epidemic

Is homeopathy the end of vaccines? Only quacks would think so...

oracknows — Fri, 31 Mar 2017 07:15:32 +0000

Is homeopathy the end of vaccines? Only quacks would think so...

Yesterday, I wrote about an antivaccine "march on Washington." As is often the case with antivaccine rhetoric, if you listened to the people organizing the conference and planning to speak there, you'd think that they were fighting an apocalyptic battle for the very future of the human race. Certainly, Kent Heckenlively seems to think so. I'm not going to write about this march again, at least not today. It's too soon. I don't know how ridiculous, how pathetic it was, mainly because, as I write this, it hasn't happened yet. What I can write about is something I came across while researching yesterday's post that has to be up there on the list of the most ridiculous things ever written about vaccines. Not surprisingly, I came across it on Patrick "Tim" Bolen's website, as I perused Kent Heckenlively's all caps rant in which he compared himself to Nelson Mandela.

Oddly enough, the post that attracted my attention was not written by Heckenlively, though. It was written by someone I've never heard of named Elissa Meininger, who bills herself as a "health policy analyst," and it encompasses some serious, serious woo. Meininger seems to be a writer of some sort who bills herself as "fighting for health freedom." Now she's writing for Patrick "Tim" Bolen's blog, which is about as far down the food chain as you can go, with the possible exception of writing for Mike Adams. No, it's even lower than Mike Adams. Adams has a lot more traffic and, as batshit nuts as he is, at least his website has better design. Of course, both are so bad that it doesn't really matter. Be that as it may, the title of the article is Is This The End Of Vaccines?, and if there's any headline for which Betteridge's Law applies, it's this one. After asking whether vaccines are the best way to deal with infectious diseases, Meininger proclaims that "vaccines have never been the safest and the best way to deal with epidemic diseases," which is, of course, a bit of a straw man and untrue as well. Vaccines are a major tool—and one of the most powerful—to deal with epidemic diseases, but it's not the only tool.

You know that you're in for some hard core woo when Meininger cites Rupert Sheldrake, a populizer (I refuse to call him an "investigator" or scientist) if paranormal phenomena, as having pointed out the "scientific truths" of today, mainly as a prelude to attacking them for rooting science in the material. Of course, where else should science be rooted, but in the material? I'm not sure that these ten "core beliefs" really are "core beliefs," but, even as distorted as some of them are in Meininger's hands (via Sheldrake), it is true that science is based on them. For instance:

5. All biological inheritance is material, carried in the genetic material, DNA, and in other material structures.

Well, yes. There's no evidence that inheritance works by any other method than the material. Genes are material. Epigenetic mechanisms are material. What else could possibly carry the information necessary for biological inheritance? You get the idea. Meininger, like Sheldrake, doesn't like science's concentration on the material because they want to believe in the immaterial. For example:

1. Everything Is essentially mechanical. Dogs, for example, are complex mechanisms, rather than living organisms with goals of their own. Even people are machines, “lumbering robots,” in Richard Dawkins’s vivid phrase, with brains that are like genetically programmed computers.

You can tell from this passage that the complaint isn't so much that everything is essentially mechanical, but the objection to the implications of such a view, which science generally supports, that there are physical explanations for natural phenomena like consciousness. Human beings don't like accepting the fact that we are biological creatures and that our consciousness derives from the function of our brains and not some other magical mystical other mechanism that infuses our meat with thought and consciousness from...somewhere. Such concepts go against our exalted view of humans as being somehow apart from other animals, even though we are just animals ourselves. Personally, even when I was a religious Catholic, I had a hard time understanding just what was so horrible about being a part of the natural order, an animal like any other, even though we have complex language, self-awareness, and complex language.

What people like Sheldrake and Meininger really object to are the last three:

8. Memories are stored as material traces in brains and are wiped out at death.
9. Unexplained phenomena such as telepathy are illusory.
10. Mechanistic medicine is the only kind that really works.

That all of these are true drives people who believe in woo crazy.

Now, here's the funny part. Meininger is basically arguing that homeopathy is much better than vaccines, as you will see. She starts out by going back to Franz Mesmer. I kid you not. She references Mesmerism, which encompassed the belief that there was an invisible magnetic "fluid" that flowed throughout nature and that, when there were imbalances in this "fluid" disease resulted. Mesmer called this “fluid” “animal magnetism” and his techniques “magnetic healing”. Naturally, Meininger paints the rejection of Mesmer's views as a grand conspiracy. Same as it ever was:

Naturally, the-powers-that-be needed to stop him, particularly because Queen Marie Antoinette was one of his most ardent supporters and King Louis XIV was not too pleased. In addition, Mesmer was the toast of pre-Revolutionary War Paris with associates suspected of being political agitators.

King Louis XIV convened a commission of “elite” scientists and medical experts to take a secret look at what Mesmer was talking about. As they were all philosophically committed to believing the world was a predictable, material, tangible system measurable by long-believed standards of measurement, they were hoping to find something they could measure. Since this “fluid” was invisible and not of the material world, they declared Mesmer a quack. That there were thousands who claimed they had been healed by his methods, didn’t count. Anecdotal information is not considered scientific evidence then or now by the standards of the “elite” “experts”. Mesmer became a laughing stock in the press so he left Paris.

After the Revolution, the Academy of Berlin formally acknowledged the validity of Mesmer’s ideas and invited him to Berlin but he chose to stay in Switzerland where he died In 1815.

I'm not sure where Meininger got the idea that the Academy of Berlin formally acknowledged the validity of Mesmer's ideas. What I got from my research was conflicting. The Academy of Berlin did acknowledge Mesmer's ideas and asked him to move to Berlin, something he didn't want to do because he was quite old at the time and not too keen to do so.

Mesmer, as important as he was to the history of the paranormal, is not the main focus, though. The One Quackery To Rule Them All (homeopathy) is:

German allopath, Samuel Hahnemann had read about Mesmer’s work and it had provided the spark of an idea that turned into the philosophy and development of homeopathy. Hahnemann understood Mesmer’s idea about a universal energy that flowed through the universe and through people as well. He decided to call this energy the “vital force”. Like Mesmer, Hahnemann saw that if this vital force was disturbed, a person could become ill and if he could develop medicines that were able to restore normal flow of this energy, the patient could be restored to health.

For the record, the Chinese call it Qi, the Ayurvedic doctors of India call it Prana. 20th Century quantum physicists Max Planck and Albert Einstein called this field of energy “The Matrix” and both of them acknowledged that a greater mind had created it, thus confirming a spiritual dimension to its existence in modern times.

You can see why people like Sheldrake and Meininger don't like current science. You can also see how she tortures quantum mechanics, as quacks are wont to do, to try to make it sound as though modern physics supports her prescientific vitalism. Notice how she conflates Max Planck's and Albert Einstein's spiritual beliefs with their scientific findings. Let's just put it this way. Planck might well have believed that "religion and natural science require a belief in God," but just because he was Max Planck doesn't mean that he was correct.

Finally, we get to homeopathy. You knew that homeopathy was coming, didn't you? Based on the defense of vitalism and how vitalism infused Samuel Hahnemann's fever dream that turned into homeopathy, it didn't take too long into the article before I knew that this would probably be about homeopathy, but first Meininger has to invoke Dr. Benjamin Rush's famous statement, "To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un-American and despotic and have no place in a republic." It's a statement that was seriously wrong-headed, although in the 1700s it might be somewhat defensible given how little was known about medicine. 200+ years later, it's an idiotic statement. Then, of course, she invokes—who else?—Thomas Jefferson, to do what people love to do with the Founding Fathers and claim that they would be "appalled to find the medical monopoly we have in America today." Of course, no one really knows what the Founding Fathers would think of today's medicine. They'd probably think it was miraculous, because physicians in the 1700s had little other than basic surgery, herbal medicines, bleeding, purging, and toxic heavy metal tinctures in their armamentarium.

Which brings us to homeopathy.

The rest of the article is basically an argument that homeopathy is better than vaccines for the control of contagious disease but has been covered up because of the evils of big pharma trying to find medicines and vaccines that could be patented:

Meanwhile, the scientific “elite” were toiling in their laboratories and the big news of the day was that Louis Pasteur of France and Robert Koch of Germany were studying microbes to figure out how to invent patentable vaccines to kill them. This lab work gave all the “elites” an opportunity to talk endlessly about their “fanciful biochemical theories” and which of the germ theories was their favorite. Chemical companies started perking up their ears as the prospect of patentable drug products that could spell major profits and international trade. The public was entertained in the front pages of the press across Europe about all the excitement.

And, of course, Pasteur and Koch were in on the conspiracy to suppress homeopathy. Claiming that both "Pasteur and Koch were well aware of Homeopathy’s major successes," Meininger lays down this major bit of revisionist history:

Consequently, each, in his own way, developed vaccines that were material in nature so they could be patented using what they thought were homeopathic principles. Problem was, homeopathy is an energy medicine and its healing qualities are based on Mesmer’s idea that it’s the vibrations that matter. They are non-toxic in nature unlike the allopathic vaccines, which had and still have all sorts of material ingredients that can cause harm. In addition, homeopathy, as a practice is focused on strengthening the person’s entire body and spirit, and not in the business of trying to kill germs.

Homeopaths frequently claim that vaccines are based on "homeopathic principles." This is utter nonsense. Homeopathy, being The One Quackery To Rule Them All, posits two pseudoscientific principles. The first is the Law of Similars, which states that, to relieve symptoms, you should administer something that causes those symptoms. There is no scientific basis for this as a general principle—or even in the vast majority of individual diseases or symptoms. The second is the Law of Infinitesimals, which states that diluting a remedy makes it stronger. So homeopaths take whatever tincture they're using and serially dilute it, usually by factors of 100, represented as "C." To a typical 30C homeopathic dilution is in reality a 100³⁰, or 10⁶⁰ dilution. Given that Avogadro's number is roughly 6 x 10²³, the chances that a single molecule of original substance remains after a 30C dilution is very small, other than carryover contamination on the glassware.

Now come the claims frequently used by homeopaths that homeopathy did so much better in epidemics of infectious disease, for instance, in a cholera epidemic in England in 1854:

The first report stated that under allopathic care, the mortality rate was 59.2%. When a member of the House of Lords asked why no homeopathic figures were included, the answer was that such information would “skew the results”. It turned out the homeopathic rate was only 9%.

Of course, I've frequently pointed out that "conventional" medicine in the 1800s and before was frequently toxic and ineffective and suggested that part of the reason that homeopathy seemed to do better at the time was that, for some conditions, doing nothing (which is all that homeopathy is) really was better than conventional medicines of the time, which, even though bloodletting was on the wane by then, still relied on purgatives, toxic metals like mercury and cadmium, and other potentially harmful interventions. There's also the matter of selection bias, in which patients who were less ill might have chosen to try homeopathy while patients who were sicker would go to the conventional doctors of the time. Basically, what these figures, even if accurate, tell us is not informative, nor does it tell us whether homeopathy works. Then there's the question of how many patients first sought out homeopathy, failed to get better, and then went to a conventional doctor before they died, where they would be counted as having been treated by conventional medicine.

Not surprisingly, Meininger also trots out the claim, frequently made by homeopaths, that during the 1918 pandemic of influenza victims treated with homeopathy had a 30-fold lower mortality rate (1% versus 30%). I've addressed this claim before when it was trotted out around the H1N1 influenza pandemic in 2009. No doubt homeopaths reported low mortality, but was there any objective evidence that this was true? How do we know that patients who got sicker under the homeopaths’ care didn’t go to real physicians or die without being followed up. Do we know that the homeopaths’ patients were comparable to the patients treated by “conventional” medicine? We don’t.

Meininger even trots out this old homeopathic chestnut:

Confronted with an epidemic of leptospirosis in 2007, an epidemic that followed the annual hurricane season in Cuba, the Cuban Ministry of Health decided to conduct a study on homeopathy in several provinces that season. It was so successful that for the next 10 years they have used homeopathy on the entire 11 million Cubans. The disease is basically considered eradicated so they no longer administer the remedy automatically. The Cuban Ministry is now expecting similar results for dengue fever, “swine” flu, hepatitis A and conjunctivitis.

I covered this "study" when it was published, as did Le Canard Noir and apgaylard. It's a bad study poorly described and reported. Basically, homeopaths claimed credit for something that they had nothing to do with. Same as it ever was.

Meninger basically concludes that "our future has already arrived" in the form of homeopathy as a vaccination strategy. What she's really arguing for embracing mystical thinking that is 220 years old over modern science, although she does her best to slap a patina of real science over the mysticism and vitalism. I'll stick in the present and look to the future, thank you very much.

oracknows Fri, 03/31/2017 - 03:15

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Of course, no one really knows what the Founding Fathers would think of today’s medicine.

Several of the Founding Fathers were known supporters of vaccination, which makes her comments even stupider.

That's a lot of creative history. And as a history buff, although this is a minor point, I would point out that Mesmer was born after Louis XIV's death in 1715.

9. Unexplained phenomena such as telepathy are illusory.

This one is a straw man. Science is willing to accept the existence of phenomena for which there is as yet no explanation, provided there is sufficient evidence that the phenomena exist. For instance, dark matter has never been directly observed, and we don't have a firm idea what it is. We know, however, that provided general relativity is the correct macroscopic description of gravity, dark matter must be present in order for the universe to appear as it does. By contrast, the evidence for telepathy is not nearly as compelling, which is why most scientists are skeptical about its existence.

Wasn't George Washington killed by quackery?

I will never understand people's obsession with wanting to live in the past. Like, oh yeah, life in the 1700s was just SO GREAT. Life expectancy looked to be about 36 years old in the late 1700s. I am approaching thirty now, so I would have been considered a geezer, if I managed to survive this long at all. These days I still have people telling me I'm young; although that really only happens now when someone wants to inform me that I have understood something incorrectly and want to use their own age that is a higher number to prove that I'm wrong and couldn't possibly understand as much as they do.

Ben Franklin et al debunking of Mesmer was classic and not secret at all. Should be required reading for everyone.

They have this idealized view of things - not realizing that our ancestors at 100% organic food, worked outside, got lots of fresh air and exercise....yet they died in droves from disease.

Lawrence, it is so crazy. I just don't understand why people think this. It's so obviously and objectively untrue that people's health was better during those times. It also strikes me as some really weird privilege thing, and privileges that were afforded by things like vaccination and other advancements of modern medicine at that. It never ceases to boggle my mind.

I believe it starts with the failure of schools to impart critical thinking skills, backed with very poor requirements for teaching history....

Any serious knowledge about past civilizations should include a study of how public health and disease shaped societies....most people don't realize that Rome was stricken with a series of plagues throughout its history that killed millions.

A study of Smallpox, by itself, would be enough to put the fear of disease in anyway - a disease, which even controlled by mass vaccination & inoculation, still managed to kill more than 300 Million people in just the 20th Century.

This cavalier attitude exuded by people today is extremely dangerous. Just ask the people studying emerging diseases - there are plenty of bat-borne diseases which are beginning to spill over into humans. Any one of them could turn into the next Pandemic.

There is a reason why there are people who dedicate themselves to disease surveillance.

Like, oh yeah, life in the 1700s was just SO GREAT.

The people who imagine this tend to think they would be (depending on gender) a Fitzwilliam Darcy or an Elizabeth Bennett. In reality, they would be far more likely to be servants, or manual laborers.

It's not just diseases, either. Death in childbirth was distressingly common: women actually had shorter life expectancies than men in those days because of this. Not to mention medical conditions other than infectious disease that are treatable today that were not treatable then. And as noted in the OP, many standard medicines of the day were actually harmful--the reason homeopathy was able to gain any foothold at all is because by definition it meets the letter of, "First, do no harm."

Certain moral scolds like to point out that divorce was almost nonexistent back then. That's technically true, but second marriages were quite common--often, one had to replace a deceased spouse.

Lawrence (#7) writes,

They have this idealized view of things – not realizing that our ancestors at 100% organic food, worked outside, got lots of fresh air and exercise….yet they died in droves from disease.

MJD says,

Very clever, although, our distant ancestors ate sporadically and often consumed unhealthy choices based on availability and unreliable preservation techniques (dehydration, salting, tree hanging, ground burial, etc..).

When available, spices were often used to disguise the rancid odor and taste of their food-stuff.

