This week has seen all kinds of activity on the war-against-disease front. Small planes dive-bombing big cities with pesticides! Ebola re-emerging! A superbug rampaging through the NIH! Vaccine clinics popping up at Walmart -- now it's not just for flu anymore, you can get your Gardasil shot right by the checkout aisle and fight killer papilloma viruses! Back-to-school-shots frenzies, lest your child come down with chickenpox and die at the hands of a ruthless aggressor! The war-and-death imagery alone is enough to make me want to lay in a year's supply of tuna and baked beans.
All this reminded me of something I've been mulling since I read the book, "The Mirage Man -- Bruce Ivins, the Anthrax Attacks, and America's Rush to War," by David Willmon. Like you, no doubt, I had thought that the hunt for the anthrax killer, who sent tainted envelopes to media and government outlets and created a mega-panic right on top of the 9.11 attacks, was conducted by the best and brightest crime-fighters in the U.S. government, who let no tip pass them by in a relentless high-tech hunt for the killer.
As Keith Jackson would put it, Oh My. The clues were thicker than a cloud of freeze-dried anthrax bacillus radiating from a deadly envelope, but the bigshots managed to miss them. All they really had to do was look into Ivins' deranged and well-documented history, and then look at the lab hours he logged alone right before and during the attacks. The ultimate irony, of course, was that the killer was among them -- the lunatic government expert who wanted more attention to his vaccine effort and was smack in the middle of the investigation himself.
An incident that caught my eye was when Iraq was still suspected of the attacks: "As Saddam Hussein continued to rebuff the United Nations and the White House, war grew imminent. Thousands of U.S. troops were being deployed, many to Saudi Arabia. Given the circumstances, the USAMRIID specialists knew that waiting 18 months for each GI to achieve immunity with injections of the anthrax vaccine was out of the question. Commander Bailey needed an answer to the original question: For how long would a soldier need to take an antibiotic to overcome exposure to inhaled anthrax? And what antibiotic would be best?"
So they asked, who else, Bruce Ivins, the anthrax killer! "But which antibiotic would be best? One product, erythromycin, could cause harmful side effects if used by persons exposed to prolonged direct sunlight. ... Two low-cost options, doxycycline and penicillin, along with Cipro, a drug patented more recently, were found to be effective ...
"Deputy Commander Peters had a related question for Ivins. Pondering it would allow the eager microbiologist to think like an intelligence agency analyst -- or to put himself in the shoes of Saddam Hussein's military scientists: 'Bruce, how hard would it be for them to make penicillin-resistant anthrax?' Ivins replied, 'High school science fair project.'"
In other words, penicillin, and presumably also doxycycline, would be worthless in treating anthrax -- according to the anthrax killer. "At that time Cipro had just been shown to work against anthrax in Petri dishes," Peters said. "So we cranked up animal testing -- and Bruce was very important in running the samples and pulling everything together."
How convenient -- the anthrax killer helped steer the government to the belief that Cipro was the best way to treat the effects of his own terrorism attack. But was it? Cipro, I believe, was overkill.
In 2002, when I had just begun working on the issue of dangerous prescription drug side effects, my UPI colleague and I wrote our first story on ... Cipro as a treatment and preventive for anthrax infections. We were working at the time on problems with an anti-malaria drug, but our first article was several weeks away. We knew that the malaria drug was a chemical cousin of Cipro and certain other antibiotics, and so when we saw that some anthrax survivors were suffering unexpected long-term effects, supposedly from anthrax, that matched the side-effect profile for Cipro, we got curious.
The article we wrote in 2002 was headlined, "Anthrax ills mirror Cipro side effects," and began this way:
"WASHINGTON, April 25 (UPI) -- Doctors treating several survivors of last year's anthrax attacks describe a continuing set of symptoms that are similar to reported side effects of the main drug used to treat them.
"Those patients -- who received treatment after actually contracting anthrax and not just as a precaution -- suffer from symptoms including confusion, memory loss, fatigue and joint pain. That same constellation of mental and physical problems also has been associated with patients taking Cipro for other reasons."
In short, the treatment may have been causing effects that were attributed to the disease, prolonging the suffering and preventing an understanding of what was really going on. There were deaths as well from seizures and heart attacks in Postal workers who were being treated preventively, because they had worked in places that were contaminated, and did not actually contract anthrax.
What is so interesting is that after several months of recommending Cipro, the CDC switched its recommendation to doxycycline -- a much more benign antibiotic that also caused problems with sun exposure, problems I suspect began to pale in comparison with long-lasting mental and physical problems officials were beginning to suspect Cipro itself was responsible for. Cipro -- which a doctor who prescribed it to a friend of mine called "the atom bomb" of antibiotics, certain to cure what ailed you but strong enough to lay waste to everything else, too -- had been approved by the FDA for a 10-day course, but in the anthrax wars it was being used for months at a time.
