Jun 242015
 

Helena Rho: A looming whooping cough epidemic — that’s totally preventable

A school nurse prepares a vaccine against whooping cough before giving it to students at Mark Twain Middle School in Los Angeles.

Kevork Djansezian/Getty ImagesA school nurse prepares a vaccine against whooping cough before giving it to students at Mark Twain Middle School in Los Angeles.

A looming whooping cough epidemic — that’s totally preventable

Imagine coughing so hard and for so long that you turn blue and stop breathing. Pertussis, or whooping cough, can do that to an infant. The disease is caused by the bacterium Bordetella pertussis and causes unstoppable, sustained, violent coughing accompanied by a “whoop” when you inhale. Pertussis can affect anyone, but it poses the most danger to infants.

A pertussis vaccine became available in the 1940s, and incidence of the infection dropped from around 200,000 per year to barely over 1,000 by 1976. But today the United States is in the middle of a pertussis epidemic. According to the Centers for Disease Control and Prevention (CDC), more than 41,000 cases of pertussis were reported in the U.S. in 2012. At least 18 people have died, mostly infants younger than three months of age — too young to be fully vaccinated. There hasn’t been such a major outbreak since 1959. The states with the most cases per capita are Wisconsin, Minnesota and Vermont.

The epidemic is due in part to the reduced effectiveness and the shortened duration of immunity conferred by a relatively new vaccine. But the epidemic is also spreading because of a low vaccination rate.

Vaccination needs a critical mass to effectively confer “herd immunity” on a population. When vaccine rates fall below 90%, diseases spread readily enough to endanger people who can’t be vaccinated because of illness or because they are too young. In parts of Vermont, the vaccination rate is only 60%. It is one of 20 states that allow a philosophical as well as religious exemption to vaccines, and it has one of the highest philosophical exemption rates in the country.

George Till, a state House representative and a physician, tried to change that last year by proposing a bill to eliminate the philosophical exemption to vaccines. Instead, Act 157, which became law on July 1, 2012 — when the current pertussis epidemic was already raging — turned into a complicated, compromise vaccine bill that preserved the philosophical exemption.

The protesters blared the discredited claim that vaccines cause autism

Till lives and practices near Burlington, Vt., and was elected to the House four years ago. In his re-election campaign, he spent $18.55 for dog bones. With dog treats in hand, this soft-spoken doctor went door to door and asked his neighbours to vote for him. Till, an OB-GYN and a Democrat, did not accept donations to his campaign from any group — he even sent back a cheque from Planned Parenthood.

Act 157 originated when a pediatrician neighbour of Till’s came to him with a concern. In a local kindergarten class, 75% of students were not fully vaccinated. Till researched the issue and thought it was reasonable to get rid of the philosophical exemption in order to increase vaccination rates. Till proposed a bill in the House, and state Senator Kevin Mullin proposed an almost identical bill in the Senate.

The Senate bill passed quickly, but not so in the House. The bill languished in the health-care committee. Then the Legislature was off for a week because the first Tuesday in March is reserved for town meetings in communities across the state.

By the time the Legislature reconvened in the capitol building, the anti-vaccination community had organized itself. “They were in the building every day, in people’s faces,” Till says. The activists blared the discredited claims of Andrew Wakefield that vaccines do more harm than good, that vaccines cause autism. Wakefield, a British physician, was stripped of his medical license for fabricating a connection between vaccines and autism. Till could not believe what was happening: “He is God to these people.” Millions of lives have been saved through vaccines, numerous scientific studies have debunked the myth that vaccines cause autism, and the only studies to show a link have been exposed as frauds. Yet anti-vaxxers were successfully spreading misinformation.

The most egregious was their exploitation of the death of seven-year-old Kaylynne Matten of Barton, Vt. The anti-vaccine community claimed her death was due to adverse effects of the flu vaccine. However, the coroner listed the cause of death as complications from parainfluenza virus, a different category of virus from influenza.

Till could not even convince his own health-care committee in the House that Vermont’s declining vaccination rates were a public health problem.

