Vaccines for a Healthy Community

Edward Jenner discoverer of vaccination. Image via Wikipedia

The anti-vaxxer movement (AVM) just won’t lie down and die. Its proponents are misinformed, wilful and stubborn about their perception of and insistence on their individual rights as distinct from the communal rights that their societies are entitled to expect of the individuals that form part of the societies. These are the communities in which the anti-vaxxers and the rest of us live our lives, enjoy a semblance of security and reap benefits of various sorts. We don’t expect to run into hitherto eradicated diseases because some community members arc up at vaccination and carry on dictating their human rights in a totally inappropriate arena.

It is the sheer arrogance and ignorance of these people that makes me liken them to religites. Under the guise of so called ‘personal choice’, they wilfully put whole communities at risk of infectious diseases by refusing vaccination for their offspring. That is unconscionable in anyone’s language. Especially in a language that has written cogent research papers about the efficacy of inoculation against disfiguring and fatal diseases that spread like wild fire amongst closely knit communities. The public health officials are trying to eradicate the potential for epidemics after all. The research scientists are of immense value in isolating and developing remedial measures.

And then these selfish, individualistic and socially inadequate people want to take the rest of the communities back to the 1800s before disease was even identified as emanating from bacteria and viruses. Germ theory was in its infancy, not really coming into its own until Koch’s Postulates in 1890.

The ant-vaxxers tend to be white, middle class and/or religite First Worlders. Most have never seen, and certainly don’t appear to understand, the threat of these diseases in developing countries and, by extension, into their own communities.

Immunisation programmes in the developed countries have minimised outbreaks of virulent viral and bacterial infections and this current generation has no knowledge of and has never seen the devastation of major outbreaks. They should count themselves lucky and keep their communities’ health stable. Deadly Choices by Paul Offit details how the AVM threatens our communities and the hard won battles we have waged against disease. This link is a late edit: I only found out about it today (10 Jan.2012). It is an interactive algebraic model showing the different effects within communities of immunisation and non-immunisation. Click through the different scenarios and watch what happens.

But no, they sit on their high horse and try to dictate personal choice against communal health. There are very few Andrew Wakefields among them. But they have done immense and very wilful damage. It took a long time to have Wakefield struck off the Medical Practitioners’ register. The damage that man has done to public health is immeasurable. Then there are the Meryl Doreys of the world and the idiots that she associates with. This article by David Gorksi reprinted on Richard Dawkins’ web site mentions the others especially in the US.

Smallpox virus. Image by Sanofi Pasteur

This is smallpox. Image via Wikipedia

When I think of the incredibly organised global effort by WHO to eradicate diseases like small pox, my heart sinks at the prospect of the anti-vaxxers undoing all that work. The following is taken from the WHO web site.

‘Ten years after the launching of the intensified plan to eradicate smallpox by WHO, the last instance of smallpox infection by natural route was recorded in Somalia, Africa. The very last patient of smallpox–from laboratory acquired infection–died in Birmingham, United Kingdom in 1978.

The global eradication of smallpox was certified, based on intense verification activities in countries, by a commission of eminent scientists in December 1979 and subsequently endorsed by the World Health Assembly in 1980.

For the past 30 years, populations the world over have breathed a sigh of relief at not having a single case of smallpox in their midst. This became possible because of two major strides in public health over two centuries of human quest: the first by Edward Jenner, a country physician and vaccination pioneer in England in 1798, and the second by WHO in 1958 when the World Health Assembly made the concerted call for global smallpox eradication.’

The Triple Antigen vaccine covers those dreadful diseases of Tetanus, Diphtheria, Whooping Cough and Polio. Anyone who has seen these diseases in action knows how helpless you can feel to alleviate suffering and potential death. Seeing wee babies die because they have contracted a deadly disease from an unvaccinated person at a time when they are too young to be vaccinated themselves is appalling.