Cipro had another weird effect -- it could snap someone's Achilles tendon! That happened to one Senate staffer, whose boss, the senator, wrote a sharp note to regulators about whether such a drug was a bit much to be taking for months at a time to prevent a possible anthrax exposure. (I've always wondered about Vice President Cheney's hobbling around on crutches shortly after all the Executive Branch bigs took Cipro themselves as an anthrax precaution.)
I've always suspected the real reason the CDC switched its recommendation to doxy was it realized Cipro was far too strong and dangerous to deal with a threat that an old-line, much safer antibiotic could handle. In the war on germs, it seems, atoms bombs are not always the best weapon. They can end up killing people, too.
From the Editor posts this week included:
TRUMP TWEET: “Massive combined inoculations to small children is the cause for big increase in autism,” Trump wrote. “Spread shots over long period and watch positive result.” -- ABC, which doesn't like. We do!
HOTEZOLOGY: The last time I heard from Peter Hotez he was leaning over and whispering to me, "She's NUTS."She was Barbara Loe Fisher, and we were all on a panel about communicating vaccine risks, which as is so often the case was really about how to stop people like Barbara and I from communicating the unavoidably unsafe truth about the current nutty vaccine schedule. Literally whispering behind Fisher's back on a supposedly collegial panel, while she was speaking -- not too collegial, professor.
The dapper, diminutive vaccinologist (he could have strolled around Vienna in 1900, twirling an umbrella and very much channeling the Weltanschauung) popped back on my radar last weekend with a piece in The New York Times titled, "Tropical Diseases: The New Plague of Poverty." Hotez appears to have moved on from George Washington University (in: Jake Crosby; out: Peter Hotez! Score one for GW!) and is now, according to the Times, "dean of the National School of Tropical Medicine at Baylor College of Medicine and the president and director of the Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development."
In the Sunday Review piece, Hotez makes the useful point that grinding intergenerational poverty along the hot and humid Gulf Coast has allowed nasty tropical diseases to gain inroads. "Poverty takes many tolls, but in the United States, one of the most tragic has been its tight link with a group of infections known as the neglected tropical diseases, which we ordinarily think of as confined to developing countries."
Dengue fever, cysticercosis, toxocariasis, leishmaniasis, murine typhus, Chagas disease -- these sound scary, and if you get them, they are. "We have an opportunity to stop these diseases, but we need to act," Hotez writes. The actions he recommends revolve around new treatments and vaccines -- no surprise there, he's a vaccine developer -- and stepped up involvement by university medical centers in the area -- no surprise there, he's part of one. "Without new interventions, [these diseases] are here to stay and destined to trap people in poverty for decades to come."
After his big windup about poverty leading to these diseases -- because of poor access to health care, lack of air-conditioning, poor street drainage, plumbing, sanitation, and garbage collection -- his pitch lacks the seemingly obvious big step: Reduce poverty! Improve social services and sanitation! Treat people decently! Maybe that's so obvious or so impossible or so intractably tied to the diseases themselves it doesn't merit mention, at least in Hotez's mind.
But it's an interesting omission.
By contrast, in the Hotez Weltanschauung, a new vaccine is the answer to whatever ails you. My approach is more nuanced. I favor vaccine choice, and I believe some vaccines clearly have proven to be useful public health tools (as we wrote in our book, "Vaccines have played an important role in public health, from the eradication of smallpox to the near-eradication of of the rubella virus that can cause fetal harm"). My co-author Mark Blaxill and I have written extensively about two: the polio vaccine, we've argued, ended the era of global poliomyelitis epidemics (although what caused them was in fact the interaction of pesticides with the otherwise benign polio virus, and the best outcome would have been to not cause them in the first place); and the rubella vaccine (although using mercury-containing treatments in pregnant women probably made autism one of the manifestations of CRS). The fact that we can see the value of vaccination in some cases has made us a bit unpopular on our own side of the fence with some, but we call 'em like we see 'em.
But we, and many others, have noted that the general improvement in sanitation and public health measures like clean water and sewage removal was the main driver of reduced epidemics in the 20th century. We are no longer in Dickensian London or turn-of-the-century Vienna. You've not doubt seen the charts, in which diseases like measles were on a long toboggan-style slide to oblivion before the vaccines ever arrived, like Mighty Mouse, to supposedly "save the day." (Dr. Hotez as Mighty Mouse is an image I can't get rid of now.)
So who's the absolutist here -- who's really nuts, shall we say? Is it Barbara Loe Fisher, or is it those with massive conflicts of interest who are treated like gods by the likes of the Times, whose titles take up half the article but who can't remember to say, oh yes, because poverty breeds pestilence the real action step is not just their beloved medical "interventions," but a wise understanding of the natural history of diseases and their eradication?
