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Christiane Northrup: more bad medicine

A question popped up on facebook the other day about Dr. Christiane Northrup, an OB/GYN who has been a frequent guest on Oprah.  I hadn’t heard much about her for a while, but a foul taste still lingered from previous encounters with her work.  So I went over to her website to see what fare she’s currently dishing up.  It isn’t pretty. (Cached version).

This month’s news item is titled “Angst Over Not Vaccinating Children is Unwarranted.” Regular readers will be expecting a typical antivax screed, and they won’t be disappointed, but I’d like to highlight some of the propaganda techniques Northrup uses to advance her dangerous lies.

She begins her story with this:

In June, 2010 there was an outbreak of pertussis (whooping cough) in California that reporters were calling the worst epidemic in 50 years.

There are two problems with this opening sentence.  The outbreak is ongoing, and it’s not “reporters” who are calling it “the worst epidemic in 50 years.”  The California Department of Public Health reports that the state has seen the largest number of cases in the last 55 years.  Of course the state was much smaller 55 years ago, so for comparison they give us an incidence rate: 10.3 cases/100,000 in 2010, the highest rate in 48 years (when the rate was 10.9 cases/100,000).  So far in California, there have been 9 deaths.  All of the deaths were in babies eight of whom were unvaccinated and one of whom had been vaccinated only days before becoming ill, not early enough to develop immunity.

The precise reason(s) for this outbreak are unclear, but there are probably a number of factors.  Pertussis outbreaks are cyclical, so increases in disease incidence are expected, but not to this extent.  The vaccine itself is imperfect, and immunity wanes fairly quickly.  Adults who have not been re-vaccinated can serve as a reservoir of the disease.  While adults do not normally become seriously ill (although I’ve seen plenty of cases of adults with pertussis coughing so hard that they fainted and injured themselves), adults can pass it on to those who do suffer more dire consequences: infants.  There are also significant reservoirs of disease in communities of vaccination refusniks throughout California, and while these communities tend to be wealthy, it is the poor who suffer.

Because the vaccine is not completely effective and not terribly long-lasting, herd immunity is even more important, and adults younger than 65 who haven’t had a tetanus shot in the last 2 years can get a TDaP, which includes a pertussis booster.

But since Christiane Northrup doesn’t believe in pesky things like germs and cellular and humoral immunity, she doesn’t get it:

Getting your child or yourself immunized is a culturally agreed-upon ritual, designed to shore up your first chakra. The first chakra, or first emotional center, of your body controls your bones, joints, bone marrow, blood, and immune system.

It’s sometimes hard for me to believe that someone who isn’t under the influence of a controlled substance can write something like that without a shred of irony.  She goes on to cite—I kid you not—Sherri Tenpenny, a noted antivax loon who writes for the Huffington Post.

Most people don’t know that the pertussis vaccine doesn’t provide lifetime immunity! Unlike chicken pox, having the disease once doesn’t protect you from having it a second time. This is why I don’t believe there was an epidemic at all. According to my colleague Dr. Sherri Tenpenny, who I consider to be the foremost medical expert in vaccine safety, “Outbreaks of pertussis are cyclical and tend to peak every two to five years, regardless of the vaccination rate….” Further, “Your child can be fully vaccinated and still contract pertussis.”

Um, no.  Outbreaks occur cyclically, but outbreaks this large do not.  Neither is Tenpenny a medical expert in vaccine safety.  Nor are doctors ignorant of the imperfections of the pertussis vaccine.

This negates accusations of California health officials who assert that when parents don’t vaccinate their children, they can create a rampant resurgence of diseases, like polio or pertussis. These conditions are thought to be under control because of mandatory vaccinations. Our society buys into something that Dr. Tenpenny calls herd immunity: If we vaccinate as many people as we can, especially the healthy ones, it will protect those who are young, elderly, and immuno-compromised. Unfortunately, this isn’t true. Just because you are healthy and vaccinated against pertussis, you can still carry the disease without knowing it and become sick or infect others

This negates no such thing.  And Tenpenny didn’t invent “herd immunity”.  We’ve already established that the vaccination is imperfect.  What is she suggesting?

Babies under six months of age are at risk the most for contracting pertussis and dying from it. Babies have very narrow bronchial passages, which block air flow to the lungs. Sadly, this causes death in some. Six died in California this year as of July 21, 2010. The CDC believes that these same children are at risk because they aren’t fully vaccinated before six months (if you follow the recommended vaccination schedule).

