Virus Sharing: a Puzzle of Consequences

A scare of pandemic bird flu has been circulating through the news for a few years now, but recently a new flu crisis has sprung up that threatens the readiness of all countries for next year's flu season. Indonesia, the world's hot spot for flu viruses, has refused to provide the World Health Organization (WHO) with this years collected virus samples. The Indonesian government is demanding compensation for providing such crucial information in the fight against seasonal flu, a prospect that the United States has condemned.

US Secretary of Health and Human Services, Michael Leavitt, is currently in Indonesia to discuss the matters of mutual interest with the Indonesian government. The main topic was the Indonesian government's opt out of the international influenza surveillance system which has been in place for almost 60 years and provides vital information on what flu strains to include in the next year's seasonal flu shots. But non-seasonal flu viruses are also part of global surveillance, including the all-famous H5N1 avian influenza virus (bird flu) and Indonesia's decision to opt out means that the biological and genetic character of viruses from the world's hot spot for bird flu disappeared from the view of the world scientific community.

In my view, Siti Supari, the Indonesian Health Minister, has acted irrationally and shown bad judgment but the uncomfortable truth is that there is merit to her concerns.

Last year a virus isolate from the bird flu virus was used by Australia to create a vaccine for emergency workers should a pandemic occur. They then followed up with an announcement that only Australians would have access to the vaccine. This pushed Supari over the limit and as of January 2007 she suspended sharing of viruses isolates. It has always been a dirty secret that the countries who provide the most valuable genetic information for vaccines rarely gain access to the high-cost, low-supply vaccines, but this time was too much.

Supari has long been an outspoken critic of the current surveillance system as the truth is an incredibly small amount of vaccine is made available in Indonesia, and even that small amount is too expensive to be useful to the populace. Hence, a small country sharing the bulk of the important health information we need is also shouldering a large burden from the disease while industrialized nations produce and quickly price out any weaker competition. Supari suggests being able to auction off the virus for money that would be used toward the purchase of the vaccine. This sounds like a logical answer as countries recognize the intellectual property of the vaccine developed from the virus, but do not recognize the value of possessing the genetic information to produce the vaccine.

Selling viruses though is a rather slippery slope because you open the option that one country could purchase a virus to hoard or produce biological weapons (in fact, this was one of Supari's concerns, that the samples she was sending the WHO were being shared with Los Alamos Laboratories, and they were).

When considering Indonesia's situation it is easy to see how dire economic stability and public funding is. The country was devastated by the 2004 Indian Ocean Tsunami and now are suffering through a vicious food crisis (as is the rest of the world), and their virus information is a valuable commodity which could hold substantial value.

Its been said that the governments have failed to reach an agreement during a United States visit to Indonesia this month and that outside help will have to be employed. It just so happens that Bill Gates will be representing the Bill Gates foundation in Indonesia in two weeks and I feel that his organization may try to bring the stalemate to an end.

The real danger in this situation is a rise in a highly contagious and deadly strain of flu which escapes surveillance and hits the world unprepared. Honestly the world isn't ready to deal with a pandemic outbreak of the bird flu, which is scary since we have a vaccine for it. The US doesn't have enough vaccines to ensure the safety of the nation and I can guarantee you that many Asian, African, and South American countries won't be ready either, and that could create an incubating population that can't escape the grasp of the illness. And why do I think this is really getting serious now?

The countries surrounding Indonesia have been gearing up on the defensive lately which makes me believe the situation inside of Indonesia is worse than they are letting on. They have confirmed more cases (113) and more deaths (91) than any other country, are the fourth most populous country and have a vast reservoir of infected poultry (and who knows what else). Who knows what the actual numbers are now or if people are able to be quarantined and effectively stop the transmission or incubation of a highly potent killer.

Japan will shortly begin pre-pandemic vaccination -- based on older H5N1 strains from China, Indonesia, and Vietnam -- of up to 10 million citizens involved in maintaining crucial social infrastructure and as mentioned earlier, Australia is gearing up to provide essential citizens with a vaccine. The proverbial "pandemic ballgame" has moved to a defacto higher level.

