Should you allow your kids to be vaccinated, or are you worried about autism?
Penn and Teller lay out the facts. Warning: Profanity (well deserved, but profane, all the same):
Tip of the old scrub brush to DrJohnSea.
Should you allow your kids to be vaccinated, or are you worried about autism?
Penn and Teller lay out the facts. Warning: Profanity (well deserved, but profane, all the same):
Tip of the old scrub brush to DrJohnSea.
Once upon a time I easily found a chart from the World Health Organization (WHO) which provided a year-by-year tally of malaria deaths, worldwide, from the 1940s to the present.
Of course, now that I need that chart to note that malaria deaths are much lower today than they were when DDT was overused generally and sometimes misused in the fight against malaria, I can’t find it. So, we’ll take the figures where we can find them.
In 2008, worldwide there were over 880,000 deaths from malaria. This is significantly lower than the usual claim of “millions of deaths each year.” We can find this figure in a document from the Global Environmental Facility (GEF), the organization that organizes the work of 182 nations to work for solutions to environmental problems, including fighting malaria, in a report on the 2009 meeting of the Stockholm Convention focused on fighting malaria, “Countries move toward more sustainable ways to roll back malaria.”
However concern over DDT is matched by concern over the global malaria burden in which close to 250 million cases a year result in over 880 000 deaths. Thus any reduction in the use of DDT or other residual pesticides must ensure the level of transmission interruption is, at least, maintained.
Numbers here may be estimates not updated from current-year records. The figure “over 880,000 deaths” looks and sounds awfully close to numbers reported in 2006, as you can see in this report from the Kaiser Family Foundation on U.S. global health policies:
Number of Annual Malaria Cases Worldwide Decreases, Disease Still Remains a Challenge, WHO’s World Malaria Report 2008 Says
Thursday, September 18, 2008
There were about 247 million malaria cases worldwide in 2006, according to the World Malaria Report 2008, which was released by the World Health Organization on Thursday, Reuters reports (MacInnis, Reuters, 9/18). According to the report, 3.3 billion people worldwide were at risk for malaria in 2006, and the disease remains a major burden among children younger than age five and in many African countries (AFP/Google.com, 9/18).
The report included reduced estimates of the global malaria burden that were calculated with new surveillance measures for non-African countries. The estimate of 247 million malaria cases is lower than the estimated 350 million to 500 million annual malaria cases reported in WHO’s World Malaria Report 2005. The new report estimated there were 881,000 malaria deaths in 2006, down from the previous estimate of one million deaths. The reduced figures are the result of new calculation methods, and it is unknown whether malaria cases and deaths actually declined from 2004 to 2006, WHO said (Reuters, 9/18). Although malaria control efforts have helped reduce the global malaria burden, most malaria-endemic countries are not meeting WHO targets for malaria control, the report said, noting that there is “no evidence yet to show that malaria elimination can be achieved and maintained in areas that currently have high transmission” (Bennett/Doherty, Bloomberg, 9/18).
WHO attributed the revised malaria estimates to new assessment measures in Asia, where data used for the 2005 report had not been updated for 40 years. According to Mac Otten — coordinator of surveillance, monitoring and evaluation at WHO’s Global Malaria Program — factors such as deforestation, urbanization and malaria control efforts have affected malaria estimates in Asia (Blue, Time, 9/17). Cambodia, Laos, the Philippines, Thailand and Vietnam all reported a decline in malaria deaths in 2006 (Bloomberg, 9/18).
WHO’s surveillance methods in Africa, which estimate malaria prevalence by using climate data and sample surveys, have remained the same since the 2005 report, the report said (Reuters, 9/18). According to the report, 45 of the 109 malaria-endemic countries worldwide are in Africa, and more than half of the continent’s malaria cases in 2006 occurred in the Democratic Republic of Congo, Ethiopia, Kenya, Nigeria and Tanzania (AFP/Google.com, 9/18). The report noted that malaria interventions have helped reduce malaria cases and deaths by more than 50% in Eritrea, Rwanda, Sao Tome and Principe, and the Tanzanian island of Zanzibar (Time, 9/17).The report found that about 40% of people at risk for malaria in Africa had access to insecticide-treated nets last year, compared with 3% in 2001 (Bloomberg, 9/18). The report also found that the number of ITNs distributed to national malaria control programs was enough to cover 26% of people in 37 African countries but that most African countries did not meet WHO’s target of 80% coverage for the four main malaria treatments: ITNs, artemisinin-based combination therapies, indoor-insecticide spraying programs and treatment for pregnant women (AFP/Google.com, 9/18).
Note also that this total of 880,000 is more than the previously reported 863,000. Hmmm.