There’s much you can do to support your infant’s health, the most important of which is to breastfeed her. It’s well documented that breast milk contains antibodies against all kinds of germs a newborn is likely to encounter, organisms to which her mother is already resistant.

So, Northrup is saying that because the vaccine is imperfect, we should simply toss up our arms and give in to an horrible, asphyxiating death?  Or is she saying we should rely on a potential passive immunization from breast milk, breast milk which her earlier comments imply no longer contain pertussis antibodies?

I was going to skip the rest of her article, but when I read her take on meningococcal meningitis, I shuddered.  Not only is her advice dangerous, it betrays a fundamental lack of medical knowledge.

The meningitis vaccine is one of the safer vaccines, because it’s acellular. That means there is no live virus in the vaccine. It’s also not preserved with mercury or other toxic material that are still in many vaccines. When my youngest daughter went to college, I threw in the towel and had her vaccinated. (I’m referring to the one given to college-age children, not infants.) It just wasn’t worth the fight with her school’s administration at the time. But I was ambivalent, and would have opted out if it had been easier to do.

Three childhood vaccines protect against meningitis: Hib, pneumococcus vaccine, and meningococcus vaccine.  Meningococcus is most relevant in certain populations and situations, such as college dormatories and military barracks.  She is correct in stating that the vaccine contains no live virus.  One of the main reasons for this (aside from the manufacturing process) is that meningococcus is a bacterium, not a virus.  While Northrup doesn’t come across as entirely against this vaccine, her decision is based purely on superstition and convenience rather than reality:

The main reason kids get sick when they’re in college is they are run down. Meningitis is no different. Like pertussis and HPV, typically a child will be sick and recover—it’s not fatal. The main reason these adult children get sick is due to a shaky first chakra.

Ten percent of people who get meningococcal meningitis die.  They do not get sick because of their “chakras” but because they have been colonized by a dangerous bacteria (not a virus) that becomes invasive, and once it does, you’re in big trouble.

I’m not simply troubled by Northrup’s truth- and fact-impaired version of the science of immunology and infectious disease.  I’m more troubled by her representing herself as a doctor and an authority on health, when she doesn’t know a bacterium from a virus and thinks chakras are real.

She is a danger to the public health, and for the sake of public health, she should retire into obscurity.

Posted in: Science and Medicine

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57 thoughts on “Christiane Northrup: more bad medicine

  1. “Ten percent of people who get meningococcal meningitis die. They do not get sick because of their “chakras” but because they have been colonized by a dangerous bacteria (not a virus) that becomes invasive, and once it does, you’re in big trouble.”

    One of the boys in my son’s kindergarten for children with hearing/speech impairments lost his hearing due to meningitis (I don’t know which kind). His parents say before the meningitis he was on target for motor skills and speech, his hearing was fine. Now he has profound hearing loss, very little speech as well as fine and gross motor delays. This is a sweet kid who’s life was made a heck of lot harder by this illness.

    I’ve read that in people who get meningococcal meningitis, 12 percent will long term complications that include limb amputation, skin grafting, hearing loss, seizures, and mental retardation.

  2. Dawn says:

    What the heck happened to Christine Northrup? Way back when, she used to write fairly normal, sensible things (especially about breastfeeding, and I’m talking 20-25 years ago). Now she has REALLY drunk the woo koolaid and I can’t believe a doctor is saying these things. This is really sad.

  3. Jurjen S. says:

    Unlike chicken pox, having the disease once doesn’t protect you from having it a second time.

    Speaking as someone who’s had chicken pox twice (once in childhood, and again in my late twenties), I feel the need to point out that “protect” is not synonymous with “render immune,” in the same way that body armor protects you from bullets and shrapnel to a degree.

    The main reason kids get sick when they’re in college is they are run down. Meningitis is no different. Like pertussis and HPV, typically a child will be sick and recover—it’s not fatal.

    Personally, I’m very happy that the medics at my barracks weren’t so sanguine when one of the guys in my basic training platoon came down with meningitis; he was carted off to the military hospital (and discharged from the army the day he was discharged from the hospital) and the medics kept the rest of his squad quarantined and under observation in the infirmary for a week (fortunately, there was an entire medical battalion stationed on the same post as our training battalion, so ample facilities were available). Last I heard, though (and this was 17 years ago), the patient did suffer some permanent debilitating effects.

  4. Chakras! I get exposed to a great deal of vaccine-rejection mythology IRL, but I haven’t heard anything about chakras. I must have been distracted by sunscreen rejection trend. (Even though we live in a sunny place positioned over 7000 feet closer to the sun than the sea.)