One thing is certain, our ancestors lived in a world wherein the "Hygiene Hypothesis" was inconceivable.

Meininger seems to be a writer of some sort who bills herself as “fighting for health freedom.”

"In the mid-1980s, she almost died of mercury poisoning from dental fillings." Patty's new Augean stable of authors is a riot. Does Caquias still have a license anywhere?

8. Memories are stored as material traces in brains and are wiped out at death.

This really shouldn't trouble Christians so much. I mean, if it's true that our memories are stored exclusively in the physical matter of our brains, why worry? We all recite the Apostles Creed, right? It doesn't say "and when we die, our souls go to heaven while the body rots away." No, indeed. It says "the resurrection of the body". Obviously, our brains are indeed necessary for a life after death according to Christian doctrine, which *furthermore* teaches that our bodies will be reincarnated perfect, with any injuries healed. (I personally have my doubts that it's this straightforward, but I figure the details aren't important. Someday, we will all either find out, or not.)

If God is all powerful, He could clearly resurrect us with all of our memories available to us in our reincarnated brains. Even things we had forgotten, I suspect. He could do it in a way that would preserve us at our best. (Will He? Well, that's up to Him, isn't it?)

That fundamentalists have a problem with the idea of memory being stored physically tells me that they are weak in faith, or lacking in imagination, or quite possibly both. I do think it ties into their strange inability to see beauty and wonder in the material world, even as they go around claiming you can cure diseases with infinitesimal dilutions of material tinctures.

Like, oh yeah, life in the 1700s was just SO GREAT.

The people who imagine this tend to think they would be (depending on gender) a Fitzwilliam Darcy or an Elizabeth Bennett.

Even for the Upper Classes, life could be short.
I read an article several years ago from a journalist who had gone to a historical site once occupied by Henry II. He concluded that he, a commoner living today, had a better quality of life than Henry, a royal living nearly a millennium ago. Scientific and technological advancements were the reason.
The saying goes "nostalgia isn't what it used to be". We look back and see the good things, but don't register the bad things of centuries past.

Elissa Meininger, who bills herself as a “health policy analyst,”

Oogh. One of them.
I am reminded of an old joke, which I will paraphrase:

"Is a health policy analyst a health care provider?"
"Is a barnacle a ship?"

@Calli Arcale #13:

Some medieval theologians posited the existence of a metaphysical bone in the human skeleton, immaterial and intangible but always present. This bone would survive any fate which befell the, um, owner: if the physical corpse was lost at sea and consumed by fishes; for example, or burned down to nothing but ash, the bone would still exist upon the Earth. It was a theological necessity so that on the Day of Judgment everyone could rise from the grave and be made whole once more.

To my mind, that's a hypothesis almost as far-fetched as homeopathy...

@Michael J. Dochniak, #

One thing is certain, our ancestors lived in a world wherein the “Hygiene Hypothesis” was inconceivable./blockquote>
Now that you mention it, "hygiene" is a favorite excuse of quacks and believers in 'natural remedies' to play down the benefits of vaccination, antibiotics and other scientific/medical achievements - without them realizing that this hygiene theory didn't magically pop up out of nothing, but stems from the exact same science that underpins both vaccines and antibiotics.

[Oops, something got badly mangled here... once again, this time proper]
@Michael J. Dochniak, #11

One thing is certain, our ancestors lived in a world wherein the “Hygiene Hypothesis” was inconceivable.

Now that you mention it, “hygiene” is a favorite excuse of quacks and believers in ‘natural remedies’ to play down the benefits of vaccination, antibiotics and other scientific/medical achievements – without them realizing that this hygiene theory didn’t magically pop up out of nothing, but stems from the exact same science that underpins both vaccines and antibiotics.

Louis Pasteur of France and Robert Koch of Germany were studying microbes to figure out how to invent patentable vaccines to kill them.

How many vaccines did Pasteur patent?

Even for the Upper Classes, life could be short.

True, and in the 1970s even some rock musicians understood this:

A bullet had found him
His blood ran as he cried
No money could save him
So he laid down and he died

Interesting trivia I learned in my Google search for that: Greg Lake wrote the first version of this song when he was only 12. It was recorded only because they needed one more song to satisfy their contractual album length.

@herr doktor bimler, #19
I think is is truly appalling how antivaccine fundamentalists try to make even the greatest scientists of all time look bad in order to prop up their paranoid antivaccine world view...

It was recorded only because they needed one more song to satisfy their contractual album length.

You Say France and I Whistle.

^ Comment in moderation re recording contracts has yet another blockquote fail.

@Lawrence # 9

I am also very concerned about critical thinking skills. Dr. Novella made a good post about teaching critical thinking the other day over on Neurologica, and I believe specifically mentioned a study where critical thinking was taught in a history course.

I have an MLIS and when I was in graduate school I taught a course on information literacy to incoming freshman (and a few seniors who needed some easy credits in order to graduate). The course was essentially a primer in how to evaluate literature when conducting research. Nothing really crazy, mostly very basic information literacy techniques. A lot of the students were fresh out of high school, but their lack of trouble-shooting skills and their inability to critically examine any literature or distinguish quality sources from nonsense was pretty troubling. We spent time each week on how to identify and evaluate a different source of information (primary sources, websites, periodicals, peer-review, reference, etc.). I didn't realize that so many students had essentially NO background in research or critical thinking. It was a big eye-opener.

@Eric #10

I didn't mention it in my previous post, but one of the reasons I would NEVER want to live in the 1700s is that as a woman I would have been expected to have child and probably would have died in child birth. Another reason the Mr. Darcy/Elizabeth Bennett crowd annoy the shit out of me, and which has nothing to do with health, is that women and minorities were horribly oppressed back then. I certainly do not want to go back to a time where I wouldn't be able to boat and would be expected to pump out babies and then die before the age of thirty. Definitely I will pass on that. And as you mentioned, most people would be laborers, not a part of the wealthy elite, so the lifestyle these people glamorize is almost certainly not the one they would have lived in those times.

A quick correction: I would not want to go back to a time where I wouldn't be able to vote. What I wrote was "I certainly do not want to go back to a time where I wouldn’t be able to boat..." although don't get me wrong, I am all for women's boating rights.

While thinking about medical history and whether life was really better in the good 'ol days, I once "researched" (translation--rummaged about on the internet) whether the emperors of medieval China, who presumably had access to the best that traditional Chinese medicine had to offer, actually lived longer. This is a nice dataset, with over 200 generations of emperors to chose from.

Answer was no. In fact, numerous emperors died prematurely due to excess consumption of various concoctions of the "elixir of life".

So, TCM isn't the answer either, especially if it recommends large quantities of heavy metals with a liberal spritz of mercury.

Doubtless Pasteur and Koch had seen all the reports in the financial magazines of the great payouts from Big Pharma to those who had patented the numerous vaccines they wanted to manufacture. The immorality of Pasteur in wanting to profit from high-priced anthrax and rabies vaccines, when he knew perfectly well both diseases could be cured overnight with some simple herbal remedies that cost next to nothing, is astounding.

It may be that the word "patentable" found its way into the context of Koch and Pasteur only because Meininger had been given a list of Snarl-words that she was supposed to shoehorn into her screed someshere.

All these ideas about how great the past was, I wonder if the people who think that have ever gone camping?

The BBC has done several programs on farming in various historical periods (Tudor, Stewart, Victorian, Edwardian, WWII) and the one theme in all but the WWII is how *cold* everyone was, all the time. Inside and out.
You read descriptions of what the Victorians wore and you think "wow that's a ton of wool!" But you needed it because home heating, even for the wealthy, was crap and everyone kept their windows open for fresh air.
Historian Ruth Goodman (who was on all those programs and has written several books as well) talks about just how miserable the constant cold was.

Hmm, once in while an idea hits. I may start making a homeopathic pain relief potion. Aspen bark diluted to 30c using 30 yr Glenfiddich. Dose as needed.

You probably can get around the revenuers because it is a medicine.

Being very sarcastic here, I wouldn't want to ruin a good 30 yr old scotch.

Yeah. I just call whiskey tincture of oak.

Being very sarcastic here, I wouldn’t want to ruin a good 30 yr old scotch.

Not to mention the amount of it you would have to discard in the process. I'm not personally into scotch, and even I think that would be a waste of perfectly good scotch.

It would also be overkill. The analgesic properties of ethanol are well known.

20th Century quantum physicists Max Planck and Albert Einstein called this field of energy “The Matrix” [..]

(1) Never start a sentence with a number.
(2) I think she's (I think it's a 'she' (too stupid for malespeak)) is conflating Heisenberg's Matrix Mechanics with an invisible force.

You can see why people like Sheldrake [...] don’t like current science.

Whoa! Sheldrake loves science, he just think that there are forces that haven't been full realized yet.
⁽³⁾⁶⁰⁽¹⁾⁽²⁾⁽³⁾⁽⁴⁾⁽⁵⁾⁽⁶⁾⁽⁷⁾⁽⁸⁾⁽⁹

To a typical 30C homeopathic dilution is in reality a 100³⁰, or 10⁶⁰ dilution. Given that Avogadro’s number is roughly 6[.022] x 10²³, the chances that a single molecule of original substance remains after a 30C dilution is very small, other than carryover contamination on the glassware.

Capillary electrophoresis can measure one fluorescent molecule using a very thin capillary and laser to excite the molecule.
Experimenters were able to measure the neurotransmitters liberated from one single snail neuron using capillary electrophoresis.

Pasteur didn't patent any vaccines. He patented a process for brewing beer, and a process of producing yeast (for beer). He never tried to commercialize either of them.

He didn't actually patent either the rabies or the anthrax vaccines. He did engage in rivalries with other scientists over the development of these vaccines, as a matter of ego.

Justatech:

Even in the 60's, the British styles which migrated to Canada when I was a kid involved layers of woolen knits, tweed and leather. Great in the outdoors, not so much indoors with central heating.

@Narad, #22
I'm not quite sure if I fully understand your cryptic comment, but as there is no way of either previewing or correcting these errors, there's always the conundrum of 'to repost or not to repost'.

About homeopaths and vaccination: some 9 months ago, I lodged complaints with the Dutch Advertising Authority against eight homeopaths for offering 'Homeopathic Prophylaxis' as a viable alternative for regular vaccination, while also proclaiming antivaccine untruths ('vaccines cause autism' etcetera) to further their business.
And while all eight cases were ruled in my favor, these quacks so far failed to comply with the ruling (i.e. that they should remove the offending claims and untruths from their Web sites). And unfortunately, they can do this because the aforementioned authority is a toothless commission, without possibility to enforce actual sanctions(*).
It is rather disheartening. Not only are homeopaths allowed to swindle people by selling them placebos as 'remedies' for existing ailments, even when their quackery clearly puts children's lives at risk by falsely claiming to protect them against potentially life-threatening diseases, there is nothing that can be done to stop them.

*: This is quite a bit better in Australia, where a stubborn homeopath by the name of Frances Sheffield was fined to the tune of $138,000 in all for spreading misleading information about vaccination and for offering useless sugar pills in lieu of real vaccination.

That’s a lot of creative history. And as a history buff, although this is a minor point, I would point out that Mesmer was born after Louis XIV’s death in 1715.

And indeed Louis XIV died 40 years before Marie Antoinette was born, so I for one doubt he cared what she said.

The rest of the article is so completely ignorant it is hard to know whether this was merely a typo or actually reflects Meininger's knowledge of history.

When available, spices were often used to disguise the rancid odor and taste of their food-stuff.

No.

https://historymyths.wordpress.com/2014/10/25/revisited-myth-31-spices-…

20th Century quantum physicists Max Planck and Albert Einstein called this field of energy “The Matrix” [..]

(2) I think [Meininger] is conflating Heisenberg’s Matrix Mechanics with an invisible force.

If we're going to bring actual science into Meininger's crayon-drawing depiction, Einstein was not well-pleased with the Heisenberg-Born matrix formulation, and Planck even less so. But neither Meininger nor the Bolen readership give two tugs on a dead dingo's dick about Einstein's and Planck's actual opinions about "this field of energy". So here scientists become authority figures, to be credited with support for the magical / conspiratorial Bolen world-view, in contrast to the rest of the article where "science" is a boo-hiss snarl-word. She is under a contractual obligation to pass on the lies of her sources and make up a few more herself.

The first report stated that under allopathic care, the mortality rate was 59.2%. When a member of the House of Lords asked why no homeopathic figures were included, the answer was that such information would “skew the results”.

Here Meininger is strike>plagiarising pukefunneling an earlier homeopathic fabulist, who in turn cites Victorian-era fabricators as his authority:
http://www.whale.to/v/winston.html

Capillary electrophoresis can measure one fluorescent molecule using a very thin capillary and laser to excite the molecule.

But only if the molecule is actually present. The point of the sentence you quote is that in a dose of a typical homeopathic remedy, the number of molecules of the alleged active ingredient you expect to have is much smaller than 1. For the 30C dilution example, you expect to have of the order of 10^-36 molecules of the alleged active ingredient in one mole. And the typical dose is often less than a mole: typically tens to hundreds of milligrams if taken in tablet form (a mole of water is 18 g).

And even if there is a molecule of the alleged active ingredient present, how do you know it didn't come from the water you used at one of the dilution stages, or from the wall of the glassware you used at one of the dilution stages? Or it could be in your tap water.

Samil Ozavar is probably Travis J. Schwochert, fuckhead.
Ozavar, major nutbar, is found, with his email address, is found here

Again, I have to give Travis credit - he tries new material, unlike the NitWitOrdure fool.

There's no "probably" about it. He's been banned. Again.

Shay simmons (#38) writes,

MJD says,

Thanks for the reference, Shay.

Below is a reference titled, Beneficial Effects of Spices in Food Preservation and Safety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030248/

Do you still believe that spices have not been used to treat and disguise the unpleasant odor of food?

The article goes on to say that spices have exhibited numerous health benefits in preventing and treating a wide variety of diseases such as cancer, aging, metabolic, neurological, cardiovascular, and inflammatory diseases.

@Orac,

Would this be homopathy?

All you need to know about "paleo" and the good old, old, old days:
https://www.ipscommons.sg/wp-content/uploads/2015/01/cavemencpf-e142129…

In the 18th Century my ancestors lived in ghettos and shtetls under the constant threat of pogrom, extortion, and expulsion, along with daily indignities of all sorts perpetrated by their so-enlightened Christian neighbors.
In fact, Jews tended to suffer a lower incidence of many plagues due to somewhat better hygiene. This lower incidence was just one more reason to blame Jews for causing the plague, so of course another round of pogroms would be needed to teach them the benefits of Christian love and charity.
The only good thing about the "good old days" is that they're over and done with.

The article goes on to say that spices have exhibited numerous health benefits in preventing and treating a wide variety of diseases such as cancer, aging, metabolic, neurological, cardiovascular, and inflammatory diseases.

The authors say so in the abstract, but provide exactly 0 evidence in the body of the review. Indeed, the review reads more like boosterism for the authors' particular passion than a real scholarly review, but then what would you expect from a predatory open access publishing house.

ORD: are they really over and done with? It hardly seems so.

In the 18th Century my ancestors lived in ghettos and shtetls under the constant threat of pogrom

Some of my ancestors live in grand country houses from where they oppressed Irish peasants. It still did not stop them losing numerous children to vaccine preventable diseases.

My 6th great grandmother lived into her 80s though and claimed to have had 27 children. I have no idea how she did that though.

are they really over and done with? It hardly seems so.

In the words of the great philosopher, Billy Joel

"You can linger too long
In your dreams
Say goodbye to the
Oldies but goodies
Cause the good ole days weren't
Always good
And tomorrow ain't as bad as it seems"

With Trump's proposed budget cutting to the NIH and his anti-vaccination beliefs, you may see the Good Olde Days come back with a vengeance.

@Chris: She must have had several sets of twins.

Though I do know a guy who is one of 11 siblings, no multiples.

Then there's 19 and counting. IIRC, the mom in that show nearly died in her last couple of pregnancies. It wouldn't surprise me if her uterus falls outs, packs its bags and yells "I'm going to Disney world!"

Then there’s 19 and counting.
It's NOT A CLOWN CAR.

