Health Spectator

Karen Hays died July 17 from complications to swine flu.

A 51-year-old nurse in Sacramento, CA became that state’s first health-care worker to die of swine flu. Karen Ann Hays died July 17 of a severe respiratory infection, pneumonia and H1N1, according to her death certificate. She also had methicillin-resistant Staphylococcus aureus (MRSA), a staph infection that is resistant to many antibiotics.

The Sacramento Bee reported the death on July 31. Hays was a triathlete, skydiver and marathon runner—not the typical sort of person to die of the flu, one might think.

“It’s not surprising for an otherwise healthy person to die of H1N1,” said Dr. Glennah Trochet, Sacramento County’s public health officer in a statement to the Bee.

“Nationwide all along there have been people who have died who did not have underlying medical conditions” such as obesity or pregnancy, she said. “When a disease is common enough and circulates enough, you will see all kinds of deaths.”

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have both said that health-care workers should be among the first to receive vaccinations against swine flu.

British health authorities reported July 14 that Dr. Michael Day of Bedfordshire, north of London, died from complications of the flu, becoming the first physician known to have died in the pandemic.

As of Thursday, August 6, 2009 the CDC has reported 436 deaths in the U.S. attributed to swine flu out of 6,506 cases reported. These figures were posted on the CDC website today.

One thing clearly different about this flu compared to the so-called “seasonal flu” that people have previously been exposed to is its relative virulence during the summer months. The chart below from the CDC shows the percentage of influenza-like illnesses (ILI) compared to the total number of illnesses reported by outpatients during the seasons 2006-2007 (blue line) 2007-2008 (green line) and this year (red line). While the winter spike from the 2007-2008 flu season (green) was a higher percentage of total cases reported than this year’s (red), this year’s level has remained higher during the summer months.

Chart of influenza-like illnesses as percentage of total illnesses. Source: CDC

In what came as a surprise move, the House passed a sweeping food safety reform bill a day after defeating a previous version. House Democrats kept revising the bill until they got it right. The previous version would have placed onerous burdens on small farmers and small food producers.

The version that passed the House today exempted these groups so long as they are selling their good directly to consumers, retailers and restaurants. When selling to wholesalers, however, they are covered by the same rules and restrictions as larger producers. That is, they are required to pay an annual $500 registration fee and to maintain a track-back system that identifies lots of food and their origins.

If passed by the Senate, the bill would require all facilities to have a food safety plan in place, would give the Food and Drug Administration the power to order food recalls, and would expand FDA access to company records.

Supporters of the bill say it will enable the Food and Drug Administration (FDA) to prevent food contamination through increased inspection of large food-preparation facilities. More than 76 million Americans fall sick every year from food-borne illnesses, while 5,000 of those die.

Under the bill, inspections would take place every six to 12 months at high-risk facilities and every three years at lower-risk plants.

Currently, plants may go years without an inspection.

The U.S. Food and Drug Administration (FDA) Tuesday announced its decision that mercury amalgam fillings—the so-called “silver” fillings most Americans have in their teeth—contain insufficient mercury to warrant concern.

“While elemental mercury has been associated with adverse health effects at high exposures, the levels released by dental amalgam fillings are not high enough to cause harm in patients,” the FDA website proclaims.

A national group called Moms Against Mercury, along with three other organizations, had sued the FDA in 2006 to have mercury fillings removed from the U.S. market. Later that year, an FDA panel of outside experts voted 13-7 against two statements put to them regarding the FDA’s position that mercury amalgam fillings were safe:

The panel’s rejection of these statements caused quite a flurry among pro-mercury and anti-mercury forces alike. Those opposed to the use of mercury in fillings were heartened that at last the government might be listening. The American Dental Association (ADA), which has long favored the use of mercury fillings and supported the FDA’s position, was stirred to action over the possibility that mercury amalgam might finally be banned.

According to the FDA’s website, Tuesday’s ruling was the FDA’s final word on the subject, to the disappointment of those who were hoping to have mercury banned from dental fillings because of its proven adverse health effects.

Denmark Norway, and Sweden have banned the use of mercury amalgams. Several other countries do not allow the use of mercury fillings in young people under the age of 18.

To see a video entitled “How Mercury Causes Brain Neuron Degeneration” produced by the University of Calgary Faculty of Medicine, click here.

Sometimes we come across pieces in our files that never made it into “print” because they still had a few unfinished paragraphs or sentences, or maybe we just didn’t find time that week to do a final edit, after which it was forgotten. We think of them as orphans. This is one of those that we’ve come back to, finished and updated. We hope you find it useful, if much belated.

