). Likewise in the biocontainment industry, the electrical supply to the BSL-3 laboratory has N+1 redundancy. The “N” represents the utility that normally supplies electricity to your facility. The “+1” would be the redundant power supply (e.g., emergency generator, uninterruptible power supply, flywheel) that can provide enough power to run the entire or a portion of the building systems which serve the laboratory. Just like a commercial jet airliner, the laboratory will be able to operate until corrective action can be taken. This is extremely important for containment and especially for animal facilities as the animals will suffer if the building systems are not restored. Personnel can leave the laboratory while animals cannot. Deciding to what extent you provide redundant components (N+1, N+2, or N+3, etc.) requires a risk assessment. What Does the BMBL and WHO Say? The BMBL states, “A ducted mechanical air ventilation system is required. This system provides sustained directional airflow by drawing air into the laboratory from ‘clean’ areas toward ‘potentially contaminated’ areas. The laboratory is designed such that under failure conditions the airflow will not be reversed at the containment barrier”. The key words here are “under failure conditions.” The BMBL and WHO guidelines rely on the best tool we have in biocontainment: “risk assessment.” Risk Assessment for N+1 Redundancy Some factors we need to consider for N+1 redundancy when conducting a risk assessment are (among others): BSL-3 laboratory location (isolated, building, city, campus, etc.) Research protocol and volume of samples or biological material to be used Budget BSL-3 laboratory size Design intent and acceptance criteria Capability for ease of annual testing of HVAC and electrical systems When World BioHazTec consults on the design of containment laboratories located at universities, research campuses and public health laboratories, meeting the N+1 redundancy provision is a group decision with input from the biosafety officer, users, facilities management, designers and cost estimators to reduce risk to an acceptable level. The resultant design needs to be reviewed for performance criteria, especially for the timing of the transfer from the failed component to the redundant component. This is particularly important for the electrical and HVAC components’ sequence of operation to restore the system to full operation parameters. The restoration of a system with the redundant component is a critical operation which needs to be observed and documented to show there was not an airflow reversal caused by the redundant component taking over. A robust sequence of operation and programming, supported by a strong biosafety program which addresses system failure events, reduces risk and documents performance. For more information about N+1 redundancy, risk assessment and laboratory design, contact World BioHazTec for a free consultation, or send us an email.

Council Rock Consulting, Inc. d/b/a World BioHazTec Becomes an IACET Accredited Provider

Prestigious Accreditation Demonstrates Commitment to High-Quality Adult Learning May 1, 2023 – The International Accreditors for Continuing Education and Training (IACET) has awarded Council Rock Consulting, Inc. (CRC) d/b/a World BioHazTec (WBHT) the prestigious Accredited Provider accreditation. IACET Accredited Providers are the only organizations approved to offer IACET Continuing Education Units (CEUs). The accreditation period extends for five years, and includes all programs offered or created during that time. “CRC and WBHT are proud of our education programs which educate biosafety professionals each year in critical environment safety, and maintenance and operations skills so that our clients can maintain relevancy in today’s world,” stated Kerstin Haskell, President. Kerstin added, “Our accreditation with IACET is a demonstration of our commitment to quality adult education and high standards for all our programs. We are very pleased to join such a prestigious organization as well as an elite group of organizations that offer excellent continuing education and training programs.” “We are pleased to recognize and celebrate the achievement of CRC and WBHT as an Accredited Provider,” stated Randy Bowman, interim President & CEO of IACET. Bowman added, “CRC and WBHT proudly joins nearly 600 organizations around the globe that have matriculated through a rigorous peer-reviewed process by experts in continuing education, thereby ensuring the highest possible standards are met.” Example course offerings include: Biosafety Principles, Select Agents and Toxins, Aerosol Hazards Decontamination and Sterilization; Autoclaves and Biosafety Cabinets Engineering for the Biosafety Professional Part I Engineering for the Biosafety Professional Part II Risk Assessment and Working With Institutional Biosafety Committees Biosafety Standard Operating Procedures Effluent Decontamination Systems and Waste High-Containment Laboratory Design Review BSL-3 Operations and Maintenance for Sustainability