Not the Ducks! – eBola

One of our greatest fears, especially in the USA is a deadly disease. Mainly because with a privatised medical system you end up with people “toughing it out”. You would be surprised (since India’s universal medical system is so overworked most people have to turn to private) what people can tough out.

Things like “my child has swollen to twice his normal size. I am sure he will get better”. And indeed, there will be someone who thinks his symptoms of ebola aren’t that deadly and stay at home. Or go to work. Typhoid Marys are things that do exist.

This is the deadliest outbreak of Ebola so far. Medicin Sans Frontier report more than 1,400 infections and a fatality rate of 57%. To many  people, the isolation tents are places to die rather than places where you are saved. And these people are incredibly brave.

I have told you guys I work with Tuberculosis patients who hold a similar fear. But TB doesn’t spread as easily as Ebola nor is it as fatal. Doctors tend to bear the brunt of such illness because we don’t wear masks when we see patients and can fall ill from what they have. So far 800 people have died.

There are brave men and women out in Africa fighting to save lives and stem this disease. And the fact the case rate is so low is testament to their efforts. Our capacity to control population movement via quarantines has helped stop the spread. I have often said that you don’t know who you are until you are in the dark. That what we consider ourselves is a careful construct. That until we are pushed to the very edge we will never realise what sort of people we are. These people who are out there fighting this disease in Africa are incredibly brave and doing a vital service to the rest of humanity.

Ebola was discovered in 1976. Africa has a long history of deadly diseases coming out of it. It is a zoonotic disease that used to have deadly outbreaks in isolated villages.

It is a severe acute viral illness. The symptoms are fever, weakness, pain, headache and sore throat. Followed by vomitting, diarrhoea, rashes, reduced kidney and liver function. Haemorrhage occurs. People are highly infectious as in the haemorrhagic stage blood is often sprayed via coughing. Ebola has a long period of infectivity with some people testing positive 60 days after infection. The incubation is also rapid with some patients showing symptoms in as little as 2 days.

The lethality of the disease was what helped keep it from spreading. It literally spread so fast and so lethally that it never left anyone to carry the disease. This outbreak is unusual in that it has hit a major city.

You are at your best in the dark, you are also capable of your worst. And the vultures from the quack brigade have come crawling out of the woodwork.

If you guys send Donald Trump to Africa then you will have fewer problems

We must suffer the consequences of helping others! If we were all selfish like Trump, we would all be Millionaires. Arseholes… but millionaires.

Or you know. Our world class medical facilities will help us formulate new ways of treating a deadly disease and help protect real live people (not just real live millionaires) from dying pointlessly of something we could fight.

 How dare we help. Save us from Libertarian’s champions. I cannot even parody Trump’s casual villainy here.

If the mere shade of ebola turns Donald Trump into a gibbering idiot and all round douchebag then I truly fear what sort of man he at the darkest of times. Remember all those anti-vaccination stances Mr. Trump held? I wonder will he stand behind them if we do invent the ebola vaccine.

Probably this guy

And he isn’t the only one.  This site makes a rather interesting claim.

Thieves oil can be diffused to kill airborne microbes, applied topically on the skin to help the body fight off infection, and also used internally in homemade capsules. If Ebola was going around in my area, I would diffuse Thieves oil daily for 15 minutes every few hours. I would apply it to my feet and armpits 2x/day or more and take it in capsules at least 2x/day for preventive purposes.

Apart from the subtle irony in calling your snake oil “Thieves Oil”. This simply doesn’t get how Ebola works or how it spreads.

Ebola is magically killed by this random plant as long as you spray it around your house like air freshner for 15 minutes a day (Ebola is a very polite pathogen and makes appointments). I don’t even know why you would apply it to your armpits and feet. The only pathogens I know that like feet and armpits are fungal infections and the elusive armpit to armpit transmission has since eluded scientific discovery.

And the homeopaths have got in on the action too. This to my knowledge would simply not work.

1. Crolatus horridus (rattlesnake venom) 2. Bothrops (yellow viper) 3. Lachesis (bushmaster snake) 4. Phosphorus 5. Merc. cor.