I have barrier nursed tetanus patients. Not easy for them. The slightest noise can send their nerves and muscles into fatal spasm. Watching children die is not a pleasant thing to behold. Watching children with polio is not pleasant. Watching anyone in pain, distress and in danger of potential death from viruses and bacteria that can be eradicated makes any thinking, compassionate person determined to utilise all the medical and chemical science available to us to ensure our own children and the larger communities around us are not exposed to these hideous diseases. Tuberculosis is another one. Nearly eradicated and now a newer, more resistant strain crops up to threaten our communities again.

Off we go again, hunting for a way to stem its spread. And it isn’t just in developing countries that public health initiatives keep on adding further disease control to their programmes. This is from the New Australian Immunisation Schedule:

 A new immunisation schedule applying to children born after 1st May 2000 was introduced several years ago. The main change was the introduction of hepatitis B vaccination for infants.

From November 1st 2005, this schedule has been further modified. The most recent changes include the inclusion of polio with the diphtheria, tetanus and pertussis injection, universal pneumococcal vaccination and chickenpox vaccination at 18 months. Hepatitis A is also provided for all indigenous children.

The numerous influenza viruses and the burgeoning common cold bacteria are cases in point. Viruses and bacteria mutate very quickly – that is their evolutionary strength, if you like. They have been making a living on this planet for much longer than we have and thousands of them inhabit our bodies. Usually they have a vested interest in keeping us (their host) alive so we can supply nutrient and habitat to them. On their generous side, they help us break down food into usable nutrients for our and their delectation!

Make no mistake – there are disadvantageous bacteria and viruses out there. They constitute the vast number of different species in this world. And they will survive long after we have overseen our own demise.

Should people with colds be expected to wear masks to prevent infecting others as Pascal Wallisch indicates?  A resounding yes from me.

This link repeats the question that Wallisch asks:

‘Pascal Wallisch  Should people with colds be expected to wear masks to prevent infecting others? My question is: Should this paradigm be extended to things beyond vaccination? Something that comes to mind immediately this time of year is coughing/being sick and wearing masks to prevent the infection of others. It does make a big difference. See this “paper” published in the New England Journal of Medicine and the related Schlieren imaging videos (below is one frame).

http://www.nejm.org/doi/full/10.1056/NEJMicm0904279’

It is time that we started assuming some responsibility for the larger coherent community than just our own family structure. While there are those who only extend the responsibility for communal health to those who wish to not become infected, I have to say that that is not good enough. Those who know they are infectious also have a responsibility to the larger community to protect the members of that community from their infection.

TOO MANY PEOPLE! CONFRONTING THE POPULATION DILEMMA

Can this planet sustain the number of people our population is heading for? Almost certainly not, but rarely do we hear calls to reduce our numbers. 2011 Edinburgh Medal recipient Carl Djerassi, co-inventor of the contraceptive pill, Sara Parkin, founding director of Forum for the Future and Aubrey Manning, zoologist and broadcaster, discuss the thorny issues of religion, contraception, economics and women’s right to choose, as they take on the population taboo. Chaired by Richard Holloway, former Bishop of Edinburgh.

The Edinburgh International Science Festival is chock-a-block full of all sorts of events and one of them was the above described event. I am glad we went.

No answers were forthcoming – as usual. The topic itself has been of interest to thinking people since at least Thomas Malthus wrote An Essay on the Principle of Population that was published in 1798. In it, he argued that the human population would increase inexorably until it was halted by what he termed ‘misery and vice’.

This is Darfur repeated throughout the world

I first started reading about the impact of global population growth in 1970 in a book called The Ghost in the Machine by Arthur Koestler. I have watched this exponential population growth with increasing horror ever since. It is virtually impossible to discuss or otherwise politicise such debate as is necessary if we are not to become the shortest lived species on this planet.

I think all of us would agree that as a species we are disunited individually and nationally, politically and economically. The only thing we do as a species imperative and with gay abandon is reproduce like rabbits.

Yep. Thats us.