Is this a common expression in New Zealand or a bimler neologism?
It has not caught on more widely. Despite my best efforts. Not everyone shares my weakness for alliteration

Orac writes,

Is homeopathy the end of vaccines? Only quacks would think so…

MJD says,

Slightly off topic...

Is homeopathy the end of climate change?

I've finished a book about climate change but failed to disclose or recognize a connection between homeopathy and climate change. :-(

Here's a summary of the unpublished book: .

After 4.5 billion years of change, is the planet earth a complex and delicate ecosystem? It is well known that some human activities may be part of a climate-change process that affects global warming. Environmental scientists continue to make substantial progress in our understanding of how such activities affect climate change. Since the year 1989, hundreds of global warming-related patents have been granted by the United States Patent and Trademark Office. Michael J. Dochniak has written this original and important book to provide an easy-to-read summary of such patents. Within many of the summaries, there are inventor profiles and news articles that are insightful and thought provoking. Pioneering inventors hail from many locations including Brazil, India, Japan, Mexico, and Taiwan. At the beginning of several chapters, you will experience contradictory opinions on climate change in the form of quotes. In chapter 7, there is an example of a sincere application that failed to gain US Patent protection. Most importantly, the book "There’s No Place Like Home – Climate Change -Thinking Patents" is about keeping the planet earth a comfortable place to live.

Is there anecdotal evidence that homeopathy could end climate change?

Please advise...

Rachel french, I am curious as to what those fond memories are memories of.
I continue to be surprised at the breadth of topics I have seen here. We have discussed all sorts of things here on RI, but as far as I know we have yet to get around to necrobestiality.

two tugs on a dead dingo’s dick

My first sighting was on Popehat, 2-3 years ago. I've used it a time or two.

HDB: I thought it was good for a laugh until the wife almost killed herself trying to have another baby.

ORD: I have to wonder if this isn't Travis's latest incarnation.

Do you still believe that spices have not been used to treat and disguise the unpleasant odor of food?

Spices are used in the PRESERVATION of food (pickling, specifically). The whole point of preserving food is to prevent it getting rancid and unwholesome, which is why pickling recipes old and new tell you to examine the foodstuff carefully and cull anything that's already started to go bad.

@Dorit Reiss and Chris Preston
This french commenter was pretty amused by the whole "Marie Antoinette / Louis XIV" thing. :)
I suppose Meininger meant Louis XVI, Marie Antoinette's husband.

MJD: I'm sure you don't know this, but humans have a built-in revulsion response to food that's begun to go rancid. No amount of spices will disguise rotten meat. People learned to recognize food borne illnesses early on- think of the prohibitions on pork in the Middle East.
Smoking, salting and pickling are ways to arrest the decomposition process and most groups figured this out pretty quickly. As for spices in the middle ages in Europe, they tended to be used as a display of one's wealth. Not to mention that they taste good.

So how many pages is the latest book? I'm actually kind of surprised you accept climate change, given that you don't seem to know much at all and I would have pegged you for a Republican.

I think Richard has missed something, yes homeopathy is woo but so is vaccination. Replacing one with the other is a double fraud, vaccine isn't science - it's marketing. No one needs them to stay alive and having them does not contribute to health on jot.

PGpig asks,

So how many pages is the latest book?

MJD says,

108 pages (zero misspelled words).

I don't have a publisher yet but that's just the way the ball bounces sometimes.

Here's an example:

BENIGN GLOBAL WARMING SOLUTION OFFERS UNPRECEDENTED ECONOMIC PROSPERITY

(Ace, Ronald S. in Application 20100252647 - October 7, 2010)

Abstract – This describes making clouds.

The author explained that there were upwards to 2-3 times more large trees long ago, which were mowed down by advancing glaciers and are currently transpiring less water, and therefore, are now producing fewer clouds than thousands of years ago; less hydration and fewer clouds now allow more solar energy to warm the planet. Of course, it is obvious that evaporating more water into the atmosphere will eventually produce more precipitation. More precipitation is unavoidable. But the priority is to make more numerous and more persistent daytime-clouds (not nighttime clouds), to maximize the amount of reflected solar energy with a minimum of applied input energy to macro-evaporate water.

@PGPig,

Read the book when it publishes, and stop the squeaking, then I will consider burying the hatchet.

Potblack: "I think Richard has missed something, yes homeopathy is woo but so is vaccination.....No one needs them to stay alive and having them does not contribute to health on jot."

Citation needed. Or you can tell us with supporting evidence why the number of reported measles cases dropped 90% between 1960 and 1970 in the USA. Please do not mention deaths (the census data is morbidity), please do not mention any other decade unless the drop is at least as big (and never goes above again), do not mention any other diseases, and finally do not mention any other country than the United States of America. This is only to keep you on topic with the following 20th century data from the US Census:

From http://www.census.gov/prod/99pubs/99statab/sec31.pdf
Year.... Rate per 100000 of measles
1912 . . . 310.0
1920 . . . 480.5
1925 . . . 194.3
1930 . . . 340.8
1935 . . . 584.6
1940 . . . 220.7
1945 . . . 110.2
1950 . . . 210.1
1955 . . . 337.9
1960 . . . 245.4
1965 . . . 135.1
1970 . . . . 23.2
1975 . . . . 11.3
1980 . . . . . 5.9
1985 . . . . . 1.2
1990 . . . . .11.2
1991 . . . . . .3.8
1992 . . . . . .0.9
1993 . . . . . .0.1
1994 . . . . . .0.4
1995 . . . . . .0.1
1996 . . . . . .0.2
1997 . . . . . . 0.1

I believe that Potblack is Travis J Schwochert.

People learned to recognize food borne illnesses early on- think of the prohibitions on pork in the Middle East.

G-d, I hate this particular line of stupidity. Explain shatnez.

Julian, it may or may not be. I post that census data for the lurkers mostly. No antivaxers have come up with a satisfactory answer, they just try to change the subject.

The idea that people back in the good old days (god) learned to recognize foodborne illnesses is at best a half truth. Yes, smoking, pickling and salting were methods to preserve food longer but were not fool proof.

Many men, women, children died from foodborne illnesses back when and continue to die today (although in far fewer numbers). Just recently, a soy nut butter was directly linked to E. coli o157 h7 contamination. There are at least 29 victims and possibly 2 of them have died.

So tell me how human senses can determine if food contains a contaminant that may kill you? Botulism toxin (develops often in improperly canned foods) is heat stable and has no taste. One of the known vectors for Ebola is contaminated bush meat.

I could go on and on about this. The only reason we don't see more foodborne illness is because we have better medical care, vaccines and at least in the most of the modern world at least some basic food safety regulations (of which trump would like to dump most).

Chris #62: I'm now awaiting an anti-vaxxer's post here saying that "Sanitation" reduced measles incidence!

RobRN, that has been used. Except they can't quite come up with any evidence of a some drastic change in sewer systems and water treatment that was introduced in the 1960s.

This is the most silly answer I have been given:
http://shotofprevention.com/2012/07/26/vaccine-questions-answered-the-r…

It is hilarious.

Julian Frost (#63) writes,

I believe that Potblack is Travis J Schwochert.

MJD says,

Dear Travis J. Schwochert,

With all due respect, please consider lessening Orac's work load here at RI.

Many of us, wrongfully placed in auto-mod, suffer inattention and severely delayed comments because of your deception.

Stick with a nym and accept the consequences thereafter, please...

Understand that auto-mod is not simply a filtering technique to protect the collective (i.e., Orac's minions), it's a way-of-life for those who over-come barriers and make a difference.

Best Regards,
MJD

MJD:Global warming is a good thing, huh? That's a new spin on it. The science seems sort of off, since I don't know if you know this, but rain happens at night too. Seriously, clouds are clouds, they're the same in the morning as they are at night. And I think the Maldives and the Netherlands might have a few bones to pick with you.

As for reading the book, please. I can find ten better novels by just blindfolding myself in the local library. The novels would be more educational.
I don't actually care what you think of me, clack-dish. You're so dim, you make brown dwarf stars look bright. There's no hatchet to bury, as my life would only be diminished by having you around.
Actually, I'd like you to leave the state, and if I had my druthers, orbiting earth.

I'm actually just asking you to maybe be a little less of a prick and maybe consider learning something about the world sometime rather than relying on the echoes that bounce around your pathetic little skull. No wonder you're single. How'd voting for Trump work out for you?

@PGPig (#70),

There you go squeaking again.

Here's the preface for the unpublished book:

As we discover more about climate change and attempt to reduce global warming, intelligence not politics will guide our success. With respect to global warming-related patents, I wrote this book to capture some of mankind’s effort to sustain and protect life on the planet earth., These inventions clearly show that many are proactive, and change their way-of-life, to benefit the well-being of future generations. The book "There’s No Place Like Home – Global Warming – Thinking Patents" has taught me that climate change is manageable.

@PGPig,

Don't you hate politics Politicalguineapig?

Explain shatnez
Let me guess... it's a prohibition against watching scenery-chewing over-acting hams from Star Trek.

Narad et al, I was taught that the likely reason that my ancestors rejected pork was that as the most human-like of quadrupeds, pigs were used as a substitute for humans in sacrifice by some of the people they were trying to differentiate themselves from. Anyone who has ever dissected a fetal pig in an anatomy class or studied their uses as stand-ins for humans in research will confirm the resemblance.
It's also possible that they were rejected,because they will eat both carrion and humans when the opportunity arises. The laws of kashrut rule out terrestrial carnivores, so omnivores wouldn't make the cut either. Pigs also root in the ground for food,which is not an appealing thing for your dinner to be doing.
Kashrut is complicated and the reasons behind the rules have been lost over time, so there is plenty of room to speculate.

"Let me guess… it’s a prohibition against watching scenery-chewing over-acting hams from Star Trek."
Das Güte Doktor, your five-year mission is to live to live that one down.

ORD: Okay, I can see being reluctant to eat pork after examining pig's habits closely, but what about shellfish?

HDB: Oh, my keyboard is so lucky I swallowed before reading that. How Shatner got any serious acting jobs is beyond me.

MJD: Hello, read my nym. I cut my teeth on political blogs and read the papers daily. I wouldn't say I like politics, more that I think paying attention to them is sort of a civic duty.

MJD: intelligence not politics will guide our success.

Well, first you'd have to go FIND some intelligence. Good luck with that, idle-headed waste of space. Look, why don't you go read Bill McKibben, who's actually intelligent and a good writer? I highly doubt you have any insights on the matter that he hasn't already written of, and he's a thousand times better at writing than you'll ever be.

It seems to have escaped your notice that global warming is an international problem, and nothing gets done at the international level without..politics.

By the way, what is your obsession with my 'nym? I explained why I don't use my real name, and most people here don't use their names either. So is this some sort of schoolyard thing? Why don't you go down to the playground and get yourself arrested instead?

I think pigs are generally not eaten because they are so cute: http://cosmouk.cdnds.net/cm/14/31/640x414/53d4e528effea_-_270913-microp…

PGP @59: I'll be that person: actually in some cultures rancid sheep fat is a delicacy. Sadly, it is also strongly associated with a very nasty cancer of the upper airways, so hopefully people will stop eating it soon.
(Based on a paper I read for my epi exam.)

Pigs generally not eaten? Sheeeeeeeet. The saying is that you can use every part of a pig except the squeal.

Pulled pork is practically a religion around here. I, myself, am somewhat of a heathen in these parts, because I will, on rare occasions, BBQ a brisket. Amongst the devout, the only critter fit for the pit is the pig, with the only discussion allowed being do you cook up the whole hog, or just pieces (and which pieces).

"I can see being reluctant to eat pork after examining pig’s habits closely"

That's the very reason why I'm not a cannibal.

Johnny, I hope if you use any wild or family raised hog that you cook it well done. Something both wild (and sometimes family raised) hogs and bears have in common is trichinosis. The last I saw almost all cases of trichinosis in this country are either from undercooked wild or family raised hog or bear. Pork from commercial sources are incredibly safe when it comes to trichinosis.

I saw a pig snout at the Asian supermarket! It kinda looked like this: https://thumb1.shutterstock.com/display_pic_with_logo/1188536/110068070…

I knew what it was immediately. It was by the beef tripe and beef uterus.

At least they're honest. Americans and Europeans just covertly stuff these organs in hotdogs (pseudosausage) and sausages proper. If you've ever had a hotdog, then you've probably had cow penis and cow nipples!

And if you've ever had Spam, then you'd likely eaten porksnouts! Cute, wet, baby porksnouts! http://1.bp.blogspot.com/-XR8Jy61o7Hk/TygxtbMbPOI/AAAAAAAAA58/R54VTBEPQ…

IRT trichinosis, according to https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6401a1.htm
(bolding mine)

Results: During 2008–2012, a total of 90 cases of trichinellosis were reported to CDC from 24 states and the District of Columbia. Six (7%) cases were excluded from analysis because a supplementary case report form was not submitted or the case did not meet the case definition. A total of 84 confirmed trichinellosis cases, including five outbreaks that comprised 40 cases, were analyzed and included in this report. During 2008–2012, the mean annual incidence of trichinellosis in the United States was 0.1 cases per 1 million population, with a median of 15 cases per year. Pork products were associated with 22 (26%) cases, including 10 (45%) that were linked with commercial pork products, six (27%) that were linked with wild boar, and one (5%) that was linked with home-raised swine; five (23%) were unspecified.

I like those odds.

But the chance is zero, anyway. I'm talking about cooking for so long the trichinosis worms die from boredom - 4 to 6 hours (for ribs) to 10 to 12 hours (for pork shoulder), to a day or so for whole hog (I don't cook a whole hog myself, but I know those that do). Low temps, sure, but not so low the little beasties can survive. I try to shoot for 180-200.

The Inuit don't seem to have a sixth sense for rotten food:
http://www.straightdope.com/columns/read/2500/can-tupperware-cause-botu…

@Joymama -- and if you've ever eaten Jello, you've had the rest of the pig.

Who let the vegan in? Btw, I've never seen cow uterus in an Asian grocery store, and I've been going to them since I was in elementary school. So, I'm pretty sure Joymama's making that up.
So,

http://s251.photobucket.com/user/carlylane131/media/IMG_4879.jpg.html

Depends on the store. The Japanese ones concentrate more on live crabs and fish. The Vietnamese stores are the ones with so many organs. They even have canned frozen pork blood.

Depends on the store. The Japanese ones concentrate more on live crabs and fish. The Vietnamese stores are the ones with so many organs.

Depends on the store.

Fuck off, Travis.

Btw, I’ve never seen cow uterus in an Asian grocery store

In my part of the world it's popular in Pacific Islander communities.

KeithB: Uh, you don't need a sixth sense at all, just a working sense of smell. And I'd suspect that northern populations like Inuit, Scandanavian and Lapplanders have a bit of a higher tolerance of microbes than other people.

HDB: Huh. My local one is sort of all purpose; mostly caters to the Hmong community,foodies, Japanese and South Asian community, though they've been adding more Somalian and Indian goods to the inventory, especially since a mosque moved next door. They mostly concentrate on fruits, veg, sauces and seafood, and of course, rice.

Joymama: Ok. That however, doesn't explain why you popped up here all of a sudden.

JoyMama, I've heard about that cow penis in hot dogs.
I hear they also use bull's vaginas.

I don't worry about hot dogs. That's one of the few ways I keep kosher - my uncle used to be chief engineer for Hebrew National, and he would tell us how strict the mishgiach (kosher inspector) was. True, it was a long time ago, but I have seen no reason to think it's changed much.

Fuckin Travis = Tom Morris

Tom Morris is, of course, our scokpuppet Travis.

Banhammer summoned via obscene comment.

ORD: Hebrew National's one of my favorite brands. I haven't had it in a while, but from what I remember they always tasted good.

@PGP #75:

ORD: Okay, I can see being reluctant to eat pork after examining pig’s habits closely, but what about shellfish?

1) Shellfish are scavengers and will eat anything that can't move fast enough to outrun them, including dead and decaying sealife.
2) Several people are allergic to shellfish. My brother in law is one. He once had Chinese takeaway that had been cooked in the same oil as prawns. Within minutes he was vomiting hard.
A lot of the Jewish dietary restrictions have turned out to be sound, even though, as ORD says, the reasoning h=behind them is lost to the mists of time.