French researchers looked at men who possess a gene that predisposes them to Parkinson’s Disease, and found that DDT exposure correlates with actual onset of the disease.
(Reuters) – Men with certain genetic variations who were exposed to some toxic pesticides which are now largely banned run an increased risk of developing Parkinson’s disease, French scientists said Monday.
Researchers found that among men exposed to pesticides such as DDT, carriers of the gene variants were three and a half times more likely to develop Parkinson’s than those with the normal version of the gene.
The scientists, whose work was published in the Archives of Neurology journal, think the brains of people with the gene variant fail to flush out toxins as efficiently as those with normal versions of the gene, suggesting environmental as well as genetic factors are important in the risk of Parkinson’s.
DDT, which belongs to a group of pesticides known as organochlorines, is one of the “Dirty Dozen” chemicals banned by a 2001 United Nations convention after it was found to be a toxin that can suppress the immune system.
It is infamous for threatening bird populations by thinning eggshells, and has also been linked to increase risks in humans of diseases such as cancer and Parkinson’s — an incurable and often deadly brain disease.
But exemptions to the DDT ban are allowed in many developing nations because it so effective in killing mosquitoes. DDT’s Swiss inventor Paul Hermann Muller won the 1948 Nobel Prize for Medicine — before its wider toxic effects were known.
Alexis Elbaz and Fabien Dutheil, of France’s National Institute for Health and Medical Research (INSERM) studied 101 men with Parkinson’s and 234 without the disease to look at links between organochlorine exposure and Parkinson’s disease.
The study included only men, and all of them had had high levels of exposure to pesticides through their work as farmers.
The scientists found the link was around 3.5 times stronger in men who carried two copies of a gene known as ABCB1, which plays a role in helping the brain flush out dangerous chemicals.
File that one away for the next time some yahoo claims there are no harmful effects to health from DDT. The study probably could not distinguish between heavy exposure to pesticides and the much lighter exposure assumed to result from Indoor Residual Spraying of DDT, such as is used in some places in Africa in the fight against malaria.
Anybody got a copy of the actual study, in English?
Dr. Andrew Wakefield’s license to practice medicine in Britain was stripped away by British authorities earlier today, due to his “ethical lapses” in conducting research against measles vaccines.
Wakefield’s research claims, published in the distinguished medical journal Lancet in 1998, sparked a worldwide hysteria over the claimed link of Mumps-Measles-Rubella vaccine (MMR) to autism. The journal earlier withdrew the article when the research was exposed as faulty and reaching erroneous conclusions.
Lancet retracted the paper earlier this year.
Effects of Wakefield’s errors ripple across the globe, as children pay the price with measles rates up worldwide, especially in Africa, and in North America. Rob Breckenridge described the damage for the Calgary Herald:
However, Wakefield’s foul legacy is very much consequential. His latest comeuppance is hopefully a small step in undoing that legacy’s damage, but much damage has already been done.
Wakefield authored a now-discredited paper published in 1998 in The Lancet, which implied that the MMR (measles-mumps-rubella) vaccine was linked to autism.
Numerous studies have shown no such link exists, but Wakefield’s research had the predictable effect of scaring people away from the MMR vaccine. Vaccination rates plummeted in the U.K., and the number of measles cases soared.
In 2008 in the U.K., there were almost 1,400 cases of measles compared with 56 the year Wakefield’s paper was published. In 2006, a 13-year-old boy died from measles — the first time in 14 years such a death had been recorded.
On top of the multiple studies rejecting the MMRautism link, The Lancet issued a formal retraction of Wakefield’s paper in February, citing his unethical and irresponsible conduct.
Once a disease like measles becomes rare, we tend to drop our guard, either forgetting how serious it is or assuming it can never come back. As we’ve seen in the U.K. it can come back with a vengeance. Unfortunately, it’s not only the U.K. where we’re learning that lesson.
This month, Alberta Health Services confirmed five cases of measles in the Calgary area. Given our lack of recent experience with measles — there was only one case provincewide in 2009 — AHS offered a primer on the disease.
Measles is extremely contagious, meaning one need not have close contact with an infected person. There is no cure, but vaccination can prevent it. There are still pockets of the province where vaccination rates are low and measles cases there have been higher.
Southwestern Alberta is one of those regions. Not only has measles made a comeback there — a 2000 outbreak closed a Lethbridge-area private school — but cases of mumps and whooping cough have been documented over the past two years.
In B.C., 87 measles cases have been confirmed this year. It’s believed many stem from infected out-of-country visitors at the Vancouver Olympics.
All cases involve people who were either not vaccinated, or only partially vaccinated. Eight cases were associated with a single household, where no one had been vaccinated.
A paper in the May 20 edition of Nature reports that global warming probably won’t expand the range of malaria much. That’s good news.