CRC and WBHT develop site-specific courses in collaboration with you to meet your learners’ needs. To achieve Accredited Provider accreditation, CRC and WHBT completed a rigorous application process and successfully demonstrated adherence to the ANSI/IACET 2018-1 Standard for Continuing Education and Training by addressing the design, development, administration, and evaluation of its programs. CRC and WBHT has pledged its continued compliance with the Standard and is now authorized to use the IACET name and Accredited Provider logo on promotional course material. In addition, CRC and WBHT are now linked to the IACET website and is recognized as offering the highest quality continuing education and training programs. CRC dba WBHT works on special, meaningful projects that promote safety and health for the constantly changing world. Taking on challenges requires flexibility, creativity, and technical knowledge. WBHT is one of the first movers in the biocontainment industry to provide biosafety and biosecurity consulting that focuses on creating a safe and conducive work environment for the scientific industry. The mission of WBHT’s continuing education and training program is to support our client organizations by developing programs unique to their needs to promote workplace safety and health, safe facility operations, continuity of operations, and professional development to meet the client’s organizational goals. About IACET: The International Accreditors for Continuing Education and Training (IACET) is a non-profit association dedicated to quality continuing education and training programs. IACET is the only standard-setting organization approved by the American National Standards Institute (ANSI) for continuing education and training. The ANSI/IACET 2018-1 Standard for Continuing Education and Training is the core of thousands of educational programs worldwide. For more information, please visit www.iacet.org or call 703-763-0705.

Members of World BioHazTec including the President, Kerstin Haskell holding the proclamation

How a Simple Click Turned Into Maryland’s First “Biosafety Day”

By Kerstin Haskell, President, World BioHazTec and 2024–2025 President, Chesapeake Area Biological Safety Association (ChABSA) Back in January, I was on the State of Maryland’s website—why, I honestly can’t remember—but there on the homepage I saw a link: “Request a Proclamation.” Something about that link sparked a thought: What if ChABSA's annual symposium had an official proclamation to recognize biosafety and the professionals who safeguard our labs and communities every day? As the President of World BioHazTec and the 2024–2025 President of ChABSA (Chesapeake Area Biological Safety Association), I’m constantly thinking about how we can raise awareness and elevate the biosafety profession—not just within our community, but in the broader public sphere. This felt like a unique opportunity to do just that. So I clicked. What followed was a journey that reminded me of the power of persistence, collaboration, and simply asking. After clicking through, I realized I had to write the proclamation myself. I turned to artificial intelligence, which helped me shape the language, structure, and tone—guiding me through examples and best practices for proclamation writing. With that support, I drafted the text and submitted it through the official portal. Then I waited. A week went by. Silence. I started wondering if it had gone into a bureaucratic black hole. That’s when I remembered my colleague and friend, Brian Castleberry at the Maryland Department of Commerce. I had met Brian through World BioHazTec’s participation in the 2023 Arab Health Show, which was supported by a Maryland export promotion grant for small businesses. I reached out, shared the proclamation request, and Brian kindly forwarded it to a deputy director at the Governor’s Office. Another month passed. Still nothing. Brian followed up again on my behalf (thank you, Brian!), and I continued to wait. Then came a stroke of serendipity. I was in Annapolis testifying before the Maryland House Ways and Means Committee on a proposed tax on life sciences services. Sitting beside me on the panel was Kelly Schulz, President of the Maryland Tech Council. I had long admired Kelly’s work supporting the state’s life sciences community, and this was my chance to finally meet her. After the hearing, we exchanged contact information and started texting. I told her about the proclamation and asked if she might be willing to help. Without hesitation, she said yes. Kelly advised me to follow up after the state’s budget cycle closed at the end of March. I did—and when we met in person, she followed up with the Governor’s Office...right there in front of me. Around the same time, Tracey Brown, World BioHazTec’s Training Manager, who also serves as ChABSA’s Treasurer, reached out to our long-standing partners at the Universities at Shady Grove (USG). ChABSA has proudly supported USG’s Biosafety and Biosecurity Scholarship Program, and the relationship has