5 years ago when calls for planning for a pandemic were raised nations looked internally, forgetting that infection and disease can't see boundaries on a map. The poor countries where these problems will arise need a plan, this action by Supari is desperate and her people will die in droves as the government crumbles if this is allowed to continue.

But even given time and money I don't know that the world can trust governments like Indonesia; after the tsunami they got the bulk of a billion dollars and they stole it. What they didn't steal they didn't use for bird flu prevention either, which is why we're in this mess in the first place.

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Uber Fail by the Anti-Vaccinationists

I was searching around for some flu information at work dealing with an NIH project I have and my google search turned up some pretty freakin scary results. One of the first hits, "Building a Child's Immunity the Natural Way" is so fundamentally wrong about all matters medical that it took a while for me to read through it. It starts off really bad.

New Jersey's Public Health Council gave its citizens a Christmas present that will not please the health-conscious, as it became the first state in the nation to require flu shots for preschoolers.

So being "health-conscious" now means your are anti-mandatory vaccinations. What the fu...

Vaccines are dangerous for the health of any individual, but when administered to small children in their important developmental years, they are especially damaging. Medical "experts" have not even determined the correct dosages for small children, who in this regard are not just small adults. When we talk about daycare, we are talking about babies as young as a few months of age. Additionally, not only do vaccines usually contain mercury, but many lack effectiveness and can cause problems with the development of the child's natural immune system (emphasis mine).

Look, I'm not going to address all of the anti-vaccination canards present in this piece, other than refer you to other excellent sources. Two things really get me though: lies, and this "immunity" thing.

Even if the evidence of a relationship between vaccine use and autism is disregarded, there are more debilitating results of vaccine administration to children. Due to the availability of new health information, a growing number of scientists and doctors have realized the problems revealed by recent immunology research and have begun to challenge the foundational tenets of vaccination. Because it seems that vaccines have eradicated many diseases in the last 100 years, many doctors have been reticent to question them. Such claims have mainly been based on epidemic studies rather than on clinical evidence.

For example, Europe never used the polio vaccines, yet it experienced the same rise and fall of polio cases as did the U.S.

That, my dear reader, is a lie. OK, if you are being generous, it is just ignorance, but I find it hard to be generous, given a 3 second stop at google will take you over to the World Health Organization and explain its polio eradication campaign in Europe. After a lie like that, it's hard to believe anything that follows.

Also, many diseases that were believed to be wiped out have re-appeared under different names. As an example, spinal meningitis and polio have almost the same exact symptoms. There have never been any studies that proved the vaccines actually did cause the eradication of any disease; it has only been assumed by the fact that that the epidemics seemed to have ceased. The CDC uses the concept that a relationship does not prove causality to downplay the autism-thimerosal link, yet ironically, they don't apply the same standard to the relationship between vaccination usage and the end of an epidemic.

That isn't just "moving the goalposts"; that's digging them up, burning them, and scattering the ashes. We all know epidemiologic studies have their limitations, but it's pretty clear to the scientific community, beyond a reasonable doubt, that vaccines successfully prevent disease. (By the way, "spinal meningitis" and polio are completely unalike, and, believe it or not, we actually have tests to tell us what organism is causing an infection. Welcome to the early 20th century!)

All vaccines depress our immune functions. The chemicals in the vaccines depress our immune system; the virus present depresses immune function; and the foreign DNA/RNA from animal tissues depresses immunity. Studies have found that some metabolic functions were significantly reduced after vaccinations were given and did not return to normal for months. Other indicators of immune system depression included reduced lymphocyte viability, neutrophil hyper-segmentation, and a reduced white cell count. So we are trading a small immune depression for immunity to one disease, our only defense against all known disease for a temporary immunity against one disease, usually an innocuous childhood disease. Vaccines have been linked to AIDS and other immunodeficient disorders as well. The trade-off is not at all fair and not worth the risk.

Wow. This is so damned stupid. And dangerous. First, what does this phrase "immune depression" mean? I don't know. They do give a hint futher down, throwing around big words like "neutrophil hypersegmentation" but that's pretty meaningless as an observation, and without references is completely useless. Then the nice scare tactic of vaccines and AIDS. Nice. Really nice. OK, time to explain how vaccines actually work.
Vaccines and the Immune System

This is really cool...much cooler than the cultists would like you to believe. It is teh uber-kool. And please forgive the over-simplification.

