Immune to the facts
The measles virus is remarkably contagious, infecting more than 95% of susceptible humans exposed to it.
About 1 in 1,000 people infected requires hospitalization and may become permanently disabled, and 1 in 300,000 infected with measles develops a progressive neurological disorder, subacute sclerosing panencephalitis, which invariably causes death.
But along with smallpox, yellow fever and poliomyelitis, measles is remarkably well controlled by vaccination. sale pandora bracelet Before routine measles vaccination in the United States, some 4,000,000 people a year contracted the disease; widespread vaccination has brought this number down to less than 40. Other countries in which 95% of the population are vaccinated the proportion believed to provide 'herd immunity', which blocks the transmission of measles have experienced similar declines in cases. However, coverage in some regions of Africa is less than 50% of the population, and there are still some 40,000,000 infections each year, causing more than 600,000 deaths.
These figures highlight the amazing achievements of measles vaccines and the need for mandatory vaccination to maintain this record of success. Nonetheless, the anti vaccination sentiment, which began after Edward Jenner first used cowpox vaccine to prevent smallpox, continues today. The reasons are complex and where to buy pandora charms online multifactorial but often arise from basic libertarianism or individualism, make your own pandora bracelet along with people's desire to stop the government and public health bodies having so much control over them and their children. Others consider vaccines harmful or refuse to face even the minor risk of side effects. Many people are misled and others misinformed.
This was the backdrop to a recent attack in Britain on the combined measles, mumps and rubella (MMR) vaccine by some parents with autistic children, by news reporters and by some in the British government. As a result, MMR vaccination coverage sank to 85% or below in Britain, soon to be followed by outbreaks of measles and, sometimes, devastating after effects. So the publication of two books reviewing autism and the search for an environmental cause, especially the MMR vaccine, are particularly timely.
MMR Science Fiction by Richard Horton, editor of The Lancet, and MMR and Autism by Michael Fitzpatrick, a general practitioner of medicine and parent of an autistic child, both make the case that the MMR vaccine is safe and is not associated with autism. Both books provide the background to help readers understand the events in Britain and the players involved, as well as the evidence that supports their conclusion that the vaccine is safe.
Autism, first recognized in the 1940s, results in children having an inability to relate to themselves or to people and situations. Its cause is unknown. However, in 1998, The Lancet, with Horton as editor, published a paper by the gastroenterologist Andrew Wakefield and colleagues at the Royal Free Hospital in London that linked autism and the MMR pandora o charm vaccine. According to the paper, of 12 children who had both autism and chronic enterocolitis (bowel disease), eight had been given the vaccine and one had a measles infection before the onset of autism. No virological evidence was provided of the measles infection, nor was there any stringent epidemiologic evidence to link it, or other events, to the autism, and there was no control group of children. The publicity sparked a public movement against vaccination that quickly grew out of control.
Of the two books, Fitzpatrick's provides the more thorough and detailed account of the events as they unfolded. It includes a critical evaluation of the flawed paper in The Lancet and discusses autism in greater depth. This book is a good read.
Horton's book contains similar information but focuses primarily on the events, complications and failures that followed the publication in The Lancet. As an antidote, he suggests that an ombudsman group of scientists and laymen should evaluate such controversial findings to prevent the spread of misinformation. He also describes the profiteers: journalists and publicists, medical practitioners who received fees from lawyers representing the parents of the autistic children, and physicians and scientists who were compensated by pharmaceutical houses, biotech companies and government officials. Horton attributes the public mistrust to these sources. Horton does not deny his own responsibility, stating that if he knew in 1998 what he knows now, The Lancet "would not have published the part of the paper that related to MMR".
But the crux of the issue is missing from Horton's book. Without firm evidence of measles infection or of the measles virus in the MMR vaccine being involved in disease, why was the claim of an association between autism, the measles virus and the MMR vaccine placed in the results section of the paper? In Horton's defence, the same issue of The Lancet published a commentary pointing out the defects in Wakefield's paper, but the question remains: why did The Lancet open Pandora's box?
Good science demands objectivity based on experimental or clinical evidence that is reliable and reproducible. Subjective opinion is not proof and has no place in the peer reviewed literature. Indeed, as quoted in Horton's book, Britain's chief medical officer, Liam Donaldson, stated: "If the paper had never been published, then we wouldn't have had the controversy, we wouldn't have had the seed of doubt sown in parents' minds which has caused a completely false loss of confidence in a vaccine that has saved millions of children's lives around the world." Donaldson is correct.
What's more, the continued focus of Wakefield, journalists and parents of autistic children on autism's link with measles, coupled with the complacency of a public that has been shielded from the horrors of uncontrolled infections, has supported a continued antivaccination movement. This has had a regrettable influence on the public and the political establishment concerning measles and autism specifically, and vaccination in general.
Michael B. A. Oldstone is head of the Division of Virology, Department of Neuropharmacology, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, USA.
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