Like cures like and I know 3 of these toxins can cause haemorrhagic issues. By that logic you should infect yourself with dengue fever under the “Ninjas can’t catch you if you are already on fire” principle. And the site posits the old “we are about to swept aside by this foreign disease”.

Another site reassures its readers that while the disease is far away there is always the chance of terrorists using it.

In order for the con to work, you need the ignorance of what Ebola and indeed what Africa is. To many people it’s grass huts and lions. Just as India is all Aladdin Architecture and Temples. Mumbai would probably blow their minds.

Fortunately, for your fears there is a panacea. Water that’s been smacked against this special leather board. Because water learns if you beat it hard enough with a leather paddle.

I may hate this man’s capacity to prey on the weak but I have to admit? The guy’s got brass monkeys for not only creating a fear but then selling magic water to people who really aren’t at risk to “cure” it. It’s making a profit with water!

Pseudoscience and CAM or “quackery” as I prefer calling it demonstrates the real potential harm it can do. All that Echinacea and St. John’s Wort are  provide you with a sense of well being and positive thinking that you are protected in the same way that a lucky sock does. As we begin to take the quack industry seriously we realise one important thing. That these people are replacing medicine with quackery and while it won’t kill you if you are healthy, I am sure the care of doctors has more survivors than the quacks.

The lack of a specific protocol makes Ebola a prime target for charlatans. Unable to find any official regimen, the made up ones of charlatans seems more planned and thought out than the “intensive care” of medicine.

Prevention is about avoiding exposure, properly dealing with those already infected and disposing of the dead and any infected fluids, not deodorising your room with magical febreeze.

And conspiracy theories about ebola are out there too. Because why explain something in a simple manner when you can involve reptilian overlords and the Illuminati.

The two Americans affected are Dr. Kent Brantley and Nancy Writebol. Brantley is already in the US, and Nancy should be there by the time I land.

The dialogue from the quacks, the libertarian right wingers and the usual suspects is the same. WorldNet Daily is off scaring people about immigrants bringing in Ebola and other diseases. Dave Hodges and the president of the American Association of Physicians and Surgeons, Dr. Jane Orient are both working together to undo any goodwill the public have to doctors by claiming that “100,000 West Africans are in Central America, have been taught to speak Spanish and are coming across our Southern border” carrying Ebola, naturally. Because these people not only show a complete lack of understanding of how difficult it is to learn other languages but how hard it is to do so while having ebola. That’s like trying to play Contra blindfolded.

The dialogue of many of the fears are dominated by people like Mike Adams, Orient and Trump. As of now? Trump’s ideas have had thousands of views.

The truth is? You know how there are so many panic stories coming out of Africa? A lot of them are simply that. People panicking. The media is in general after a “scoop” and the more sensationalist the better. It’s why the “buzzfeed” headline exists. Avicenna Last travelled to the UK and you won’t believe what he wrote! The same fears that people have in Africa are mirrored in the press of the USA and UK. For all our education, we rarely remember our own education.

We have effectively forgotten that ebola is not spread by air but by bodily fluids. So we begin to treat its victims as if they had TB. The truth is? If the CDC are planning to bring a highly deadly disease into the USA for study and treatment then at the very least you would see staff following a strict checklist of aseptic technique to rule out infections. The staff themselves will be under scrutiny and if they really want to go all out they will put patients into isolation booths with a negative air pressure (meaning air comes in, not out if doors are opened) preventing the spread of the pathogen.

Ebola Clinic from Medicin Sans Frontier

These are the people who will help beat ebola.

Not people like Trump. People like Trump are the sort of people who throw their fellow man to the wolves for a quick dollar. If it were profitable to help? Then I am sure he would be out there making a killing.

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Vickie Sorensen – Natural Birth, Home Birth Midwifery and Deadly Consequences

Vickie Sorensen is one of the least talked about and deadliest breed of quacks out there.

Home Births are a hidden form of quackery. Wreathed in the language of female empowerment, bad statistics and anti-medical quackery home births have a rather deadly toll that is often not widely advertised and not often fought.

My “personal” anti-Obstetric nemesis is Mayer Eisenstein. A reknowned home and natural birth advocate. And a real doctor to boot. Mayer is brought out when the Natural and Home Birthers want a real doctor. [Read more...]