grown through collaborative events and shared goals. In response to the outreach, Tom Clifford and Joyce Fuhrmann submitted a formal letter of support to the Governor’s Office, strongly advocating for the proclamation to recognize Biosafety Day. Then, just a week before the symposium, I received the news: Governor Wes Moore had officially proclaimed June 4, 2025, as “Biosafety Day” in Maryland. This would not have happened without the advocacy and belief of people like Brian, Kelly, Tom, Joyce, Tracey and others who understand the value of biosafety to Maryland’s workforce, research institutions, and public health system. It’s a reminder that biosafety professionals are making a difference every day—and that our work deserves to be seen and celebrated. Sometimes, all it takes is a click. And a follow-up. And a little courage to ask. Proclamation: Biosafety Day June 4, 2025 WHEREAS, The field of biosafety plays a critical role in protecting public health, scientific research, and the environment by ensuring the safe handling and containment of biological materials in laboratories and research settings; and WHEREAS, Biosafety professionals work diligently to establish and maintain policies, procedures and physical containment measures that prevent accidental exposure to harmful biological agents and promote the responsible use of biotechnology; WHEREAS, Maryland is home to one the nation’s strongest life sciences industries, employing more than 54,000 people across a wide range of roles in research and development, manufacturing, and laboratory operations; and WHEREAS, The Chesapeake Area Biological Safety Association will hold its 35th Scientific Symposium at the Universities at Shady Grove in Rockville, Maryland; and WHEREAS, Through ongoing training, inspections, risk assessments and containment measures, biosafety professionals uphold rigorous standards that protect against biological risks and support safe scientific progress; WHEREAS, The establishment of Biosafety Day serves as an opportunity to highlight the achievements of biosafety professionals, encourages collaboration across disciplines and raise awareness about the importance of effective biosafety programs and protocols. Now therefore, I, Wes Moore, Governor of the State of Maryland, do hereby proclaim June 4, 2025 as Biosafety Day in Maryland, and do commend this observation to all of our citizens.

TB and America’s First Public Health Campaign: A Look Back at Early Efforts to Combat Tuberculosis

Early History of Tuberculosis in the U.S. Tuberculosis (TB) has a long, devastating history in the United States. Once known as “The Captain of Death” and the “White Plague,” this deadly disease shaped not only the public’s health but also everyday behaviors and how we as a society responded to infectious threats. Though its grip on the nation has loosened with modern medicine, TB’s early impact on the U.S. led to the creation of some of our first organized public health campaigns. A Devastating Disease: TB’s Early Years in America In the 1700s, tuberculosis earned ominous nicknames like “The Robber of Youth” and “The Captain of Death.” In the 1800s, it became known as the “White Plague,” referencing the pale appearance of its sufferers. It was also commonly called “Consumption” because of its high mortality rate and how victims were consumed by hacking, bloody coughs, debilitating pain in their lungs, and fever, making it impossible to get out of bed. The disease, caused by the bacterium Mycobacterium tuberculosis, spread primarily through the air when an infected person coughed or sneezed. The disease became rampant, thriving in overcrowded urban areas where poor sanitation and malnutrition were common. Without effective treatments, TB was often fatal, leading to widespread fear and stigma. (Stolley & Spector, 1966). 80% of those individuals who developed active tuberculosis died of it. At the time, there was little understanding of how the disease was transmitted, and medical knowledge regarding its treatment was limited. Public health infrastructure was still in its infancy, and many people with TB were left untreated, which further contributed to the spread of the disease. A Public Health Crisis At the beginning of the 19th century, tuberculosis had killed one in seven of all people that had ever lived. During the nineteenth and early twentieth centuries, it was the leading cause of death in the United States, and one of the most feared diseases in the world. It was estimated that, at the turn of the century, 450 Americans died of tuberculosis every day, mostly between the ages of 15 and 44. The death rate in 1900 measured 194 per 100,000 persons. Comparatively, the death rate in America during the COVID-19 pandemic was 61.3 per 100,00 persons. At the turn of the century, TB was a ubiquitous component of American society and culture. While it was a disease that typically impacted lower socio-economic classes who often resided in overcrowded cities, living and working in poorly ventilated structures, more prominent Americans