A lot of the Jewish dietary restrictions have turned out to be sound, even though, as ORD says, the reasoning h=behind them is lost to the mists of time.

Without the reasoning, it's impossible to say whether they're "sound." Swaths of kashrut are absolute gibberish, such as treifiosity being carried by zeiah.

Oy vey, enough already!

Many Jews will tell you that the kashrut laws have a healthy basis. I love teasing my relatives about this, when they tell me beef is healthier than pork (God didn't know about TB?). Some rabbis will tell you that the dietary laws belong to the category of commandments that cannot be explained rationally. In other words, it's the Word of God, and it is not for us to question, just to obey.

Undoubtedly, someone will now come back with a rabbinical opinion that contradicts what I said above. I don't care--in my experience, when you ask two rabbis a question, you're going to get at least three contradictory answers.

Beef is OK, Cheese is OK. What is wrong with cheeseburgers?

(When my wife worked at a Jewish Community Center I was tempted to ask if a Veggieburger with cheese was OK.)

The origins of this specific prohibition is a biblical clause that said "do not cook a kid (goat's child) in its mother's milk."

In a herders society where people ate their flock, I think it was a nice humanitarian idea - that there is something cruel in using a mother's milk this way. It has less meaning in today's world, and remains more as tradition, but that was the origin.

What is wrong with cheeseburgers?

I spent just over a week in Israel, and as soon as the wheels touched down, I wanted a bacon cheeseburger. There isn't one to be had in the whole country, even at the Embassy.

Once we had wheels-up, the craving went away.

Elliott @100: I've read that at least some of the kashrut laws are about marking inclusion to the group ("we are different from them because we eat X and they eat Y"), which seems to be pretty much the same answer as "God says".

Ooh, now I want kosher-for-Passover Coke. Mmm, sugar Coke.

KeithB, a veggie burger with cheese is perfectly okay under kashrut. Dorit has the origins of the milk/meat separation right, and over time was extended to prohibit all milk products and all meats from being mixed.
Under Talmudic Judaism, the wider prohibition is in the nature of crating "a fence around the law", in other words to make the rule so broad that it' discourages getting close in spirit or in action to the the thing that is forbidden. It should be added that there are likewise positive commandments, not just negative ones, and a long tradition of encouraging the positive acts.

JT--the intent has been argued about ever since Moses descended from Mt. Sinai. However, it does seem to me that the overall effect is certainly to reinforce a group identity,

Enjoy your cane sugar Coke---it's more healthy. God says so.

Understanding the History of HIV

milhayser — Fri, 18 Nov 2016 13:52:41 +0000

Understanding the History of HIV

On Aetiology, Tara C. Smith explores the story of Gaetan Dugas, a man who was long blamed for precipitating the AIDS epidemic in the United States. The vilification of Dugas had nothing to do with science; instead he was dubbed "patient zero" in a misinterpretation of his study moniker "patient O" (for Outside). Dugas' portrayal in the media turned him into a modern Typhoid Mary, but he was not an originator of the U.S. epidemic, as a 2007 molecular analysis proved and a new paper in Nature confirms. Smith writes "This is the real scandal and lingering tragedy of Dugas. His story was used to stoke fear of HIV-infected individuals, and especially gay men, as predators seeking to take others down with them." Does science finally have the clout to revisit such an entrenched media narrative?

In other news, The Verge reports on a man who may hold the key to halting the spread of HIV and AIDS. Patient Z258, as he is known, exhibits natural immunity to "a whopping 98 percent of the de-clawed HIV virus strains the scientists generated in the lab." Understanding the broadly neutralizing antibody that protects Z258 could lead to powerful new treatments for the disease.

milhayser Fri, 11/18/2016 - 08:52

Tags

Mike Adams and "natural biopreparedness" against Ebola and pandemics

oracknows — Thu, 18 Sep 2014 11:00:33 +0000

Mike Adams and "natural biopreparedness" against Ebola and pandemics

This one will be much shorter than usual, mainly because I was out late last night for a dinner function at which I was on a panel of breast cancer experts. I must admit, even after having been an attending surgeon for 15 years, it never ceases to make me feel a bit weird to be presented as a “breast cancer expert”—or an expert at anything, for that matter. It’s rather like how I sometimes feel a bit weird that skeptic groups still invite me to give talks. Ten years ago, I sucked at public speaking. Now I’m apparently good enough that people want to hear me. Go figure.

In any event, I hate to harp on everyone’s favorite New World Order conspiracy mongering quack, Mike Adams (a.k.a. the Health Ranger, or, more appropriately, the Health Danger), but regular readers might remember that a little over a month ago one of Adams’ blogging minions posted a bit on using homeopathy to treat Ebola virus. True to the precepts of homeopathy, the homeopath, Ken Oftedal, recommended finding the blood or bodily fluids of someone suffering from Ebola and then diluting it homeopathically to 30C, which, as you recall, is basically so many dilutions that nothing is left. Of course, aside from the fact that homeopathy is quackery, it was astoundingly irresponsible and stupid of Oftedal to recommend coming into contact with bodily fluids of Ebola victims, given that that’s how the virus is spread. Any homeopath (or person, given that Oftedal gave an explicit recipe for how to make his homeopathic Ebola remedy) who did this and didn’t have the proper protective gear, not to mention the training necessary on how to handle infectious blood and bodily fluids properly, would be at high risk of infecting himself and possibly others, particularly during the shaking of each serial dilution. In any case, this was something too quacky even for Mike Adams, and he took it down in horror, no doubt fearing lawsuits if some hapless and stupid homeopath actually tried to do what Oftedal recommended or if someone actually tried to rely on such a remedy to prevent or treat Ebola.

At the time, some of you thought that perhaps I was being too easy on Adams. The suggestion was that he hadn’t taken down Oftedal’s post because he cared that it was not just quackery but highly dangerous quackery, but rather because it was competition. Back then, I pooh-poohed those suggestions, mainly because Adams has a long track record of quackery and I’m always a bit leery of pulling the “shill gambit” even on a quack like Adams because of how often it’s been aimed at me. It’s a form of ad hominem attack, poisoning the well. Now I have to admit that today I learned that you, my readers, might have been right. Today, Adams posted an article entitled Pandemic Preparedness: The world's most powerful antiviral herbs and natural medicines revealed in free audio recording, which is basically a post touting another Adams project, BioDefense, specifically, an episode of an online “pandemic preparedness” course Adams has put together: Episode 6: Antiviral herbal medicines vs. Ebola and other viral pandemics.

Now, I must admit, I haven’t listened to the whole thing. There’s only so much of Adams smug droning I can take. However, there’s a pretty good summary at the links. In particular, Adams starts right out by saying that “nothing on the planet is proven to treat Ebola.” This is sort of true, if you mean nothing has yet been proven to treat or prevent the disease at its cause: The virus. However, we do know that excellent supportive care can greatly decrease the death rate from Ebola, although unfortunately that death rate, even with the best science-based medical care, remains hovering around 50% or more.

Here’s the part at the beginning of the audio that got me though. Adams goes on and on about how everything he is about to discuss is “experimental” because “nothing on the planet” has yet been proven to treat or prevent Ebola. I nearly choked on my coffee as I heard this. Basically, he’s not-so-subtly implying (OK, he’s basically beating his audience over the head with it) that because science-based medicine doesn’t yet have an effective drug for Ebola and all its currently existing drugs are experimental the “herbal antivirals” that he’s going to talk about are the same: experimental. “Experimental.” You keep using that word. I do not think it means what you think it means, Mr. Adams.

Next up: The argument from antiquity. Adams claims that there is an herbal preparation in traditional Chinese medicine that’s thousands of years old and was used by a practitioner to save “thousands of lives” from a pandemic that was sweeping through China. This reminds me very much of the claim that homeopaths were very successful treating victims of the Spanish flu during the pandemic of 1918; i.e., it’s not very convincing. For one thing, thousands of years ago, no one back then knew what viruses were or even how such diseases spread. In any case, while it is true that there are antiviral drugs that have been derived from plants, it does not follow that using herbs will treat Ebola, which is what Adams is claiming despite all his quack Miranda warnings that that’s not what he is doing.

One herbal preparation he’s real high on is Xi Jiao Di Huang Tang, or the “blood heat formula,” which was developed by Sun Simiao. He’s written about it before. One notes that Sun Simiao speaks of “ymptoms of both excess heat and deficient yin (because the heat has burned up the yin resources)” as the cause. Naturally, there is no evidence presented that anything Sun Simiao used in the seventh century AD demonstrated any utility against infectious disease.

What Adams does claim includes a list of herbs that allegedly treat virals and this:

Chinese Medicine can save millions of lives in a global pandemic, especially if western medicine fails

Western medicine is monopolistic and entirely intolerant. Dogmatic pushers of vaccines and drugs have zero openness to any other system of medicine
Most citizens of the world use plant-based medicine, not pharmaceutical medicine
People who are foolish enough to believe solely in western medicine may pay for their delusions with their lives
Survivors will be people who are open to the full spectrum of available treatments and cures for viral pandemics
The truth about the anti-viral potential of natural medicinal herbs cannot be suppressed forever
Dogma is deadly: The arrogance of western medicine will get a lot of people killed
Things you can start doing RIGHT NOW to boost your immune defenses against viral pandemics

He also claims that you should beware of “western medicines” interfering with the action of the herbs, not the other way around! He’s also into “essential oils,” as well. Not surprisingly, he advertises doTerra OnGuard Essential Oil Blend, which claims to “support the immune system.” In fact, he advertises a bunch of products. One wonders how much he makes off of this advertising.

Of course, it doesn’t matter why Adams is doing this. It doesn’t matter if he’s making money off of it or not, although it’s not a trivial consideration if you first demonstrate how he gets the science and medicine wrong, which I’ve done. In fact, over the years, I’ve shown time and time again how Adams gets pretty much everything wrong. Anyone who relies on his advice to prevent or treat Ebola, much less any other viral pandemic disease, will likely regret it.

oracknows Thu, 09/18/2014 - 07:00

Tags

Antivaccine nonsense

complementary and alternative medicine

traditional Chinese medicine

complementary and alternative medicine

medicine

Being unwilling to feed into the woo that Mike Adams likes to feed his followers, what other remedies does Adams like to tout against pandemic disease?

I ask this because I'd like to compare it to what herbs people actually used in the past against infectious diseases. You know, calling him out on his nonsense.

But Adams is right.

When you consider the many millions of Chinese people who've died in pandemics of cholera, influenza and other infectious diseases - think how much worse it would've been without Traditional Chinese Medicine!

One herbal preparation he’s real high on is Xi Jiao Di Huang Tang

I assume the pun was not intentional.

It's hard to be sure because often many Chinese characters will have the same Pinyin transliteration (especially if you don't use tone markers), but one of the characters transliterated as "xi" means "west". In particular, when that word is used in a medical context, it means science-based, or at least evidence-based, medicine (i.e., Western medicine), as opposed to "zhong" (Chinese) medicine. So I did a double take when I saw the name of that preparation. Perhaps ironically, Adams reminds us to be wary of Western medicine.

So I did a double take when I saw the name of that preparation.

One might hope that rhinoceros horn is in short supply. Way to go, Mike.

Please tell me the "Antiviral herbal medicines" included forsythia in the ingredients... http://www.imdb.com/character/ch0188900/?ref_=tt_cl_t4

(Damn, that movie creeped me out.)

-- Steve

Mikey bills this as a "free online audio course"- which I wanted to audit HOWEVER my computer absolutely refused to play it, probably exhibiting more sense than I did- since I already know pretty much what it'll say..

At any rate, I just had an interesting thought: Mikey lives in Austin, Texas as do Alex Jones, Andy Wakefield, Polly Tommey, Arthur Krigsman, Jake Crosby and probably quite a few other woo-doers... all in one place.

Draconis, do you hear me?

Survivors will be people who are open to the full spectrum of available treatments and cures for viral pandemics

This looks like an excuse to use the evil Western medicine to me.

BUT Science Mom:

Mikey is so outlandishly healthy precisely because he ran away from evil Western medicine yearsago ( see his bio)
or possibly because he lost 60 lbs.

i was sent an urgent message telling me about this launching of Mikey's new site Biodefense.com, on 9/11, from a lovely but quack sibling.

In Mikey's introduction to the series, he mentions that "given that numerous viral pandemics are now spreading which have absolutely no vaccines, antibiotics, etc. . ."

which seems to indicate that Mikey is acknowledging the need for vaccines and antibiotics.

Then he lists all the things we will learn in this course, including "why you already have a genetic blueprint for survival", and "how to activate your genetic miracle that will keep you alive". Apparently via herbs.

His last bullet point promises to treat us to an understanding of "why I'm driven by compassion for humanity and the drive to save lives", which doesn't really have much to do with biodefense but a lot to do with Mikey's wonderfulness. As always. I almost feel sorry for the guy.

#6, Austin is the new California.

One wonders how much he makes off of this advertising.

You know, I can remember when pharma was first allowed to advertize on the telly. It was shortly after the EMS scare and L-tryptophan ban (~1989-1990). That 'contamination', peak-E, was traced to one Japanese plant (Showa Denko) and most likely because of the use of a GMO E. Coli to produce it. Since the evidence got flushed, no one can say...

The first one I saw was a Superbowl ad.. "We're drug companies and we do great things", or words to that effect, and then came the individual Prozac ads with the happy, amorphous bouncy tard animations and the like.

In the first case, I just knew who wonderful 'drug companies' in aggregate must be advertizing against. As for the later and now contemporary ads, I wonder how many billions are spent on advertizing pushing abject shit (Chantrix, anyone? ) instead of actual research for a safe and effective product.

It's pretty clear to me -- If derived from a plant, then it must be somehow re-arranged or mutilated in order to obtain that patent. It's so understood now that I just cry when I lurk on a board and see commenters condemning the prescription (Deplin) natural Folate saying it is just an attempt at Big Pharma to change Folic Acid for a patent and expensive drug.

The obfuscation is pretty thick --

Try this people:

Google 'Folate' and the first result will be wikipedia 'Folic Acid'.

Google 'Folate deficiency' and one does get the right result for Levomefolic acid:

Folate deficiency is a low level of folate (not to be confused with the related synthetic compound, folic acid) in the body.

Naturally, 'folic acid' was not known to the human body until 1943, is a cumulative toxin for many, is made out of petroleum, and is what was mandated after 1998 to fortify our food supply.

Even scholarly articles still confuse the two. Often citing "dietary folic acid" as safe while pointing out the deleterious
effects of supplemented "folic acid". Grrummph.

Tim, do you make a hobby of being wrong about everything? I mean, please do tell me how petroleum could get into an avocado? (Or any of the other natural sources.)

Also, are you a Brit pretending to be an American or an American pretending to be a Brit?

I hate the bold tag here.

Tim, do you make a hobby of being wrong about everything?

Pot meet Kettle. And a damn fine double entendre if I do say so myself.

Why do these quacks rail against medicine & science & then tout all this immune system fol-de-rol? Immune system, that's something from science-based medical inquiry.

Scimom: At least I don't think that there are government agents roaming farms and injecting petroleum byproducts into produce.

THS: Just a guess, but I'd say they're banking on the fact that a lot of people don't understand how the immune system works.

Yes, Mikey, we're "closed-minded" because we "only examine one system of medicine". Just like we're "closed-minded" because the only systems of building skyscrapers we examine are the ones that won't topple from a firm breeze, and the only systems of rocket propulsion we'll examine are those based on the laws of physics.

Hang on - Mikey is advocating Xi Jiao Di Huang Tang? That's ****ing Rhino Horn, isn't it!

I think there are probably a few law enforcement agencies who might want a quiet word with him about that...