Aubrey Manning mentioned that death control has worked extremely well over the past 50 or so years but birth control still has to come to the party. He is absolutely correct. The tracking of global population figures since I have been alive attests this. As David Attenborough said within his address to the Royal Society in March this year:

 Fifty years ago, when the WWF was founded there were about three billion people on earth. Now there are almost seven billion. Over twice as many – and every one of them needing space. Space for their homes, space to grow their food (or to get others to grow it for them), space to build schools and roads and airfields. A little of that space might be taken from land occupied by other people but most of it could only come from the land which, for millions of years, animals and plants had to themselves.

 The impact of these extra millions of people has spread even beyond the space they physically occupy. Their industries have changed the chemical constituency of the atmosphere. The oceans that cover most of the surface of the planet have been polluted and increasingly acidified. We now realise that the disasters that continue increasingly to afflict the natural world have one element that connects them all – the unprecedented increase in the number of human beings on the planet.

Logic alone should tell us that the resources and habitable land available to us and all other species (people in their arrogance seem to forget that we only share this sphere not own it outright and to the detriment of everything else) is limited on a finite planet. But developing countries have every right to tell us post industrial nations to pull out heads in if we try to curtail their development by preaching to them whilst we enjoy the over-ripe fruits of our own development.

There is no more water now than there ever was but it gets used with such profligacy that anyone looking at us from afar could be forgiven for thinking that water was being manufactured at an ever faster rate of knots.

Desertification is rampant and rising sea levels encroach more and more on (at this stage) small Pacific islands. The Boxing Day tsunami showed us what would happen to The Maldives and other low lying atolls and shores that Kubla Khan wouldn’t even have dreamt of building on.

Carteret Islands abandoned to rising seas in 2009

Carl Djerassi  peppered his address with figures for abortions both legal and illegal at about 1 million per 24 hour period worldwide. Of course Djerassi was a co-founder of the oral contraceptive pill for women in the 1950s. He hasn’t got an answer either, but he was combative about what he sees as wishy washy talk fests that don’t address the large and looming problem that is likely to have devastating effect around 2050.

Sara Parkin is the founder of Forum for the Future. Her concern is with women’s reproductive health and education. She talked about sustainable population growth. I actually do not think there is any such concept in reality. It sounds good but doesn’t take into account the nature of our species.

We all want more. Maybe not children if you live in poverty and watch at least half of your live births die within a few years. But we always seem to want more for ourselves – more food, clothing, space to live, accoutrements for pleasure and lifestyle. That just isn’t sustainable at the levels we desire. We can’t (or won’t) afford to feed our current refugees let alone try to feed a growing population.

Most of these kids wont make it - 2011

So what to do? Question time after the talk included one from a woman who postulated punitive measures like increased taxation and decreased support availability for families birthing more than two children. It is one of my ideas as well. Djerassi pooh poohed it as virtually useless in a global sense since only developed post-industrial countries could implement such measures. Of course, he is right.

I have mentioned before that Australia’s worst Treasurer (in recent times), Peter Costello, implemented a scheme whereby he gave Australian women a one-off payment of $A5,000 to have a third child ‘for the country’; talk about wilful irresponsibility! He later resigned though not because of that!

Djerassi pointed out that, although Italy has a below replacement population growth, the contraceptive measure in that supposedly most Roman Catholic of countries is by far condom use. The contraceptive pill accounts for only 5% of Italian contraceptive measures. Until recently the most common contraceptive measure in Soviet Russia was multiple abortions!

The problem is still an unmentionable – the elephant in the room. It seems to me we are unlikely to see the end of this century in any sort of good evolutionary shape. We shall be sliding off this rather nice planet that will keep whizzing around in this rather nice galaxy without us.

These are some essentials in this race against time and space:

Contraception of all sorts, including free, safe abortion is essential.

Education of women everywhere in family planning and taking control of their reproductive functions is essential.

The removal of religious and political interference in human reproduction is essential.

Are we up for it? Somehow I don’t think so. Only in our increasingly nightmarish dreams.

Abortion in the news again!!!

I apologise for not having posted anything for ages. We have been busy finalising the purchase of a new house and all its attendant bits and pieces. And packing!! What a drag. And today is the beginning of the MOVE day. So all I have been doing is glancing through the news, keeping a close watch on the weather and running around like a headless chook.