We need an example: let's take polio vaccine---you know, the one they never used in Europe when the WHO wiped out polio in Europe. We have two choices, but the one we use the most in N.A. and Europe is the inactivated polio vaccine (IPV). Both of the polio vaccines have advantages and disadvantages, but hey, I only have so much time.

To make IPV, polio viruses are grown in the lab, then "inactivated" with a chemical. This renders them non-infectious. Then they are injected under the skin, which is where the fun starts...

When the inactivated viruses enter the tissues, immune cells patrolling the area detect foreign chemicals, usually proteins. (Viruses are not living organisms, but basically little bits of RNA or DNA and protein.) These cells engulf the invading viruses, process the parts, and actually display them on their surface, like a sign. Other cells (T-cells) come by, and if any of them happens to be able to read this sign, they get very excited. These cells, by various mechanisms, pass the news of the specific invader on to B-cells, which then mature and start making antibodies that are specific to the polio virus. This takes a few weeks. After this initial introduction of polio to the immune system, the antibody reaction dies down, and a few of these now-polio-specific B-cells go into hibernation in the spleen, lymph nodes, gut, and other nooks and crannies.

Let's fast forward a few years. You are about to go on your dream vacation to Uganda. You've been warned about sporatic cases of polio in the area. You have every intention of avoiding unpurified water and uncooked foods, but nobody's perfect. One night at dinner you accidentally eat the salad. They guy who made the salad just returned from the outhouse, which doesn't have a sink. Eww. In his stool were some polioviruses. These were deposited on his hands, then into your salad, and ultimately into your gut. I hope it was a good salad.

When the virus reaches the gut, it latches onto the intestine. Some of your immune cells recognize it, and start the same process that happened when you were vaccinated. Except you have those clever little "memory B-cells" left over from your vaccination, so instead of the immune reaction taking weeks to ramp up, it takes hours. Your B-cells start dividing and producing antibodies and secreting various important chemicals. The antibodies mark cells infected with polio with a big sign that says "kill me", and the soldiers of the immune system march in and do just that.

If it weren't for your vaccine, the antibody response would have taken too long, and you would have become infected. Chances are you would get lucky and suffer nothing worse than a "stomach flu". Or you could end up paralyzed.

So, when I read idiotic trash like the above article, I get really, really mad. All these years of science, medicine, and public health pumped into the sewer in favor of cult medicine bullshit. They should be ashamed. But of course, they have no shame.

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Its All About the Vaccines.

So after John McCain's statement that mercury based vaccinations were causing autism the anti-vaccination crowd started to rumble a little louder. Most groups want you to believe that they are against vaccines because mercury has caused autism and other neurological disorders in children (a claim which the CDC and the American Academy of Pediatrics). But the truth of the matter is that most of the groups are plain anti-vaccination and are using this mercury tactic as a ploy to circumvent the vaccination process. Take a look at this ad:

Now it looks like a rather straightforward poster with easy to read and significant data. But let me break it down. The syringe on the left indicates there were only 10 mandatory vaccines in "1983" and 1 in 10,000 children had autism. The "2008" syringe contains 36 vaccinations (although Generation Rescue cheats by including the prenatal flu vaccine recommended for pregnant women and several non-mandatory flu vaccines to pump up the 2008 number). Then comes the big bomb in the text with more fallacies than gnostic gospels.

"The statistics speak for themselves. Since 1983, the number of vaccines the CDC recommends we give to our kids has gone from 10 to 36, a whopping increase of 260%. And, with it, the prevalence of neurological disorders like autism and ADHD has grown exponentially as well.

Just a coincidence? We don't think so. Thousands of parents believe their child's regression into autism was triggered, if not caused, by over-immunization with toxic ingredients and live viruses found in vaccines. The Centers for Disease Control and the American Academy of Pediatrics dispute this but independent research and the first-hand accounts of parents tell a different story."