Another active area of research and concern is that either too much or too little folic acid in utero causes epigenetic changes to the brain leading to autism spectrum disorders.

http://en.wikipedia.org/wiki/Folic_acid#Pregnancy

Hmm...there's that ~year again -- late '90s

Levomefolic acid ...is the primary biologically active form of folic acid used at the cellular level for DNA reproduction, the cysteine cycle and the regulation of homocysteine. I...The un-methylated form, folic acid (vitamin B9), is a synthetic form of folate, and must undergo enzymatic reduction by methylenetetrahydrofolate reductase (MTHFR) to become biologically active.

http://en.wikipedia.org/wiki/Levomefolic_acid

Pteroylglutamic acid (folic acid), the common pharmacological (USP) form of folate is not found significantly as such in the body. “Folic acid is a synthetic folate form"... “(C)onsumption of more than 266 mcg of synthetic folic acid (PGA) results in absorption of unreduced PGA, which may interfere with folate metabolism for a period of years”

http://doctorsresearch.com/articles4.html

So why is folic acid so firmly entrenched in the public and mainstream professional mind as a vitamin? For the same reasons that mainstream professionals, science writers (who should know better), and the majority of the public think that horse estrogen and human estrogen are the same thing. It’s a combination of a sloppy understanding of biochemistry and some clever patent-medicine-company-supported and -promoted psychology.

http://tahomaclinicblog.com/folic-acid/

One example of this conflation of which I speak:

This study showed an 19% increased risk of breast cancer with folic acid supplements but no increased risk with dietary folic acid intake (Stolzenberg-Solomon, 2006). In summary, the data keeps saying the same thing – dietary folic acid is good for you, but taking folic acid supplements may not have any benefit or may even be dangerous.

http://anti-agingfirewalls.com/2014/01/21/jim-watsons-top-12-list-of-th…

many synthetic vitamins — A, B1, B3 (niacin), B6, B9 (folic acid), and K — are petroleum-derived.

http://smallbites.andybellatti.com/petroleum-its-whats-for-breakfast/

And now, while compiling this list of my wrongness, I just discovered (much to my surprise) that my vitamin C is not a good form, as well.

“In fact, the Food & Drug laws seem to be suspended where synthetic imitations of good foods are concerned, and actually perverted to prosecute makers and sellers of real products…The synthetic product is always a simple chemical substance, while the natural is a complex mixture of related and similar materials…

http://www.doctorsresearch.com/articles4.html

Rebecca @ #18:

Rhino horn? I'm pretty sure they did not use that in American Civil war days (other than to adorn rhinos, of course - maybe the occasional revolver/sword handle).

Which makes me wonder: what herbs *did* people use for infectious diseases back in American Civil War days? Garlic, perhaps? (Shay could better answer this than me, he's the fellow ACW buff on the board.)

@ THS:

One of the most lunatic statements about the immune system I have ever heard was a recent one from Gary Null
( Who else? He's Mikey's role model - see bio @ HealthRanger.com):
People with allergies suffer from a weakened immune system and need to more it stronger ( through ingesting gallons of green juices, supplements and a vegan diet).
There's even a video and book.

need to MAKE it stronger

@ Rebecca Fisher:

You know, a while back, he was selling deer antler 'velvet' as alternative quackery to TCM quackery involving horns. Supposedly it stews up all of those tasty androgens without killing the anilmal because they collect the stuff in the wood.

"It’s pretty clear to me — If derived from a plant, then [the active ingredients in the heterogenous plant extract itself] must be somehow [identified and isolated] in order to obtain [accurate and reproducible dose adminstration across multiple lots]."

Fixed that for you, tim.

Lettuce is made out of petroleum, timmy? Who knew...

Tim:

It’s pretty clear to me — If derived from a plant, then it must be somehow re-arranged or mutilated in order to obtain that patent.

No, you don't have to "mutilate" a substance in order to patent it. Patents protect more than just chemicals. They protect processes too, and also preparations. If you devise a novel means of extracting folate from natural sources and then processing it into a form that can be conveniently added to flour, you can totally patent that, and without modifying the molecule in the least, because it's not actually the molecule that you're patenting in this case.

One example from within the pharmaceutical industry is the patenting of new preparations of old drugs. This is one of the ways they strategically maintain their patent protection even after a patent has expired. For instance, methylphenidate's patent expired ages ago. Not coincidentally, shortly before that, the manufacturer of Ritalin got a patent and FDA approval for a sustained release formulation. The timing was most convenient for them -- it meant that just as the generic manufacturers got the chance to start making methylphenidate, they could start offering a patent-protected alternative that was just a little bit better because the patient wouldn't experience so much fluctuation of the medication during the day. (Ritalin wears off in about four hours, normally. Extended release lasts twice as long.) They could have offered the SR version much earlier, as a benefit to their patients, but as a business case, it was more strategic to wait until they were about to gain new competition. I find this underhanded, but I don't see a good solution at present, at least, not one that wouldn't cause other problems. But it's an example of patenting a drug where the molecule itself is no longer eligible for patent protection.

BTW, I'm pretty sure any patents on folic acid would've expired ages ago, if there ever had been any. And I believe commercial preparations are mainly obtained from genetically unmodified brewer's yeast. (Folate was in fact first discovered in brewer's yeast.) Why synthesize it from petroleum when existing yeasts make it practically for free?

"without killing the anilmal because they collect the stuff in the wood."
No, antler velvet is collected by sawing the antlers off of live animals. In terms of the misery it causes it is probably less horrific than collecting bile from live bears, and unlike other Traditional Chinese Superstitious Bullshit it isn't likely to result in the extinction of species.

@ doug;

You're probably right
so NN deliberately misled its readers by presenting it as a cruelty-free alternative. It was about 2 years ago as an advert for the stuff. No mention of ((shudder)) saws- rather, some variant of " we collect this in the woods" without any mention of the animal being ..uh.. INVOLVED.
But then it IS Mike Adams.

-btw-
I managed to hear MIkey's latest rant ( @ NN, today) wherein @ about 16 minutes in, he speculates that governments can 'balance their budgets' by releasing Ebola in populations who depend on entitlements thus saving money. He goes on to then list all of the governments dodgy actions concerning medical experiments and human rights. " You know how the government works"

@Calli Arcille

Patents protect more than just chemicals. They protect processes too, and also preparations.

Yes, many issues/confusion/conflation. I have been only recently cast into this nutrition area of inquiry, myself. A little knowledge... and all that. Who knew that my first eatings of *real cheeze* (with its attendant high levels of tyrocine) is incredibly contraindiced to my supplementations of 5-HTP and passiflora incarnata?? Well, I do now!

------------------------------------

The nutritional ingredient at issue in this litigation is a dietary ingredient called Folate, which is a B vitamin that helps the body make new cells. Folate is considered a critical supplement for prenatal health, and low folate intake is associated with various vascular, ocular, neurological and skeletal disorders, and may pose a serious risk to individuals with diabetes. While folate does not occur naturally in large quantities it can be found in leafy green vegetables, whole grains, citrus fruits, and organ meats. Tetrahydrofolates are the predominant naturally occurring forms of folate, and in particular, the tetrahydrofolate 5–methyltetrahydrofolic acid (abbreviated as “5–MTHF”) is one of the predominant naturally occurring folate forms

Merck was the first company to manufacture a pure and stable diastereoisomer of L–5–MTHF, a 6S Isomer Product, as a commercial source. Merck's development of Metafolin was the culmination of decades of research and the investment of tens of millions of dollars. Metafolin is one of Merck's most important products.

http://caselaw.findlaw.com/us-2nd-circuit/1673961.html

So, how is it that nobody I'm in contact with seem to know anything about one of Merck & Cie's "most important products"?

-------------------

Also, concerns have been raised about the potentially untoward effects of unmetabolized synthetic folic acid with regard to cancer, depression, and cognitive impairment. With all these concerns, early data suggest supplementation with l-methylfolate rather than folic acid may mitigate these risks.

http://ncbi.nlm.nih.gov/pmc/articles/PMC3218540/

I can't recall where I read *folate* instead of *folic acid* is what is given expectant mothers now, but I *think* it was 2010...

Still, it is the folic acid and not *folate* that is going into the flours, meals, and the like. I *feel* this to be of major significance to many aspects of health. And I, personally, would hate to see my newfound fad get hidden behind a prescription wall over the aforementioned lawsuit or similar -- Brewer's yeast aside.

Tim

Folic acid is the most stable form of the vitamin, so it has a longer shelf life. Naturally occurring folates rapidly degrade and lose their effectiveness. See http://www.fao.org/docrep/004/y2809e/y2809e0a.htm.

1mcg of folic acid has the bio equivalence of 1.7 to 2.0mcg of naturally occurring folate, so as well as a longer shelf life, you also get more bang for your buck.

Hang on – Mikey is advocating Xi Jiao Di Huang Tang? That’s ****ing Rhino Horn, isn’t it!

If there is money to be made from the extinction of a species, you can't expect Mikey to stay uninvolved.

so NN deliberately misled its readers by presenting it as a cruelty-free alternative. It was about 2 years ago as an advert for the stuff. No mention of ((shudder)) saws- rather, some variant of ” we collect this in the woods” without any mention of the animal being ..uh.. INVOLVED.
But then it IS Mike Adams.

Most of the velvet antler production comes from New Zealand, where it provides venison farmers with an extra income stream (if people are fool enough to pay for the stuff, the farmers aren't going to turn down the money). The antlers are sawn off while still part-grown and cartilaginous; NZ is on the ball about animal-cruelty issues, so vets and anaesthetic are involved.

In theory, I suppose you could follow feral deer around the forests at the end of the antler-growth season, collecting the shed shreds of dried 'velvet' before they rot into the soil; I don't think there is a market for that product (which would be about as useless as any other shed skin), but I suppose a sufficiently unscrupulous grifter with a sufficiently credulous readership might try to imply that that' his deer-based scam came from a quaint cottage industry of sustainable gathering.

In theory, I suppose you could follow feral deer around the forests at the end of the antler-growth season, collecting the shed shreds of dried ‘velvet’ before they rot into the soil

I'm very unfamiliar about this whole antler issue, so maybe I'm off base.
But even if you were around just when the antlers fall off, wouldn't the velvet be in a very poor shape? The deers would just have spend the whole mating season locking horns antlers with other males, and occasionally scratching the d@mn things on trees as they are jumping around in the forest.

trying to be smart...
"horns" should have been striked out.

No no no, Helianthus. Every year the stag spends a month or so growing a new attire*, the tines of which are covered with a vascular layer until they have grown and calcified. Then the 'velvet' peels off, or is rubbed off, and only *then* does the stag start the running-headfirst-into-other-stags behaviour..

* Known to some as "antlers", but the true pedant knows that the 'antler' is only the lowest tine on each side, each tine having its own name.

I am currently unable to find any of the adverts I encountered @ NaturalNews but I did dig up an April 2010 article about Daniel Vitalis, who created SurThrival** products including Deer Antler Velvet Gold and Silver: it seems that this product line saved dear, old Mikey when he contracted food poisoning whilst hiking at high altitudes in the Andes- HOWEVER Daniel was unscathed by restaurant-induced misery because he used his own product line regularly.

** Yeah, I know- their creativity knows no bounds

Civil War medicine (I'm assuming US Civil War, yes?) was a mix of good and bad, some really good (plastic surgery advances), some bad (mercury is not terribly healthy). But the herbal remedies were probably very similar to the remedies from 17th-century England; horehound, rosemary, borage, lady's-bed-straw. Mostly a bunch of common kitchen and garden herbs, with the addition of tobacco and laudanum (raw opium in an alcohol suspension).

Effective only if you have something that will clear up on its own. Same as the herbal "alternatives" today, actually, though I doubt anyone back then would willingly eat antler velvet. :)

You guys all seem to enjoy ripping Mike Adams a new one. Is everything he does bad? Is what he does more bad than good overall? It seems like a good thing to me to have a thorough database of so many studies, makes it easier to find them and then read them. A lot of you people seem to be either pharm industry shills or just suckers. The industry has been caught in so much cheating and gouging the public stealing money and health. No doubt the cheating we've found is just the tip of the iceberg. You all seem to be defending that and attacking NaturalNews.

Do any of you have any qualifications to be judgmental on these subjects? I"m trying to get the point of this blog, but I'm just not getting it.

I do know that NaturalNews is very successful and I don't think main stream medicine is helping anybody but themselves. Mike Adams didn't need to corrupt the legal system to beat his competition.

You must be pharm shills, I just don't see anything else that's plausible.

Please correct me if I'm wrong.

"A lot of you people seem to be either pharm industry shills or just suckers. "

Yawn. The old tired and boring Pharma Shill Gambit.

"Do any of you have any qualifications to be judgmental on these subjects? I”m trying to get the point of this blog, but I’m just not getting it."

Many do. Hang around and learn something. So exactly what are Mike Adams qualifications? What is his education?

"You must be pharm shills, I just don’t see anything else that’s plausible.

Please correct me if I’m wrong."

You've hit on it exactly. By far, the most plausible explanation is that you're wrong.

Adams claims to have a "science degree"on his bio ( @ Health Ranger.com) HOWEVER a recent post ( about his experience with poverty) reveals that the degree is in technical writing. He wrote brochures about technology in Taiwan with help in translation from his wife who is Taiwanese.

His also says he has studied natural health by reading alt med books and trying thigs out: AFAIK he has no additional formal education beyond that BS degree.

*Pardonnez les typos*: that's IN his bio and THINGs

Is what he does more bad than good overall?"

If by "bad" you mean "pad his bankroll by peddling falsehoods" then, sure.

Do any of you have any qualifications to be judgmental on these subjects?
If by 'qualification' you mean 'willingness to rant on any random topic after the third pint of beer', then I believe I have that.

elsworthy @#36:

I generally don't consider laudanum to be an "herbal" product, even though it was partially derived from plants.

As for the mercury salts they used with impunity back then, that does put the anti-vaxers' squwaks about tiny amounts of mercury in vaccines in perspective. Maybe we should remind them of *that* the next time they get all verklempt about "teh ebil toxinz" in vaccines.

Do any of you have any qualifications to be judgmental on these subjects?
If by ‘qualification’ you mean ‘willingness to rant on any random topic after the third pint of beer’, then I believe I have that.

Is that all we need? I'll start posting more often!

*jumps up and down excitedly*

I'd rather take Mike's advice than any from traditional glorified pharmaceutical doctors out there. I have seen so many people die needlessly at the hands of the big pharma. I, myself have been helped tremendously by naturopathic doctors after allopathic ones almost killed me. I am a living witness to the miracle of herbal and natural remedies.

Yawn! Michele Wright, can't you come up with something more original the old tired and boring Pharma Shill Gambit? Have you ever considered using evidence and data instead of unverifiable anecdotes?

Yawn! Woozie wozzie woo woo! This dipshit is a fraud.

bic, tired from geting pwned again and again, using the playbook of patimmy?

I have seen so many people die needlessly at the hands of the big pharma.

Please name three. Describe precisely what they died of and why it was needless.

I, myself have been helped tremendously by naturopathic doctors after allopathic ones almost killed me.

Please provide details and documentation. What was done for you, what were you suffering from, and why do you credit naturopathy for your good health, assuming you have same?

I am a living witness to the miracle of herbal and natural remedies.

Please provide both justification and evidence for this. Thanks.

Pertussis outbreaks and vaccine effectiveness

oracknows — Wed, 05 Sep 2012 02:00:53 +0000

Pertussis outbreaks and vaccine effectiveness

About a month ago, I deconstructed a typically dishonest and deceitful attempt by that Overlord of Quackery on the Internet (in my opinion, of course), Joe Mercola, to claim that the acellular pertussis vaccine doesn't work. It was a typical Mercola bit of prestidigitation that, as so much antivaccine propaganda does, took a grain of truth (that there have been outbreaks among vaccinated populations) and ran with it to construct a fantasy world in which pertussis outbreaks are somehow an indictment of all vaccines, which, of course, don't work at all, ever, under any circumstances, anywhere at least in the minds of antivaccinationists.

Perhaps the biggest difference between science-based doctors and quacks is a very simple one. When a treatment or preventative measure isn't working as well as it should, we science-based physicians ask why. We try to find out what is not working optimally. We try to figure out how to make things better. So it is with the acellular pertussis vaccine. It's no secret that recent outbreaks have been notable for a large contingent of vaccinated children being involved. Indeed, I cited two studies that both basically agreed that there appears to be a hole in the vaccination schedule that leaves children in the 10-12 year age range inadequately protected, such that the attack rate is nearly equal in vaccinated and unvaccinated or undervaccinated children during the outbreaks was nearly the same. Antivaccinationists love to cite these studies, but what they always leave out is the finding that the acellular pertussis vaccine is effective in protecting younger children and also in protecting teens who have received the recommended booster at age 11 or 12.