We saw it today on our own home page, right at the top of the list of the Reuters news feeds: Many Americans still do not get fluoridated water. The ensuing article quotes Dr. William Bailey of the Center for Disease Control and Prevention’s Division of Oral Health as bemoaning the tragedy that more Americans aren’t getting fluoridated water. Then, further down the list, we found a headline to an article on a related subject that set our hackles on end: US Mayors Agree to Phase Out Bottled Water.

Now don’t get us wrong: we’re no huge fan of bottled water. Yes, we understand that the plastic bottles are not only a huge waste-disposal problem, but generally unhealthy in their own right because of the plastic or its components leaching into the water. And so many of the commercial bottled waters are just bottled tap water sold by the likes of Coke and Pepsi anyway. (The worst of these are highly fluoridated as well.)

So we think of the American obsession with buying bottles of water as—well, misguided. It’s just one of the many things we’ve been brainwashed into doing by the corporate media. Watch enough television, and you’ll start buying bottled water too. And don’t get us started about the current practice of putting flavorings and sugar in the water and calling it a “sports drink.” (Yeah, right!)

However, one of the reasons we hate to say goodbye to bottled water is that it is the only way many Americans can get water that isn’t fluoridated, although the proposal to require fluoridation of bottled water has been put on the table.

So we couldn’t help but wax cynical when we read the following statement in the first-mentioned Reuters article about fluoridated water:

Asked if there is any responsible evidence showing negative health effects due to fluoridated water, Bailey said, “No, not at the levels that we use in community water systems.”

This statement is misleading and irresponsible. (more…)

This posting from the Cornucopia Institute is a video that portrays an emergency meeting of organic dairy farmers in Wisconsin pleading with U.S. Department of Agriculture Secretary Tom Vilsack to level the playing field against factory farms so that small farmers can survive.

One of the ironies of this piece occurs at the beginning, when an emcee approaches the refreshment stand at the fair and notes that bottled water is selling for $2.00—and milk for $0.50.

“Can farmers really be expected to sell milk for one quarter the price of water?” he asks the camera.

The farmers are protesting the fact that many large “organic” dairy farms flaunt the regulations, while “conventional” dairy farms—ironically the current term used for farms that inject their dairy cows with hormones to force them to produce twice as much milk as normal—may milk as many as 7200 cows a day.

Meanwhile, small farmers are finding it tough to survive, and more go out of business every day. This is not what we want to see if we are going to keep ourselves and our children healthy with wholesome products from small, local organic farms.

According to a posting by the Associated Press penned by Frank Jordans with the dateline Geneva, “U.S. health officials estimate the United States has passed the 1 million case mark.” The story is an interview with World Health Organization (WHO) second-in-command, Keiji Fukuda.

The wording of that story took many readers by surprise. It gave us pause, too. Finally we realized.

Health Spectator initially reported on June 25 that mathematical modeling by Lyn Finelli, an official with the CDC had projected that there might be one million swine flu infections in the U.S. at that time. So the AP and other sources are just trotting out this old figure. It does not represent a new set of figures released by any U.S. health officials, as the story seems to imply.

A recent paper in the journal Nature¹ published by University of Wisconsin (and University of Tokyo) virologist Yoshihiro Kawaoka implies that a high death toll from swine flu is a greater danger than first thought. Still, not all authorities agree that the symptoms caused by the so-called “novel” A(H1N1) virus are worse than those from seasonal flu.

It is important to realize that Kawaoka’s experiments were conducted in mice, ferrets, macaque monkeys and non-human primates; however, his lab and others have used these animals before in an attempt to analyze and predict the behavior of flu viruses in humans.

Kawaoka’s lab used a version of the novel A(H1N1) virus referred to as CA04 because it originated from a patient diagnosed with H1N1 swine flu in California on April 9 of this year. Kawaoka states that “CA04 causes more severe lung lesions in non-human primates than does a contemporary human influenza virus” and further, that “in all three mammalian models tested, CA04 seemed to be more pathogenic than a contemporary human H1N1 virus, KUTK-4.”

Severe lung lesions

In other words, the novel H1N1 virus appears to do more damage to the lungs in non-swine mammalian hosts than a typical seasonal flu virus.

Kawaoka’s lab also tested the swine flu virus on miniature pigs and found they showed no symptoms of infection, despite the efficient spread of the virus among them. This finding may provide a clue as to why no swine flu outbreaks had been noticed in pigs before the virus was transmitted to humans.

The study also found that people exposed to the deadly 1918 influenza appear to have antibodies that neutralize swine flu. This may explain why relatively few elderly people have died in the recent H1N1 outbreak. However, such immunity appears to be limited to those born before 1920—a dwindling portion of the population.

The good news—Kawaoka also found that the H1N1 virus was susceptible to a range of anti-viral or anti-flu drugs known as neuraminidase inhibitors, an example of which is Tamiflu.

