Tag Archives: public health

Andrew Wakefield loses again in court; what happened?

This is the latest update I have found detailing the life and fortunes of erstwhile Dr. Andrew Wakefield and his egregious, self-serving and very damaging lies regarding autism and the MMR vaccine.

I would like to say that due to Wakefield, measles contagion has increased worryingly in Australia, the UK and definitely in America where he is holed up still spruiking his rubbish.
Andrew Wakefield

Violent metaphors

You may have seen the news about a Texas court throwing out Andrew Wakefield‘s lawsuit against Brian Deer, the investigative journalist who did so much to uncover Wakefield’s fraudulentanti-vaccine study. You can read the court’s opinion for yourself, but I’ve already seen some inaccurate commentary on it. Here’s a little background on the case, and a quick explanation of what happened last week for non-lawyers.

view Apparently this is “Asquith as John Bull giving cheap sugar and an old age pension to a child and an elderly couple.” I have no idea what it means. But I dig old editorial cartoons (and the headline).

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Antibiotics, their overuse; viruses & bacteria, their supremacy

This coronavirus looks deadly and is

This coronavirus looks deadly and is

I have long thought that we will succumb to the bugs of the world. Infectious diseases have been and still are the bane of animal life on this planet. Our ability to isolate bacteria and devise antibiotics to combat the spread of infectious diseases is a profound achievement in medicine. Vaccines and antibiotics have been available for well over 50 years in the developed world. In the interim, we have been able to address the mortality rate due to infection and restrict the bacterial spread of some of the most virulent kind throughout communities.

Public Health agencies monitor, recommend and control as much as possible the spread of infectious disease within our burgeoning urban areas. Cities pose a great problem as people crowd in their millions into close surroundings. The megacities pose a greater problem and:

 as of 2011, there are over 20 megacities in existence … having populations in excess of 20 million inhabitants each.

It is estimated that by 2030 three out of five people will live in cities. The containment of infectious diseases is of vital importance when so many people live cheek by jowl. The use and possible over use of antimicrobial drug therapy has led to problems that are now being warned against by Public Health agencies in a number of developed countries.

streptococcus pneumoniae. Clever little one this. Knows where to hit.

streptococcus pneumoniae. Clever little one this. Knows where to hit.

The problem is that as microbial resistance leads to the emergence of new highly infectious bacteria and viruses, the discovery and development of new antibiotics has not kept pace. This is in part what Britain’s Chief Medical Officer Professor Sally Davies’ report addresses. She highlights three issues requiring attention:

*the emergence of microorganisms (bacteria, viruses, fungi and parasites) that are resistant to antibiotics and other antimicrobial drugs,

*healthcare-associated infections, which are a concern for all people accessing health services, and

*the social and environmental context in which infections occur

This is a very comprehensive report with many contributors. I am not a microbiologist and I haven’t read the whole 154 page report. I did, however, read the introductions to each of the 11 chapters and that formulates a comprehensive overview.

Superbugs can evolve resistance easily

Many superbugs can evolve resistance easily

I have also been reading some reports in the online newspapers about the effect on the food chain of the use of antibiotics in agriculture as well as the over prescription of antibiotics in human societies. It is only just starting to jolt me into understanding how we have been using and abusing the use of antibiotics. These two links lead to articles in The Scottish Farmer, both of which have to do with using antibiotics in herd management as a cheap insurance policy.

Louise Slaughter, the only microbiologist in the US Congress has tabled a Bill aimed at slowing down the spread of super bugs.

Agricultural use of antibiotics accounts for the majority of antibiotics sold in the United States. I am not sure about the UK or other countries. A problem arises when milk from a dairy cow being treated with antimicrobials is fed to calves. It is classed as unfit for human consumption. Farmers, loath to waste food, have fed the waste milk to calves. In this way, antimicrobial drugs enter the food chain. Davies considers the risk of transferring resistance from animals to humans to be minimal. This abstract in PubMed details a survey dealing with this.

Reducing the risk of herd disease needs to be placed far more on good farm management than on the easy option of throwing antibiotics at herds as an insurance policy. It is too fraught to keep doing it. Responsible  use of antibiotics in farm animals needs to be addressed. RUMA is an organisation comprising many different and concerned bodies and makes this point.

Of course, it all comes down to our over breeding and allied to that is the desire of everyone to attain a lifestyle that has food, health and shelter at its heart. The first world alternative; and why not? It will, however, only exacerbate the problem of disease resistance.

So I still see it all ending in tears. The biggest worry we have as a global species is our rampant reproduction. Religious dogma and natural reproductive imperatives hold sway. What an ignominious end for what could have been called a supersmart species able to control its base desires with better use of its frontal lobes. Ah well.

We have been able to reduce infant mortality and stave off early death. Two prongs to our dilemma. And still, no one in power will address it as an urgent – if not the most urgent – issue.

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Measles hits the unvaccinated – thanks woo wooers!

Measles on the face of this child

Measles on the face of this child

What continues to irritate me, and that means that anyone who reads this stuff I write will have to read my gripe again, is the damned and demented anti-vaccine movement. There’s an article in the Daily Telegraph concerning a current outbreak of measles reported in public health and hospital records in the UK.

I just hope that I am posting this to people who will spread the necessity for herd immunisation in communities where kiddies and babies are at risk to ensure that young parents vaccinate their children. It is so important to keep these diseases at bay.

As you know I come from the Far North Coast of NSW where there is a cute little, relatively well heeled town called Bangalow. One Meryl Dorey resides there and, until recently, fronted for an organisation she founded called the Australian Vaccination Network.