I think it's the latter, but then, how would I know? I'm nuts, too.
THE OLD MAN: A new study that once again sees a link between paternal age and risk of disorders like autism reminds me of one of the original 11 cases Mark Blaxill and I uncovered for our book. The first father whose identity we uncovered from the landmark 1943 study was Frederick L. Wellman. He was born on June 6, 1897, and his son, Frederick C. Wellman, known as Creighton, was born on May 23, 1936. So the father was nearly 40 at the time his child who developed autism was born.
Superficially, you might think that backs up the older-father idea as a material factor in the rise of autism rates. But wait, there's more -- the father was a plant pathologist, and he was working with a brand new kind of seed disinfectant made with ethyl mercury at the exact time the son was born. We found that kind of link in several of those first 11 cases, strong evidence that The Age of Autism began when ethyl mercury was commercialized as a seed treatment, lumber preservative -- and vaccine preservative called thimerosal.
Autism began, we believe, with the first exposures to ethyl mercury in the 1930s, and exploded when a passel of mercury-containing infant vaccines were formulated and mandated beginning in the 1990s. That's the kind of thing that could explain a twentyfold increase in autism in a short period -- whereas increasing parental age cannot.
In Wellman's case, the father's age may have been a factor, simply in giving him more time to work with more kinds of mercury and other toxins that could expose his pregnant wife or newborn, or to cause genetic damage. Yet this is a classic and powerful "but for" -- but for the invention of ethyl mercury compounds at the start of the 1930s, Frederick L. Wellman could have been 101 when his son was born and that child would still not have had autism.
Creighton might have had a hard time getting the Old Man to play hide and seek with him -- but he wouldn't have had autism.
SO RITE: Sometimes with language it's the subtle choice of words that gives away a big truth. For instance, this from The New York Times yesterday: "Signaling the retreat of a childhood rite of passage, the incidence of chickenpox in the United States fell by 80 percent from 2000 to 2010, the Centers for Disease Control and Prevention reported last week."
The acknowledgement that chickenpox was "a rite of passage" is an inadvertent recognition that the effort to wipe it out isn't really worth it. And that's without considering any unintended consequences, like the value of a mostly benign childhood disease to the developing immune system; the role of vaccines, which after all are officially described as "unavoidably" unsafe, in triggering consequences known, suspected, and unknown; and the apparent role of mass chickenpox immunization in the rise of a really nasty illness, shingles.
All that just to stamp out a rite of passage.
FAT CHANCE: Among the chronic disorders soaring in children is obesity -- and yes, it's a disorder, one that leads to all kinds of other issues up to and including early death. But is there a link between the almost fourfold increase in obesity over the past three decades and the out-of-control vaccine schedule that we believe lurks behind so many other childhood problems, from autism to asthma? Three (and a half) recent news stories have gotten me thinking about that.
You may have caught the story recently about the heaviest and trimmest states. The heaviest, in order, are West Virginia, Delaware, Mississippi, Louisiana, Arkansas, Kentucky, Indiana, Ohio, South Carolina, and Oklahoma. The trimmest, in order, are Colorado, Rhode Island, Utah, Massachusetts, Montana, Connecticut, New Jersey, California, New Mexico, and Hawaii.
Then yesterday, USA Today produced a chart of vaccine exemptions by state. The chart "shows percentage of kids in each state who've gotten waivers to opt out of vaccination requirements for schools." The data is from the CDC courtesy of Every Child By Two.
The lowest rate of exemptions -- zero -- is in two states, West Virginia and Mississippi. Looking at the obesity chart, those are two of the three heaviest states. Wow, what a chance occurrence!
So I did the math, writing down the 10 heaviest and trimmest states and putting the vaccine exemption rates next to each one. There is no exemption data for Colorado -- the trimmest state -- but other surveys show it has one of the highest exemption rates (remember the kerfuffle about the Republic of Boulder and its anti-vaccine attitudes?), so I assigned it a number just below Hawaii's, the highest exemption rate on my list.
Bottom line -- the average exemption rate in the heaviest states was .54 percent -- in other words, in the 10 most obese states, about 1 in 200 kids had an exemption. In the trimmest states, the rate was 1.8 percent -- more than three times the percentage of kids, nearly one in 50, getting a vaccine exemption.
As the medical journal articles like to say, there are several limitations to this study. No kidding! For one thing, it's just me and a pencil and a piece of paper. And some states with low exemption rates, like Rhode Island, also have low obesity rates. Then there's what Seth Mnookin might call the Park Slope Effect, after the cool Brooklyn neighborhood where he lives ... all those trendy Whole-Food shopping types with their misguided phobias about vaccination. They're hipper, healthier, happier -- trimmer -- and they don't vaccinate.