Kevin Mullin, Till’s co-sponsor of the bill, then proposed a compromise: placing a “trigger” into the vaccine bill so that if vaccination rates fell below 90% in any one school, the philosophical exemption would be eliminated for that school. But they could not get enough support for this provision, and it failed to appear in the final bill. The philosophical exemption stayed in place. When it came down to protecting newborns, the immune-suppressed, and children with special health needs, Till says, “This caucus threw the most vulnerable under the bus.”

Act 157 did mandate that parents refusing to vaccinate their children be required to receive educational material about vaccines and also to sign an exemption form acknowledging that they understood the risks to their children and others posed by their personal decision not to vaccinate. The Vermont Coalition for Vaccine Choice engaged an attorney, Mitchell Pearl, to challenge the language of the exemption form as unconstitutional. Pearl wrote in an open letter to the deputy commissioner of health, “signing the form is a violation of their rights under the First Amendment to the United States Constitution.” He threatened litigation if the Department of Health did not modify the exemption form’s language. The Health Department capitulated to the demands and neutralized the language of the form.

The most egregious was their exploitation of the death of seven-year-old

The Institute of Medicine (IOM) recently issued a report about the safety of recommended childhood vaccines. The 14-member panel examined numerous studies, solicited feedback from many different groups, and found the current schedule of vaccines for children, which includes as many as 24 vaccines by a child’s second birthday, to be safe and effective: “The IOM committee uncovered no evidence of major safety concerns associated with adherence to the childhood immunization schedule.” The IOM acknowledged that some parents’ attitudes toward vaccines have “shifted,” largely driven by concerns about side effects, but said its report, which is the “most comprehensive examination of the immunization schedule to date,” should help reassure these parents. The IOM was clear: “Vaccines are among the most effective and safe public health interventions to prevent serious disease and death.” What’s more, “delaying or declining vaccination has led to outbreaks of such vaccine-preventable diseases as measles and whooping cough that may jeopardize public health.”

George Till is trying again to change the law in Vermont. He believes that the pertussis epidemic was preventable. “We had the chance to be proactive, but we blew it,” Till says. In January, he introduced new legislation in the House to eliminate in public schools both the philosophical and religious exemptions to the pertussis vaccine and to require adults who work with children to be current with their pertussis vaccination. The CDC is recommending that all adults, including pregnant women, receive a pertussis booster.

Schools and homes are where disease spreads. And in Vermont, Till says there are “pockets of unimmunized” posing a threat to their communities, especially in the “hot spots of anti-vaccination.” One such hot spot lies outside the capital, Montpelier. “These young parents were born in the vaccine era and have not seen devastating diseases,” he says. Till says these parents are “picking and choosing which vaccines they give to their children.” One of the vaccines these parents are most often choosing not to give their children is against polio.

Slate.com

 Posted by at 15:43
Jun 242015
 

Warmer is better: Junk Science Week

National Post

Some present global warming as a threat to all life on the planet; others say that at best it’s a threat to human well-being. The latest from the doom-is-everywhere camp came last week from David Suzuki, who likes to float scary scenarios. He’s been a big promoter of the killer-mosquito threat, allegedly brought on as climate warming brings higher temperatures north and creates hospitable climates for disease-carrying bugs. Now he’s found a new threat: killer poison ivy. New research, he says, shows that with higher carbon dioxide levels, “poison ivy did not only grow twice as fast — it became more poisonous.”

For more of this, you can always go drown in the Suzuki Foundation’s Web site. On the other hand, there’s an alternative view of climate change. The fact is that, if the world is warming, we would see many benefits, especially for those who live in the coldest climates. Such as Canada.

Every change in our living conditions creates gains and losses, winners and losers, advantages and disadvantages. Throughout history, people have responded to change like Cassandras or Pollyannas, pessimists or optimists. The use of fear to sway public opinion, coupled with people’s natural aversion to change and media amplification of the problems it brings, has brought us to our current focus on the negatives, the problems and the disadvantages of global warming.

