At the height of the polio epidemic in 1944, Franklin Delano Roosevelt, who himself had contracted polio more than two decades earlier, pledged to Americans, "Not until we have removed the shadow of the Crippler from the future of every child can we furl the flags of battle and still the trumpets of attack. The fight against infantile paralysis is a fight to the finish, and the terms are unconditional surrender."

It would be almost impossible to exaggerate the sheer terror that gripped the parents of young children every spring and summer during the first half of the 20th century as the polio epidemics ran rampant.

Framingham resident Dave MacNeill, a participant in the Polio Oral History Project, sponsored by the International Rehabilitation Center for Polio at Spaulding in Framingham, recalls the year he contracted polio in 1949. He was 17 at the time.

"There were warnings about gathering in places where crowds congregated and about getting yourself tired.In fact, I think that summer [1949] and possibly summers before, because of the forty to fifty thousand cases of polio across the country, there were warnings, especially at swimming holes. I remember a popular Waltham swimming hole that was frequently closed because there was concern about people getting polio."

Zig Burns, a resident of Dracut, contracted polio in 1952 when he was 12. He also recalls fear and confusion about polio and how it was spread.

"I used to take care of horses. For some reason, doctors were fascinated with that because they just didn't know where the virus came from.It was a mystery disease, and everybody was petrified. I can remember going to the movies, and they'd pass the can for the March of Dimes, and you'd put change in. You'd say, 'Well, that's a shame, but it'll certainly never happen to me,' you know. But it does. It does."

There was enormous cause for celebration, then, when FDR's prophecy was fulfilled on April 12, 1955, the 10th anniversary of his death, when it was announced that the first successful trial of polio vaccines had been completed.

As Eleanor Roosevelt laid a wreath on the grave of her late husband who had lobbied long and hard to free Americans of this dreaded disease, she told reporters that she was "delighted" with the news. America breathed a collective sigh of relief and within 24 months more than 215 million doses of the vaccine had been released, and the number of paralytic polio cases had dropped by 80 percent. Jonas Salk, the man responsible for the first vaccine, became a national hero and was known as The Man Who Saved the Children.

The development of an effective vaccine against polio, arguably the most feared scourge in modern times that killed and maimed several million Americans, was one of the most significant milestones in 20th century. Fifty years later, in 2005, this crowning achievement will be commemorated in many ways.

Yet we can't be complacent. Despite the availability of an effective vaccine, polio remains a problem today in two ways. First, there are over a million survivors of polio living among us in the United States. Many, like MacNeill and Burns, who thought their ordeal with polio was "just" a bad memory of isolation, pain, recovery and adjusting to new disabilities, are, decades later, battling new symptoms such as pain, weakness and fatigue, among other problems. This collection of symptoms is known as post-polio syndrome.

As with polio, there's no cure for PPS. However, treatment is available to decrease pain, preserve strength, energy and mobility and to help prevent falls and injuries that may lead to further disability. Some medical professionals, having learned about polio as a mere footnote during their training, lack an understanding of the symptoms and treatment of PPS, causing difficulty for some survivors of polio in finding the help they need.

Second, despite the long battle fought by the World Health Organization, Centers for Disease Control, Rotary International and other organizations to eradicate polio, it continues to disable and kill people, mostly children, in parts of Africa and India.

What we can glean from the experiences of individuals who survived polio and now live with the aftereffects will help us all to better understand one of the most significant historical events of the 20th century and possibly help us to tackle future plagues.

Julie Silver, M.D. is founder and director of the International Rehabilitation Center for Polio at Spaulding-Framingham Outpatient Center and assistant professor at Harvard Medical School. She is the author of Post Polio Syndrome: A Guide for Polio Survivors and Their Families and Chronic Pain and the Family. Anna Rubin is the education and outreach coordinator at the IRCP and principal interviewer for the Polio Oral History Project. For more information visit www.polioclinic.org Physician Focus is provided as a public service by the Massachusetts Medical Society and your community newspaper. Readers should use their own personal judgment when seeking medical care and consult with their personal physician for treatment. Comments are welcome at physicianfocus@mms.org