were not beyond TB’s reach. Among the list of well-known Americans who succumbed to TB included former Presidents James Monroe and Andrew Jackson, two of Abraham Lincoln’s sons, two of Richard Nixon’s brothers, First Lady Eleanor Roosevelt, authors Henry David Thoreau, Edward Bellamy, George Orwell, Stephen Crane, and Thomas Wolfe, actor W.C. Fields, business tycoon Jay Gould, musicians Chick Webb and Jimmy Blanton, and Clara Barton, founder of the American Red Cross, just to name a few. Early Infectious Disease Control: America’s First Public Health Campaign The Sanatorium Movement By the late 1800s, public health leaders in the U.S. recognized the need to address TB through organized medical and social interventions. One of the earliest responses to TB was the establishment of sanatoriums, specialized treatment centers designed to isolate and care for people with tuberculosis. The idea behind sanatoriums was simple: fresh air, rest, and good nutrition were believed to help patients recover. By the late 1800s and early 1900s, doctors and health officials discovered that TB was most contagious during the active stages of the disease. Isolating patients in sanatoriums reduced the risk of spreading TB to the general population. These institutions were typically located in rural areas or places with clean air, and patients were encouraged to spend most of their time outdoors. These facilities not only provided physical care but also helped reduce the stigma surrounding TB, as they became recognized as centers for both healing and hope. Many sanatoriums were funded by a combination of public funds, charitable donations, and private contributions, reflecting the community-wide effort to address the epidemic. Image from the University of Virginia's Claude Moore Health Sciences Library as appeared in the digital exhibit, "The American Lung Association Crusade" at http://exhibits.hsl.virginia.edu/alav/tu Life in the Sanitorium In the first decades of the 20th century, one out of every 170 Americans lived in a sanatorium, some for many years. For many, these institutions were their last hope. While sanatoriums were not a cure for TB, they provided some relief, particularly for patients in the early stages of the disease. However, life in the Sanitoriums was not easy. Patients often left for sanatoriums in the middle of the night, without telling people. They quit their jobs, or they just left to protect their families. Entering a sanatorium required complete submission. Physicians and nurses regulated every moment of the day. When people first came to a sanatorium, many were put on 24-hour rest. All their meals were brought to bed on trays. They were required to use bedpans. Many facilities were segregated by race, and some African Americans, barred from whites-only sanatoriums, helped start their own. Despite the hardships, sanatoriums offered a sense of community for those afflicted by the disease. They were isolated from the fear of infecting others and often found solace in the companionship of fellow patients. For all the freedoms they lost, patients were able to embrace the idea of healing and hope in a place that was devoted to their care. The success of these early sanatoriums served to influence later public health policy in the U.S. The idea of isolating infected individuals, as seen in the sanatoriums, laid the groundwork for quarantine practices, which were later used for controlling other infectious diseases, including influenza, smallpox, and even COVID-19. TB Public Health Campaign: The Foundation for Modern Infectious Disease Control By the early 20th century, public health officials realized that isolating TB patients was just one part of the solution. The other part was educating the public about TB transmission and prevention. The establishment of the National Tuberculosis Association in 1904 (now the American Lung Association) marked an important milestone in raising awareness about TB. The association’s work centered around educating the public on the importance of early detection, promoting hygiene practices like covering one’s mouth when coughing, and encouraging people to seek medical treatment as soon as symptoms appeared. Public health campaigns also emphasized the importance of improving living conditions. Poor nutrition, overcrowded housing, and lack of access to healthcare were known to exacerbate TB, and improving these factors became a key focus for public health advocates. As TB research progressed and medical treatments were developed, quarantine and isolation protocols continued to be important public health tools. The early emphasis on isolating individuals with active TB in sanatoriums eventually led to more formal quarantine measures for individuals diagnosed with the disease. This practice of isolation not only reduced the risk of transmission but also contributed to the eventual creation of specialized infectious disease units in hospitals. Conclusion Early public health responses to tuberculosis in the United States laid the foundation for modern practices