    I may be confusing the first chakra with my favorite one, but something about the phrase “shaky chakra” triggered a Liz Phair earworm:

    Squeeze her knees underneath a book, you know
    A real good shakin’ is all it took
    Cause my baby’s hooked on me
    And as you can see I’m wild about her

  5. windriven says:

    It is difficult for me to understand why the medical community or the various state boards are unable to police this. Isn’t there a legal obligation to adhere to basic principles of medical care? Could I earn an MD from Dartmouth, teach at Tufts, be licensed in Maine*, and then treat patients by shaking maracas while singing “I did it my way?” No? How is schmoozing chakras different?

    *a brief summary of the professional background of Dr. Northrup

  6. cervantes says:

    If you are actually treating patients and they are harmed because you tell them not to get vaccinated and do something to their first chakras instead, the patients can sue you. In principal, you can lose your medical license if you show a pattern of incompetence although licensing boards are absurdly reluctant to do that.

    But you can go on teevee or Your Intertubes and spout any kind of nonsense and idiocy you want to. A little something called the First Amendment.

  7. LovleAnjel says:

    Arg! At least the university her kid went to made a fuss and made him get him vaccinated. Nothing like being in constant close quarters and sharing unclean bathroom facilities to spread infection.

    Back in undergrad, my friend shared an elevator with a coughing kid who turned out to be the first victim of a meningitis outbreak. This was before the vax was mandatory, so she had to be quarantined for a week in the student health center. And note: she is not the stressed-out type of student.

  8. @windriven:

    (Not a complete answer). Medical societies used to do some of the disciplining, but no more. After the chiropractic antitrust suit of the 80s they lost their nerve. State medical boards are highly variable, but even the good ones are limited by money and other difficulties. Below are links to a series that provides some insight, by no means comprehensive.

    The State Regulation Series:

    1. Pitfalls in Regulating Physicians. Part 1
    2. Pitfalls in Regulating Physicians. Part 2: The Games Scoundrels Play
    3. The Pseudomedical Pseudoprofessional Organization (PPO*)
    4. A New Twist for Autism: A Bogus “Biomedical” Board
    5. How State Medical Boards Shoot Themselves (and You) in the Foot
    6. “Integrative Medicine Experts”: Another Barrier to Effective Discipline
    7. Bogus Diagnostic Tests

  9. windriven,
    I think it’s up to patients to complain or to sue for malpractice. If patients are happy, the boards don’t get involved.

  10. Squillo says:

    @ Dawn:

    What happened?

    My guess is that she discovered that relieving the credulous of their money is much easier and more lucrative than relieving suffering through the practice of actual medicine.

  11. windriven says:

    @Alison Cummins
    I suppose you’re correct. But imagine, if you will, a certified public accountant who, rather than adhering to GAAP, prepared financial statements based on wishful thinking. His or her state board of accountancy would have their license in a heartbeat.

    In the case of the CPA there is a notion of public exposure. That is, members of the general public may base investments on the financials prepared by the CPA. So more interests are involved than just the client’s.

    But isn’t the same true with physicians? When a physician argues against immunizations for potentially fatal diseases, the well-being of the general public is compromised as well as that of the patient.

  12. Jann Bellamy says:

    She will never retire as long as she is making big bucks selling her books and speaking at woo-fests like this one: The “I Can Do It!” seminar in Tampa,
    http://www.hayhouse.com/event_details.php?event_id=1005

    Dr. Northrup will be joining such illustrious speakers as:
    “DENISE LINN
    Past Lives/ Present Dreams!
    Have you ever wanted to know who you were in a past life? Have you ever wondered how your past lives are affecting your current life? Did you know that you can use your dreams to “see” your past lives? In Denise Linn’s dynamic seminar, meet your past-life guide and travel back in time to experience (and heal, if necessary) a past life that’s directly influencing you today. Also, learn what incarnations you have shared with loved ones. P.S.: It’s no accident where you sit in this seminar.”

    And that’s not all! Dr. Northrup also sells gift items, such as calendars, on her website, and cell phone apps. For $46 annually (a limited time discount, normally $72 annually), new members can sign up for exclusive internet access to Dr. Northrup. And then there is the radio show.

    In other words, so much easier and more profitable than the grind of the actual practice of medicine!

  13. Ian says:

    There’s no such thing an alive virus anyways, at least by any conventional definition of what a living thing is. I’ve never understood why people attach terms like “living” and “dead” to viruses. At most they can be deactivated.

    @Jann: actually that does sound like quite a bit of work. A quiet family practice somewhere sounds easier to me. :) But I guess she enjoys the attention.