Meanwhile, one of Kawaoka’s erstwhile critics, Scott McPherson, seems to be in agreement with Kawaoka at least on the currently underestimated potential virulence of the A(H1N1) strain. Following reports by the BBC about H1N1′s case fatality rate (CFR) and the predicted number of dead in Great Britain from the H1N1 swine flu, McPherson had this to say:

Using the 30% [rate of population infection] figure, the British government expects 18,283,000 or so [Britons] to be infected, and around 9 million to be seriously ill. The 65,000 dead equates to a case fatality rate of .003, or .3 percent. This is in contrast to the current USA CFR of .0056 and the global CFR of .0045.

So the British are expecting two things to occur: First, they fully expect this virus to gain rapid and extremely efficient methods of human-to-human transmission. Second, they are hoping for a moderation of the lethality of the virus as it gains increased communicability. Both are reasonable assumptions.

Contrast this dire British warning with the decided lack of vocal response from the American government. Considering that seasonal flu kills nearly 40,000 Americans a year, and assuming a current CFR of half a percent, why isn’t anyone in Washington using the same dire (and realistic) warnings? This is yet another example of poor risk communication. The same people who are preaching transparency (and absolutely not practicing what they preach) are at great risk of blowing it in preparing Americans for a second, more powerful wave of pandemic flu.

McPherson is not a virologist. Indeed, his main qualification appears to be that he is a formerly elected Republican in Florida (elected to the Florida House of Representatives in 1980) which he followed up with a career as a technology and communications consultant, which landed him back in politics (he became Director of Information Technology for the Republican Party of Florida, 1995, then served under Florida governor Jeb Bush in various capacities, including Y2K preparedness).

Our point here is that McPherson might be expected to criticize the current administration’s handling of the H1N1 pandemic on the basis of politics alone. Still, he seems to be making valid points in his pandemic analysis, and predicts about 400,000 deaths in the U.S. from swine flu in a recent posting:

The published global CFR in late June was plugging along at .002, while the US CFR was at .0045. Now, the US CFR is .0056, and the global CFR is at .0045. So the world has caught up with America in terms of its death rate, and the figure of .0045 places this pandemic squarely within the HHS Category Two pandemic status. But the threshold to Category 3 status is .0051. For the past two weeks, the US CFR has exceeded the Category 3 benchmark. Like the hurricane that spawned this HHS analogy, those winds — and deaths — have to be sustained. The next few weeks will tell us if we are seeing a drop in the CFR, or if the numbers are holding steady. That may also signal the waning of the pandemic’s first wave.

In a more recent posting still, McPherson recalculates the CFR and finds that it has at least temporarily entered into CDC Category 3 status:

all I will say is that the CFR is increasing, now to an aggregate .006475. This means that of every thousand confirmed or suspected cases reported to the CDC, 6 people died. At the end of June, the CFR was .0045. Of course, I agree that we are still talking about early and relatively small numbers. But the CFR has increased nonetheless, or has remained very consistent, however you might define it…. this pandemic may have crossed the threshold into Category 3 status.
Category 3 is no small threshold to cross. It changes things. First, it means that we are looking at a much stronger pandemic than the media and the decision-makers would have you believe. Second, while the number of reported cases is declining (as the WHO declares swabbing should cease if only done for purposes of determining infection and not for collection of viral samples), the death toll is not also declining. The deaths attributable to swine [A(H1N1)] are accelerating.

It is worth noting that McPherson’s calculations of CFRs does not take into account the presumed high number of people who contract swine flu and never so much as see a doctor, thereby reducing the number of reported cases vs. the number of reported deaths from swine flu. However, since he appears to be using published numbers from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) his method is consistent. We cannot propose a better method, but one must realize that the increase in case fatality rates may be apparent rather than real.

If the apparent increases are real, however, there is cause for alarm. Certainly Kawaoka’s findings of lung damage as opposed to mere invasion of the nasal passages and pharynx by seasonal flu could explain a higher mortality rate from the new swine flu.

Profit motives cited

For the most part, public statements by such health authors as Dr. Joseph Mercola have emphasized the apparent profit motive behind any hyping of swine flu dangers. (Health Spectator too has noted some of these early indications.) Vaccine manufacturers are about to make another killing, Mercola and others warn, and it’s best not to be taken in by them. Some say it is best to avoid the flu shots altogether once they finally become available. Vaccinations may be linked to autism, Guillain-Barré syndrome, Alzheimer’s Disease and other serious disorders.

