I also wasn't surprised when four more Minnesota children exposed to the polio-infected child were also infected with the poliovirus. These children, who are Amish, weren't vaccinated against polio. The Amish often shun modern medicine, like vaccines, but will travel thousands of miles for "natural" cures -- from herbal enemas to Laetrile -- for diseases ranging from diabetes to cancer. Since the poliovirus infecting the Minnesota children is from the Sabin vaccine, the virus must have been imported into the country. It may be that members of the Minnesota Amish community traveled to another country -- perhaps to Mexico for some kind of "natural" treatment -- and brought back an unwanted hitchhiker: polio. This is exactly what caused America's last polio epidemic. In 1979 unvaccinated Amish women in Pennsylvania, Iowa, Wisconsin and Ontario developed paralytic polio after attending an Amish wedding in Wisconsin. But in these cases, it wasn't the Sabin vaccine but the naturally occurring "wild" type 1 poliovirus that had been imported from Europe to Canada, and then brought to Wisconsin, infecting the unvaccinated Amish, who then exported the poliovirus to other states.

The fact that the poliovirus, whether a Sabin vaccine strain or the original wild poliovirus, can be imported into the country at this time is especially frightening because polio broke free of international vaccination efforts. Nigerian Muslim clerics, worried that Americans had poisoned the polio vaccine, forbade its use. During the past two years polio has spread from Nigeria to other African countries, up to Yemen and all the way to Indonesia, with more than 1,000 new polio cases reported. Why should we worry about poliovirus being imported when all American children are supposed to be vaccinated against polio? This is what surprised me: All American children are not vaccinated. The polio vaccine has been a victim of its own success. Today, parents think that polio is gone and vaccinations are no longer needed. The Centers for Disease Control estimate that 90 percent of U.S. children under 3 years old are vaccinated against polio. Ninety percent sounds good until you realize that 10 percent of American children -- that's one million toddlers -- are not vaccinated against polio. The vaccination rates are lowest in poor cities. In Newark, N.J., only 86 percent of kids are vaccinated; in Detroit, only 78 percent are vaccinated. What happens if a polio-infected child from Nigeria lands in Newark, or Detroit, or a densely populated city like New York, where an estimated 23,000 toddlers are unvaccinated? America's next paralytic polio epidemic could be just a plane ride away.

Legislators have recognized the danger of forgetting polio. A Senate-passed resolution and a pending resolution in the House of Representatives proclaim 2006 a national "year of polio education," reminding Americans that, although polio has been forgotten, it is far from gone. The state of New Jersey has begun a polio awareness campaign, educating healthcare professionals, parents and polio survivors about vaccination and PPS.

Please contact your governor and state legislators and ask that your state have its own polio awareness campaign. Every child must be vaccinated against polio and every polio survivor and healthcare professional needs to learn about and treat post-polio sequelae now, before the next American paralytic polio epidemic and before PPS steal polio survivors' ability to function. For both vaccination and PPS, the new motto is "don't wait until it's too late."