Polio 2010
Filed under: CDC Watch, Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis, WHO Watch
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
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
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]
Vaccine Myths Round Four
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
Myths 3.2 Chickenpox “the disease can be severe”
Filed under: CDC Watch, Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis
Parents who take their children to chicken pox parties have forgotten how devastating this childhood disease can be according to vaccination experts:
“What happens if you bring your child to a chicken pox party and they’re the one in 10 who has a complication and is hospitalized?” said Dr. Jane Zucker, head of the city Health Department’s immunizations bureau.
We went back to 1951, when chickenpox afflicted millions of children every year in the U.S. to see if complications and hospitalization from chickenpox were common:
In general, chickenpox is a disease of young children and in them it usually runs an uneventful, if uncomfortable, course without leaving behind it any permanent bad effects. In very rare instances, a case of encephalitis or inflammation of the brain may occur after chickenpox, causing such symptoms as sleepiness, stiff neck, convulsions, coma, and even death.
Ordinarily, however, chickenpox is a mild though highly contagious disease…
This view of chickenpox as mild continued to exist in the U.S. for many years as this two part video snippet illustrates. Read more
Vaccine Myths 3.1: The Scourge of Childhood
Filed under: CDC Watch, Parents' Pages, Vaccine Myths, Vaccine/Disease Analysis
“…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”
Filed under: CDC Watch, News, Opinion, Parents' Pages, Vaccine/Disease Analysis
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
Vaccine Myths, Round Two
Filed under: Parents' Pages, Vaccine Myths, Vaccine Science, Vaccine/Disease Analysis
Introduction: A while back, we explored some common anti-vax myths. Because in the great vaccine debates, the myths tend to outnumber the facts, we’ve decided to begin a multipart series dispelling some of the mythologies people argue over which preclude productive discussions over real issues. Below, you will find the facts behind two more common vaccine myths: herd immunity, and whether or not vaccines are profitable to pharmaceutical companies.
Myth: herd immunity isn’t real, and all the vaccine preventable diseases were declining in incidence prevaccine
Reality: vaccine induced herd immunity is a real phenomenon, and the incidences of the “diseases of childhood” (measles and mumps, for example) averaged out to be constant in the prevaccine era.
Here’s a chart showing the incidence of measles from 1912 till 1960.
Although the “death rate per cases” dropped an amazing amount, the same number of cases were happening per year on average. Read more
Pandemic – When did the definition change?
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.
H1N1 Influenza in the U.S.
While it’s too soon to be sure, influenza numbers are dropping and the season may be coming to an early close. The CDC has these numbers:
During week 51 (December 20-26, 2009), influenza activity decreased slightly in the U.S.
154 (3.9%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
Translation: of thousands of tested cases of “might be flu”, 154 turned out to really be flu, only 3.9% of the total specimens tested. Lots of sneezing and coughing out there, and not an insubstantial number of hospitalizations and deaths for “influenza-like-illness and pneumonia” , but no influenza viruses are the main cause at this point.
2009 H1N1 virus did turn out to be more dangerous to children than the typical yearly influenza virus: the CDC received 225 reports of deaths this year, 130 last year, 88 in 2007 and 78 in 2006.
The breakdown by age:
Since August 30, 2009, CDC has received 225 reports of influenza-associated pediatric deaths that occurred during the current influenza season (42 deaths in children less than 2 years old, 25 deaths in children 2-4 years old, 83 deaths in children 5-11 years old, and 75 deaths in children 12-17 years old).
How likely was a child under 2 to die from H1N1 based on these numbers?
Live births in 2007: 4,317,000, minus 29,000 infant deaths, gives us a starting number of 4,288,000. The number of births has been going up every year for the last few years, so if we assume the same number in 2008 we are erring on the side of caution. We’ve got a total of roughly 8,576,000 children in the U.S. under the age of two. Forty-two of those children died this year as a result of H1N1, according to the CDC. This means that one child out of every 204,190 died from 2009 H1N1 according to the reported number of cases.
Are the reported number of cases reflective of the true burden of illness? Probably not entirely, but in November, CBS news reported that:
It’s a little counter intuitive,” Frieden said, “but the best way to estimate the total burden of illness is not to count the cases, but to estimate them based on the best available science.”
However, Ashton pointed out, things are very different when reporting pediatric flu deaths. She said states are required to document each case with the CDC, and every week the updated numbers are an accurate reflection of the entire country.
The numbers of pediatric deaths from 2009 H1N1 are based, therefore, on actual case counts in the U.S., during 2009.
Infants and toddlers were one of the groups recommended for the 2009 H1N1 vaccine. However, if saving the maximum number of lives is our goal, then there are several other causes of death in infants and toddlers which we feel should be addressed with a vigor to match the actual death and injury rates for each category.
Among 1- to 4-year-old children, injuries accounted for 42 percent of all deaths, followed by deaths due to congenital malformations (birth defects), malignant neoplasms (cancer), homicide, and diseases of the heart.
Or to give some comparative numbers:
More than 16,500 lives could be saved each year in the United States alone if our under-5 mortality rate was the same as Iceland. If the U.S. rate of under-5 mortality was similar to that of France, Germany and Italy (all 4 per 1,000 live births), over 12,000 child lives could be spared.
The causes of child deaths in the industrialized world differ dramatically from those in developing countries. In the developing world, over half of under-5 deaths are caused by pneumonia, diarrhea or newborn conditions. In the industrialized world, these problems rarely lead to death. Children’s deaths are most likely the result of injury suffered in traffic accidents, intentional harm, drowning, falling, fire and poisoning.