But of course that gets to be a problem for the other side, doesn't it, if the best way to lead a healthy life is to adopt consciously considered health approaches including no, slow, or selective vaccination of children? Conversely, the fact that West Virginia and Mississippi have zero exemptions is because they are the only states that don't allow even religious exemptions, so there's just no getting away from the needle. This might be a marker for an overall authoritarian approach to public health in the two states -- we know what's good for you poor uneducated shiftless people, and we're going to make you take your medicine.
It's also possible that variations within each list could mean that the full effect of the ramped-up vaccination effort beginning around 1990 has worked its way through various states on various timetables.
And then there's the classic "correlation does not mean causation" -- just because the states with the highest obesity rate have a three times lower vaccine exemption rate doesn't mean vaccines cause obesity (you idiot!). Of course it doesn't. But correlation also doesn't not mean causation.
What it is, in epidemiology-speak, is something that calls for further study -- or, in Age of Autism speak, it's kinda interesting, just like the low rate of vaccination and autism in the Amish. Open minds want to know more, closed minds want to start attacking or, better yet, ignoring. (And speaking of the Amish, doesn't the high rate of exemption in some states, as documented by the CDC, offer opportunities for the vax-unvax study they claim is impossible?)
The second news story was in a recent issue of of Bloomberg BusinessWeek, which for unknown reasons has begun arriving in my mailbox. "Obesity, the Other Gulf War Syndrome," is the title. "As waistlines in Kuwait and across the Persian Gulf have expanded over the last three or four years, so too has the business of bariatric surgery. Ten years ago, Al Sanea says, there were only two bariatric surgeons in Kuwait. Today, there are 20. By 2015, he predicts, there will be 40."
The reason for this, according to the magazine, is basically a Big Mac attack. After the Gulf War, the fast-food franchises flooded the culinary desert: "In Kuwait, malls and food courts stocked with American franchises such as Burger King, Domino’s, and Krispy Kreme Doughnuts have since proliferated." The illustration shows a couple of fat Arabs snarfing up burgers being disgorged from the jet engines of U.S. bombers (chemtrails for foodies!).
And it's hot over there, don't you know -- who wants to walk around in 120 degree heat -- and, “'In the Middle East, people are lazy,' says Sarah Dimashkieh, the Lebanese dietetics operation manager at Diet Care, the largest provider of healthy, gourmet meals in Kuwait."
Wait, Arabs are lazy? You can just say that? Were they not lazy 40 years ago? Are Mississippians lazy Chick-Fil-A chompers? Do the mountains of West Virginia make it hard to go for a walk? Burger-binging and bogus cultural sneering is not a very evidence-based way to explain why Kuwait has become the stomach-stapling capital of the known universe.
Here's another idea -- when Kuwait was liberated, the U.S. swooped in not just with burgers but with Western-based medicine, including the beefed-up, bloated vaccine schedule that had just been whomped up in these United States. I've heard for years about soaring autism rates in Kuwait that coincided with that boom, and I've heard that one public health official was so upset she quit. (If anyone has tips or leads on this, let me know and we'll pursue it.)
This is just a speculation, but so is the wackadoodle idea that hot lazy Arabs inflated by Special Sauce have suddenly resorted to stomach-stapling.
Story number three, pointed out to me by my co-author and editor Mark Blaxill, from Science Daily: "Researchers at the University of Maryland School of Medicine have identified 26 species of bacteria in the human gut microbiota that appear to be linked to obesity and related metabolic complications. These include insulin resistance, high blood sugar levels, increased blood pressure and high cholesterol, known collectively as 'the metabolic syndrome,' which significantly increases an individual’s risk of developing diabetes, cardiovascular disease and stroke...."
Now, we're all familiar with issues of gut bacteria, the dysregulation of the metabolic and immune system, and vaccination. Predisposing a child to these problems would be a very, very serious outcome of vaccination policy. Let's see -- preventing chickenpox, or causing insulin resistance, high blood sugar, high blood pressure, high cholesterol, diabetes, heart disease stroke ... basically, obesity and death. You make the call.
Story 3 and a half -- Jesse Jackson Jr.'s mental health issues may have been triggered by bariatric/gastric surgery, according to doctors treating him. Studies suggest depression may be a risk after such procedures. Of course, when you ask the orthodox "experts" -- as the mainstream press accounts did -- you hear how people who get the surgery may fall into a funk because it didn't solve all their problems, or because they gained the weight back, or because it finally allowed underlying depression that might have contributed to obesity in the first place to emerge.
Or, hey, how about this? There's a connection between the gut and the brain, and when you start cutting and stapling people's innards to solve a problem that could be treated by better lifestyle decisions, and fewer medical interventions including that one, you unleash mayhem.
Body, brain, bad medicine -- there's a connection here. Will the medical orthodoxy realize it? OK, I'll say it: Fat chance!