Yesterday I noticed an article about the Abortion Act of 1967 and a High Court challenge to the interpretation of this piece of legislation. And I couldn’t let this slide.

I thought that finally a little more sense was creeping into the abortion debate. In fact, I thought the abortion issue should have been over. Over my life I have seen legislation changed and replaced from draconian and punitive law to a more humane understanding of the rights of women to control their own reproductive capacity.

The abortion issue should be over, finished, except for diehard fruitcakes. We need reproductive responsibility not unbridled population growth.

However, this week the newspapers are reporting on this High Court challenge on the interpretation and practice of the 1967 Abortion Act that has hitherto been interpreted to mean that women opting for early stage abortions involving oral medication had to attend a clinic twice. This should be an easy challenge sensibly resolved.

The British Pregnancy Advisory Service (BPAS) is making a legal challenge to that interpretation. BPAS is the UK’s largest abortion provider. It has been joined in battle by the UK Department of Health insisting that the current interpretation should be upheld. Why? I can’t work it out. The Chief Executive of BPAS, Ann Furedi has a good, explanatory blog in The Independent.

There is another group, predictably so-called pro-life, called the Society for the Protection of Unborn Children vowing to intervene in the case because it thinks BPAS is “trivialising abortion and jeopardising women’s welfare”. Apparently some politicians, blowing hot and cold as is their wont, are demurring as well. Ah, well, maybe there is the reason!

This article is worth reading because it presents figures indicating that women would prefer to opt for taking the second set of pills – misoprostol – at home where they are close to bathrooms, have privacy, are comfortable and have family members with them. The very, very practical reason for being at home is that misoprostol induces cramping, bleeding and the miscarriage within a couple of hours, sometimes sooner.

So, why should there be a problem with women taking these second stage pills at home? Women who want to stay at the clinic are still able to do so even though 96% of BPAS clients appear to want to leave and go home.

The politician who was instrumental in the 1967 legislation has stated that “the development of these pills has long since overtaken the 1967 Act,”. Easy to make a court ruling, one would think, that takes account of further developments in medical and pharmaceutical technology, no?

So, I want to know why the Department of Health is so insistent about this when it is so unnecessary. One can understand the stupidity and cupidity of politicians who blow one way or the other depending on what they think the electorate wants.

But the Department of Health is not (or should not be) so politically controlled as to argue that an antiquated interpretation needs to be adhered to in the face of evidence and studies by the patients themselves indicating the opposite. The various nursing organisations appear to have no problems with the proposed change to the legislation. BPAS is a charity working in conjunction with NHS. So what is the problem?

In 2007, the House of Commons Science and Technology Committee reported that it would be “safe, effective and acceptable”. The fatality rate is one/100,000. Other developed countries allow this, even that strange religious country, the US, let alone secular countries like France and Sweden.

The clinical trials find no problem. So what is going on here? Has the growing stranglehold of religiosity on this island permeated the government departments? Surely, in this 21^st Century, commonsense and reason will triumph over the “fear of criticism from those who oppose abortion in principle”

Opposing something on principle is fine but don’t expect everyone to agree with peculiar and particular principles just for the sake of it.

Scotland, often able to set its own regulations, is hamstrung on this issue because abortion law is the province of Westminster. Damn!!

GM Food Products

Cloned cattle munching

I noted a couple of days ago now that the ‘campaigners’ are up in arms because cloned meat has been sanctioned for sale and consumption by the Food Standards Agency’s chief scientist, Andrew Wadge. Milk from cloned dairy cows is also on sale on supermarket shelves.

Wadge made his statement based on the Advisory Committee on Novel Foods and Processes’ conclusion that cloned food products are safe for human consumption. Actually the decision is based on food products from cloned animals and their offspring.

By and large it would appear that ‘campaigners’ of one sort and/or another tend to be a tad hysterical and are often driven by conspiracy theories that lay blame at the feet of those capitalist companies, individuals and governments that make money.

