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The first major documented polio outbreak in the United States occurred in Rutland County, Vermont. Eighteen deaths and 132 cases of permanent paralysis were reported.

Charles Caverly, MD, noted the appearance of acute nervous system disease in the county. He was one of the first physicians to recognize that polio could occur with or without paralysis. He did not assume, however, that the disease could be spread from person to person. The contagious nature of polio would be established in 1905.

The element of contagium does not enter into the etiology either. I find but a single instance in which more than one member of a family had the disease, and as it usually occurred in families of more than one child and as no efforts were made at isolation, it is very certain that it was non-contagious.

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