October 24th, 2009 19:56 EST
Twitter, Baseball, Vaccines, Mumps, Autism and Stage Zero
By Curtis Porter
As American as Baseball and TwitterJoin more than 600 people who follow ACSH on Twitter at http://twitter.com/JeffACSH. There won`t be another Morning Dispatch until Monday, but Jeff will be Tweeting with all his might from home (as well as Yankee Stadium).
Vaccination VacillationACSH staffers were suspicious when we learned that New York State health officials rescinded the ruling that H1N1 flu vaccine should be mandatory among healthcare workers, citing a shorter supply of the vaccine than previously anticipated. The Associated Press quoted Dr. Richard Daines, the state health commissioner, who said, New evidence is showing that H1N1 can be especially virulent to pregnant women and young people - so they should get vaccinated first. "
They say the reason healthcare workers don`t have to be vaccinated is that there is a short supply? " asks ACSH`s Jeff Stier incredulously. The shortage was the reason they were being prioritized in the first place. Children and pregnant women are the ones being exposed to healthcare workers. "
ACSH`s Dr. Gilbert Ross agrees: Healthcare workers are the priority because they`re the ones who transmit disease. The State`s justification is bogus. Dr. Daines cites "new information` about higher-risk groups " but that information has been well-known for months, and he`s just using that as a convenient excuse to cave in to the workers, who " for no valid reason " don`t want to get the shot. This is the opposite of good public health policy. We make our kids get immunized before we let them go to school. Demanding that healthcare workers be immunized before they interact with sick people is perfectly reasonable, indeed essential. "
Dr. Wakefield`s Legacy
A small outbreak of mumps that began in Borough Park, Brooklyn about two weeks ago seems to be the result of a single student`s recent trip to the UK, where mumps vaccination rates are considerably lower than those in the U.S.. Most of the suspected cases occurred in patients who had received the MMR (measles, mumps, rubella) vaccine.
Most of the kids that are sick in Brooklyn were vaccinated, but the vaccine isn`t 100% protective, " says Dr. Ross. It`s a good thing that the large majority of kids in the U.S. are immunized against MMR. If they weren`t, we`d likely be seeing many more cases as a result of this, and mumps can be a very serious disease. It`s also worth noting that the reason the vaccination rate is not as high in the UK as in most of the rest of the western world is that England`s Dr. Andrew Wakefield demonized it as a cause of autism in a 1998 paper in the British journal The Lancet. Of course, the study was later disproved and withdrawn, and it was discovered that he wrote the study to influence a legal case. "
This is just another example of the global consequences of not getting vaccinated, " says ACSH`s Dr. Elizabeth Whelan.
Autism is Most Likely Genetic
A study published in the Archives of Pediatrics & Adolescent Medicine about autism spectrum disorders in twins confirms the importance of genes in the development of autism. This is not new information, " says Dr. Whelan. We have long suspected that the major cause of autism is genetic rather than environmental. "
This tends to support our suspicion that much of the so-called "autism epidemic` over the last ten or more years is actually due to better awareness of the disease among diagnosing physicians, " says Dr. Ross. The high numbers are also possibly due to some degree of secondary gain, that is, schools get more financing when they have more autistic children, so they`re classifying more "special needs` kids as autistic. Of course, no one has any idea what an increase in autism rates would be caused by. The only thing we can say with some confidence is that it`s not due to vaccines. "
An article in U.S. News and World Report discusses the increasingly common conundrum of how to deal with stage zero " breast cancer: That means abnormal cells are lodged in one or more of the breast ducts "the "highways` connecting the milk-producing lobes to the nipples "but they haven`t yet escaped to invade the other tissues in the breast. Will they ever do so? Maybe, maybe not. "
This is an important example of a point we`ve been making for a long time now, " says Dr. Whelan. How do you deal with the early detection of a cancer that is possibly insignificant? Prostate cancer screening is the classic example, and breast cancer is similar since mammograms pick up these "stage zero` cancers. A significant percentage of these are noninvasive, but standard procedure is to treat surgically anyway. This is costly considering that most stage zero cancers do not become metastatic. The trick is to know which ones will never spread, and which ones will--and we can`t say for sure. "
Still, it`s hard to argue with a woman who has stage anything cancer and tell her not to do something about it, " says Dr. Ross. Many women who find out they have stage zero cancer say, "Well, it might turn into stage one, and I want it out.` We just don`t know how to tell which lesions will become dangerous. "
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