Not the Ducks! – The Financial Post Hosts Anti-Vaccination

Measles is a killer.

Measles once killed millions per year. The lethality of the disease wasn’t high but it was so universally prevalent that it didn’t need a high lethality rate.

In the developed world the death rate dropped due to improvements in food and medicine.

But the Financial Post and Lawrence Solomon add doubt to the issue. 

Early in the last century, measles killed millions of people a year. Then, bit by bit in countries of the developed world, the death rate dropped, by the 1960s by 98% or more. In the U.K., it dropped by an astounding 99.96%. And then, the measles vaccine entered the market.
 
After the vaccine’s introduction, the measles death rate continued to drop into the 1970s. Many scientists credit the continued decline entirely to the vaccine. Other scientists believe the vaccine played a minor role, if that, noting that most infectious diseases similarly petered out during the 20th century, including some, like scarlet fever, for which vaccines were never developed.

The credit for the century-long decline, scientists generally agree, goes to improved nutrition and improved health care, side effects of the West’s growing affluence. In the U.S., the death rate dropped by about 98%, from about 10 per 100,000 population a century ago to one fifth of one person by 1963, the year measles vaccines made their American debut. Both before and after vaccination started, victims tended to be poor.

Yes the reason for this is very sensible. Poor kids have weaker immunities and are so most likely to suffer the more severe issues with Measles and so more likely to die. Rich well fed kids were more likely to live. The same applies to nearly all diseases. It’s why people think Measles is harmless, because most of our children count as rich world wide and so survive Measles. And as always the dialogue of the anti-vax is the same. Rich, educated flogger, but not educated in anything to do with vaccination.

Let us take Neil DeGrasse Tyson. Educated man. Smart man. But would you trust him to fix your car? Wire up your house? Operate on your appendix? No. Because you know as well as I do that there is a domain of knowledge. On some matters I speak as a lay person. On some I speak as an educated person. The Financial Post flogs their expert without realising he isn’t one.

I have seen cases of Scarlet Fever. And Scarlet Fever lost its mode of transmission because we invented penicillin. Scarlet Fever is caused by Streptococcus Pyogenes.

Ever heard of Strep Throat? That’s the pathogen that causes it. Strep. Pyogenes is effectively killed before it gets to the stage of scarletina. There are other infections too.

Examples of mild infections include pharyngitis (“strep throat”) and localized skin infection (“impetigo”). Erysipelas and cellulitis are characterized by multiplication and lateral spread in deep layers of the skin. Invasion and multiplication in the fascia can lead to necrotizing fasciitis.

Infections due to certain strains cause the release of bacterial toxins. Throat infections associated with release of certain toxins lead to scarlet fever. Other infections may lead to streptococcal toxic shock syndrome which can be fatal.

It can also cause other auto-immune syndromes like rheumatic fever and glomerulonephritis. Luckily Strep. remains sensitive to penicillin. Failure of treatment with penicillin is generally attributed to other local commensal organisms producing β-lactamase, or failure to achieve adequate tissue levels.

So basically? Scarlet Fever is killed off before it manifests and we have improved hygiene due to improvements in spacing of children, proper dental care and education. However? If we could vaccinate for this disease we would.

Yet again anti-vax misrepresent falls in fatality rates with falls in incidence. To them a visit to the hospital is not a bad thing. And with no mention of morbidity.

A study in the American Journal of Public Health, “Measles mortality in the United States 1971-1975,” found the measles death rate to be almost 10 times higher among families whose median income was less than $5,000 than among families whose income exceeded a modest $10,000. Families outside metropolitan areas, who tended to have poor healthcare, had three times the death rate.

See, we are still discussing mortality.

Let’s take diabetes. The mortality rate of diabetes has fallen a lot.

But it doesn’t mean that having diabetes is pleasant, cheap or without side effect. The same goes with measles.

An earlier, landmark study in the American Journal of Epidemiology by the Center for Disease Control’s Roger Barkin found similar disturbing results of measles’ toll on the disadvantaged. Here race entered the picture because black children were disproportionately victimized, not by the measles virus per se but by poverty. A poor black child and a poor white child had the same high chance of dying from measles, but because white children rarely lived in abject poverty, measles claimed the blacks.