  14. David Gorski says:

    Ten percent of people who get meningococcal meningitis die. They do not get sick because of their “chakras” but because they have been colonized by a dangerous bacteria (not a virus) that becomes invasive, and once it does, you’re in big trouble.

    And, contrary to the germ theory denialism view, this disease attacks healthy, vigorous young adults, no matter how much they exercise and eat well. It’s quite possible for a 20-year-old athlete to get meningococcal meningitis and die.

    Holy crap. I knew Northrup was bad, but I never suspected that she was full-blown anti-vax. (And, make no mistake, this is pure antivax.)

  15. Shannon says:

    her comments about HPV are almost equally horrifying. Apparently, there’s no quality of (sex) life lost for women who have to disclose, to every potential partner, their status as a carrier of HPV. Let alone having them treated. Or the future risk of cervical cancer, which she completely breezes past. :-\
    She disgusts me.

  16. windriven says:

    @Dr. Atwood

    Thank you for the reading list. This is becoming a critical issue as even top rank medical schools are succumbing to the dark side and teaching nonsense for credit. Medicine is a profession. The erosion of professional standards will invariably lead to declining trust in the profession itself and to the perception that ‘health care practitioners’ of all stripes are interchangeable. That does not bode well for anyone.

  17. Khym Chanur says:

    @Ian:

    I’ve never understood why people attach terms like “living” and “dead” to viruses. At most they can be deactivated.

    If you’re trying to communicate to the lay public using “live” and “dead” is easier, especially if you time constraints (live interview) or space constraints (article in a newspaper/magazine).

  18. Calli Arcale says:

    The meningitis vaccine is one of the safer vaccines, because it’s acellular. That means there is no live virus in the vaccine.

    Forgiving for a moment the stupidity of being worried about live virus in a vaccine against a bacterial disease, why does this make the meningococcal vaccine better than the TDaP? Perhaps Dr Northrup doesn’t read labels very often, but the “a” stands for “acellular”. The pertussis vaccine which she decries is acellular, just like the meningococcal vaccine which she supports.

    The chakra stuff is ridiculous, but what I really can’t get over is how nonsensical some of her stuff is. I mean seriously, sometimes I can’t make out what her actual point is. Take this one:

    Most people don’t know that the pertussis vaccine doesn’t provide lifetime immunity! Unlike chicken pox, having the disease once doesn’t protect you from having it a second time. This is why I don’t believe there was an epidemic at all.

    1) Chicken pox infection doesn’t provide lifelong immunity either. If it did, nobody would get shingles. (Oh, and I’ve had chickenpox twice.)

    2) True, pertussis vaccine doesn’t produce lifelong immunity. That’s why the CDC is recommending adult boosters. Not their fault most people don’t listen, including, apparently, actual doctors. (Exhibit A: Dr Northrup.)

    3) WTF does that have to do with not believing there was an epidemic? Logically, lack of immunity should increase the odds of an outbreak. This is, therefore, a nonsequitor — she doesn’t disbelieve an epidemic because of the stuff before, she just isn’t capable of forming an actual argument and is instead randomly throwing together sound bites with a few “whys” and such to make it look like they relate to one another in some way.

    Is she actually forming any cogent thoughts at all? Or is she doing a Sarah Palin and just babbling with enough conviction that her audience doesn’t usually notice?

  19. Alexie says:

    Good. God.

    Guys, you have to do some research and write a post on why highly educated people are the most likely to buy into this crap. Too often the sceptical community like to assume that people adopt woo beliefs because they’re poorly informed. This woman is a very good example of someone who is neither poorly informed nor stupid, yet somewhere along the way she’s abandoned what she spent some years working hard to learn, in favour of a belief in fairies.

  20. Enkidu says:

    Northrup says regarding the pertussis deaths this year: “There’s much you can do to support your infant’s health, the most important of which is to breastfeed her. It’s well documented that breast milk contains antibodies against all kinds of germs a newborn is likely to encounter, organisms to which her mother is already resistant.”

    I wonder, is it known what the infants that passed away from pertussis were fed (breast milk Vs formula)? Northrup makes it seem like breastfeeding is just as good protection against pertussis as vaccination/ herd immunity.

  21. Dawn says:

    @Enkidu: Dr Northrup is right and wrong. Sure, breastfeeding will pass on some antibodies. But mom has to HAVE antibodies in order to pass them on, and studies are finding that with either disease or vaccine, pertussis immunity is not life-long.

    No antibodies? Can’t pass them on in your breastmilk.

