Thursday, March 31, 2016

attention Hollywood: Black Lives Matter

Nurses and doctors are being killed at hospitals, clinics, and nursing homes, or when they go out to give children vaccines that will save life and limb.

the UKGuardian notes:

The body of Salma Farooqi, a 30-year-old who had been involved for years in Peshawar's battle against polio, was recovered from a field 4km (2.5 miles) from her home on Monday, a day after armed men stormed her house, tied up family members and took her away.
Police said the mother of five had been tortured and repeatedly shot.
Attacks on vaccination teams, many of whom are drawn from the country's 100,000 strong army of "Lady Health Workers", are common, with more than 30 killed in the last two years.

But are they made heroes? No. Hollywood spent oodles of money instead on a movie to show a hero who found (or maybe not) a problem with MMR vaccine and Autism.

Ah, but why is he a hero? Maybe because he is white, and the anti vacccine movement is one of the limbs of the anti-globalization/ anti science/ back to nature movement of the clueless elites, including celebrities.

whereas those killed trying to stop children from dying of measles, polio, whooping cough, polio etc. are "people of colour", often Muslim, and the kids whose lives were saved were also "people of colour", not rich white kids in the affluent USA/ UK.

uh, Black live matter?

the point is that this was an expensive vaccine that had to be given by someone who knew how to store it and how to give an injection (and in these post HIV days, to use a seperate disposable syringe for every injection). Other obstacles include getting into remote villages and convincing people to bring in their children (i.e. trust).

Which is where the anti vaccine idiots are killing people.

Clueless mullahs/immans/bishops often pick up these stories in the western media, believe them, and then forbid their people from getting vaccines. And if a child dies after a vaccine (usually from something else, because childhood deaths are common in these areas) it allows local anti western types to blame the doctors.

So is it any wonder that local mindless idiots are shooting the medical people who dare to cross the demands of their local  religious dictators.

When I worked in Africa, I saw many many children die of measles or post measles complications. We buried four of five children of one mother, whose polygamist husband had forbidden her to get them their vaccinations.

Some measles deaths might not be listed as "measles" (even if someone reported the case, which will not happen if the kid dies in the remote village).  The dirty little secret is that a lot of kids died one to four weeks after having measles from pneumonia, ear infections, meningitis, or croup.

because the virus caused an immune problem measles might also cause latent TB to flare up (Measles induces anergy for PPD, suggesting they lost their ability to fight TB infection).

Nor was this just in rural Africa: when I was in medical school in the 1960's, we saw many children hospitalized with measles, but who lived thanks to antibiotics. And I saw one child who suffered severe brain damage from post measles encephalitis.

But no more.

when we had a case (from Mexico) in our hospital in the 1990's, only two of us were old enough to have seen a case, so were called to diagnose it.

But thanks to vaccines, the death rate from preventable diseases, including measles has gone down dramatically all over the world.

from the WHO:

Key facts

  • Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available.
  • In 2014, there were 114 900 measles deaths globally – about 314 deaths every day or 13 deaths every hour.
  • Measles vaccination resulted in a 79% drop in measles deaths between 2000 and 2014 worldwide.
  • In 2014, about 85% of the world's children received one dose of measles vaccine by their first birthday through routine health services – up from 73% in 2000.
  • During 2000-2014, measles vaccination prevented an estimated 17.1 million deaths making measles vaccine one of the best buys in public health.

so more vaccines lead to a lot fewer deaths among poor children.

Oh,, but the anti Vaccine types insist the death rates were either getting lower without the vaccines so we don't need vaccines, or they insist that the cut in measles deaths would have happened anyway. No I won't link to them but here is a typical misleading statistic.

[Measles deaths (from 1901/2, averaged) declined by 99.4% before vaccination in 1968! ... (Source: Twentieth Century Mortality CD, Office of National Statistics,
it essentially is cherry picked from this article that notes the same drop in measles death in the affluent USA.

reason of course: better nutrition, more antibiotics, less tuberculosis in children.

In the affluent USA, your kid might not be exposed to measles, so the risk is low for your kid...

But in Zimbabwe, where only 83 percent of kids get the vaccine, there is an added risk that these kids will spread it to those who were too young to get the vaccine (i.e. under 18 months), or might have received a suboptimal dose due to storage etc. or who might have a poor immune response because they have HIV, they have had an epidemic of 4000.

Here is an example from a country where I worked.

the article about the latest epidemic in Harare: 4000 cases.. Not that many considering the millions of kids in the country.

But the 17 percent un immunized leave a reservoir for new cases:. So enough people around to let the disease spread.

But to complicate the problem is that you don't get the vaccine until 18 months. So many of the case in this recent epidemic were in "under 2 years"

at this point, let me note that you don't just care for one problem: Health clinic outreaches try to care for several interlinked problems to stop epidemics.

Our hospital did a lot of outreach for immunzations, which we combined with family planning, nutrition counseling, and health screening for malnutrition. I date before HIV, but the docs there now have an active clinic to give out anti HIV drugs, something especially important for pregnant moms since their children can catch HIV from their moms.

The unvaccinated kids tend to be in the poorer areas of the country, sometimes in areas where local religious cults forbid vaccines, modern medical care, and sometimes education...
Black Live Matter. Even if they are poor.

In the USA, malnutrition is rare (although HIV and immune problems remain a problem). So are you safe? Why are there still cases?

Well, most of the new cases can be traced to cases imported from overseas, where vaccinations might not have been done or the vaccine given wrong (too early an age, or maybe because the vaccine defrosted and got weakened: See earlier article about the unlicensed Chinese vaccine distributors who let their vaccines defrost but sold them anyway).

the 2014 epidemic in the US was traced back to an epidemic here in the Philippines, where almost 60 thousand people got measles and 180 of them died.

and the story cited below about poorly stored vaccines ight have contributed to the recent cases in China (but of course, the anti vaccine crazies use those mere 700 cases as proof the vaccine doesn't work. No I won't link. If the vaccine didn't work at all the actual number would have been thousands, not a few hundred).


But it is alas more trendy for intellectuals to be anti science. Nor is this a new problem:
Cherry picking by people who seek attention or who need to feel self righteous is nothing new, but what they do is take a problem out of context, manipulate it, make the small problem seem the entire story, and then use the lie to manipulate public opinion.

a good review article about the history of measles, descriptions of the disease, of how the disease kills, and other factors including immunizations can be found HERE> including how HIV has increased the death/complication rate in measles in Africa.

So fewer deaths, thanks to good nutrition and antibiotics etc. albeit complications remain high if you catch it.

Finally, when I worked in Africa, quite a few medical personnel were killed or hurt during a civil war. If you want to help publicize this, try checking out this site: LINK

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