Measles didn’t only discriminate by income — in another study, Barkin found that children with underlying diseases were particularly vulnerable, and that the “majority of this group were physically or mentally retarded, or both.” The realization that measles was selective in whom it killed led Barkin to emphasize that vulnerable populations, rather than the general population, should be targeted for measles vaccination.

“Vaccine should be accessible to all populations, but intensive efforts need to be directed toward groups at high risk of dying from measles who are suffering from a myriad of other health, social, and economic problems.” – Roger Barkin

Another well known anti-Vaccination tactic. Quoting papers and not mentioning important things from them. Such as the fact that the vaccine should be available to ALL and with greater targeting of at risk children. Note how this is not what Lawrence Solomon says.but an attempt to claim that we should only vaccinate at risk children.

This is a terrible idea because it accepts that vaccination works but is trying to push for LESS vaccination.

In the pre-vaccine era, when the natural measles virus infected the entire population, measles — “typically a benign childhood illness,” as Clinical Pediatrics described it — was welcomed for providing lifetime immunity, thus avoiding dangerous adult infections. In today’s vaccine era, adults have accounted for one quarter to one half of measles cases; most of them involve pneumonia, one-quarter of them hospitalization.

Clinical Paediatrics isn’t a book… It’s a bunch of books by different authors.

Typically Benign With Modern Medicine. Without it, it comes with side effects. Lawrence is trying to downplay the seriousness of Measles by discussing only the cases of Measles that didn’t require hospitalisation or with no side effects.

Also importantly, measles during pregnancies have risen dangerously because expectant mothers no longer have lifetime immunity. Today’s vaccinated expectant mothers are at risk because the measles vaccine wanes with time and because it often fails to protect against measles.

And Measles has generally fallen among pregnant women due to the sheer incidence being lower. It’s gone up recently though.

But if we have a vaccinated population the herd immunity would protect them. The problem is we don’t have a properly vaccinated population so people who need to be protected aren’t any more. What we have is waning immunity with age but a restoration of a new group of people who are not vaccinated to be a reservoir of the disease. This was something in the making since the anti-vax hit the mainstream via Andrew Wakefield. 

A study in Houston of 12 pregnant women and one who had just given birth, all of whom had measles, found one died, seven suffered pneumonia and seven hepatitis, four went through premature labour and one lost her child in a spontaneous abortion. A study of eight measles pregnancies in Japan found three ended in spontaneous abortions or stillbirths while four babies were born with congenital measles; two mothers endured pneumonia and one hemorrhagic shock. A Los Angeles study of 58 such pregnancies found 21 ended prematurely (three induced abortions, five spontaneous abortions and 13 preterm deliveries); 35 of the 58 mothers were hospitalized, 15 contracted pneumonia, and two died.

Twelve pregnant women and one woman who had just given birth were hospitalized with measles in Houston between 1988 and 1990. The most common and serious maternal complication was pneumonitis (seven patients). Other maternal complications included hepatitis (seven patients), premature labor (four patients), spontaneous abortion (one patient), and death (one patient). For four of 13 patients, all of whom had severe measles and pneumonitis due to measles virus, an adverse fetal outcome such as abortion or prematurity was associated with their conditions. Historical accounts describing maternal sequelae of measles have suggested more severe disease in pregnant women, although this observation has not always been confirmed by more recent reports in developed countries. The clinical course in our patients suggests that measles during pregnancy may be associated with serious complications. 

From the Abstract of the paper Lawrence quotes.

This is a consistent thread with the anti-vaccine lobby. Bad paper reading. And here is the thing. Lawrence and by association the Financial Post probably hoped no one would check on the source. In fact in general this piece is stealth anti-vax.