    Your baby died? You must have been doing SOMETHING wrong. Obviously not granola-mom enough to have a healthy baby. The perfect granola mom had the ideal pregnancy, no exposure to vaccines EVER herself, only eats organic foods, wears only organic clothing, lives in a totally organic house, had the perfect labor and delivery in a warm water tub with full bonding and instant and constant breastfeeding, and only makes organic baby food.

    I don’t think it is known if the CA infants were breast or bottle fed. And it probably wouldn’t have made any difference (IIRC, Dana, who died in S. Australia from pertussi several months ago, was breastfed).

    Been doing more reading about Dr N’s woo and just getting more and more pissed off. As a nurse-midwife, I think I need to go find a paper bag to put over my head rather than be associated with her.

  22. Scott says:

    The perfect granola mom had the ideal pregnancy, no exposure to vaccines EVER herself, only eats organic foods, wears only organic clothing, lives in a totally organic house, had the perfect labor and delivery in a warm water tub with full bonding and instant and constant breastfeeding, and only makes organic baby food.

    You forgot to specify “instant and constant breastfeeding until at least age 10″.

  23. Wolfy says:

    “Sure, breastfeeding will pass on some antibodies.”

    This has always been something of interest to me, especially since most proteins are degraded by acid proteolysis. From my brief review of the literature, it appears that IgA is passed from mom to baby via breast milk and is acid stable in the infant’s stomach.

    Is there someone out in the blog-sphere who can direct me to the original basic science literature?

    Much thanks.

  24. aeauooo says:

    Dr. Tenpenny a “loon?” You’re much more charitable that I am.

    Sherri Tenpenny uses one of the antivaccinationist standard tactics of citing legitimate research but completely misrepresenting the content and/or conclusions of that research.

    In my book, that makes her a liar.

  25. Enkidu says:

    I just don’t get the “either or” approach that anti-vaxers have. It’s like they are saying that you don’t need to vaccinate infants because antibodies (with the stipulation that Dawn provided of the mom actually having said Abs) in breastmilk will protect them just as well or better. My daughter received monthly RSV antibody shots through her first two winters (she was premature). The pharma company that supplied the shot said in its literature that it would reduce severity of disease and hopefully keep her out of the hospital should she contract RSV. I was under the impression that these antibody shots were a help but were no where near as good as having an actual vaccine. Was this a false impression?

  26. Todd W. says:

    @Wolfy

    Perhaps that could be a topic for a future SBM post, if it hasn’t been covered already: what anitbodies are actually present in breast milk and which ones survive the digestive process to grant immunity to the infant? Also related: what is the percentage efficacy of such immunity?

  27. Wolfy says:

    @Todd W

    Agreed. I just looked through a few of the old breast milk posts and didn’t find that topic discussed. I think it would be interesting for someone to review the molecular make up of breast milk and the chemical processing of those components within the infants GI tract. The passive immunity piece has always been of interest to me.

  28. Chris says:

    I have always been amused that breast feeding was the cure to all childhood ailments. This is because my daughter was only getting breast milk when she came down with chicken pox. The poor baby was miserable. She could not sleep, she cried and cried, and did lots of shaking. I recently found a photo of her as she was recovering, and I noticed one of the poxes was very close to her eye. I believe it was pure luck that she did not become permanently injured.

    Of course, it was the next year when the vaccine came out!

  29. nybgrus says:

    Reading something like this makes me want to get everyone I know and care about and move them to an island far far away from these frackin’ nutjobs. We NEED to pass legislation to augment the first amendment to say that if you spout of nonsense that is clearly contradicted by scientific knowledge, you get your speech license revoked. And if that nonsense can in any way, shape, or form translate into someone getting injured or dead you get your a** thrown into jail. Free speech is one thing but especially in a mass media world there needs to be accountability for just making s**t up. Calling the meningitis vaccine an “acellular virus” vaccine is not only wrong it is internally contradictory (viruses are not cells!) and should immediately get duct tape firmly placed over your mouth. And maybe a steel toed boot to the gut for good measure. >:-0 !!!!

  30. Considering how Oprah ripped into James Frey for his fictional “memoir”, it seems a bit ironic to see that a person who spouts these scientific fantasies is frequent guest on her show.

    Makes me wonder, if fictional memoir=evil than fictional science=?

  31. nybgrus “We NEED to pass legislation to augment the first amendment to say that if you spout of nonsense that is clearly contradicted by scientific knowledge, you get your speech license revoked.”

    Whoa, dude…no,no,no. What happens when the anti-science folks get elected? (when?) What prevents them from declaring all the woo stuff science and the real science dangerous?

