Going nuclear to fight polio

 

S. Ananthanarayanan

FA&CAO(C)CR

 

Originally published in Indian Express January 25, 2003

 

An important component of the Atomic Energy Programme may just have the answer to the disconcerting news that India is still some distance from being free of polio.

One of the reasons of this failure may be the need to keep the polio vaccine under refrigeration. Scarce refrigeration equipment and uncertain power makes this difficult. But heavy water, which is manufactured at great cost for Pressurised Heavy Water Nuclear Reactors, has been found to be effective as a medium for the storage of the polio vaccine without refrigeration.

Heavy water differs from ordinary water in that in place of hydrogen in its composition, it has deuterium, the ‘heavy isotope’ of hydrogen. Deuterium is exactly like hydrogen in all its chemical properties, but in its nucleus, which is the tiniest part of its volume, it has an extra, neutral particle. As this extra particle in the nucleus is neutral, or without a charge, the rest of the deuterium atom takes no notice of it and deuterium behaves like hydrogen. But the mass of the atom is all in the nucleus and an extra particle there makes the deuterium atom twice as heavy as hydrogen. Now, the water molecule consists of two hydrogen atoms and one of oxygen. As the oxygen atom is 16 times as heavy as the hydrogen atom, the mass of the water molecule is about as much as 18 hydrogen atoms. But if the water molecule had deuterium in place of hydrogen, then the water molecule would weigh as much as 20 hydrogen atoms. This kind of water is called ‘heavy water’ and one can see that it is about 10 per cent heavier than ordinary water.

But reverting to polio, this is a disease that became endemic in Europe and the US after 1850. Right up to the discovery of vaccines for it, the toll it caused is probably unprecedented and there are records that suggest that the fear it aroused parallel the present feelings about AIDS. Ironically, the disease became widespread with the arrival of piped water, better drainage and better health care, because infants stopped routinely contracting it in the cradle, when it passes as a mild intestinal infection but imparts lifelong immunity. When contracted in later childhood, the virus often affects the nervous system, leading to paralysis, disability and even death.

The tide turned with the injected Salk vaccine of 1954, and then the oral, Sabine vaccine a few years later. The oral vaccine was easy to administer and helped wipe out polio in the West. It also held great promise of controlling it in Africa and Asia, except that the need to keep it refrigerated made things difficult. One reason that the vaccine becomes ineffective at normal temperatures is that the motion of molecules of the water medium that carries the vaccine is too vigorous and deforms the vaccine. The vaccine, a weakened form of the polio virus, is a large, complex molecule, which is easily denatured by high-speed impacts. Hence the need to keep the medium cool.

This is where using ‘heavy water’ as the medium becomes useful. As the heavy water molecule is heavier, the molecular motion is somewhat more ‘sluggish’, even at temperatures where ordinary water damages the vaccine. Studies by the Enterovirus Research Centre, Mumbai and the DAE reveal that the oral polio vaccine in heavy water retains its potency for a week even at 37oC. This could make it possible to double the coverage of a vaccination programme, with the same effort and infrastructure.