Our modern obsession with vaccines and their use of adjuvants (see our swine flu posting from May 30) and other additives certainly may pose a health threat in its own right, particularly for infants, children and the elderly. Infants are currently required to have 24 vaccinations by age one and that number will nearly double by the time they go to school.²

A common viewpoint is that the actual antigens involved might not pose a problem (we’re constantly bombarded by pathogens in our environment anyway) but modern vaccines tend to rely heavily on adjuvants, which are additives that arouse the immune system to assure that antibodies will be manufactured by the body against the relatively small sample of antigen injected. This is where the pro- and anti-vaccine camps part paths.

This constant inflammation caused by arousal of the immune system, and particularly of the brain’s microglia (immune cells) may be a major contributor to Parkinson’s and Alzheimer’s diseases.

Vaccination immunity not permanent

However, Russell Blaylock, MD points out that while previous infection confers a permanent immunity, vaccination does not.³ Furthermore, natural infection by most pathogens does not occur by injection of the pathogen into the muscle of the arm. There is even a growing body of evidence that some vaccines may do more harm than good.

The Internet is currently swarming with links to a video of a 1979 60 Minutes report by Mike Wallace on the consequences of the mandatory 1976 flu vaccinations that left dozens dead and hundreds injured, many from the Guillain-Barré syndrome.

Still, the situation of public health officials who must deal with the current crisis is utterly unenviable. Various outcomes could make them appear foolish or negligent. And so long as there is any possibility of a pandemic with even an average death toll, vaccine manufacturers have the upper hand in negotiating not only price, but concessions such as responsibility for death and injury resulting from the vaccines themselves.

Certainly the worst fear of all concerned is that the H1N1 virus could mutate into something resembling one of the current strains of avian flu such as H5N1, which has killed 50-60% of the humans it infected. Currently, H5N1 shows none of the infectious ability of H1N1 in human populations, but were that to change—as through a genetic recombination that combines the worse of both pathogens—the nightmares of those who fear the worst could be realized.

In light of all this, some may choose to heed Kawaoka’s warning:

In fact, the ability of CA04 to replicate in the lungs of mice, ferrets and non-human primates, and to cause appreciable pathology in this organ, is reminiscent of infections with highly pathogenic H5N1 influenza viruses, as acknowledged in a recent report by the World Health Organization (http://www.who.int/wer/2009/wer8421/en/index.html). We therefore speculate that the high replicative ability of [H1N1 swine flus] might contribute to a viral pneumonia characterized by diffuse alveolar damage that contributes to hospitalizations and fatal cases where no other underlying health issues exist. In addition, sustained person-to-person transmission might result in the emergence of more pathogenic variants, as observed with the 1918 pandemic virus. Furthermore, [H1N1 swine flus] may acquire resistance to [Tamiflu] through mutations in their [neuraminidase] gene (as recently witnessed with human H1N1 viruses), or through reassortment with co-circulating, [Tamiflu]-resistant seasonal human H1N1 viruses. Collectively, our findings are a reminder that [swine flus] have not yet garnered a place in history, but may still do so, as the pandemic caused by these viruses has the potential to produce a significant impact on human health and the global economy.

[View the Mike Wallace 60 Minutes video regarding the 1976 swine flu vaccine.]

A special advisory panel to the Food and Drug Administration recommended Tuesday that Vicodin and Percocet—two prescription pain-killers that combine acetominophen with narcotics—should be banned. The panel noted that prolonged use of aceominophen, which is the primary ingredient in Tylenol, causes liver damage in many patients and further recommended that at least seven other medications that combine acetominophen with narcotics should have their use discontinued.

Doctors would still be allowed to prescribe the narcotics, which include oxycodone (found in Percocet) and hydrocodone (found in Vicodin). They would further be allowed to prescribe acetominophen if they wished, but many doctors are already reluctant to prescribe medications that combine acetominophen with narcotics because of its known toxicity to the liver.

In fact, the same panel voted 24 to 13 to recommend that the FDA reduce the highest allowed dose of acetaminophen in over-the-counter pills such as Tylenol to 325 milligrams, from the currently allowed 500 mg. They further voted 21 to 16 to reduce the maximum daily dosage of the drug to less than 4,000 mg.
(more…)

Surprisingly, the Centers for Disease Control and Prevention’s swine flu tally for all 50 states plus the District of Columbia, Puerto Rico and the U.S. Virgin Islands does not appear to have changed much since the last time we looked. This week, the CDC changed its normal schedule of updating the figures on Friday in honor of the Advisory Committee on Immunization Practices meeting yesterday. Yesterday’s figures, which are the final figure for the week, were effective as of 7:00 PM Thursday, June 25 EDT.

The U.S. is reporting 27,717 confirmed or probable swine flu cases with 127 deaths confirmed to be the result of swine flu. Wisconsin continues to lead the states with 4,273 cases reported and 4 deaths. Texas and Utah have 10 deaths apiece, while New York has 35, California 16, and Illinois has 12.