    As much as I am fascinated with the sci-fi scenario of science-based-medicine guerrilla doctors working in an underground network to vaccinate people and circulate banned peer reviewed journals, in defiance of the mainstream complementary medicine establishment (much like the HVAC repair man in Brazil). I’d rather not help along that apocalyptic future by “augmenting” the first amendment.

  32. TsuDhoNimh says:

    @# Todd W.
    IF the mother has been exposed to the disease, AND IF she is producing the right kind of antibodies, they will go through the breast milk and into an infant IF and ONLY IF that infant has not made the switch to digesting proteins.

    Somewhere between 3 and 6 months the infant’s gut stops absorbing antibodies and starts digesting them like all other proteins.

    So – giving pre-pregnant women (basically late teenaged women) a booster for all the childhood crap would help protect their babies.

    But you also need to vaccinate the dad, grandparents and siblings.

  33. Wolfy says:

    @ TsuDhoNimh

    “Somewhere between 3 and 6 months the infant’s gut stops absorbing antibodies and starts digesting them like all other proteins.”

    Is this general pediatric knowledge: old school like Nelson’s Pediatrics or something more recent in the literature?

    Thanks.

  34. lizditz says:

    the most important of which is to breastfeed her.

    I would like to ask Christiane Northrup what she would have to say to women who for whatever reason cannot breastfed their newborns.

    It is just another way of blaming mothers

  35. nybgrus says:

    @ micheleinmichigan: Yes, of course you are right. I was just so pissed off at this that I started spouting nonsense. I hoped it would seem enough like an angry rant to be realized and written off as just that. But, no, clearly that is not a path I would actually go down… though I guess with my all caps “need” it certainly seemed I was suggesting that. Apologies – just emphatic ranting on this one.

    @wolfy: Yes, it is general immunological knowledge that we learn in first year med. Passive immunity is conferred to the infant until ~6 months of age. This is why genetic immune disorders are usually first recognized around this age. Severe Combined Immune Deficiency (SCID – think the boy in the bubble) first manifests as frequent recurrent infections to normally non-pathological bacteria right around the 6 month mark. The change in gut absorption has also been theorized as part of the development of allergies – normally proteins are broken down into individual amino acids or very short peptide chains before absorption, but the younger an infant, the longer the chain and fewer the single aminos. The hypothesis is then that a protein (say peanut) could get absorbed in a large enough form to be antigenic and the developing immune system could see it as foreign and react later in life. Of course, this is clearly not the whole picture of allergy (which is poorly understood) and I am not sure if this has been proven yet, but a few years ago it was an interesting idea. But I digress. Yes, that is the switch of immunity that is normal of growing infants and part of the reason why we don’t recommend vaccinating at under 6 months of age (except in certain special circumstances).

  36. nybgrus – okay, I’ll unruffle my first amendment feather’s then.

    also – “But I digress. Yes, that is the switch of immunity that is normal of growing infants and part of the reason why we don’t recommend vaccinating at under 6 months of age (except in certain special circumstances).”

    I’m not sure if you are in the U.S. or if you are talking about a specific vaccine? The current CDC vaccination schedule starts at birth with HepB, then 2months with RV, DTap, Hib, PCV, IPV….I’m working from the parent chart. I don’t have experience with infant vaccines since I did not have the opportunity to start vaccinating my children til age 1 and 2.

  37. Wolfy says:

    @nybgrus:

    it has been a few years since the first year of med school for me, but i recall the passive immunity stuff.

    what i don’t recall is the mechanism of IgA (or other immunoglobulin) stability in the infant’s gut as suggested in the above comment by TsuDhoNimh:

    “the infant’s gut stops absorbing antibodies and starts digesting them like all other proteins.”

  38. khan says:

    # David Gorskion 23 Sep 2010 at 10:45 am

    And, contrary to the germ theory denialism view, this disease attacks healthy, vigorous young adults, no matter how much they exercise and eat well. It’s quite possible for a 20-year-old athlete to get meningococcal meningitis and die.

    Long ago (1970) in a college far away (Potsdam NY) a friend died from meningitis. His roommate survived because the other guys in the dorm physically carried him to the hospital.

    Both healthy athletic 20 y o, who had just hitchhiked cross country.
    ————————————————————–
    Is this a vax an older adult should get?

  39. Cloud says:

    As a scientist and a mother of a baby living in California, the nonsense spouted by Ms. Northrup (I don’t think she deserves the “Dr”) makes me furious. My baby is past the age of highest danger now, but my heart breaks for those 9 mothers (and fathers) whose babies died. I’m angry that this is happening.

