Medical Hysterias - real or the result of irresponsible jour

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Saint Kurt
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Medical Hysterias - real or the result of irresponsible jour

Post by Saint Kurt » Tue Nov 04, 2008 6:03 am

This is a subject I think about a lot.

Often, when medical issues are reported by the mainstream media, they are reported in such a way as to present a "headline" that is attention grabbing and appears newsworthy. The problem is that the articles rarely get the facts straight and the public that reads them doesn't have access to peer reviewed medical journals, nor are they equipped to read them.

A recent examples in veterinary medicine would be the contaminated pet food scare and the discovery of a new strain of parvovirus in the US.

The melamine scare caused all sorts of problems. Vets were overloaded with calls and visits by owners with well pets that had eaten food that may or may not have been exposed to the tainted food. At the height of the hysteria, the hospital were I work saw exactly 1 case of suspected poisoning and exactly 0 deaths. The animals that became ill were either very young, very small (such as cats), or already had impaired kidneys (the food pushed them over the edge). The treatment for renal insufficiency due to the tainted food was to stop feeding it (duh) and hospitalize over night on fluids to diurese (clear the kidneys) the animal. The food companies paid for these treatments.

The real cost was not the vet bills that was the real problem, but the general reaction of course. A lot of people told me they had switched to cooking for their pets to insure they were getting safe food. My response was "why? They're going to find melamine in the human food supply too."

Which, they have.

The parvo strain is another one. (Parvo is a virus that causes very serious diarrhea in dogs. Puppies are vaccinated against it and dogs receive booster vaccinations as adults. Like the flu virus, there are different strains, and like the flu vaccine we get, only certain strains are included.) Since last August they've been posting all sorts of notices at shelters about how this new wave of "stronger more deadly parvo" is sweeping shelters and describing the steps taken to protect their populations (and thus your pets if you should adopt one of their animals) against it. The news media has reported about it as well.

Again, vets are receiving frantic calls and visitis particularly since the main symptom of parvo virus is diarrhea and this is dogs we're talking about. Just like us, sometimes dogs get diarrhea. But not all diarrhea is parvo. (In fact, it usually isn't parvo.)

Another thing is that owners are demanding the "special parvo vaccine" recommended by their local shelter/neighbor/google. The thing is, the AVMA and the CDC jumped on this and all of the currently available vaccines protect dogs against the new strain in their non-biased tests.

So while vaccine breaks do happen with the new strain, it's not really news since they happen with all vaccines.

And speaking of vaccines and medical misinformation, back in the human medical world, there is still a debate about whether or not childhood vaccines cause autism. The result is parents refusing to vaccinate their children and disease that were at one time nearly eradicated in the US (such as measles) are on the rise.

People seem so willing to follow what is news that they don't look at facts it seems. One of the facts is that vaccination is one of the single greatest medical discoveries of our time and is directly responsible for the longer lives we live and the incredibly low childhood mortality parents enjoy.

It shocks me that people would give that up just because they fear unproven rumor.

What do you think? Am I an alarmist on the other side or should journalism enjoy the same checks and balances that medical journals do (they are peer reviewed to insure the accuracy of the data and reporting) when reporting on subjects that may affect public health and safety?

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Medical Hysterias - real or the result of irresponsible jour

Post by fourpawsonthefloor » Tue Nov 04, 2008 4:53 pm

I think that people do follow the 'new fears' for certain. Remember SARS? Holy canonli. And the blunt fact of the matter is that a ton of people die from silly things that they don't think about like the flu or taking too much tylenol. So lets all freak out about mad cow disease when it's killing say...a dozen people...and ignore the flu which kills thousands every year.

Or how about the diseases in the third world countries like maliaria that should really have a cure by now.
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Medical Hysterias - real or the result of irresponsible jour

Post by Scumfish » Tue Nov 04, 2008 8:20 pm

Amen to that. I remember talking to one guy at a bus stop (as you do, I think crazy people must think I smell familiar) during the SARS thing and he was like 'Oh, I have the symptoms, I'm getting SARS. I'm going to die'.

....I kinda edged away at that point, but I remember thinking that wouldn't he kinda be in hospital? On top of that, I suddenly saw a lot of people with face masks on. My whole reaction was very much 'WTF'.

As for the MMR jab? Just the thought of that makes me angry. The pure coincidence of the timing of the jab and the outset of symptoms of autism has led to an almost epidemic of what is potentially a very dangerous set of diseases. Thing is, people think that measles is just a slightly worse form of chicken pox. If that was the case, then wouldn't we have long started jabbing our kids for that too, instead of sending them around to catch the damn thing?