She was a vociferous misinformation specialist spreading and scare mongering all around the place. She came to prominence when a wee baby died because of a preventable disease – whooping cough. The baby died because it was too young to have received the start of the vaccination schedule to provide the protection that most of us take for granted because we were vaccinated against infectious childhood diseases when we were kiddies. So we had mild doses of these diseases by and large. Nothing is 100% sure any way.

Measles on this 7yr old's body

Measles on this 7yr old’s body

A monitoring group developed calling itself the Stop the Australian (Anti) Vaccination Network and its success has been to publish the scare-mongering of Dorey and her group which has finally forced the government regulator to demand that AVN to change its misleading name or be deregistered.

That’s the background to my more generalised gripe. I have also railed against Andrew Wakefield here in London who has been struck off the register and banned from practising medicine in the UK. Unsurprisingly he now lives in the US which is where Dorey hails from.

Andrew Wakefield - medic no more

Andrew Wakefield – medic no more

During the period of the MMR scandal that Wakefield virtually singlehandedly spearheaded, vaccination rates in the UK dropped from 92% to below 80%. The kiddies that missed out are now adolescents of 18 – 20.

These are the current victims of an upsurge in the incidence of measles in the UK. The rate is reported as being the highest in 18 years with 2016 confirmed cases by early 2013. The Daily Telegraph reported this and among the comments made to the article are some of the most uneducated and scaremongering statements, presumably in an attempt to misinform people of the benefits of vaccination while highlighting a singular case of infection after vaccination.

Anti-vaxxers behave in the same way as religites. They suffer from confirmation bias and cherry pick what data they can and then propose their own interpretation of that data. You have to deconstruct the comments to find anything worth a second glance. And the anti-vaxxers lie. They make a bald statement like 47,500 paralysed kids from Gates Foundation polio shots. This then takes an immense amount to time to track down the what and why of comments like this to lay the lie to rest and understand what the figure actually refers to which is a rise in India in the number of non-polio acute flaccid paralysis that has nothing to do with the vaccine.

Then some people comment on their own circumstances as though one can extrapolate from anecdotal evidence to a generalised community data base.

You are entitled to your own opinion but not entitled to your own facts. Apparently attributed to DP Moynihan. Well, he is right regardless.

There was a good blog article in 2009 on scienceblogs about the anti vaccination movement. The irony is, of course, that medical research and technology has contributed to a diminution in the mortality rate of human beings.

Rubella fell sharply when immunization was introduced

Measles cases 1944-1963 follow a highly variable epidemic pattern, with 150,000-850,000 cases per year. A sharp decliine follows introduction of the vaccine in 1963, with fewer than 25,000 cases reported in 1968. Outbreaks around 1971 and 1977 gave 75,000 and 57,000 cases, respectively. Cases were stable at a few thousand per year until an outbreak of 28,000 in 1990. Cases declined from a few hundred per year in the early 1990s to a few dozen in the 2000s.

Measles reported in the US before & after introduction of the vaccine

And, of course, there’s small pox. Hasn’t been a case world wide since 1979 but an estimated 300 million died from small pox in the 20th century. I am sure even the silly and dangerously misinformed anti-vaxxers are glad that a global public health effort was undertaken to rid the world of that little nasty virus.

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Religions and babies – a TED talk

Lots of us-probably too many of us

I have had a problem (I am not alone) with global population and its exponential growth for years now and am sometimes quite vociferous about the impending global over-population that will chomp its way through all available resources on our wee planet.

Now, I am being told that we have to think in terms of a global population limitation of 10 billion because that will represent the number at which we humans will actually be able to reproduce – given some criteria, of course. I have a bit of a problem getting my head around this.

In April of this year, the remarkable Hans Rosling gave a talk in Qatar to a mixed audience representing different religions in the country of Qatar. I would suggest that the most represented religion in that audience in that country would be Islam.

Hans Rosling – quite a remarkable man

Rosling’s talk was to do with global population growth and religion. To those of you who have not come across Hans Rosling, he is a quite extraordinary purveyor of statistical data in visual form. He developed the software that he uses to display data and manipulate the stats from present to past and projected future.

He is probably the cleverest statistician around at the moment. He is also a medico and qualified in Public Health in Bangalore. Anyway here’s the blurb from the TED talk:

‘Hans Rosling had a question: Do some religions have a higher birth rate than others — and how does this affect global population growth? Speaking at the TEDxSummit in Doha, Qatar, he graphs data over time and across religions. With his trademark humour and sharp insight, Hans reaches a surprising conclusion on world fertility rates.

In Hans Rosling’s hands, data sings. Global trends in health and economics come to vivid life. And the big picture of global development—with some surprisingly good news—snaps into sharp focus.

“The number of children is not growing any longer in the world. We are still debating peak oil, but we have definitely reached peak child.” (Hans Rosling)’

Of course, this does not mean that all of a sudden I will let go of and summarily dismiss my concerns about global population. Our ability to breed and reduce infant mortality while increasing longevity and sending terminal diseases back into the ether where they can do no harm just increases the problem of global overpopulation.

We are still only 7 billion and Rosling’s prediction that we will have to think of managing a finite world with a projected 10 billion and all the resources needed to maintain life for that 10 billion still fills me with despair.

The only way we can reduce our breeding rate or, at least, keep it to some sustainable level (and I don’t think 10 billion is sustainable), is by lifting the living and educational standards of the most dispossessed of us on this planet. This of necessity involves an increase in the consumption of the planet’s limited resources.

Much as I enjoy Rosling’s delivery of statistics and can be caught up by his enthusiasm, I cannot bring myself to think that all will be well. The planet will go on for its projected life which is about 4½ billion years, albeit in different form with a different (if any) atmosphere and different forms of life that can adapt to changing planetary conditions. Homo sapiens won’t make that grade I am afraid. We are too specialised. The top of the tree tends to be that way. Therein lies the fall.

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