The danger extends to babies, whose bodies are too immature to receive measles vaccination before age one, making them entirely dependent on antibodies inherited from their mothers. In their first year out of the womb, infants suffer the highest rate of measles infections and the most lasting harm. Yet vaccinated mothers have little antibody to pass on — only about one-quarter as much as mothers protected by natural measles — leaving infants vulnerable three months after birth, according to a study last year in the Journal of Infectious Diseases. HIV-infected children, who may account for most recent measles-related child deaths, also suffer when their mothers have been vaccinated, since HIV further reduces the antibodies they inherit.

Aww… Didums.

The MMR vaccine can be given anytime from 6 months to a year. I work by India’s standards and administer it at 9 months which is round about the point most people stop breast feeding. But in the UK the MMR is given at 1.

Again the study is mentioned without a link so I looked it up.

The suggestion is to undertake early vaccination at 6 to 12 months rather than after 1 year.

Again Lawrence pushes a false understanding.

He is trying to push the notion that if everyone got Measles, babies would not get Measles because they would be protected for longer. Okay. The difference is 3 vs. 5 months in Antibody Titres. There are two solutions. You can either vaccinate babies earlier to protect them or issue a booster shot for girls aged 20 and above to increase titres.

However the corollary is this. If 1 in 1000 cases of Measles is fatal with modern medicine, in the USA that’s 3000 deaths. By contrast with vaccination the number of infants who die of measles is miniscule particularly since we disrupt the chain of transmission. The study is flawed because it is comparing Measles Antibodies between two groups without pointing out that Measles is much rare in one group than the other so the chance of your baby being exposed to Measles is exponentially lower if you vaccinate than if you don’t.

And HIV infected children are extremely benefited from vaccination since the herd immunity protects them.

I normally understand what the anti-vax do because they have a clear goal. Lawrence is just flailing around. HIV patients are benefitted from high vaccination rates because the herd immunity keeps them safe. Children with HIV infections in the west are on anti-retrovirals and still have functioning lymphocytes. In fact most children who are HIV + are vaccinated particularly if they are in areas with high disease burden.

Factors such as these increased the death rate for adults and the very young, helping to reverse the decline in deaths seen in previous decades, according to a 2004 study in theJournal of Infectious Disease, authored by researchers at the Centers for Disease Control and Johns Hopkins Bloomberg School of Public Health.

Yes but the overall decline in incidence mean that these small (if any since I have pointed out flaws above in paper reading) increases are an overall decrease. Again we see the anti-vaccine “if it is not 100% effective it is ineffective and not worth adopting” argument.

Vaccines for measles have had spotty safety records. Soon after their introduction, the Vital Statistics of the United States began recording deaths from the measles vaccine, along with deaths from other vaccines. By 1970, one of the two original measles vaccines was withdrawn in Canada and the U.S. after causing atypical measles syndrome, a harsh disease triggering high rates of pneumonia. In 1975, the second original vaccine was withdrawn due to 103-degrees-plus fevers, among other severe side effects. Two variants of this vaccine also proved unsatisfactory. A measles vaccine then became part of the combination MMR (measles, mumps, rubella) vaccine in the 1980s, only to be withdrawn in 1990 by Canada and in 1992 by the manufacturer after reports from Canada, the U.S., Sweden and Japan blamed MMR for febrile convulsions, meningitis, deafness and deaths. A second version of MMR, now in widespread use, is believed safe by government officials.

Prior to the advent of medical science, many parts of Africa and India had a measles fatality rate of 30%. Nearly 1 in 3. Measles killed more people a year than AIDS. Only Smallpox and Malaria have killed more.

And in every case people were willing to risk the side effects because the side effects were rare and more survivable. And in every case the vaccine was replaced by better ones with fewer side effects. Lawrence assumes that the vaccines were not effective which simply isn’t the case. Mass vaccinations in Russia showed us how extraordinary the effect was in the 60s and across the globe such results were repeated. Measles Vaccines caused HUGE drops in incidence within a year of the vaccinations beginning.

Safety aside, vaccines repeatedly failed worldwide in the 1980s and 1990s. As described in “Measles Elimination in Canada”, a 2004 report authored by Canadian government officials and academics, “despite virtually 100% documented one-dose coverage in some regions, large outbreaks of measles involving thousands of cases persisted … Clearly, because of primary vaccine failure, Canada’s one-dose program was insufficient.”