In other words, antivaccinationists willfully invoke the fallacy of the perfect solution (also known as the Nirvana fallacy), which I like to liken to an old sketch Mike Myers back when he was on Saturday Night Live in which he played a Scotsman who would loudly say, "If it's not Scottish it's crap." Basically, under this fallacy, if a vaccine doesn't work perfectly 100% of the time, it's crap. If it isn't absolutely, positively, 100% safe, it's crap. If it fails, even just once, to protect against the disease it's designed to protect against, it's crap. Never mind that nothing in medicine is 100% effective and safe and the only certainty in medicine (and life) is that all of us will one day die.

None of this is to say that we shouldn't strive to improve the acellular pertussis vaccine or improve the vaccine schedule, and that was the topic of a recent paper in the New England Journal of Medicine by Dr. James D. Cherry, a pediatrician at the David Geffen School of Medicine, University of California at Los Angeles, Los Angeles entitled Epidemic Pertussis in 2012 — The Resurgence of a Vaccine-Preventable Disease. He begins by noting that we are currently experiencing what may turn out to be the largest outbreak of pertussis in 50 years, asking the question: Why has this theoretically vaccine-preventable disease been on the upswing? Several answers are forthcoming, but here's a graph of pertussis versus time:

It's first noted that whooping cough is a cyclical disease. In the pre-vaccine era, there were epidemics every two to five years. Although vaccination was wildly successful in reducing the incidence from 157 per 100,000 in the 1940s to 1 per 100,000 in 1973, infection does not, contrary to the claims of antivaccinationists that "natural immunity" is permanent, produce lifelong immunity; neither does the vaccine. Cherry notes that this is in marked contrast to, for example, measles, for which immunity due to the vaccine is much longer. So now, even though there isn't as high an incidence of whooping cough, the causative organism, Bordetella pertussis is still circulating in a manner similar to the way it did in the pre-vaccine era. Until recently, it just wasn't causing epidemics the way that it did before.

Cherry tells us that there are actually two relevant issues to consider: The epidemiology of reported pertussis cases and the epidemiology of pertussis infection. He notes that existing studies suggest that 13 to 20% of prolonged coughs in adolescents and adults are likely due to B. pertussis infection, and studies examining antibody titers suggested an infection rate between 1% and 6%. In other words, there's a lot of mildly symptomatic pertussis out there, which leads Cherry to ask:

So what are the causes of today's high prevalence of pertussis? First, the timing of the initial resurgence of reported cases (see graph) suggests that the main reason for it was actually increased awareness. What with the media attention on vaccine safety in the 1970s and 1980s, the studies of DTaP vaccine in the 1980s, and the efficacy trials of the 1990s comparing DTP vaccines with DTaP vaccines, literally hundreds of articles about pertussis were published. Although this information largely escaped physicians who care for adults, some pediatricians, public health officials, and the public became more aware of pertussis, and reporting therefore improved.

Antivaccinationists will no doubt scoff at this suggestion the same way that they scoff at any suggestion that the increased prevalence of autism over the last 20 years could possibly be due to greater awareness and intensive screening programs, but as I've pointed out before, it's a truism in medicine that whenever you look for a disease you will find more of it—sometimes a lot more, particularly if you use more sensitive tests or broaden the diagnostic criteria (the latter of which was done for autism in the early 1990s).

Even though I've used this example within the last six months, it bears repeating because it's in my specialty and it illustrates the concept. Basically, the same sort of thing happened when mass mammography screening programs were undertaken with an entity called ductal carcinoma in situ (DCIS). This is a premalignant precursor of breast cancer, some proportion of which will progress to full-blown cancer. Basically, it’s cancerous cells that haven’t broken out of the breast ducts yet to invade the surrounding tissue. A few decades ago, DCIS was fairly rare because by the time it grew large enough to be a palpable mass, it almost always had become invasive cancer. Now, thirty years or so after mass mammographic screening programs began, DCIS is common. In fact, it's the most common diagnosis of breast cancer made, making up approximately 40% of breast cancer diagnoses Once again, I'll cite a recent study that reported that DCIS incidence rose from 1.87 per 100,000 in the mid-1970s to 32.5 in 2004. That’s a more than 16-fold increase over 30 years. There's no reason to suspect that the "true" incidence of breast cancer is increasing. (Indeed, it's not.) So that implies that this increase was pretty much all due to the introduction of mammographic screening. Other examples abound in medicine, including hypertension, hypercholesterolemia, and others.

Cherry suggests that one factor behind the rise in pertussis lately is similar:

Moreover, during the past decade, polymerase-chain-reaction (PCR) assays have begun to be used for diagnosis, and a major contributor to the difference in the reported sizes of the 2005 and 2010 epidemics in California may well have been the more widespread use of PCR in 2010. Indeed, when serologic tests that require only a single serum sample and use methods with good specificity become more routinely available, we will see a substantial increase in the diagnosis of cases in adults.

In other words, some of what's going on here might just be overdiagnosis, in which mildly symptomatic cases or cases that aren't that serious are picked up that once might have been dismissed as a persistent "crud." Clearly, though, that's not the only thing going on. Two other issues are likely also contributing. The first is the issue that I discussed before, namely waning immunity from the acellular pertussis vaccine. Cherry cites five studies showing that the old DTP (the whole cell pertussis vaccine combination with the tetanus and diphtheria vaccine) was more efficacious than the DTaP (the acellular pertussis vaccine combination), as well as the California studies whose misuse by Mercola I discussed before. One needs to remember that the switch from the DTP combination vaccine to the DTaP combination vaccine was largely due to concerns about the safety of the DTP back in the 1980s that led to the rise of Barbara Loe Fisher and her antivaccine group the National Vaccine Information Center (NVIC) over reports of encephalopathy after the vaccine, fears that later studies failed to confirm. So, in essence, we traded a highly effective vaccine for one that's effective, but not quite as effective.

Finally, there's this:

Finally, we should consider the potential contribution of genetic changes in circulating strains of B. pertussis.4 It is clear that genetic changes have occurred over time in three B. pertussis antigens — pertussis toxin, pertactin, and fimbriae. In fact, changes in fimbrial agglutinogens related to vaccine use were noted about 50 years ago. Studies in the Netherlands and Australia have suggested that genetic changes have led to vaccine failures, but many people question these findings. If genetic changes had increased the rates of vaccine failure, one would expect to see those effects first in Denmark, which has for the past 15 years used a vaccine with a single pertussis antigen (pertussis toxin toxoid). To date, however, there is no evidence of increased vaccine failure in Denmark.

These are the observations behind the claims by cranks like Mercola that vaccines are "causing dangerous mutations." While it is possible that the B. pertussis bacteria is developing "resistance" to the vaccine through natural selection, the evidence that it is doing so strikes me as rather weak and preliminary. Even if it were, the answer would be to change the vaccine in order to include the altered antigens. After all, do we decide that antibiotics don't work when bacteria evolve resistance or that chemotherapy doesn't work when tumors manage to do the same? That's a rhetorical question, of course. Some segments of the alt-med world do, but reasonable scientists do not. They work to overcome that resistance.

Leaving aside that hypothetical problem that might be contributing to pertussis epidemics in the era of the acellular vaccine, what can be done to bring these epidemics under control? Some of what Cherry mentions are the same things I mentioned the last time I discussed this issue. First, he notes that the purpose of vaccination against B. pertussis is not to eliminate all disease. It's to prevent serious disease with its potentially horrific complications, up to and including death, particularly among young infants. One possible approach would be to start DTaP at a younger age with shorter intervals between doses. Another strategy is to immunize pregnant women in order to reduce the risk that the mother will acquire pertussis around the time of delivery, with the added bonus that it would give the infant some protection for a month or two through maternal antibodies.

The point of course is that these recent epidemics, while they point to problems with the current vaccination schedule, do not by any means demonstrate that the vaccine doesn't work or that it's failed.

I also have one final point. While the evidence that pockets of unvaccinated children are the nidus for measles outbreaks is very clear, these latest pertussis outbreaks do not appear to be strongly related to pockets of unvaccinated children. There's no doubt that having pockets of unvaccinated children doesn't help. They are, after all, at a 23-fold increased risk of catching whooping cough, which allows for the degradation of herd immunity at the very least as well as providing a reservoir for the offending bug, and even the latest studies out of California indicate that for most age ranges unvaccinated and undervaccinated children are at a significantly higher risk of catching pertussis than fully vaccinated children; the problem is primarily at one age range where waning immunity from the DTaP leaves a gap in immunity. However, in this case, as far as I've been able to tell, they do not appear to be the primary drivers of these most recent epidemics, as they are for measles outbreaks. We as science-based supporters of vaccination have to be careful not to overstate our case.

Would that antivaccinationists would do the same. Actually, would that antivaccinationists would actually stop spreading misinformation. The difference between science-based supporters of vaccination and antivaccinationists is simple. We face reality. Evidence and science matter to us. When vaccines do not function as well as we would like and try to fix it. As Cherry reminds us, even with these new epidemics, today's incidence of pertussis is still about one twenty-third what it was during a typical epidemic year in the 1930s. Indeed, a reader sent me a link to a presentation by Thomas Clark, MD, MPH about pertussis epidemiology and vaccination. This slide set includes a slide that takes the slide above and puts it in context:

That rather puts the antivaccinationists' attacks on the acellular pertussis vaccine into perspective, doesn't it? Indeed, I can't help but note that the graph above shows the total number of cases. Because the U.S. population has grown considerably over the last 90 years, if it were graphed by incidence, the effect of the vaccine would be even more striking. In any case, this graph illustrates quite clearly that the pertussis epidemics over the last few years are mere blips on the curve compared to what we saw in the past, before there was a vaccine available to combat pertussis. Still, although this is good, it is not nearly good enough. We can do better. Contrary to what antivaccinationists tell us, recent outbreaks of pertussis do not mean that vaccines don't work. They mean that we need to use the vaccine we have better and possibly develop newer vaccines that overcome the shortcomings of the existing vaccine.

oracknows Tue, 09/04/2012 - 22:00

Tags

I know the vaccine schedule in Denmark is different from the US: they don't vaccinate against Hep A or B, for example.

They also have a different timeframe for the MMR and DTaP - with the 2nd MMR dose at 4 years, and the DTaP at 5 years, where a lot in the US get it at 4 years (even though the range is 4-6).

Might be part of the reason there's no incidence of increased vaccine failure.

Here is some of the evidence that natural immunity is only mildly longer lasting than vaccine acquired immunity.
http://journals.lww.com/pidj/Fulltext/2005/05001/Duration_of_Immunity_A…

Range for natural immunity is 4-20 years, for vaccine-induced immunity it is 4-12 years, with little tangible difference between wP and aP vaccination, though some observations suggest wP-induced immunity is more durable. The experience of differing vaccination schedules seems to have given rise to much of this evidence for duration of immunity.

However, I should also point out that more recent epidemiological analysis suggests natural infection induces immunity that may be around 30 years on average, but which is very variable.
http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppa…

Orac - I mentioned this in the anti-vaccine thread a few days ago, but here in the UK the Department of Health is considering vaccinating newborns against pertussis.

From January to August we had three times as many cases* as in the whole of 2011, and babies have already died.

www.bbc.co.uk/news/health-19454493

*Mumps has quadrupled, I believe measles cases have doubled. These are confirmed cases only.

Infectious disease data for the UK is here: www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/

dingo199,

I recall reading somewhere that one way to reconcile these is for the actual ‘natural’ immunity to be quite short, but for some people to get sub-clinical infections that effectively act as boosters. (It might be the first of the two papers you cite, actually; haven't time to revisit it to check - excuse me for that.)

I ran some numbers on the Washington state pertussis outbreak and unvaccinated/undervaccinated have higher attack rates:

Attack rates for vaccinated (ARv) and un/der vaccinated (ARn) are as follows:

Ages 5-9: (ARv) 500/411023 x 100 = 0.12%
(ARn) 159/21633 x 100 = 0.73%

Ages 10-13 (ARv) 356/329076 x 100 = 0.11%
(ARn) 469/17320 x 100 = 2.7%

Ages 14-18 (ARv) 477/431968 x 100 = 0.11%
(ARn) 141/22735 x 100 = 0.62%

As we can see, more un/undervaccinated children have been infected with pertussis than fully vaccinated across all age bins. This translates to children ages 5-9 un/der vaccinated children are 6 times more likely to become infected with pertussis than fully vaccinated. Children ages 10-13 un/der vaccinated are 25 times more likely to become infected with pertussis than fully vaccinated. And un/der vaccinated children ages 14-18 are 6 times more likely to become infected with pertussis than fully vaccinated.

http://justthevax.blogspot.com/2012/08/washington-state-pertussis-outbr…

Grant, that is probably very true, and is referred to in the PLOS article. It certainly applies for diseases like chickenpox and measles, where natural boosters keep immunity topped up.

This bit of the PLOS paper was interesting:

Accurate assessment of the duration of immunity after natural infection or vaccination is crucial for pertussis control, and yet our understanding of immunity to pertussis is limited. The central obstacle is that despite a great deal of clinical research, it remains impossible to correlate protection against pertussis with a quantifiable immune response against a single protective antigen [16]–[18]. This is partly because, in contrast to other vaccine-preventable bacterial infections, such as diphtheria or tetanus, where antibodies are known to protect against the toxin that mediates disease, pertussis produces a range of toxins including pertussis toxin, endotoxin, adenylate cyclase toxin and tracheal cytotoxin, which are known to play a role in pathogenesis and immune evasion [19]. Immunity to pertussis is further complicated by the production of numerous virulence factors (filamentous hemagglutinin, pertactin and fimbriae) that aid bacterial persistence in the respiratory tract. Moreover, in addition to binding to epithelial cells in the respiratory tract (which facilitates extracellular multiplication), pertussis also survives within macrophages and other cell types, an observation that argues for a role for cell-mediated as well as humoral immunity in protection [19],[20].

Much of the pertussis work stems from the era predating widespread use of the acellular vaccine. Our concepts about vaccine-induced immunity will probably change to account for this.

Also interesting is the idea that pertussis control is still an achievable goal through vaccination

In turn, the implications of these observations are that (i) natural pertussis infection induces, on average, considerably long-lasting immunity, (ii) repeat infections contribute relatively little to the transmission cycle, and (iii) secondary exposures generate few infections (and may lead mostly to immune boosting). Taken together, these conclusions raise doubts over the impact of repeat infections in pertussis dynamics. If correct, these findings represent reasonably encouraging news for pertussis control, indicating that a reduction in prevalence (and an increase in the CCS) is possible with continued focus on increasing vaccine uptake and reducing both primary and secondary vaccine failure.

Sequencing is so cheap now, if people are hypothesizing "vaccine-driven" evolution it should be a trivial to sequence several historical strains, assuming some are in freezers that haven't been passaged too many times, and modern epidemic strains from wherever.

The genome is like 4mb, that means you can multiplex 4 or 5 strains per Illumina lane so like $3500 per 4 strains sequenced.

Very nicely written article.

The periodic nature of outbreaks leaves mlimited confused than usual. Does anyone have a proposed mechanism for why we observe three to five year surges in cases?

- pD

OT ( but it's a dreary, grey day and I thought some of you might be entertained by the inverse of brilliance- which is NEVER OT @ RI)

Mike Adams ( Natural News) informs us that the recent review ( Annals of Internal Medicine)- that compares organic and conventional foods and found no important health differences- is nothing but a "media psyop" ( his neologism).

But, but, but, he sputters, they don't consider GMOs, artificial sweeteners and growth hormones.

Obviously this is but another example of media lies! Just like those told about vaccines!

The periodic nature of outbreaks leaves mlimited confused than usual. Does anyone have a proposed mechanism for why we observe three to five year surges in cases?

That's a good question that isn't really understood. My guess would be that it has to do with the ebb and flow of susceptibles reaching a critical mass during peaks.

It was a typical Mercola bit of prestidigitation that, as so much antivaccine propaganda does, took a grain of truth [...] and ran with it to construct a fantasy world

That summarizes much of the usual modus operandi of alt-meds.
Start from something real (vitamine C is good for you, cancer cells crave for glucose, vaccines have side-effects...) and just extrapolate an exponential curve from this single point.
It makes rectifying their deluded theories all the more difficult.

pD, the usual explanation for cyclic peaks of infectious disease is that there are regular epidemics which become established only when the herd immunity level has declined to a sufficiently low level to precipitate one, so it is a function primarily of the infectiousness of the agent (R0) and the duration of protective immunity following infection.

This is rather simplistic, but in the prevaccine era we did see very regular cyclical patterns primarily for these reasons.

However, things can get thrown off very easily. There is an underlying stochastic element to all these cycles, and population variables have an impact in a way they never did before. These include overall size of the population/communities, frequent movement in and out of populations, varying birth rates and therefore variable cohorts of infants, varying recognition and antibiotic treatment of cases affecting transmission dynamics etc, the picture can get muddled quickly.

The clinical nature of pertussis cases is important too. We may always have seen largely asymptomatic or trivially symptomatic cases in adolescents/adults which were never diagnosed. These may have acted to help boost self and herd immunity. Today, because of greater awareness and better diagnostic techniques such as PCR there are more being diagnosed as clinical pertussis cases. However it is only those cases which have persistent cough/symptoms who may directly affect ongoing transmission, but even these cases are likely to be less infectious than a primary case of pertussis.

@dingo199

Pertussis could, theoretically, be eliminated, as there are no known non-human reservoirs. Granted, there are more strains than we currently immunize against, so completely wiping out pertussis is not something likely to happen in the near future. Then there are the related Bordetella species that produce illnesses similar to pertussis.

Finally, we should consider the potential contribution of genetic changes in circulating strains of B. pertussis

Eh, if it's true, it's evolution in action: the strains which are able to bypass whatever we use to keep them at bay are being selected.
We don't exist in a vacuum, but as part of a big ecosystem, so that would not be a surprising discovery. Welcome to round 2 of the fight :-)
It's an issue, but one we can handle. To some extent, we are confronted with something similar with influenza - a pathogen whose dominant strains keep changing from year to year.

I was reading somewhere how prevention measures for HIV are much better than post-infection treatment, from a natural selection prospective:
- with prevention, you limit the number of people the pathogen have access to. Aggressive strains will be less likely to propagate, as they are more likely to kill their host before he/she meet someone they can infect. So we end up selecting strains which do less damage to the host.
- if focusing on treatment only, we are more likely to select aggressive, fast-replicating strains, as their time is limited: the pathogen needs to jump to a different host before the current host receives medication.

Conclusion: don't bypass prevention. Even if it looks like it's backfiring and the pathogens learn how to get around it. They will do it anyway with anything we do. And if we are lucky, we can force the pathogens to be more tame.
Of course, allotting resources for both prevention and treatment is even better...

perspective, not prospective.
Sorry, ESL. And me thinking I was bilingual. Still plenty of room for learning...

"Does anyone have a proposed mechanism for why we observe three to five year surges in cases?" -- For juveline disease with initially high post-infection immunity, it takes a while to build up a supply of new customers. Think of [generally more regular] predator-prey cycles in the Arctic, or the re-release strategy of Disney cartoon features!

pD, you might try and look at these articles, however I am struggling to even understand their titles, never mind the body of text!

Opposite patterns of synchrony in sympatric disease metapopulations

Persistence, chaos and synchrony in ecology and epidemiology

( I have stripped the links out as they seemed to get caught in the spam filter)

IMO, the implementation of the recommendations for a Tdap vaccine for children 11 years old and older and for any adult who expects to be caring for, or have close proximity to, an infant less than one year of age...is only a stopgap measure.
In February, 2012 that Tdap boosting recommendation, in lieu of the 10 year Td booster, was extended to those age 65 and older.

Presently, the Tdap booster is a "one time only" booster. The CDC, IMO, will have to recommend Tdap boosters every 10 years, in place of, the every-ten-year Td boosters.

Here's a CDC website showing States with enhanced surveillance activities:

http://www.cdc.gov/pertussis/surv-reporting.html

Enhanced Pertussis Surveillance (EPS)

CDC has partnered with six states (CO, CT, MN, NM, NY, and OR) participating in the Emerging Infections Program (EIP) network to conduct enhanced surveillance of pertussis and other Bordetella species. EPS is characterized by enhanced case ascertainment and augmented data collection that goes beyond what is requested nationally through NNDSS. Participating sites collect isolates and specimens, when available, for further characterization at the CDC Pertussis and Diphtheria Laboratory. EPS sites also provide the infrastructure for conducting pertussis special studies including those aimed at evaluating pertussis prevention and control strategies.

@ Ikr

the re-release strategy of Disney cartoon features

I like the analogy. A good Disney movie sure can go viral :-)

The CDC has already provided some figures for uptake of Td 10-year boosters for individuals in various age groups, to evaluate the uptake of the newly recommended one-time dose of Tdap vaccine. The study was conducted to determine self-reported tetanus coverage by posing the question, "Have you received your tetanus shot within the last ten years?" We have a lot of work to do to encourage people to get their Tdap vaccine:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5940a3.htm

@science mom + dingo199 + lkr -

Thanks and interesting thoughts. I guess (?) age adjusted rates over the surges might inform this question somewhat.

I wonder, are there other childhood diseases that followed similar patterns? Maybe this is a function of my information filters that I don't know the answer to this; are there (somewhat) predictable patterns to Hib, or diphtheria, or other diseases? Some patterns are pretty clear, flu in the winter, but other than that, I havent seen such temporal patterns mentioned for other

If a waxing and waning susceptibe population is at the heart of this, shouldn't a similar pattern be visible for lots of diseases? Does the fact that there are no known non human reservoirs inform this question in some way?

@lkr - disney analogy very much appreciated.

iPad / typos / trying to avoid the network overlords. Sorry.

pD:

If a waxing and waning susceptibe population is at the heart of this, shouldn’t a similar pattern be visible for lots of diseases? Does the fact that there are no known non human reservoirs inform this question in some way?

It is very common. If you look at the CDC Pink Book Appendix G you will see there are oscillations for measles and polio. In this old paper, Mass measles immunization in Los Angeles County, explains how they calculate susceptible numbers for an expected epidemic year.

@chris -

Very nice!

I wonder, are there other childhood diseases that followed similar patterns? Maybe this is a function of my information filters that I don’t know the answer to this; are there (somewhat) predictable patterns to Hib, or diphtheria, or other diseases? Some patterns are pretty clear, flu in the winter, but other than that, I havent seen such temporal patterns mentioned for other

Measles had a cyclic ossilation but mass vaccination has interrupted that. Hepatitis A seems to have a ten year cycle. As far as I know, Hib and diphtheria do not have cycles but do have seasonal peaks. Meningococcal disease seems to have epidemic peaks in under-developed countries but not developed.

If a waxing and waning susceptibe population is at the heart of this, shouldn’t a similar pattern be visible for lots of diseases? Does the fact that there are no known non human reservoirs inform this question in some way?

A critical mass of susceptibles isn't the only reason for some oscillations observed in infectious disease epidemiology. There are numerous other factors such as infectivity, host factors, immune duration and so on. For example, Hib disease is almost exclusively observed in children less than five years old. Children less than two years old do not adequately mount antibody responses to polysaccharide coats as what is on Hib and pneumococcal spp. This is a host factor. Hib is a transient commensal organism (not so much anymore but I'm thinking more pre-vaccine) which would periodically boost immune response as well as become an opportunistic pathogen. This is an ecological and infectivity factor. So you can see that it isn't as straightforward as something like measles.

More on measles epidemic cycles:
http://asi23.ent.psu.edu/publ/bcf/bcf1.pdf
http://asi23.ent.psu.edu/publ/bcf/bcf2.pdf

Spoiled slightly by the authors' inability to spell "Ipswich"

@Science Mom -

http://i.imgur.com/3w1ej.gif

- pD

Very cute pD. :D

And another one, this time looking at how outbreaks will differ when they affect more highly vaccinated populations.
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed…

Looking at these pertussis statistics, I wonder why boosters aren't pushed more for adults - whether you have a baby in the family or not? This demographic must be quite a welcoming reservior for pertussis if boosters are neglected. Perhaps the health system is a bit more proactive beyond our shores, but here in NZ, boosters don't seem to be pushed at all (correct me if I'm wrong Grant, Alison, et al.). I agree that the focus should be on the most vulnerable population, but what good is this if only a small portion of the herd are immune?

@Hinterlander

In the U.S., pertussis boosters for adults haven't really been pushed until recently, when research started to discover that adults tended to be the ones passing pertussis along to kids, thanks to waning immunity (from either infection or vaccination) and the generally (though not always) milder manifestation in adults. For as long as I can recall, adults were only recommended to get Td boosters. A couple years ago, I had to ask my doctor for the Tdap instead (I decided to be proactive, considering the CA outbreak in 2010). Since then, when I've talked about pertussis or tetanus boosters with people, I always recommend that, if it's been a few years, they ask their doctor for the Tdap, emphasizing that they should ask for a pertussis booster, so they get the right shot.

Yet another factor in measles outbreaks...with the history of the last major outbreaks late 1980s-early 1990s in the USA...which resulted in the decision to add a second dose of measles vaccine to the Recommended Childhood Vaccine Schedule:

http://www.chop.edu/service/vaccine-education-center/a-look-at-each-vac…

"Why do children have to get two doses of MMR vaccine?

In the early 1990s, a second dose of the MMR vaccine was recommended. This recommendation was made because outbreaks of measles swept across the United States in the late 1980s and early 1990s. Most of the people who were infected with measles during these epidemics were adolescents and young adults. An investigation of what went wrong found that many people who caught measles had never been immunized. So the primary reason for recommending a second dose of MMR was to give children two chances to get one vaccine.

The other reason that a second dose of MMR vaccine was recommended was to allow for more children to develop a protective immune response. About 95 of every 100 children will develop immunity after one shot, but about 99 of 100 children will develop immunity to measles after two shots. Immunizing that additional 4 percent of children is important when trying to protect against a disease as highly contagious as measles."

The addition of mumps and rubella vaccines in this recommendation increases the percentage of children who develop immune responses to those viruses as well.

Misplaced quotation marks; need to close the quotation at the end of the last sentence of my post.

I think I had whooping cough in mid 1990s; had vax in late 2010.

@ Todd W.

Hopefully NZ will follow suit soon. I've often thought that our Ministry of Health could use the annual flu vaccine media campaign to remind the public to check that their other vaccines/boosters are up to date. There are probably other confounding factors here such as funding, etc, that I'm overlooking.

@ lilady - I never knew that about the MMR vaccine. That's very interesting.

@ Hinterlander: IIRC, the second dose of mumps vaccine was recommended in the USA in 2006...because of large outbreaks in previous years and active surveillance of those outbreaks.

Prior to that year, single antigen mumps, measles vaccines and rubella vaccines were still being manufactured and available in extremely limited number of doses.

Imagine then, the parents who would search for and got single antigen vaccines for their children, because of their belief that triple antigen MMR shots could overload their children putting them at risk for autism. Most of the children (~ 95 %) were immune to measles with only 1-single antigen measles shot, verifiable by serum IGG levels indicating immunity, which was "proof" for school entry. In 2006 the second dose of mumps vaccine was recommended and there were no single antigen mumps vaccines available. So, they had to immunize with the combination MMR vaccine.

You can easily look up all the Recommended Childhood Vaccines in the CDC Pink Book...an excellent reference for the histories of vaccines development.

http://www.cdc.gov/vaccines/pubs/pinkbook/index.html

"the only certainty in medicine (and life) is that all of us will one day die."

I'm hedging my bets on that one. So far so good.

Hinterlander: here in NZ, boosters don’t seem to be pushed at all (correct me if I’m wrong Grant, Alison, et al.).

I don't think you're wrong; when I've gone in for a tetanus booster (or had one perforce due to foolishness with sharp implements), I've never had even the breath of a suggestion that a pertussis booster would be in order. A combined vaccine is certainly available - http://www.immune.org.nz/vaccines/boostrix%C2%AE - so it's odd that it's never been offered to me (yes, yes, I know, anecdote!). Could be a cost issue, I suppose/

@ Alison: This is the 2012 CDC VFC (Vaccines For Children) Program price list. It lists costs per dose charged by vaccine manufacturers for Td, Tdap (and every other recommended childhood vaccine), for the VFC Program versus costs per dose for private providers.

http://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/pr…

Regards the pertussis boosters and 'cocooning' in New Zealand, my impression was that there is no 'mandatory' boosters or cocooning, but it is encouraged, e.g. this from the IMAC pertussis page regards pregnant women and their families, at least for the Canterbury region:

“All the young children in the household should be up to date with their childhood immunisations. Older children and adults in the household should have a tetanus, diphtheria, whooping cough vaccine too. However they have to buy their vaccine through their GP.”

(I really must not self-promote... ah, stuff it: There was some discussion of this in media last year, which I wrote about. The journalist interviewed an anti-vaccine organisation spokesperson as ‘balance’; I choose to try position myself as someone without a strong science background [e.g. reporter/public] check out the spokesperson’s claims. Basically: “My exercise shows that readily-found sources, including one Rudgley recommends, contradict what she offered the journalist.”)

Grant, I was just looking at the NZ vaccine schedule, and it looks like they only give a Tdap at age eleven. While we in the USA are encouraged to get a tetanus booster every then years (which we pay for, unless we happened to have health insurance at the time), it seems your health service only provides it when you are 45 and 65 years old. And it is not the Tdap.

Our system is often based on state policy. Last year I tried to get a Tdap from my family doctor, but he said it was too soon (my last Td was in 2005). So I got it at TAM9 in Las Vegas. Now there is a pertussis epidemic in my state and he wanted to give me a Tdap... it was interesting explaining that I got it a year before in Nevada!

Well, I did try to get it before I went to "The Amazing Meeting", where I met Orac and our Lord Draconis.

@ Grant

It would be good if this information was presented more at the coal face, so to speak. For example midwives or Plunket nurses could raise the subject of cocooning. The more the information is out there the more general consciousness is raised.

@ Alison
Well if we're sharing anecdotes... :-) The nurse who administered vaccines at my old medical centre said that the varicella vaccine was really aimed at children who attend daycare, so that their parent's wouldn't have to take time off work if their child contracted the disease. Following that logic I shouldn't have bothered having my daughter immunised for varicella as I'm working from home...

I created a little ditty to model what @sciencemom explains above here - http://op12no2.me/toys/sir.php - the oscillations decrease in amplitude and frequency in the presence of vax with a side effect of the average age of infection going up - which is OK for pertussis but not CP. Recovery rate also increases freq which is probably why pertussis oscillations are generally > measles...?

Colin - nice work. Must have a peek at how you're generating the graphs.

My 11 year old recieved a pertussis booster 9 months ago. He has whooping cough and is very ill. Vaccines are not perfect. I think their effectiveness is diminished when a large percent of the population is not immunized.

I actually just got my pertussis booster yesterday (I'm 29). Don't know if I've ever had a booster, and the only ill effect I've felt so far is a little bit of soreness at the injection site.

OH WAIT I also immediately developed autism, too. So there's that. :-)

@ Nancy: I'm sorry that your son is ill. Was the diagnosis of pertussis confirmed by a laboratory test ordered by your doctor?

Confirmatory laboratory tests are reported to local health departments and you will be hearing from a public health doctor or nurse. This person will be asking you about your son's pertussis vaccines history.

Nancy -- yes, if lots of people are unvaccinated, the vaccines are less effective. Well, the individual vaccines are just as effective either way, but the actual protection you get is definitely less if you're the only one getting vaccinated than if everybody's getting vaccinated.

I hope your son gets better soon; pertussis *sucks*, plain an simple. I wish they could come up with a more effective vaccine; it's a whole lot better than nothing; most people get immunity from it. But I wish the percentage was a lot higher.

We may have a first developing over at the "Shot of Prevention" Blog. Our resident insane troll (Thingy) is getting into an argument with an ardent HIV & Germ Theory Denialist......this could be the first time I've ever seen that happen, could be very interesting to watch.

@ Lawrence: And how long did it take for the blog owner to send a tepid response. I'm half wanting to leave the sorry mess to the trolls.

Lawrence - linky please? This I must see.

A study I was involved in (Bisgaard et al Pediatrics 2005) noted that one factor in the spread of pertussis was the presence of large households which were often the mixture of several (usually related) families.
The financial and housing-mortgage meltdowns starting in 2007 resulted in many families moving from single-family residences to other situations such as multi-unit apartments or even multiple families in the same housing unit. This would have resulted in many older children/young adults being in closer contact with a wider range of individuals e.g. infants and adults whose immunity to pertussis would be low. Also, those older children/young adults with full histories of pertussis vaccination might also than have been in closer contact with older children/young adults who were under or even unvaccinated for pertussis.

It seems that the understanding of relative risk / benefit and efficacy are sadly becoming a rare competence among most of the population - and the situation is only going to get worse!

The fact that the UK has just appointed a health minister who believes in homeopathy fills me with dread!

http://londonskeptic.org.uk/uk-health-secretary-believes-in-magic-fairi…

If we can't dissuade those elected to make informed decisions of blatantly ludicrous beliefs, what hope is there for more nuanced debate?

Tom -- I do love, though, that he's being described as the Minister of Magic. At least some of the general populace realizes how preposterous homeopathy is.

Would you say DR Maurice Hilleman of Merck was anti vaccine? After all he developed them then said the monkey component of the polio vaccine caused cancer through SV 40 virus exposure. I'm not sure where else I have had close contact with monkeys other than being vaccinated with their cells.

You got cancer from polio vaccine? Have you reported your cancer to the CDC?

Pali, Hilleman found SV40 in the vaccines, and then worked to make sure they were removed over fifty years ago! The "SV40" bit is only outdates the thimerosal bit by forty years.

The "Danes" did it again. :-)

http://jnci.oxfordjournals.org/content/95/7/532.abstract

Cancer Incidence in Denmark Following Exposure to Poliovirus Vaccine Contaminated With Simian Virus 40

Eric A. Engels,
Hormuzd A. Katki,
Nete M. Nielsen,
Jeanette F. Winther,
Henrik Hjalgrim,
Flemming Gjerris,
Philip S. Rosenberg and
Morten Frisch

".....The relationship between exposure to SV40-contaminated vaccine and cancer incidence was evaluated by examining incidence in birth cohorts that differed in exposure to SV40-contaminated vaccine. In addition, cancer incidence was examined in children who were 0–4 years of age before, during, and after the period of vaccine contamination. Incidence was compared using Poisson regression, adjusting for age differences. All statistical tests were two-sided. Results: After 69.5 million person-years of follow-up, individuals exposed to SV40-contaminated poliovirus vaccine as infants (i.e., born 1955–1961) or children (i.e., born 1946–1952) had lower overall cancer risk (age-adjusted relative risk [RR] = 0.86, 95% confidence interval [CI] = 0.81 to 0.91 and RR = 0.79, 95% CI = 0.75 to 0.84, respectively; P<.001 for both) than unexposed individuals (i.e., born 1964–1970, after the vaccine was cleared of SV40 contamination). Specifically, SV40 exposure was not associated with increased incidence of mesothelioma, ependymoma, choroid plexus tumor, or non-Hodgkin’s lymphoma. After 19.5 million person-years of follow-up, incidence of all cancers combined, of intracranial tumors, and of leukemia among children aged 0–4 years was also not associated with SV40 exposure. Ependymoma incidence was higher during the exposed period than during the unexposed period (RR = 2.59, 95%CI = 1.36 to 4.92; P = .004 versus the period before contamination); however, incidence peaked in 1969, after the vaccine was cleared of SV40. Conclusion: Exposure to SV40-contaminated poliovirus vaccine in Denmark was not associated with increased cancer incidence....."

Would you say DR Maurice Hilleman of Merck was anti vaccine? After all he developed them then said the monkey component of the polio vaccine caused cancer through SV 40 virus exposure.

Perhaps you could link to the occasion on which Hilleman said polio vaccine causes cancer, so we will know that you're not just another lying douchebag.

There is an audio clip of an interview with Hilleman in which he makes some sarcastic comments about importing HIV and SV40 and about them causing cancer that are greeted with laughter by his audience. Hilleman had a very dry sense of humor which has been misinterpreted by idiots as Hillemman and his evil Big Pharma cronies cackling about the deaths he caused. Here's deranged dentist Len Horowitz presenting the clip.

I would also remind Pali that this article is about pertussis. The only thing it has in common with polio (the vaccine that had SV40 in it until the early 1960s) is that the words both start with a "p."

Innate Immune Response Defines Pathology and death in Those Infected by Highly Pathogenic Influenza

gregladen — Sat, 14 Feb 2009 10:31:33 +0000

Innate Immune Response Defines Pathology and death in Those Infected by Highly Pathogenic Influenza

For the last couple of decades, perhaps beginning around the time of the publication of Laurie Garret's excellent thesis (The Coming Plague: Newly Emerging Diseases in a World Out of Balance) on disease and politics and continuting through Gina Kolata's "Flu: The Story Of The Great Influenza Pandemic" there has been increased attention on the 1918 flu virus and pandemic, as well as subsequent outbreaks. This interest has probably been fueled by increased knowledge of (or incidence of?) tragic and highly newsworthy outbreaks of Ebola, SARS, and so on. More recently, the perception has grown that the Bird Flu is a'comin' any time now to ultimately replace the Great Pandemic of 1918 as well as the mud shark in our mythology.

If you read the better done public-oriented literature of this period, you will learn that the nature, cause or origin, and pattern of the 1918 epidemic has been very mysterious. The same level of mystery (but with only a few victims) arose in connection with the Swine Flu threat of the 1970s (see expecially Garret's book for how this event links to current attitudes as well as public policy regarding vaccines).

This brings us to some time last year or so, when key papers were published (and I presume presented at conferences) regarding what may ultimately be seen as the most important single step in the history of understanding the way the flu vaccine works, and thus, how to combat it. (See this to explore one of those key moments in research history.)

The new knowledge is essentially an improved evolutionarily and developmental understanding of how influenza virus strains change over time. To put it very simply, these viruses are made of chunks that come apart in the host and then recombine. If there are multiple 'strains' (think species, more or less) of influenza in an individual, these genetic chinks, each representing a huge percentage of the influenza genome, can and do re-combine to form entirely new strains.

That is in a sense macro-evolution of a pathogen in situ, in the host. What is an immune system to do!?!!?!?? Not much, really. This can be very fatal.

It is now understood that these epidemic or pandemic influenza outbreaks arise from these recombination events. If you now look back at the quirky data, the odd logic influenza seemed to be patterned by, the epidemiological dead ends that seemed to confound everyone through the lens of knowledge of these genetic chunks, called "reassortants," things suddenly become much much clearer.

A paper has just come out in PNAS reporting research using a primate model to explore immune response and associated pathology under the influence of a recombinant influenza virus, and this research is a direct outcome of this new way of looking at the flu. I offer it here without comment largely because you can get the article yourself, since this one is an OpenAccess piece from the normally not OpenAccess PNAS. Here.

The Abstract from the paper:

The mechanisms responsible for the virulence of the highly pathogenic avian influenza (HPAI) and of the 1918 pandemic influenza virus in humans remain poorly understood. To identify crucial components of the early host response during these infections by using both conventional and functional genomics tools, we studied 34 cynomolgus macaques (Macaca fascicularis) to compare a 2004 human H5N1 Vietnam isolate with 2 reassortant viruses possessing the 1918 hemagglutinin (HA) and neuraminidase (NA) surface proteins, known conveyors of virulence. One of the reassortants also contained the 1918 nonstructural (NS1) protein, an inhibitor of the host interferon response. Among these viruses, HPAI H5N1 was the most virulent. Within 24 h, the H5N1 virus produced severe bronchiolar and alveolar lesions. Notably, the H5N1 virus targeted type II pneumocytes throughout the 7-day infection, and induced the most dramatic and sustained expression of type I interferons and inflammatory and innate immune genes, as measured by genomic and protein assays. The H5N1 infection also resulted in prolonged margination of circulating T lymphocytes and notable apoptosis of activated dendritic cells in the lungs and draining lymph nodes early during infection. While both 1918 reassortant viruses also were highly pathogenic, the H5N1 virus was exceptional for the extent of tissue damage, cytokinemia, and interference with immune regulatory mechanisms, which may help explain the extreme virulence of HPAI viruses in humans.

C. R. Baskin, H. Bielefeldt-Ohmann, T. M. Tumpey, P. J. Sabourin, J. P. Long, A. Garcia-Sastre, A.-E. Tolnay, R. Albrecht, J. A. Pyles, P. H. Olson, L. D. Aicher, E. R. Rosenzweig, K. Murali-Krishna, E. A. Clark, M. S. Kotur, J. L. Fornek, S. Proll, R. E. Palermo, Carol. L. Sabourin, M. G. Katze (2009). Early and sustained innate immune response defines pathology and death in nonhuman primates infected by highly pathogenic influenza virus Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.0813234106

gregladen Sat, 02/14/2009 - 05:31

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The Invisible Cure: Africa, the West, and the Fight Against AIDS

grrlscientist — Wed, 20 Feb 2008 09:59:59 +0000

The Invisible Cure: Africa, the West, and the Fight Against AIDS

tags: book review, HIV, AIDS, Africa, epidemic, public health, Helen Epstein, The Invisible Cure

"AIDS has come to haunt a world that thought it was incomplete. Some wanted children, some wanted money, some wanted property, some wanted power, but all we have ended up with is AIDS."

-- Bernadette Nabatanzi, traditional healer, Kampala, Uganda, 1994.

The occurrence of AIDS in East and southern Africa is uniquely severe: even though less than 3 percent of the world's population lives here, this region is home to more than 40 percent of all those people with HIV infections. Throughout much of the world, HIV is mainly limited to gay men, intravenous drug users, sex workers and their customers, but things are very different in Africa. In Africa, AIDS is widespread throughout the general heterosexual population, even among those who have never engaged in risky sexual behavior. Why? And what can we do to help those in need? In this insightful and compassionate book, The Invisible Cure: Africa, the West, and the Fight Against AIDS (NYC: Farrar, Straus and Giroux; 2007), molecular biologist and writer, Helen Epstein, explores these questions in great depth and provides some surprising answers.

The story begins in 1993, after Epstein heard a scientific talk that discussed research problems involved with developing a vaccine against HIV/AIDS in Africa. Inspired by this presentation and by her confidence in her laboratory skills, the author decided to leave her postdoctoral work in San Francisco to join a biotech company's ongoing research project in Uganda to help develop an HIV vaccine. But after she's there, she is confronted with numerous problems, ranging from undelivered research materials and samples to a severe lack of lab space, combined with sudden power outages lasting as long as one week, and even having to invest weeks into simply obtaining a few liters of distilled water -- all these challenges eat up her time and energy, eventually causing her own research project (and its funding) to derail.

While tackling these obstacles, Epstein spends a fair amount of time interacting with and learning from the people of Uganda and from the medical personnel who work there. She travels to clinics all over the country and talks with the people there and along the way, often finds herself involved in very detailed discussions about her research with taxi drivers, construction workers, high school students, hair dressers and janitors -- all of whom are surprisingly well-informed about HIV, possessing a commanding knowledge of the virus and the intricacies of its biology that is comparable to that of her colleagues.

As the result of all her conversations, Epstein later realizes that Uganda represents a unique social experiment among sub-Saharan African nations because this country, and this country alone, managed to reduce its own staggering rates of AIDS using methods that were misunderstood by Western nations. In short, the message was "Abstain, Be Faithful, and Use Condoms," combined with instilling a healthy fear of AIDS into the populace through "ordinary, but frank, conversations people had with their family, friends, and neighbors -- not about sex -- but about the frightening, calamitous effects of AIDS itself."

The author's quest to understand how Ugandans accomplished this dramatic reduction in HIV/AIDS provided the impetus for this book, and she discusses both the successes and failures along the way, beginning with her own failed research project. Epstein writes in the preface; "Much of this book is concerned with donor-funded AIDS programs that failed in some way, beginning with my own vaccine project. I tell these stories not with a sense of satisfaction. I could not have done better myself at the time. But in science, failures are often as important as successes, because they tell us where the limits are. Only by looking honestly at our mistakes can we hope to overcome them." [p. xvii].

Numerous interviews throughout the eleven nations of sub-Saharan Africa convinces Epstein that there are two main factors that underly the tremendous spread of HIV in this region. First; boys are not circumcized, even though this practice remains a vital weapon in combating the HIV infection. For example, one 2006 study revealed that circumcision can reduce the risk of HIV transmission by roughly 50%.

The other factor that underlies the runaway HIV infection rate is the widespread social practice of concurrent sexual partners. This is not to say that concurrent partners constitute rampant promiscuity or prostitution, nor that Africans have more sexual partners than in other places in the world, nor do they have anywhere near as many as do gay men in America (who have much lower HIV rates). Instead of one-night-stands, Africans maintain a complex web of intimate relationships that sustain them when familes are torn apart by the demands of having to work jobs that are located hundreds or even a thousand miles away from their families for many years at a time.

Concurrent sexual relationships are more dangerous for spreading HIV than promoscuity or prostitution because the probability of one sex act infecting a partner is very low. However, those who have HIV are most contagious shortly after they themselves have become infected, thus, the complex web of sexual relationships in sub-Saharan Africa allows this virus to spread throughout the network rather than remaining trapped in a monogamous relationship, as seen in the West. Epstein includes a series of graphics that nicely illustrate her point.

The social context that supports the lack of circumcision and concurrent sexual partners -- crushing poverty, the socially-sanctioned abuse of women, civil war and political upheaval -- is complex and difficult to address. Worse, when Western aid agencies, such as the UN and various faith-based organizations enter the picture, they arrive with their own pre-ordained agendas instead of trying to understand and work within the social framework that has already been established in countries such as Uganda. The author wryly observes that "[w]hen it comes to fighting AIDS, our greatest mistake may have been to overlook the fact that, in spite of everything, African people often know best how to solve their own problems."

Epstein's own view of these aid organizations is quite cynical. AIDS is a multibillion-dollar industry in Africa, and many of the officials and experts engaged in this battle are not altruists at all, but rather, they are making a wise career move that proves both lucrative and politically expedient. Sadly, political agendas, misdirected priorities, ignorance, and incompetence among these agencies are commonplace. Worse, this fact is not lost on the very people whom they presume to help: a Ugandan doctor whom Epstein interviews repeats his countrymens' harsh words specifically about these aid agencies;

[T]hey talk about two kinds of AIDS in Uganda: slim AIDS and fat AIDS. People with slim AIDS get slimmer and slimmer and slimmer until they finally disappear. Fat AIDS afflicts doctors, bureaucrats, and foreign-aid consultants with enormous grants and salaries; they fly around the world to exotic places and get fatter and fatter and fatter. Fat AIDS had become so prevalent in Uganda that .. if you were working on HIV, people thought you were a thief. [p. 27]

Despite the overall high quality of the writing and research supporting this book, I was surprised to discover one mistake. Epstein states that the HIV strains that infect Africans can develop resistance to antiretroviral drugs. However, there is no evidence that I am aware of indicating that these "African" varieties of HIV are more likely to become resistant to the multi-drug cocktails than those "Western" forms of HIV that AIDS patients are treated with in the Western world. Further, there is overlap between HIV varieties found throughout the world.

This 326 page book reads like a memoir, a scientific mystery, and a social and political commentary. It is carefully researched and well-documented, and passionately written. This is a readable true account of a terrible tragedy that is happening right now, that we can prevent, if only we knew what to do. Anyone involved with AIDS/HIV funding programs, medicine and public health in Africa must read this book, and those who are seeking to develop a vaccine against HIV would be wise to read this book to get a clearer understanding of the problems they face. Even though Epstein's own pursuit of an HIV vaccine was short-lived, her positive contribution to the fight against HIV/AIDS in sub-Saharan Africa is both important and ongoing. Highly recommended.

Read the first chapter online.

Helen Epstein is a molecular biologist by training, but she currently is an independent consultant and writer specializing in public health in developing countries. In the early 1990s she worked at Makerere University in Uganda. She was until recently visiting scholar at the Center for Health and Wellbeing at Princeton University and is currently working for Human Rights Watch. Her papers and articles have been published in both academic journals and in popular magazines such as Discover, New Scientist, The New York Times Magazine, Granta, and she has written frequently on AIDS for the New York Review of Books. Helen earned her PhD from Cambridge University, UK, and her MSc from the London School of Hygiene and Tropical Medicine.

grrlscientist Wed, 02/20/2008 - 04:59

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