Since 1983 a few other things have happened that are ignored in the text. For example, in the early 1990s, the diagnostic criteria for autism were broadened, and campaigns for greater awareness were begun. Diagnoses of autism in 1983 were made using the DSM-III, where the criteria for an autism diagnosis were much more restrictive than those in the DSM-IV, released in the early 1990s. Moreover, in 1983, categories of Asperger's and pervasive developmental disorder-not otherwise specified, both of which are lumped into the 1 in 150 figure for 2008, weren't recognized in the DSM-III. In 1983 the Apple Macintosh debuted and IBM released a PC, the first CD also showed up later that year. I blame the rise in autism on these three things (I really don't, but you see my point).

And a lot of other things have happened since 1983 as well, but to Jenny McCarthy and now John McCain it has to be those evil vaccines. And since the mercury theory is taking a beating in the scientific community the antivax people were ready to up and move onto something else.

Why do we only test vaccines individually and never consider the combination risk of vaccines administered together? Given the dramatic rise of autism to epidemic levels, isn't it time for the scientific community to seriously consider the anecdotal evidence of so many parents?

Here note the moving of the goalposts and unfalsifiable hypothesis that it is some "combination" of vaccines that causes autism. How would you test this theory unless you purposely withhold necessary and sometimes lifesaving vaccines from very young children? I'm sure the antivax would love that but it is unethical to subject children to an increased risk of disease contraction to see if you're right. Note the post hoc ergo propter hoc fallacy and conspiracy mongering. Everytime one of their theories on causation is shot down by scientific studies they never give up, and just keep going. If you still think this is about the mercury then check out this rally held by a group of antivax.


If that doesn't seal the deal then I don't know what does. These guys have surrounded themselves with a false theory and are attacking the medical community based on false observation and conspiracy mongering.

And usually I would let this lie, but now a possible President has thrown his hat behind the antivax movement. This is an egregious miscalculation and oversight by a large public figure. Universal vaccination is one of the pillars of modern community health and circumventing the health of the nation to pander to right-wing conspiracy theorists is unacceptable for someone who will control the machinery of our public health system. Beware if McCain is elected, he obviously will support science very little.

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"Strong Evidence" Mercury Causes Autism claims McCain

Jake Tapper, ABC News' Senior National Correspondent, reports John McCain's views on thimerosal and autism.

At a town hall meeting Friday in Texas, Sen. John McCain, R-Ariz., declared that "there's strong evidence" that thimerosal, a mercury-based preservative that was once in many childhood vaccines, is responsible for the increased diagnoses of autism in the U.S. -- a position in stark contrast with the view of the medical establishment.
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McCain said, per ABC News' Bret Hovell, that "It's indisputable that (autism) is on the rise amongst children, the question is what's causing it. And we go back and forth and there's strong evidence that indicates that it's got to do with a preservative in vaccines."

Really John? Well lets check out what the established medical and research community has to say about this.

The Centers for Disease Control (CDC) says "evidence from several studies examining trends in vaccine use and changes in autism frequency does not support such an association." The CDC was supported by a scientific review* by the Institute of Medicine (IOM) which concluded the "evidence favors the rejection of a causal relationship between thimerosal-containing vaccines and autism."

The American Academy of Pediatrics says "No scientific data link thimerosal used as a preservative in vaccines with any pediatric neurologic disorder, including autism."

The Food and Drug Administration (FDA) conducted a review in 1999 -- the year thimerosal was ordered to be removed from most vaccines -- and said that it "found no evidence of harm from the use of thimerosal as a vaccine preservative, other than local hypersensitivity reactions."

And a study of California Department of Developmental Services data published last month indicated that there was "an increase in autism in California despite the removal of thimerosal from most vaccines."

There is a vocal and determined group of medical researchers who dispute what the medical community says about the issue. One question they ask is why would the thimerosal have been removed from the vaccines if there was no real harm? The answer so far has been, according to the Public Health Service, "because any potential risk is of concern."

Either way the Republican nominee is stating that he at the very least isn't as sure about thimerosal than the medical community. Even further, the way he speaks about the vaccine totally masks the fact that the thimerosal is gone from almost every childhood vaccine, and has been since 1999. Now explain that John.

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