So nothing has changed. Except the burgeoning number of newspaper articles as journalists scramble to create as much controversy as they possibly can over what is perceived as controversial.

This issue poked its head up during August when some offspring from US cloned cattle embryos that had been imported into the UK ended up on supermarket shelves. No recording traces had been kept on those offspring and the outcry that ensued was loud but short-lived as I would imagine this one will also be.

There are a couple of reality checks that need to be applied here:

Biological and genetic science is fairly easily monitored. Public Health and Food Safety may not be exact sciences but both disciplines have come a mighty long way in the past century.

Cows (and other animals) born from cloned embryos and bananas grown from tissue-cultured stock are products of the same process. Each method – cloned reproduction in the case of animals and vegetative propagation in the case of plants produces exact clones of the parent tissue.

As bananas go, and you buy them every day in the green grocer’s shop, you can’t get a better, more technically perfect piece of fruit (just ask Ray Comfort!!). It has been suggested that I link to Ray Comfort’s video on youtube in case readers haven’t come across this creationist kook before.

Ray Comfort Gods Banana

Meat and milk products from animals produced by cloning represent greater homogeneity and therefore greater control over non-diseased and as clean food that you can reasonably expect.

Tissue culture as a method of propagation in the plant world produces exact clones of parent plants with desirable qualities. Here: have a quick read of good ol’ Wikipedia on tissue culture.

At what point do those of the ‘natural foodstuffs only’ brigade who call vociferously for sustainable agriculture on a realistic grand scale start to realistically address the feeding of the world’s population. A lot of this population lives on the margins of agriculturally viable land and are poorly fed. Malnourishment is rife.

Agriculturalists, governments and world health authorities are trying to provide nutritious food for a burgeoning global population. Some of the most abundant food available is the least nutritious and GM is addressing the rectification of this problem.

They are attempting to produce GM engineered staple food stuffs as intensively as possible because of the subsuming of good agricultural land by that same burgeoning population for residential purposes. Cities and towns tend to grow up around waterways, on coasts and around river deltas into which waterways spill and pollution becomes concentrated. As agriculturally viable land, such areas become less able to produce food.

Let’s rewind a few thousand years before science and GM. What did we eat and how did we determine what to eat? Our evolutionary history gave us the tools whereby we knew what to eat. If it was good, we ate more. If it wasn’t we didn’t eat it or if we did, we didn’t reproduce and we died. Good way to learn.

As the meerkat says: Seemples.

I will be accused of being simplistic. Today, we are arguing about only what minor detrimental effect GM or tissue-cultured foods may have on our short term health. Maybe there will be possibly long term cumulative effects on human health.

Prof. Pam Ronald

Nowadays we have the likes of Pam Ronald (a Plant Pathologist) and her research. Her blog Tomorrow’s Table is a wealth of information.

In the face of ever increasing global population and decreasing resources, long term effects are irrelevant.

The same basic evolutionarily derived rule of taste equalling good and bad taste equalling bad, therefore reject still applies.

Some commenter on one of the newspaper articles linked to snidely tried to tie BSE and Wadge together in an attempt to disparage and discredit him in his professional position. It is a straw man argument. Erecting the straw man of BSE distracts from the discussion (I don’t think there is  a meaningful discussion to be had anyway) and is totally irrelevant to the question.

If disaster befalls us and I am forced to eat a fellow human being, I will be an equal opportunity consumer and not distinguish between anti GM and GM supporters as I am certain they will both taste equally well and perform the function of nourishment thereby keeping me alive at least in the short term which will be all I can expect in an uncertain world.

No WIBs but JY Simpson

I have a friend whose father wrote the forward for a biography of James Young Simpson. A fitting person to write such a forward to such a book, Ian Donald pioneered the introduction of ultra sound to midwifery in Glasgow. He was also a Professor of Midwifery, though at Glasgow. Simpson (1811 to 1870) was in Edinburgh in the century before. When I think about the remarkable rapidity with which new technology is expanded and overtaken by newer technology, I am full of awe. But that’s what happens!

