Martha Lillard, the last American polio patient with an iron lung, has died at the age of 78.
Lillard said she first developed symptoms of the disease on her fifth birthday in 1953, according to an interview she gave KFOR eight days before she died.
"I woke up, and it was sunny outside, and I started to sit up. My neck was killing me, I couldn't lift my head off the pillow," she said.
The virus damaged the nerves that controlled her breathing, leaving her dependent on an iron lung, a large, tank-like ventilator that helped her breathe for decades.
Lillard had contracted polio just two years before the first vaccine became available, a breakthrough that would eventually eliminate widespread transmission of the disease in the US.
Although many polio survivors eventually switched to newer ventilators, Lillard remained dependent on her iron lung after finding that modern respiratory devices did not provide the support she needed.
She initially only used the machine while sleeping, but her condition worsened over time after developing post-polio syndrome, a disorder that can cause progressive muscle weakness, fatigue, and pain years after the initial infection.
Lillard's need for the iron lung became constant, and maintaining the decades-old machine became increasingly difficult because replacement parts were scarce.
Cindy McVey, Lillard's sister, told KFOR that some components for the iron lung dated back to the 1940s and were difficult to replace.
Her health further declined after contracting COVID-19 twice and developing long COVID, which was ultimately listed as her cause of death.
How Polio Attacks the Body
Polio is a highly infectious disease caused by the poliovirus, which spreads primarily through contact with contaminated food, water, or surfaces. Most people infected with the virus experience no symptoms or only mild, flu-like illness.
In a small percentage of cases, however, the virus invades the central nervous system, damaging motor neurons in the spinal cord and brainstem. This can lead to muscle weakness, paralysis, and, in severe cases, paralysis of the muscles responsible for breathing.
Before modern ventilators became widely available, many patients with respiratory paralysis relied on iron lungs to stay alive.
Why Patients Needed Iron Lungs
The iron lung, first widely used during the 1930s and 1940s, was a negative-pressure ventilator designed to help patients breathe when their respiratory muscles no longer functioned.
The machine enclosed most of the patient's body while leaving the head outside. Alternating changes in air pressure caused the chest to expand and contract, allowing the lungs to inhale and exhale.
Although advances in critical care eventually replaced iron lungs with more compact positive-pressure ventilators, some survivors of paralytic polio continued using the machines for decades because they worked well for their long-term needs.
How Vaccines Changed the Course of Polio
The development of effective polio vaccines transformed one of the world's most feared childhood diseases into one that is largely preventable.
The first widely used vaccine, developed by Jonas Salk and introduced in 1955, was followed by Albert Sabin's oral polio vaccine in the early 1960s. Widespread vaccination campaigns dramatically reduced cases across the United States and many other countries.
Today, the Centers for Disease Control and Prevention recommends routine polio vaccination during childhood, and the disease has been eliminated in the U.S. for decades thanks to high vaccination coverage.
Why Polio Hasn't Disappeared
Despite tremendous progress, polio has not been completely eradicated worldwide. According to the World Health Organization (WHO), wild poliovirus remains endemic in Afghanistan and Pakistan, while vaccine-derived poliovirus outbreaks have occurred in communities with low immunization rates.
Public health officials warn that declining vaccination coverage can allow the virus to spread again, even in countries where polio had previously been eliminated. In 2022, health authorities detected poliovirus in wastewater in parts of New York and confirmed a case of paralytic polio in an unvaccinated adult, underscoring the importance of maintaining high vaccine uptake.
For many survivors, the effects of polio did not end after the initial infection. Some develop post-polio syndrome decades later, a condition characterized by new muscle weakness, fatigue, pain, and declining mobility years after apparent recovery.
While the iron lung has largely become a museum artifact, Lillard's story remains a powerful reminder that the diseases it once treated should not be forgotten.
As long as poliovirus continues circulating anywhere in the world, maintaining high vaccination rates remains one of the most effective ways to prevent history from repeating itself.