    And I have to say- breastfeeding and vaccinating your baby aren’t mutually exclusive. I do both.

    Anyway, @Wolfy- about the immunity from breastmilk, I found this article on Kelly Mom, which is usually a fairly reliable website for breastfeeding information:
    http://www.kellymom.com/newman/how_breastmilk_protects_newborns.html

    There are citations to original literature in there. They may or may not answer your question, but as far as I can tell, the idea that infant’s gut isn’t “sealed” until about 6 months is fairly standard. I’ve heard it from many sources, including my pediatrician.

    It isn’t just antibodies in breastmilk- there are also macrophages. I think this is why I can squirt some breastmilk in my baby’s eye to cure pink eye. (Yes, this really works. It is awesome. And it stings a lot less than the prescription drops. Yes, I’ve tried it on myself.)

  40. TsuDhoNimh says:

    @Wolfy … really ancient, lost in the mists of antiquity kind of school.

    Newborns are “immunologically competent” for some things and not for others at birth. The HepB vaccine, for example, works when given at birth.

    Pertussis vaccine, on the other hand, for reasons I don’t remember, is basically invisible to the baby’s immune system until some time between 2 and 6 months. The recommended 2,4,6 month injections are hedging the bets; some infants will have an immune response to the earliest shot, others will not. Rather than leave them ALL unprotected until 6 months old, vaccinating earlier can protect quite a few of them and it’s one less vulnerable infant.

    At about 12 months the baby’s immune system is well-matured

  41. Jurjen S. says:

    Anthropologist Underground wrote:

    I may be confusing the first chakra with my favorite one, but something about the phrase “shaky chakra” triggered a Liz Phair earworm [...]

    Personally, I have had Bon Jovi’s “Bad Medicine” stuck in my head since reading this post.

  42. nybgrus says:

    @micheleinmichigan: Sorry to ruffle them in the first place. I do find myself many times thinking “If only we could get a l’il good ol’ Stalinist binding and gagging of the nutjobs….” but then realize that such methods will inevitably lead to downfall, even if the “right” people do the binding and gagging. I’ve heard enough stories from my parents growing up in Soviet Russia to realize that. However, this is also why I would advocate using precise language and educating the populace – rather than using convenient buzzwords and shortcuts (like saying an alive virus, for example). As for the vaccines – I am actually in Australia currently, and was going off of what I recalled from lecture notes a couple months back. I think TsuDhoNim also hits on a lot of the reasons why, but I am sure there are many exceptions though the vaccine schedule was worked out for good reasons.

    @wolfy: Sorry, I missed that you were looking for the mechanism. I actually have not explored it in detail, but as best as I understand it it has to do with the paracellular absorption route for large molecules. In an infant gut, the junctions between the enterocytes would be more leaky, in essence, and so whole proteins (and carbohydrates) could pass through. I believe there is a gradual “tightening” of this route and a steady up-regulation of brush border enzymes. How the IgA manages to make it through the stomach might have to do with how rapidly the food bolus gets into the duodenum – I have no children of my own, but I recall my sister having to feed the little devils every couple of hours. Perhaps a relatively low level of pepsin and chymotrypsin are expressed and coupled with the rapidity with which stomach contents are emptied leaves a significant amount of intact protein to be absorbed by this paracellular route. Seems to make evolutionary sense as well.

    @Cloud: Nice tip about the breast milk in the eye! Makes perfect sense and I will certainly keep it mind for future recommendations.

  43. WilliamOBLivion says:

    :::
    The precise reason(s) for this outbreak are unclear, but there are probably a number of factors. Pertussis outbreaks are cyclical, so increases in disease incidence are expected, but not to this extent.
    :::

    Not to anyone who has lived in California in the last 20 years and is paying attention.

    While there are indeed biological issues with degraded immune response over time, and a LARGE NUMBER of idiots in that area who refuse any sort of rational anything (including medical care), the biggest problem (at least with TB and Pertussis) is “undocumented aliens” coming from Mexico and further south who have never been vaccinated, and are carriers of some sort (either asymptomatic, or just f’ing sick).

  44. WilliamOBLivion says:

    @Alexie

    “Guys, you have to do some research and write a post on why highly educated people are the most likely to buy into this crap.”

    They aren’t. They’re just the ones who are articulate enough to integrate the nonsense and repeat it in ways that don’t obviously sound stupid.

    Also education IS NOT intelligence. You know what they call the lowest ranked graduate of Medical School, right?