(Speaking as someone who's never had CP and will probably end up having shingles if he ever catches it ><)

Gaaaaah. Summery = media can be REALLY dumb sometimes. Yes, I think they should get their facts straight and be checked before panicking the public. I'm all for freedom of the press etc, little anarchist that I am, but goddamn it would make the lives of our medical prfessionals so much easier, both vetinary and human...ary.
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Medical Hysterias - real or the result of irresponsible jour

Post by Saint Kurt » Wed Nov 05, 2008 3:45 am

Originally posted by Scumfish
Thing is, people think that measles is just a slightly worse form of chicken pox. If that was the case, then wouldn't we have long started jabbing our kids for that too, instead of sending them around to catch the damn thing?
We do vaccinate for Chicken pox in the US. We have been since 1995. :)

Of course, that vaccine has its own detractors. This is just a short section from an internet diatribe about vaccines from a person claiming to be giving parents "the real truth your doctors are keeping from you about your children's health". Reading it nearly made my head spin exorcist style.
The normal route of entry of chickenpox into a child's body is through the mouth and nose-- usually inhaling particles that an infected person has coughed. This means that the virus will come in contact with the mucous membranes and trigger the beginnings of an immune response. After this initial "alert" of the immune system, the virus travels to the lymphatic system, where additional body defenses are mustered. Finally, after the body has had adequate time to gear up, the virus gains access to the blood stream and major organs. But by this time, the immune system is mounting a full response (thanks to its being alerted early by the mucous membranes and lymphatic system) and will usually protect the major organs from damage from this virus.

Now compare this scenario to what happens when one's first exposure to the virus is from a vaccine: The mucous membranes are bypassed. The lymphatic system is bypassed. The live virus gains immediate access to the bloodstream and major organs -- a situation that millions of years of evolutionary wisdom seems to have tried to avoid!

No one really knows what the long term ramifications of exposure to this virus in this unorthodox way are. Since it is so new, there is no long term data available. In fact there is no data to even suggest that after ten years, immunity from this vaccine is sufficient to prevent the disease -- possibly leaving people vulnerable to getting chickenpox as adults when the risks of this illness are much greater!
This is written by someone who "got out their college Microbiology textbook" to look up the Herpes virus. I'm sure it was very informative since microbiology is the study of bacteria (and virology is the study of viruses).

The section that I bolded is what makes this stuff so maddening. It seems that her college microbiology textbook failed to mention that there are 5 immunogloblins, 4 immune responses, and 2 totally independent immune system mechanisms for dealing with pathogens which the doctors and researchers were undoubtably aware of even if the article's author wasn't.

To set the record straight: The mucous membrane response she describes happens via IgA an immunoglobulin that one of the body's ways of identifying potential pathogens BEFORE they reach the lymphatic system. For things like a flu vaccine, an intranasal vaccine to exploit this response would be ideal. (and we do have those) She is right that IgA is like an early warning system in that it is an immune response at the level of the tissues. But it isn't the only way in.

Many viruses, like the one that causes chicken pox, need to replicate systemically and create a state of "viremia" - in which the virus is circulating in the blood. That's where the cellular immune mechanism (the one that makes vaccines work) kicks in. So injecting a "modified live virus vaccine" will expose the right immune mechanism to the closest thing to chicken pox so that should real chicken pox show up - the immune system cells actually have antibodies "on file" in order to kick ass directly rather than trying to make them right then. (This is because it is the second exposure, not the first during which the body mounts its most powerful immune response. THAT is why there are booster shots. It's not because we "run out of immunity" after a while. Physicians and researchers actually studied the immune system and figured out the most effective method of activating it. Booster shots are what confers long term immunity even if the body is never challenged by the real pathogen.)

Vaccine fears REALLY get me going because people don't understand them and it doesn't seem like much is done to educate. Right now there is a vaccine against cancer that could save the lives of millions of women, but isn't being administered because parents don't understand it.

The HPV vaccine (guardasil) protects against the human papilloma virus which is the virus that causes cervical cancer - one of the most common cancers in women. (Looking for this cancer is the reason you have a "pap smear". It is a screening test for cancerous changes in the cells of your cervix due to infection with the PAPilloma virus and it is so common that doctors advise women to screen for cervical cancer once a year.) This vaccine is effective against 40 different strains of HPV and would save the lives of appoximately 4000 a year (~12000 have a positive pap smear and are treated for cervical cancer).

So, here we have a way to completely eliminate a form of cancer that kills women. Why aren't parents breaking down their doctor's door to have their daughters vaccinated?

Because the vaccine is most effective when administered between the ages of 11 and 12, before most girls are sexually active and before her cervical cells begin to take on adult characteristics. Most parents don't like to think about their daughters having sex when they are 11 or 12 or they fear it will give their daughter carte blanche to have all the unprotected sex she wants because she's "vaccinated".

Are we really this stupid? Are we really giving up a cure for cancer because we are squeamish about sex?

It seriously makes my head spin.

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