Scientists have noticed and discussed climate change, and then fear-mongers have magnified it into a threat. The possibility of global warming is a classic example. Here’s the conclusion of journalist Don Philpott, author of “Global Warming: How Serious Is The Threat?“, a paper published in January: “Global heating threatens our health, with the elderly, young and poor particularly at risk. It threatens our ability to grow crops and store them safely. It opens the door to a fearsome spread of diseases; it threatens drinking-water supplies and air quality.”

Sounds fearsome, doesn’t it? My response is, “Thank goodness for global warming.” Just 20,000 years ago, Canada was under a massive ice sheet, two kilometres thick in the Hudson Bay region. Just 300 years ago, a Little Ice Age would have precluded agriculture as practiced in Canada today. In fact, just 30 years ago, global cooling was the scientific consensus, transmitted to the public by the same transmission belt, the popular press.

We were told in 1976 by libertarian radio host Lowell Ponte in his book The Cooling: “This cooling has already killed hundreds of thousands of people. If it continues and no strong action is taken, it will cause world famine, world chaos and world war, and this could all come about before the year 2000.” Mount Pinatubo in the Philippines erupted in 1991, and that event caused a 1C drop in global temperature in 1992, resulting in a late, poor harvest in Canada and close to no harvest at all. Cooling is a much greater problem for Canadians.

What happened in Canada as it emerged from under the ice? Fifteen thousand years ago, flora and fauna quickly moved in. In more recent times, the treeline has moved north an average of 200 kilometres in northern Manitoba since the nadir of the little Ice Age, a period of global cooling that followed what’s called the “medieval climate optimum.” That’s about one kilometre per year. Aboriginal people moved north to capture the opportunities provided by warming 6,000 and again 1,000 years ago. Contrary to what you hear, historic evidence shows that warming offers plants, animals and people greater chances for development and survival.

In warmer times, Queen Elizabeth I had a geopolitical goal of controlling the north Atlantic and north Pacific by dominating the Northwest Passage and Arctic waters. Several people, especially Frobisher in the east and Drake in the west (see Sam Bawlf’s book The Secret Voyage of Sir Francis Drake) were looking to establish settlements at each end. Elizabeth was a leader with vision.

A later comment on the potential of the north came from the Royal Society in 1817: “New sources of warmth have been opened and give us leave to hope that the Arctic Seas may at this time be more accessible than they have been for centuries past, and that discoveries may now be made in them, not only interesting to the advancement of science, but also to the future intercourse of mankind and the commerce of distant nations.”

Canada is one of the few countries with access to three oceans. As we evolved as a nation, the focus shifted from the Atlantic to the Pacific coast. That left the centre essentially landlocked. But this will change if global warming occurs as predicted by the doomsayers. Access to the Arctic Ocean as ice conditions ameliorate and temperatures increase will open another door to the world.

Ironically, for 200 years most western development and settlement came through the ports at York Factory and Churchill. The plan for a Hudson Bay route — by the trading company, now a retailer, bearing the same name — tried to continue this pattern, but essentially failed because of political domination by the east and a three-month limit to the shipping season by insurance companies. With icebreaker support, new cargo vessels and better insurance, the current shipping season could be extended to five or six months. Predicted warming would extend this even more. Commerce is shorter and more direct because great-circle routes put Arctic and Hudson Bay ports closer to Europe and Asia.

Just a brief list of the benefits to our coldest province, Manitoba, and the coldest city, Winnipeg, illustrates the positive potential of global warming:

– Reduced heating costs.

– Reduced fuel bills for travel.

– A longer growing season, allowing a greater variety of crops.

– Less frost damage and crop loss.

– A greater variety of plants for gardens and other uses.

– More rapidly growing forests and an increased rate of reforestation.

– Less frost damage to streets and roads.

– The potential for direct access to world markets through northern ports.

– Reduced construction costs in an ameliorated climate.

– A longer summer season for tourism, and for cottagers and campers.

As for mosquitoes, Winnipeggers at least have been dealing with the pesky bugs since long before David Suzuki even heard of global warming.

A warmer Canada would improve our lives in these and other ways too numerous to list. Global warming? Let’s hope so.

 Posted by at 15:36