Here’s the press release from the University of Florida, touting the paper written by two University of Florida researchers, among others:
Scientists: Malaria control to overcome disease’s spread as climate warms
GAINESVILLE, Fla. — Contrary to a widespread assumption, global warming is unlikely to expand the range of malaria because of malaria control, development and other factors that are at work to corral the disease.
So concludes a team of scientists including two University of Florida researchers in a paper set to appear May 20 in the journal Nature.
Scientists and public policy makers have been concerned that warming temperatures would create conditions that would either push malaria into new areas or make it worse in existing ones. But the team of six scientists, including David Smith and Andy Tatem, faculty members with UF’s biology and geography departments and both at UF’s Emerging Pathogens Institute, analyzed a historical contraction of the geographic range and general reduction in the intensity of malaria — a contraction that occurred over a century during which the globe warmed. They determined that if the future trends are like past ones, the contraction is likely to continue under the most likely warming scenarios.
“If we continue to fund malaria control, we can certainly be prepared to counteract the risk that warming could expand the global distribution of malaria,” Smith said.
The team, part of the Wellcome Trust’s multinational Malaria Atlas Project, noted that malaria control efforts over the past century have shrunk the prevalence of the disease from most of the world to a region including Sub-Saharan Africa, Southeast Asia and South America, with the bulk of fatalities confined to Africa. This has occurred despite a global temperature rise of about 1 degree Fahrenheit, on average, during the same period.
“The globe warmed over the past century, but the range of malaria contracted substantially,” Tatem said. “Warming isn’t the only factor that affects malaria.”
The reasons why malaria has shrunk are varied and in some countries mysterious, but they usually include mosquito control efforts, better access to health care, urbanization and economic development. The banned pesticide DDT was instrumental in ridding the disease from 24 countries in Southern Europe, the former Soviet Union and elsewhere in the world between 1955 and 1969, Smith said. Researchers debate how the U.S. defeated malaria, but the reduction of mosquito breeding grounds, improved housing and reduced emphasis on agriculture that comes with development — and the reduced risk of bites that accompanies urbanization – probably played a role, Smith said.
“There is no one tale that seems to determine the story globally,” Tatem said. “If we had to choose one thing, we would guess economic development, but that’s kind of a cop out” because the specific mechanisms may still remain unclear, and controlling malaria might also help to kick-start development.
In any case, current malaria control efforts such as insecticide-treated bed nets, modern low-cost diagnostic kits and new anti-malarial drugs, have proved remarkably effective, with more and more countries achieving control or outright elimination. Unless current control efforts were to suddenly stop, they are likely to counteract the spread of mosquitoes or other malaria-spreading effects from anticipated temperature increases, Smith said.
Simon Hay, an author of the Nature paper and one of the chief architects of the Malaria Atlas Project, noted that modern malaria control efforts “reduce transmission massively and counteract the much smaller effects of rising temperatures.”
“Malaria remains a huge public health problem, and the international community has an unprecedented opportunity to relieve this burden with existing interventions,” he said. “Any failure in meeting this challenge will be very difficult to attribute to climate change.”
Key to controlling malaria is the treatment of the disease in human victims. Malaria parasites must spend part of their life cycle in humans; if medical care can cure humans, mosquitoes have no well of the disease to draw from, to spread it.
This paper says that global warming won’t spread the disease, so long as medical care and local health officials can keep effective treatments — a complete cure for human victims — coming quickly.
Malaria plagues too many nations, still. Between 400 million and 500 million people in the world get infected with one form of the malaria parasites every year. About a million die, most of those children. Death disproportionately strikes pregnant women, too.
Advances in medicines and advances in controls of the insects that help transmit the disease led to several campaigns to eradicate the disease over the past 60 years. Malaria no longer torments most of Europe and most of North America, but it remains a serious, economy-crippling disease across Africa and Asia.
Malaria also poses as a political football. Over the next couple of weeks you can find dozens of articles on valiant efforts to fight malaria, including the RollBack Malaria Campaign, and efforts by the Gates Foundation and histories of the work of the Rockefeller Foundation. But you can also find a pernicious political campaign against malaria fighters and “environmentalists,” claiming that DDT is a magic potion that could have ridded the world of malaria by killing off all the mosquitoes, if only that great mass murderer, Rachel Carson, had not imposed her will on the unstable dictators of African nations who did all they could to prove to Ms. Carson that they were environmentally friendly by banning DDT.
All of that is a crock. But we see it every year.
It’s already shown up in the formerly-known-as-accurate Wall Street Journal, European edition. (Please watch — I may have more to say on that piece, later.)
Over the next two weeks I will ask myself a hundred times, why do these people fiddle with trying to impugn scientists, physicians and environmentalists, while fevers burn in the brains of children across Africa and Asia?