in infectious disease prevention and management. The establishment of sanatoriums, public health campaigns to educate the public, and advances in medical research helped reduce TB-related mortality. Additionally, the development of isolation protocols and laboratory biosafety measures, informed by TB research, established the groundwork for how the U.S. manages infectious diseases today. Though TB is no longer the threat it once was, the lessons learned during this time continue to influence how we approach modern public health crises. References Ahmad FB, Cisewski JA, Xu J, Anderson RN. (2022). COVID-19 Mortality Update — United States, Retrieved from https://www.cdc.gov/mmwr/volumes/72/wr/mm7218a4.htm American Experience. (2015). The Forgotten Plague. Retrieved from https://www.pbs.org/wgbh/americanexperience/films/plague/#transcript American Lung Association. (2020). A Brief History of Tuberculosis in the United States. Retrieved from https://www.lung.org/research/trends-in-lung-disease/tuberculosis Centers for Disease Control and Prevention (CDC). (2021). Tuberculosis (TB) History and Timeline. Retrieved from https://www.cdc.gov/tb/about/history/default.htm Fennell, M. L. (2018). The Rise and Fall of the Tuberculosis Sanatorium: The Role of Sanatoriums in Early Public Health Responses. Journal of the History of Medicine, 73(2), 130-142. Mackenzie, R. W. (2002). Public Health and Tuberculosis Control in the United States. Health Affairs, 21(3), 182-192. Rosen, G. (1993). A History of Public Health. Johns Hopkins University Press. Rothman, Sheila M. Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (New York: BasicBooks, 1994) Snider, G.L. (1997). Tuberculosis then and now: a personal perspective on the last 50 years. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9027277/ Stolley, P. D., & Spector, W. S. (1966). Tuberculosis in the United States: The Role of Medical Interventions and Public Health Efforts in Reducing Tuberculosis Mortality. The Journal of Infectious Diseases, 118(3), 184-197.

“Like Patenting the Sun”: America’s Fight Against Polio and the Power of a Vaccine

In the early 1950s, as the United States relaxed in the post-WWII glow, a terrifying disease threatened to disrupt the safety and peace that families had fought so hard to secure. Polio, a virus that cast a shadow over families for decades, surged to alarming levels, with a peak of 57,879 reported cases in 1952, resulting in 3,145 deaths. This terrifying epidemic, which primarily struck children, shattered the idealized vision of suburban life and posed an existential threat to the very idea of family safety in a modern, scientifically advanced world. A Nation Gripped by Fear For middle-class American families, polio was an unwelcome intrusion into a life they believed they could control. The postwar years had promised safety—victory over the Great Depression, success in World War II, and the newfound comforts of suburban living. But polio, which could paralyze or kill seemingly without reason, introduced a sense of vulnerability and helplessness. The random nature of its spread left families in constant fear. An otherwise healthy child could be struck down in an instant, leaving parents to wonder where they went wrong. The polio virus could take anywhere from six to twenty days to incubate and remained contagious for up to two weeks. Its long incubation period, coupled with the fact that the virus was highly stable in the environment, made it nearly impossible for experts to track how it was spreading. Some believed it was spread through water, leading to public pools and beaches being closed during the summer months. In fact, one book about the epidemic is aptly titled The Summer Plague, emphasizing how the virus seemed to return each year, adding to the dread. The Impact of Polio on Daily Life During the height of the epidemic, life as usual was put on pause. Swimming pools, movie theaters, and even playgrounds were shut down to protect children from the virus. Parents, gripped by the fear that their children could "catch polio" at any given moment, kept them isolated, away from friends, and away from public spaces. Rumors abounded, blaming soft drinks, weather patterns, or even the use of paper money for spreading the disease. Health officials, overwhelmed by the unpredictability of the virus, took extreme measures—such as isolating children suspected of being infected and quarantining them in sanitariums. By the time the polio epidemic reached its peak, fear was ingrained into American life. Each summer, when the virus was most active, the country seemed to hold its breath, waiting for the next wave of infections. Counterintuitive Culprit: Hygiene and Clean Water Polio had existed in obscure forms before the twentieth century, with occasional outbreaks in the 18th and 19th centuries. But it wasn't until the early 1900s that the disease became a widespread epidemic. The clue to its terrifying rise was hidden in something presumably beneficial: improving sanitation and clean water systems. Before the 