Except we knew even in the 1960s that one dose coverage is only temporary and near permanent Measles immunity is achieved by a two dose regimen. After the 1960s fall we began to see a rise so we had two doses.

The solution finally arrived at — adding a second dose for children — initially seemed to tame measles outbreaks. But in recent years, the new vaccination regime, too, has been failing, with widespread outbreaks again occurring, including among those who have received the recommended dose and especially among infants too young to be vaccinated, and thus unprotected because their mothers had been vaccinated. Now health experts, scrambling to find solutions, are suggesting numerous reforms, including earlier child vaccinations and second doses for adults.

Actually in this case it is due to people like yourself.

Anti-Vaccination.

Put it this way. The state of Tamil Nadu in India has a higher vaccination rate than the UK or the USA. In my  5 years here I have seen just 2 cases of Measles. TWO! If I wanted to see Measles, I would be better off staying with Hera where there was an outbreak. Why?

Daily Mail, Andrew Wakefield and people like yourself sir. People who pretend that their education in one field makes them masters in another. I would not dream of giving out financial advice beyond “Spend within your means” and “Don’t loan money from the Mob”, yet Lawrence here seems to think he is educated enough to dance my dance.

Clearly, the science is not settled, making for parents a numbers game of the decision to vaccinate their children. Some parents rely on the press or health authorities to interpret the numbers. Others defy the authorities and weigh the risks in the numbers differently, in deciding what’s best for their own families. Who are these others? According to a survey in Pediatrics, unvaccinated children in the U.S. have a mother who is at least 30 years old, who has at least one college degree and whose household has an annual income of at least $75,000. In the absence of studies showing vaccinated children to be healthier than those unvaccinated, the parents in these educated households have determined that the numbers argue against vaccination.

The science is settled. It was settled back in the 1980s when we made Smallpox Extinct and now when we nearly made Polio extinct.

And we have studies showing unvaccinated children to be worse off. Every single study done on this has shown the incidence of common “fear mongering” disorders associated with vaccines are found equally in both vaccinated and unvaccinated children and the only difference really is that unvaccinated children have more diseases that could be prevented by vaccination. Unvaccinated children are LESS healthy than those vaccinated. The KIGGS study is the largest out there by the way. Nearly 17,500 cases were analysed.

And no. Just because you have  a college degree doesn’t mean you are an expert in medicine. High income doesn’t make you correct either. You can be incredibly well educated and still fall for nonsense.

One of the “cutest” statements was on “brain training”. One of the exercises involved drinking water slowly and holding the water in your mouth so it is absorbed by the brain. This is laughable to me as a medic since I know that above the roof of your mouth lies your nasal passages and if water gets into that, things go wrong. But according to Ben Goldacre, a kid asked the question “does this mean if I drink water really fast it will come out my bottom”.

And college degrees wildly vary in scope. Engineers from MIT are arguably incredibly smart people but you would be an idiot if you hired one to represent you in a court of law. A doctor from Harvard makes a terrible plumber.

And a Financial Post Columnist makes for a terrible quack.

Not the Ducks! – Christians Against Gardasil

When the mom of a 15-year-old Indiana teen saw the Merck “One Less” campaign, she made sure her daughter Maddie got vaccinated with Gardasil.

After the first dose, Maddie started having pain and fatigue.

After the second one, she was in such bad shape she couldn’t even go to school.

Her mom now says that she wishes she could have “a do-over,” in deciding to have Maddie get the shot.

This is a common trope among the anti-vax. This entire piece are from a group of Christian Quacks. The claim they used to be famous for is that Biblical Lifestyle fights cancer. That rogue cancer cells would simply up and vanish if you waggled the divine knowledge of the Bible at them. Which is mighty polite.

In reality? A lot of people have died by following this piece of religious quackery. [Read more...]

Not the Ducks! – Drug Layering

The dialogue of the quack brigade is filled with the notion that there is a vast conspiracy to get you to spend enormous amounts of money on medication and that instead you should be spending it on whatever specific pseudo-science the quack wishes to flog.

And while they may all compete, they tend to unite specifically to bash medicine and universally their claims are couched in pseudo-science and conspiracy. [Read more...]