With action, hope is that we can save the million lives lost annually by stopping malaria, by 2015. Please consider joining the effort.
You should wonder about that, too. If you find a good answer, please let me know.
This appeared in the Wall Street Journal’s opinion pages on April 11, 2006 — almost exactly four years ago.
Sound like recent events?
BOSTON–Only weeks after I was elected governor, Tom Stemberg, the founder and former CEO of Staples, stopped by my office. He told me, “If you really want to help people, find a way to get everyone health insurance.” I replied that would mean raising taxes and a Clinton-style government takeover of health care. He insisted: “You can find a way.”
I believe that we have. Every uninsured citizen in Massachusetts will soon have affordable health insurance and the costs of health care will be reduced. And we will need no new taxes, no employer mandate and no government takeover to make this happen.
When I took up Tom’s challenge, I assembled a team from business, academia and government and asked them first to find out who was uninsured, and why. What they found was surprising. Some 20% of the state’s uninsured population qualified for Medicaid but had never signed up. So we built and installed an Internet portal for our hospitals and clinics: When uninsured individuals show up for treatment, we enter their data online. If they qualify for Medicaid, they’re enrolled.
Another 40% of the uninsured were earning enough to buy insurance but had chosen not to do so. Why? Because it is expensive, and because they know that if they become seriously ill, they will get free or subsidized treatment at the hospital. By law, emergency care cannot be withheld. Why pay for something you can get free?
Of course, while it may be free for them, everyone else ends up paying the bill, either in higher insurance premiums or taxes. The solution we came up with was to make private health insurance much more affordable. Insurance reforms now permit policies with higher deductibles, higher copayments, coinsurance, provider networks and fewer mandated benefits like in vitro fertilization–and our insurers have committed to offer products nearly 50% less expensive. With private insurance finally affordable, I proposed that everyone must either purchase a product of their choice or demonstrate that they can pay for their own health care. It’s a personal responsibility principle.
Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on government is not libertarian.
Another group of uninsured citizens in Massachusetts consisted of working people who make too much to qualify for Medicaid, but not enough to afford health-care insurance. Here the answer is to provide a subsidy so they can purchase a private policy. The premium is based on ability to pay: One pays a higher amount, along a sliding scale, as one’s income is higher. The big question we faced, however, was where the money for the subsidy would come from. We didn’t want higher taxes; but we did have about $1 billion already in the system through a long-established uninsured-care fund that partially reimburses hospitals for free care. The fund is raised through an annual assessment on insurance providers and hospitals, plus contributions from the state and federal governments.
To determine if the $1 billion would be enough, Jonathan Gruber of MIT built an econometric model of the population, and with input from insurers, my in-house team crunched the numbers. Again, the result surprised us: We needed far less than the $1 billion for the subsidies. One reason is that this population is healthier than we had imagined. Instead of single parents, most were young single males, educated and in good health. And again, because health insurance will now be affordable and subsidized, we insist that everyone purchase health insurance from one of our private insurance companies.
And so, all Massachusetts citizens will have health insurance. It’s a goal Democrats and Republicans share, and it has been achieved by a bipartisan effort, through market reforms.
We have received some helpful enhancements. The Heritage Foundation helped craft a mechanism, a “connector,” allowing citizens to purchase health insurance with pretax dollars, even if their employer makes no contribution. The connector enables pretax payments, simplifies payroll deduction, permits prorated employer contributions for part-time employees, reduces insurer marketing costs, and makes it efficient for policies to be entirely portable. Because small businesses may use the connector, it gives them even greater bargaining power than large companies. Finally, health insurance is on a level playing field.
Two other features of the plan reduce the rate of health-care inflation. Medical transparency provisions will allow consumers to compare the quality, track record and cost of hospitals and providers; given deductibles and coinsurance, these consumers will have the incentive and the information for market forces to influence behavior. Also, electronic health records are in the works, which will reduce medical errors and lower costs.
My Democratic counterparts have added an annual $295 per-person fee charged to employers that do not contribute toward insurance premiums for any of their employees. The fee is unnecessary and probably counterproductive, and so I will take corrective action.
How much of our health-care plan applies to other states? A lot. Instead of thinking that the best way to cover the uninsured is by expanding Medicaid, they can instead reform insurance.
Will it work? I’m optimistic, but time will tell. A great deal will depend on the people who implement the program. Legislative adjustments will surely be needed along the way. One great thing about federalism is that states can innovate, demonstrate and incorporate ideas from one another. Other states will learn from our experience and improve on what we’ve done. That’s the way we’ll make health care work for everyone.
Mr. Romney is governor of Massachusetts.