20th century, the virus was rampant in water supplies. When a very young child was exposed, it would often cause a mild reaction, such as diarrhea, that would lead to lifelong immunity. But as public health efforts improved sanitation and water systems, children no longer had the mild exposure that would naturally build immunity. As a result, polio began to affect older children and young adults who were not immune. With no understanding of the virus’s transmission or how to prevent it, epidemics like the one in 1916, and later ones in the 1940s and 1950s, were disastrous. Polio's victims were disproportionately from the middle class, which struck fear into this emblem of American global superiority. The virus struck at a time when modern society had assumed it had mastered infectious diseases. Polio was the cruel reminder that not even the most advanced systems could protect against everything. The Search for a Vaccine: A Triumph of Science and Collaboration In the midst of this public health crisis, hope emerged in the form of a vaccine. Dr. Jonas Salk, a name now synonymous with polio eradication, developed the inactivated polio vaccine (IPV), which would change the course of history. By 1955, the vaccine had been tested and found to be both safe and effective. This was a monumental breakthrough. For Salk, the success of the vaccine was not about personal profit—he famously refused to patent it, saying it would be like “patenting the sun.” The introduction of the vaccine led to a massive public health campaign. Between 1955 and 1962, over 400 million doses of the vaccine were distributed, dramatically reducing cases by 90%. Polio, once the most feared disease in America, began to fade into memory. The collective effort that brought the vaccine to fruition—through the leadership of President Franklin Roosevelt, the work of scientists like Salk, and the bravery of volunteers who tested the vaccine—was a triumph of cooperation and public trust in science. The Cold War Twist: The Sabin Vaccine and Global Cooperation While Salk’s vaccine was taking hold in the U.S., another breakthrough emerged. Dr. Albert Sabin developed an oral polio vaccine, which could be taken in a simple pill rather than requiring an injection. However, by the time Sabin was ready to test his live-virus vaccine in the U.S., many children had already received the Salk vaccine, so he turned to Eastern Europe for testing. In one of the most remarkable stories of Cold War collaboration, Sabin tested his vaccine on millions of children in the Soviet Union, Hungary, and other Eastern European countries, where the results were overwhelmingly positive. The success of the Sabin vaccine in these countries demonstrated the power of international cooperation during a time of immense political tension. Hungary, in particular, became a pioneer in polio vaccination, beginning its nationwide vaccination campaign in 1959—four years before the United States adopted the Sabin vaccine. This global effort to eradicate polio marked a rare moment of unity in an era defined by the ideological divide of the Cold War. A Faint Memory: Polio's Legacy and the Ongoing Struggle By the end of the 20th century, the specter of polio had receded into the background of public consciousness. With vaccination programs and public health campaigns, polio became a disease of the past in many parts of the world. However, the legacy of this disease lives on, not only in the memories of those who lived through the epidemic, but also in the ongoing fight to eradicate it completely. In some ways, polio is now a victim of its own success. Today’s parents, who have never seen the disease’s devastating effects, may take vaccines for granted. But the history of polio serves as a reminder of the power of science, collaboration, and public trust. It also underscores the importance of remaining vigilant in the face of new and evolving health threats. References Janssen, Volker. (2023). When Polio Triggered Fear and Panic Among Parents in the 1950s. Retrieved from https://www.history.com/news/polio-fear-post-wwii-era Kurlander, Carl. (2020). How the deadly polio epidemic changed American life for decades before a vaccine was found. Retrieved from https://www.milwaukeeindependent.com/syndicated/deadly-polio-epidemic-changed-american-life-decades-vaccine-found/ Lienhard, John H. Polio and Clean Water. Retrieved from https://engines.egr.uh.edu/episode/1527 Rochford, Rosemary. (2022). A virologist explains polio’s history as fears of a resurgence grow. Retrieved from https://arkansasadvocate.com/2022/09/08/a-virologist-explains-polios-history-as-fears-of-a-resurgence-grow/ Vargha, Dóra. (2018). Polio Across the Iron Curtain: Hungary’s Cold War with an Epidemic. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK565345/ Weeks, Linton. (2015). Defeating Polio, The Disease That Paralyzed America. Retrieved from https://www.npr.org/sections/npr-history-dept/2015/04/10/398515228/defeating-the-disease-that-paralyzed-america

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