Book Cover for Simpson’s biography

JY Simpson’s biography was written and published in 1972 by Myrtle Simpson who had married into the Simpson family. She was an intrepid person in her own right and has written some amazing travel books.

The biography is a fascinating story of the man who first introduced chloroform as an anaesthetic initially in both dentistry and midwifery. The first article written by Simpson seems to have been to the Lancet in 1847.

A major driving thrust was to try and reduce the pain experienced by anyone who had to undergo surgery of any sort. Sulphuric ether had been used but delivery of the ether was cumbersome, dangerous and complicated. Simpson had been actively looking for some other gas with easier properties to replace ether that had come into use in 1846.

A young James Young Simpson

He certainly was no slouch. Through 1847 he experimented (tested chloroform on himself, his colleagues and his dinner guests!!) and was satisfied that chloroform was the agent of anaesthesia he had been looking for. He produced a prodigious number of articles for the Monthly Journal of Medical Science and the London Medical Gazette during that year. The problem was always how much to give a patient.

There are some hilarious stories of eminent physicians in non-eminent straits after inhaling chloroform at Simpson’s home (and professional rooms) at 52 Queen Street, Edinburgh.

Simpson lived and practised at 52 Queen St

Simpson first used chloroform in obstetrics on 8 November 1847. He delivered Jane Carstairs of a baby girl 25 minutes after administering chloroform to Jane. When she woke up she mentioned having a restful sleep. She was unaware that she had given birth.

I often think that in the earlier times, fields of potential endeavour being wider open than now, the people who filled these fields with their inventions, their insights, their experiments and their conclusions on which later generations built, had very fulfilling and satisfying, if controversial lives.

Notwithstanding the lack of public health measures, no germ theory and a raft of other ‘didn’t haves’, people like JY Simpson forged through the accepted wisdom and was one of those who instead of asking why, asked why not. He was to all intents and purposes a practical man with an enormous energy. He wasn’t fearful of trying new things and so became well known early on in his career as a controversialist.

He lived in a time when cleanliness in hospitals came into being thus saving lives, when infant mortality dropped from 60% to 30% in the crowded cities, when silk was used for suturing rather than unclean animal tendon; it saw the end of scurvy and the idea that prevention was better than cure. Public Health initiatives started delivering clean water, air wasn’t as polluted and refuse collection and waste drainage in cities was becoming a proper urban practice.

He became Professor of Midwifery at Edinburgh University in 1840, Physician to Queen Victoria in 1847, President of the Royal College of Physicians in 1850 and Baronet in 1866.

He was an ebullient and very compassionate man given to innovation and testing and finding practical solutions to problems he came across in his everyday medical practice. He certainly had many patients and colleagues who revered him and, of course, the few colleagues whose noses were put out of joint as Simpson’s reputation grew. He locked horns with the religious on whether man should interfere with ‘god’s’ handiwork.

He had no time for religious dogma. He became a Christian but eschewed bible teachings.

“The Bible, however, as it always seems to me teaches us no kind of knowledge which the intellect of man is unable to discover. It is a revelation of religious truths, not a revelation of scientific truth; and when the Westminster divines insisted their opinion of the duration and age of the world, they took up a position in science which science has since entirely contradicted.” Simpson, p.248

My little post here is just a snippet. It serves to indicate my high regard for medical science and its pioneers. We women owe doctors like JY Simpson a lot.

The biography itself is absolutely un-put-downable. The images Myrtle creates are so evocative. The descriptions of Simpson’s Edinburgh in the 1800s made old Edinburgh come alive in my mind’s eye and I have a much better understanding of how the ‘auld toun’ was built and what a disease infested place it became during the Highland Clearances when so many, thrown off their lands, came to the towns.

What an interesting, albeit dangerous, time to have lived in over-crowded towns and cities. I don’t envy that age but am grateful for the innovative people who did live at that time. We have a lot to thank them for. They pioneered so much in the way of health and the management of a burgeoning urbanisation.

Simpson – Princes St., near St. John’s Church