What changed in the last four years? It wasn’t the need for health care reform.
At Waterloo, what do you think happened to soldiers from Britain and Prussia who defected to Napoleon’s cause? Did they regret their decision?
Jim Demint, how’s that “break this president” thing working for you?
When one agrees to do battle at Waterloo, perhaps one should pay more careful attention to whether one is on the side of Napoleon, or on the side of Wellington.
Here’s a sign that that conservatives are — finally, but not quickly enough, if they are producing so much — drowning in their own bile.
Over at Cafe Hayek (“Where orders emerge,” an economist’s joke), Don Boudreaux normally masquerades as a rational sort of guy.
Watching tonight on television the charlatans who infest Pennsylvania Avenue gaudily pronounce their saintly motives and their deity-like powers to “guarantee world-class health care for every American” (as one creep put it to a NewsChannel 8 reporter here in DC) makes me want to vomit.
These people look like serious adults; the timber of their voices make them sound like serious adults; and their titles are ones that are assumed to be reserved for serious adults. But, in fact, these people – from Obama to Pelosi to Hoyer to Reid – are nothing of the sort.
If they really believe even a quarter of the things they say, they’re imbeciles. If they aren’t imbeciles, they’re scoundrels. No third alternative is conceivable.
Either way, they’re an utterly detestable bunch.
He’s talking about elected officials. He’s talking about the president of the United States. He calls them “utterly detestable.”
Dialogue and thought lie broken down this much? This is a rant one expects of certified lunatics like Orly Taitz.
Boudreaux, of course, comes from that class of the bourgeois where intellect is so congenital that it’s not even necessary to make a case for why one finds honorable people on the other side of an issue to be in error. To Boudreaux, they’ve gone beyond error. They are “detestable” people. You know, abominable. They are people worthy of hatred.
So, we might imagine, Boudreaux is untroubled by protesters calling Rep. John Lewis (D-Georgia) a “n—-r,” and spitting at him and on his colleague, Rep. Emanuel Cleaver (D-Missouri). Such racist actions are justified, if Lewis and Cleaver are truly worthy of hatred, no? Boudreaux probably also finds victims of Parkinson’s disease “detestable,” and so would be untroubled by the mob in Columbus, Ohio, sharing Boudreaux’s views on health care, who mocked and tormented the Parkinson’s victim who expressed a different opinion and sat down. “Communist!” they called him.
Demonization. Dehumanization. Objects worthy of hatred (a definition of “detestable) are not people who deserve respect. We don’t need to offer them health care, we don’t need to listen to their views, we don’t need to honor their civil rights.
It’s conduct unbecoming. Is Boudreaux so full of hubris that he cannot even entertain the idea that the bill is a good idea, the idea that Boudreaux may be a little bit in error?
We might also imagine that Don Boudreaux might get a good night’s sleep, wake up on Monday morning and rethink.
Somebody throw them a lifeline. Maybe they can figure it out. Churchill maybe put it best: Democracy is the worst form of government conceived by the mind of man, except for all the others. Sometimes you lose. Sometimes you should lose. Sometimes the people’s wisdom is greater than our own.
Do we have any readers in Iowa City? Near Iowa City?
A presentation on the history of malaria and DDT, and the recent use and abuse of those stories to flog environmentalists and others on the internet, is set for the Hardin Library for Health Sciences at the University of Iowa in Iowa City, on January 19, 2010 (next Tuesday).
If you’re there, can you snap a couple of pictures to send, and get any handouts, and write up a piece about it?
Here is the press notice on-line:
The University of Iowa History of Medicine Society invites you to hear Patrick T. O’Shaughnessy, PhD, Associate Professor, Department of Occupational and Environmental Health, University of Iowa, speak on “Malaria and DDT: the History of a Controversial Association” on Tuesday, January 19th, 5:30 to 6:30, room 2032 Main Library. [in Iowa City, Iowa.]
Dr. O’Shaughnessy observes: ”Although it helped prevent millions of cases of malaria after its widespread use in the 1950’s, the pesticide DDT was banned from use in the United States and fell out of favor as an agent to reduce cases of malaria around the world. This history of the events associated with the effort to eradicate malaria, as well as the environmental movement that led to the ban on DDT, will center on the story of a story that incorporated both issues and grew into a modern myth still seen in books and multiple websites today.”
The session is free and open to the public. Light refreshments will be served.
Hardin Library for the Health Sciences stands on the campus in Iowa City.
Hardin Library for the Health Sciences
600 Newton Road
Iowa City, IA 52242-1098
The Hardin Library for the Health Sciences is located on Newton Road, directly north of the University of Iowa Hospitals and Clinics and approximately 1/2 mile east of Carver-Hawkeye Arena. Go here for directions and more information.
Maybe I’m not the only bothered by the usual abuse of history and science on the issues of DDT and malaria.
Update: Tim Lambert notes at Deltoid that O’Shaughnessy is the guy who wrote what may be the definitive work on the famous — or infamous — Borneo Cat Drop. If you live in or near Iowa City, this lecture may be a wise investment of time. High school teachers, your students could benefit, too.
I usually like Chris Rock’s comedy. He’s profane, so you can’t use it in class. But he’s often quite witty while exposing key problems of society.
I bumped into a YouTube video of a few minutes of Rock’s rant against doctors and science at an odd site called HealthNoob.com. On the one hand, Rock is ripping off Voltaire and others from the 18th century who noted that doctors of that time rarely cured anyone — without antibiotics and a very incomplete understanding of the human body and diseases, how could they?
On the other hand, the idea that physicians don’t want to cure people gained considerable traction among African Americans over the past 40 years, especially fueled by comedians like Dick Gregory who, God bless him otherwise, thought most of the medical establishment conspired against African Americans at every turn. Rock builds on that platform. This is not a good trend. Especially to the extent that wrong views of medicine discourage African Americans from seeking health care that could prevent serious disease until it’s too late, spreading disinformation does no one any good.
Past that, such comedy encourages crazies to crawl out of the woodwork and spread even more disinformation. For example, in the comments at HealthNoob.com, some wag claims that DDT caused polio in the 1930s, apparently ignorant of the fact that DDT was not available for use until after 1939, and no available for use on farms until 1946. This is grotesque urban legend.
Here’s Rock’s rant, below (not safe for work or school due to profanity); below that, the response I left at HealthNoob.com (which is “in moderation” as I write this).
Give us your views in comments, will you? Is Rock way off base? Is his comedy routine here more damaging than funny?
This conversation is certainly deteriorating.
A couple of observations:
Polio is caused by a virus. No one is sure exactly where it came from, or why it wasn’t more widespread prior to the 20th century. It well may be that it was around, but harmless, until a 20th century mutation caused it to become deadly. In any case, we know it’s a virus, and that’s why and how the vaccines worked against it. It’s not caused by chemical exposure, though some exposures may insult human immune systems and make some people more prone to get the disease the virus causes.
2. We know it wasn’t DDT, too. DDT was not available for use against insects by anyone prior to 1942. Polio was rampant before then (my brother caught polio in 1939). DDT was not available for use outside the military prior to 1946.
3. Diseases cured by medical care? Streps and bacterial infections, including tuberculosis (save for the drug-resistant kinds). Leukemia. Measles, almost. Polio wasn’t counted as eradicated until very recently (if at all). Goiter and iodine deficiency ($0.15 per ton of salt to “iodize” it, and cure goiter; the cheapest public health action ever).
4. Do you want to know how good cures work? The American Dental Association pushed for fluoridation to help prevent and cure dental caries. It worked fantastically. Now dentists spend more time fixing other stuff, and dental caries is basically a disease of the past — except for those people who don’t take care of their teeth or have some other special weakness to decay. Of course, were Rock to do something on that, he’d probably complain that fluoride causes disease instead of prevents it.
5. Ever heard of Voltaire? In the 18th century, he noted that doctors never cure anyone, but just hold the hand of the patient until the patient gets better, or dies. That changed with the advent of antibiotics. Interesting to hear Chris Rock rip off Voltaire.
Here’s Nathan Wolfe explaining how viruses work, quickly and at a high enough level to be entertaining, and explaining why we need to worry about H1N1.
Take us back a step or two: How did swine flu enter into the human population?
Swine flu has been known since at least the early part of the 20th century, since the 1930s. It was originally a virus of bird origin — all influenza viruses were originally bird viruses — and it probably spread to humans before it was in pigs.
Now, we still haven’t received definitive information on the underlying genetics of this particular virus. But initial reports suggest that it may be what’s known as a “mosaic virus,” which includes components of swine influenzas, bird influenzas and human influenzas. A cosmopolitan virus like that wouldn’t be unprecedented. (Editor’s Note: see Joe DeRisi’s 2006 TEDTalk for more on state-of-the-art virus detection.)
But in any case, this is a virus that appears to come from pigs, and pigs in close proximity spread the flu in much the same way that humans do — coughing, sneezing, and so on. The virus probably initially entered into human populations through people who work with livestock.
Is swine flu here to stay?
Whether this particular virus will sustain itself and become a permanent part of the human landscape is unclear, but that’s certainly what we’re watching for. As it is, the virus may just disappear because of the weather; summers aren’t good for flu viruses.
So this heat wave is working in our favor?
It might be. The virus has had a good start, from the flu perspective, considering that this is really the end of the season. But the unseasonably hot weather may bode poorly for this virus’ potential to establish itself definitively and cause a pandemic. Had this happened in September or October, it would be much more concerning.
Having said that, it’s not impossible that a virus like this might “go into hiding” — in the southern hemisphere or the tropics — and might come to light again next year. So there will be a lot of discussion about expanding the fall flu vaccine to try to control it next cycle.
Is it really possible for us to prevent future outbreaks like this?
Yes, I believe it is. We spend tons of money trying to predict complex phenomena like tsunamis, hurricanes, earthquakes. There’s no reason to believe that a pandemic is harder to predict than a tsunami. And we’d be foolish not to include forecasting and prevention as part of our overall portfolio to fight these pandemics.
Help this post go viral:
Claudia Meininger Gold practices pediatric medicine in Great Barrington, Vermont. When someone recently suggested offering flu shots at polling places, it struck her that, like voting, getting a flu shot is a good citizen’s duty. She wrote about it in the Boston Globe.
AS A pediatrician, I received my swine flu vaccine without a moment’s hesitation. I wanted to be available to treat the onslaught of illness, and to be able to go comfortably into a room with a coughing, miserable child knowing that I was not putting myself or my family at risk. I was astounded, therefore, to read recently, in a popular newsletter for pediatricians, a column by a pediatrician stating that he would not recommend the vaccine to his patients. His arguments were that the illness was relatively mild and the vaccine might not be safe.
In my practice, there are many parents who choose not to immunize their children. As a mother myself, I sometimes wonder if part of the motivation for this choice is to combat the helpless, scary part of loving someone so much. It can become overwhelming to contemplate everything that can possibly go wrong. Perhaps parents refuse vaccines because it is something they can control, a way in which they can “protect’’ their child. In the case of swine flu, or H1N1, this action is, in my opinion, misguided.
There are many different fears associated with vaccines, but the specific fear around H1N1 has its origin in a 1976 outbreak of Guillain-Barre syndrome, a disease that damages nerve cells, after mass vaccination against a swine flu. The website of the US Centers for Disease Control and Prevention addresses this issue:
“Several studies have been done to evaluate if other flu vaccines since 1976 were associated with GBS. Only one of the studies showed an association. That study suggested that one person out of 1 million vaccinated persons may be at risk of GBS associated with the vaccine.’’
The current method for making the H1N1 vaccine is the same as that for the seasonal flu vaccine. The only difference is that seasonal flu vaccine is prepared in anticipation of flu season, while manufacturing of this one was begun while the pandemic was in its initial stages. High-risk groups, such as the elderly and young children, receive the seasonal flu vaccine without a second thought.
It is true that for the majority of people H1N1 is a mild illness, generally causing two to four days of feeling lousy. But the virus is highly contagious. The sheer numbers are staggering. A school in Chicago closed last month when 800 of its 2,200 students were sick. With any flu there are people who will have complications and die. As the number of cases continues to climb, statistics are not in our favor.
For high-risk groups, such as pregnant women, talk of “mild illness’’ is meaningless. Stories are multiplying of the devastating losses of both baby and mother. In our small town there are young adults who were previously healthy now on respirators in intensive care units.
In a recent op-ed in The New York Times, Douglas Shenson proposed the use of polling places for vaccination. This led me to think of vaccination as a responsibility of being a citizen, analogous to voting. Just as one vote does not determine the outcome of an election, one person immunized does not halt the spread of illness. Yet voting is a civic duty. Similarly, vaccination, while benefiting the individual, serves to protect the population as a whole. Short of shutting down the country, mass immunization is the only way to stop the spread of this virus.
In addition, I feel that as a physician, it is my responsibility to uphold the recommendations of the CDC. If every individual citizen took it upon himself or herself to decide what was best for the country, there would be chaos.
Washing hands, covering our mouths when we cough, and staying home when we are sick are all ways to contribute to the common good. As responsible citizens, when the opportunity arises, and in keeping with CDC guidelines, we should all do our part and immunize ourselves and our children.
Dr. Claudia Meininger Gold, a pediatrician, practices in Great Barrington. Copyright to Boston Globe.
It’s the air conditioning one hears, not applause.
Did your local newspaper review the movie? Odds are the movie didn’t play in your town (did it play anywhere other than local Republican clubs?).
“Not Evil, Just Wrong” promoters and producers appear to have abandoned hopes for a wide-scale debut of their film on October 18, instead choosing direct-to-DVD release in order to salvage something from the effort.
Well, they can take solace in the fact that the John Birch Society, itself trying to rise from the dead, liked the film according to the comments in The New American. But even the Birch Society reviewer watched it on DVD, not on a big screen.
At the Birch Society site I responded, and will be astounded to see if it stays (in three parts). The review started out noting that if one asks a friend to explain the cap-and-trade system of controlling carbon air emissions, one is not likely to find that one’s friend fully understands the ins and outs of government regulation of air pollution, commodities markets, and deep economics (why should they?).
Ask a friend or associate, “Can you explain ‘cap and trade?’” More than likely you will be astounded at what a poor grasp (if any) he or she has of the subject, even though the future of our economy and even our country hinges to a large extent on whether or not cap-and-trade legislation passes or not.
Ask a friend to explain the right to bear arms, and you’re likely to get a bad explanation, too.
Does that mean the Second Amendment is evil? I don’t think so.
This movie ["Not Evil, Just Wrong"] is greatly riddled with errors, and it presents a false portrait of science, history, and government.
In one scene that made one want to throw bottles at the TV set, a well-to-do environmentalist showed no concern to a Ugandan mother, Fiona Kobusingye-Boynes, over the loss of her child to malaria, a disease that was almost eliminated by the use of DDT, but then resurged when the EPA banned DDT’s exportation and insisted other countries adopt the same policy.
When DDT was heavily used in Africa, about two million people a year died from the disease. Today? About one million die. The rates aren’t low enough, but does the movie need to lie about history to make a point? Why?
Malaria was never close to being eliminated with DDT. Most of the nations that got rid of malaria did it with the combination of better housing (with screens), better health care, and concentrated programs to attack mosquitoes to hold populations down long enough that the pool of malaria in humans could be wiped out. Mosquitoes get malaria from humans — if there is no malaria in humans, mosquito bites are benign.
DDT was never used in an eradication effort in most nations of Africa, because the governments were unable to get a campaign to fight the disease on all fronts as necessary. Do we know whether DDT was used in Uganda prior to 1967?
And if it was, are we really supposed to believe that Idi Amin refused to use DDT out of respect for little birdies and fishies, while killing and [it is often said] personally eating his countrymen?
I don’t think that environmentalists are the root of the problem in today’s malaria rates in Uganda, and any perusal of history suggests a dozen other culprits who could not be considered lesser threats by any stretch.
Now the death toll of malaria victims worldwide, but mainly in Third World countries, mostly young children, is estimated by the World Health Organization to be one million per year.
Near the lowest in 200 years.
Recently the World Health Organization, under strong pressure from human rights organizations, particularly in Africa and Asia, rescinded its ban on the pesticide that has been shown in test after test to be harmless to humans and animals, including birds.
WHO never had a ban on the use of DDT. DDT didn’t work well. It’s foolish to require malaria fighting agencies to use tools that don’t work. [Ooooh. I forgot to note the junk science claim that DDT is harmless to humans and animals -- were it harmless, why should we use it? It's odd to see the John Birch Society organ campaigning so actively to kill America's symbol, the bald eagle. Are they really that evil, or just that poorly informed?]
The environmentalists continue to push to overturn this ruling, regardless of its toll in human misery and death.
[Gee. I should have responded, "The environmentalists continue to push this goal even as malaria deaths and infections drop -- regardless the improvement in human health and reduction of misery and death."]
Environmentalists have been lobbying since 1998 to allow DDT use in extremely limited circumstances, with controls to protect human health (the National Academy of Sciences notes that DDT, though among the most useful substances ever created, is more dangerous than helpful, and must be eliminated). [I should have noted here, "Opposition came from the George W. Bush administration."] In the past three years opposition to DDT use in Uganda has come from large agricultural companies, tobacco growers and unnamed groups of “businessmen” who sued to stop DDT use.
Africans have been free to use DDT since the substance’s discovery, and some nations used it extensively throughout the period since 1946. Interestingly, they also experienced a resurgence of malaria anyway. If Africans want to use DDT, let them use it.
In the interim, tests across Africa demonstrate that bed nets are more effective than DDT, and cheaper. DDT alone cannot help Africa much; bed nets alone help a lot. But eradicating malaria will require great improvements in the delivery of health care to quickly and properly diagnose malaria, and provide complete treatments of the disease in humans to wipe out the pool of disease from which the little bloodsuckers get it in the first place.
This film is not interested in helping Africans, however. The film’s producers are interested in trying to make hay besmirching the reputations of people who campaign for a clean environment.
How long is this film? 90 minutes, IMDB says. UNICEF notes that a child dies from malaria every 30 seconds. So while you watch this film, 180 children will die from malaria, and you will have done absolutely nothing to stop the next one from dying.
Look at it this way: Every sale of the DVD of “Not Evil, Just Wrong,” deprives Nothing But Nets of a donation of two more life-saving bed nets. So every sale of this DVD more than doubles the chances that another kid in Africa will die from malaria.