Paralytic illness of Franklin D. Roosevelt
Franklin D. Roosevelt, later the 32nd president of the United States from 1933 to 1945, began experiencing symptoms of a paralytic illness in 1921 when he was 39 years old. His main symptoms were fevers; symmetric, ascending paralysis; facial paralysis; bowel and bladder dysfunction; numbness and hyperesthesia; and a descending pattern of recovery. He was diagnosed with poliomyelitis and underwent years of therapy, including hydrotherapy at Warm Springs, Georgia. Roosevelt remained paralyzed from the waist down and relied on a wheelchair and leg braces for mobility, which he took efforts to conceal in public. In 1938, he founded the National Foundation for Infantile Paralysis, leading to the development of polio vaccines. Although historical accounts continue to refer to Roosevelt's case as polio, the diagnosis has been questioned in the context of modern medical science, with a competing diagnosis of Guillain–Barré syndrome proposed by some authors.
Retrospective diagnosis[edit]
Statistical analysis[edit]
A 2003 peer-reviewed study by Armond Goldman and others reconsidered the diagnosis of Roosevelt's illness, using three diagnostic methods – pattern recognition, reconstructing the pathogenesis, and Bayesian analysis – and found Guillain–Barré syndrome (GBS) more probable than poliomyelitis.[2] For the Bayesian analysis, the best estimate of the annual incidence of GBS was 1.3 per 100,000. For paralytic polio in Roosevelt's age group, an annual incidence of 1.0 per 100,000 was used. The paralytic polio rate was derived from the exceptionally severe polio epidemic that struck New York City in 1916, to tilt the odds in favor of polio. The prior probability of paralytic polio in Roosevelt's age group in the United States in 1921 was likely much lower because paralytic polio was at one of its lowest ebbs in the northeastern region of the country at that time.[3]: 123 [25][1]: 26 In July 1921, three cases were reported in New Jersey.[26] By late August some 100 cases were reported in the state of New York.[27] Based on the incidence rates for GBS and paralytic polio, and symptom probabilities from the medical literature, Roosevelt's symptoms were analyzed by Bayesian analysis to obtain posterior probabilities, as listed below.[2]
Goldman and his co-authors found that six of eight symptoms favored GBS, with the posterior probability of GBS shown for each: