Polio and Acute Flaccid Paralysis

In post one of this series on polio, a term was introduced: “Acute Flaccid Paralysis”. [1]

Acute Flaccid Paralysis is a term which applies to the exact clinical symptoms you would expect to see from poliovirus infection, but which are not necessarily caused by polioviruses. Paralytic polio is actually considered a sub-category in the broad umbrella of acute flaccid paralysis. See pages 300-312 [1] for a chart and summary of many other causes of AFP, a few of which are: Guillaine-Barre syndrome, Cytomegalovirus polyradiculomyelopathy, Acute transverse myelitis, Lyme borreliosis, nonpolio enterovirus and Toxic myopathies.

For many years the medical profession assumed that when they saw paralysis with a particular cluster of symptoms, it was poliomyelitis. The 1954 Francis Trials of the Salk vaccine [2] triggered a reconsideration of this assumption, and a major change in the diagnostic criteria.

How were polio cases counted in 1954?

In 1954 most health departments worked with the WHO definition:

“…Signs and symptoms of nonparalytic poliomyelitis with the addition of partial or complete paralysis of one or more muscle groups, detected on two examinations at least 24 hours apart.” [3, p. 88]

How were polio cases counted in 1955?

In 1955 the criteria were changed to conform more closely to the definition used in the 1954 field trials: residual paralysis was determined 10 to 20 days after onset of illness and again 50 to 70 days after onset. [3, p. 88]

Thus, simply by changes in diagnostic criteria, the number of paralytic cases was predetermined to decrease in 1955-1957, whether or not any vaccine was used. At the same time, the number of nonparalytic cases was bound to increase because any case of poliomyelitis-like disease which could not be classified as paralytic poliomyelitis according to the new criteria was classified as nonparalytic poliomyelitis. Many of these cases, although reported as such, were not non-paralytic poliomyelitis. [3, p. 88] (emphasis added)

It was after the SALK vaccine was introduced, when fully vaccinated people continued to get “polio”, that doctors started looking a lot more carefully at the viruses in individuals. Many viruses were found to cause paralysis, for example coxsackie B, enterovirus 71, etc. Read more

Polio 2010

Poliovirus

Over the next few weeks, Inside Vaccines will be taking a closer look at Poliomyelitis infections, exploring aspects of the history of poliomyelitis; describing environmental factors that increase the incidence of paralytic polio; considering the history and efficacy of the vaccines used against polio; and finally, exploring the campaign to eradicate polio.
First, let’s look at some basic information.

When most people think of poliomyelitis, they think of children who had lameness and leg deformities, with their legs in braces, or lying in iron lungs (old-style breathing machines, or ventilators) because they couldn’t breathe. Most people link all paralysis and lameness solely to a group of viruses called POLIOMYELITIS. The World Health Organization describes polio:

Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, 5% to 10% die when their breathing muscles become immobilized. [1]

Now for a more accurate picture of exactly what “poliomyelitis” is.

The poliomyelitis viruses fall within a class of viruses called “human enteroviruses” [2]. Polioviruses belong to the viral family Picornaviridae [3]. There are three types: 1 Brunhilde; 2 Lansing; and 3 Leon.   Amongst these types there are hundreds of different strains. Type 1 is considered the most serious virus, followed by type 2.

Technically, a person can “get” poliomyelitis 3 times, since the types do not give cross protection to each other, but in practice, having clinical polio three times is very rare.

How is poliomyelitis virus transmitted?

Poliomyelitis is transmitted by person-to-person spread through fecal-oral and oral-oral routes, or occasionally by a common vehicle (e.g., water, milk). [4]

What happens when people are exposed to polioviruses?

When non-immune persons are exposed to wild poliovirus, inapparent infection is the most frequent outcome (72 percent). [4]

Most people won’t even be aware that they were sick. Read more

Myth: No Rainbow, No Pot of Gold

May 4, 2010 by · 3 Comments
Filed under: General 

Note: separate re-issue of part two of one of our myths blogs. We got a complaint that this one was too hard to find and link to. The easiest fix was to split it into a separate article. Thanks for your understanding.

Myth: Vaccines aren’t money makers for drug companies.

Reality: As spoken by Tom Broker about Gardasil and Merck (see page 19 of pdf)

“From a purely business point of view, they’ve been facing some real interesting challenges over the Vioxx issue and they are looking at this as the foundation and the savior of the company. Believe me, they have a huge stake in this, just as we all do.

How profitable are vaccines? Prevnar did very well for Wyeth:

… Prevnar, which had $2.7 billion in sales last year. Prevnar is Wyeth’s No. 2 product by revenue, behind antidepressant Effexor.

Some business press projections on the potential in the vaccine market:

Gardasil sales totaled $365 million in the first quarter of 2007, helping Merck reach nearly $1 billion in total vaccine sales for the quarter, more than triple vaccine sales from a year earlier. Analyst projections have ranged up to $4 billion in annual sales for Gardasil, assuming the government mandates widespread vaccinations for girls.

Merck launched two other vaccines in 2006 – Zostavax, for the prevention of shingles, and Rotateq, for the prevention of a rotavirus that causes diarrhea in infants. Les Funtleyder, analyst for Miller Tabak, estimates that these vaccines could reach hundreds of millions of dollars in annual sales.

“Merck showed that you can make quite a bit of money with vaccines, and I think that got a lot of people’s attention,” said Funtleyder.

If vaccines have the potential to offer huge profits to pharmaceutical companies–just like other blockbuster drugs–Lipitor or Vioxx are good examples, I think we can reasonably assume that the temptation to publish ghostwritten studies, suppress unwelcome results and use Key Opinion Leaders to subtly sell product  is there with vaccines, too. And vaccines offer two additional benefits, available for no other drugs: mandates and immunity from lawsuits (in the US). Who wouldn’t be tempted by a package involving a guaranteed market, and tort immunity?

There was a period, quite a long time ago now, when vaccines were not profitable. But time past is not time present. This myth is long past its sell-by date.

Medical Double Standards in the Third World

April 19, 2010 by · 3 Comments
Filed under: News, Opinion, WHO Watch 


    When it comes to third world medicine we almost invariably hear from the WHO about the successes of massive vaccination programs. If you look into the recent agenda for the World Health Assembly [1] you will find pandemic influenza vaccines at the top of the technical matters, and in the status section, the eradication of Poliomyelitis is at the top of that section. What is glaringly absent is a discussion of the pervasive double standards in research ethics, health-care safety and professional rigor that exist in the developing world. The WHO and its medical partners won’t talk about it publicly because when you look at the numbers, it is directly implicated in the suffering and ultimate death of millions of people in the developing world. That is what we’ll cover in this piece.

    It is well known that needle re-use can be a major cause of virus transmission. In 2000, a WHO press release states:

    Unsafe Injection practices have serious large-scale consequences…”unsafe injection practices throughout the world result in millions of infections which may lead to serious disease and death. Each year over-use of injections and re-use of dirty syringes and needles combine to cause an estimated 8 – 18 million hepatitis B virus infections, 2.3-4.7 million hepatitis C virus infections and 80,000 – 160,000 infections with HIV/AIDS worldwide. [2]

    That same press release uses an epidemic of Hepatitis C that occurred from Schistosomiasis treatment in Egypt. Notably absent is any discussion of the massive immunization campaigns waged throughout the third world coincident with the massive epidemics of HIV and other infectious diseases. However, someone there must be aware of the potential problem because the press release states the following at the end:

    In addition, to ensure the safety of immunization injections, WHO, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), and the International Federation of the Red Cross and Red Crescent Societies (IFRC) have recently called for the exclusive use of auto-disable (AD) syringes for immunization by the end of 2003.[2]

    We know quite reliably that the WHO knew years prior to this press release (2003) that medical practices in the developing world were problematic. As Gisselquist outlines in his 2009 article [3] the WHO was quietly giving UN employees the following advice in 1991.

    take special precautions to avoid HIV transmission via blood . . . If you are not carrying your own needles and syringes, avoid having injections unless they are absolutely necessary . . . Avoid tattooing and ear-piercing. Avoid any procedures that pierce the skin, such as acupuncture and dental work, unless they are genuinely necessary. Before submitting to any treatment that may give an entry point to HIV, ask whether the instruments to be used have been properly sterilized.[3]

    Read more

Vaccine Myths Round Four

February 28, 2010 by · 9 Comments
Filed under: Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis 

Vaccines saved us:  just visit an old graveyard and look at all the markers for dead babies and children.

Graph provided by Health Sentinel

Click on the graph to enlarge it. For more graphs go here.

When the vaccine arguments are hot and furious, a frequent insult is: “You don’t understand the science!”  The confusion in this case doesn’t arise from ignorance of science, but from ignorance of history.  The people who think that vaccines saved millions of children from death see the story like this:

Childhood illnesses run uncontrolled through the population leaving dead bodies in every house.  Parents are in despair.  Brave doctor cooks up a vaccine, the disease stops dead, and all children come through to a healthy adulthood. Read more

Vaccine Myths 3.1: The Scourge of Childhood

“…young parents of today do not remember…”

In 1974 the St. Petersburg Times wrote:

So many people are neglecting to get immunity shots that doctors fear the seven one-time scourges of childhood–polio, mumps, measles, rubella, diphtheria, lockjaw and whooping cough–may strike American communities again.

However, just six years earlier, in 1968, newspaper stories said things like this:

Although mumps is a relatively mild childhood disease, it can cause sterility when it strikes adult males.

At that time the recommendation was to give the recently developed shots to boys if they hadn’t had the mumps by the time they hit adolescence. Read more

“Just because you need a third dose doesn’t mean the two dose schedule is having issues or anything”

February 16, 2010 by · 2 Comments
Filed under: CDC Watch, News, Opinion, Parents' Pages, Vaccine/Disease Analysis 

Mumps story:

Because of continued spread, health authorities working with communities in Orange County are giving schoolchildren a third dose of the MMR vaccine. Gallagher says it will be two or three months before it’s known whether the effort succeeded.

Why do they need a third dose?

The infections happened despite high coverage with the measles-mumps-rubella (MMR) vaccine. Among patients ages 7 to 18 — the age group that had the most cases — 85% of patients had received the two recommended MMR vaccine doses.

This doesn’t mean the MMR vaccine isn’t working, says epidemiologist Kathleen Gallagher, DSc, MPH, the CDC’s team leader for measles, mumps, and rubella.

“Two doses of mumps vaccine is believed to be 90% to 95% effective,” Gallagher tells WebMD. “But that means people can still get mumps. If the vaccine is 90% effective and 100 people are exposed to mumps, 10 will get the disease.”

If we imagine that mumps is being sprinkled from the sky and spread evenly throughout the population, then yes, one out of ten vaccinated people would catch mumps if the vaccine was, indeed, 90% effective, or one out of twenty if it were 95% effective. But if the vaccine creates “herd immunity” then the disease shouldn’t be able to jump from vaccinated person to vaccinated person to vaccinated person. Read more

Pandemic – When did the definition change?

January 24, 2010 by · 7 Comments
Filed under: WHO Watch 

The old version:

WHO_Pandemic_preparedness_May_1_2009

An influenza pandemic
An influenza pandemic occurs when a new influenza virus appears against which the human population has no immunity, resulting in epidemics worldwide with enormous numbers of deaths and illness. With the increase in global transport, as well as urbanization and overcrowded conditions, epidemics due the new influenza virus are likely to quickly take hold around the world. Outbreaks of influenza in animals, especially when happening simultaneously with annual outbreaks of seasonal influenza in humans, increase the chances of a pandemic, through the merging of animal and human influenza viruses. During the last few years, the world has faced several threats with pandemic potential, making the occurrence of the next pandemic a matter of time.

and the new version:

WHO_Pandemic_preparedness_webpage_Sept_2_2009

What is an influenza pandemic?
A disease epidemic occurs when there are more cases of that disease than normal. A pandemic is a worldwide epidemic of a disease. An influenza pandemic may occur when a new influenza virus appears against which the human population has no immunity. With the increase in global transport, as well as urbanization and overcrowded conditions in some areas, epidemics due to a new influenza virus are likely to take hold around the world, and become a pandemic faster than before. WHO has defined the phases of a pandemic to provide a global framework to aid countries in pandemic preparedness and response planning. Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic.

The two documents above can also be found at: http://attentiallebufale.it/informazione-scientifica/speciale-bufale-pandemiche-come-difendersi/lanalisi-di-doshi-al-voltafaccia-delloms/

These two documents were sourced and provided by Dr Tom Jefferson, and  Peter Doshi.

And here is Fukuda, at WHO, claiming that they didn’t change it!

Now let me move on to the second issue. Did WHO change its definition of a pandemic? The answer is no, WHO did not change its definition.

Mumps Vaccine: Perceptions and Emerging Realities

October 12, 2009 by · 7 Comments
Filed under: News, Vaccine/Disease Analysis 

Mumps outbreaks are occurring in highly vaccinated populations and this has led to differences in opinion amongst scientists around the efficacy of the vaccine, with various mechanisms of failure being put forward. It has been suggested that the number of vaccinated young adults (18-24 yrs) who contracted mumps in the US in 2006 form a small percentage of the overall vaccinated population. The fact that 84% were vaccinated with two doses is reduced to a minor detail when numbers are crunched in the “right” way. However, this is not the view of all scientists. There is concern as to why highly vaccinated populations are having mumps outbreaks. By choosing to avoid the issue, essentially ignoring the reason why young adults who have been vaccinated twice with the MMR are coming down with mumps, the evidence on the real efficacy of mass vaccination against a benign childhood disease is not discussed. Read more

Polio

June 28, 2009 by · 2 Comments
Filed under: General 

The fourth article in the Scary Stats series: Polio, has been taken down for repair. It turned out that there were some mistakes in the article. We’d like to thank both our supporters and our detractors who help keep the information on our site accurate.

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