    I was having a conversation with 2 doctors, and a well educated relative (by marriage) the other day. We were talking about people who operate outside of their experience and knowledge with the same surety as if they were in it. The quote I used at the time was “expertise in one domain does not translate to another domain” (physics excepted).

    They agreed, chuckled at me, and immediately shifted to talking about how they were rewiring parts of their houses. Because they were smart people.

    Now, I’ll admit that wiring in a ceiling fan or a light switch is not the same level as a heart-lung transplant. After all, screw up the transplant you kill the patient. Screw up the wiring, and in the middle if the night the house burns down and three or four people die. But that’s just me.

    Educated people think they have to tools to think, mostly because they went to “good” schools and have “good” educations. Some feeds them a line of crap that is internally consistent (see “mathematics”) and makes them feel good about the world and they’re off and running.

  45. Enkidu says:

    OT: A comment I wrote 2 days ago is still awating moderation. I didn’t insert any links or use inappropriate language. Is it because it was written within 3 hours of my previous comment? Is there a guide somewhere on SBM on what constitutes a moderated post?

  46. outotdoubt says:

    What makes her article even more ridiculous? That she figured references would be necessary, so she referenced 1) an article SHE wrote 2) an article Tennpenny wrote! What a schmuck .

  47. Chris says:

    is “undocumented aliens” coming from Mexico and further south who have never been vaccinated, and are carriers of some sort (either asymptomatic, or just f’ing sick).

    Provide actual public health documentation, especially since vaccination in Mexico is free and mandatory.

  48. Sid Offit says:

    Outbreaks occur cyclically, but outbreaks this large do not.
    ———————————————-

    Yeah they do ya mo-ron.

    http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/20861

    The number of pertussis cases is now on a pace to surpass the total of 3,182 seen in the most recent major outbreak, which occurred in 2005, said Ken August, spokesman for the department.

  49. squirrelelite says:

    Read your own source, Sid.

    California is facing what could be the state’s biggest outbreak of pertussis since 1958, its top public health official said.

    “Whooping cough is now an epidemic in California,” said Mark Horton, MD, MSPH, director of the California Department of Public Health, in a statement. “Children should be vaccinated against the disease and parents, family members, and caregivers of infants need a booster shot.”

    As of June 15, 910 cases had been confirmed in the state. Another 600 suspected cases are currently being investigated by local health officials, the statement indicated.

    The number of pertussis cases is now on a pace to surpass the total of 3,182 seen in the most recent major outbreak, which occurred in 2005, said Ken August, spokesman for the department.

    August told MedPage Today that 1,200 cases were recorded in 2005 as of mid-June, meaning the state would probably exceed that this year.

    The highest yearly total on record is 3,837 cases, seen in 1958.

    So far this year, five children have died, all infants younger than three months.

    And that source is three months old!

    We’re just getting to the middle of the peak season for whooping cough now.

  50. Composer99 says:

    Whoa. Sid Offit, getting caught cherry-picking a source?

    That never happens!

    /end sarcasm

  51. Sid Offit says:

    @squirrelelite

    Is this recent enough?

    http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%209-14-2010%20-%20For%20Release.pdf

    As of 9/14/2010, there have been 4,017 confirmed, probable and suspect cases of
    pertussis reported in 2010…

    So 200 more cases and the “doctor” is acting as if this “outbreak” is orders of magnitude greater than anything ever seen before.

    PS
    Seasons almost over

    Typically the peak season for pertussis is summer and early fall

  52. wales says:

    Note that the above cited CDPH piece states that only 65% (around 2,600) of the cases have been confirmed. To make a true apples-to-apples comparision with 1958 one would need to know what percentage of cases in that year were actually confirmed, and what percentage were “probable or possible”.

    We need to realize also, when blaming the “anti-vax” crowd that the vast majority of pertussis “anti-vaxers” are adults who are overdue for boosters. They may not be self proclaimed anti-vaxers, but they are nonetheless.

  53. nybgrus says:

    According to the latest CDC data, the numbers pretty much speak for themselves. Incidence (4,223 cases) and prevalence (10.8/100,000 average for the state) are both almost on par with the highest of each stat for California in the last 55 years. And Sid Offit, the season may be “almost over” as you say, but the year is not quite there AND this latest weeks data shows a 12.6% increase in incidence (206 new cases vs 183 from the week before). That would make me wary to have a confident smirk saying the season “is almost over” to imply that we wont be seeing many new cases for the rest of the year. Additionally, 83% of cases are either confirmed or probable, indicating that indeed this is pertussis. Can we compare that to the data from 1958? I would venture to say it is a wash – it was probably under-reported back then, but also likely over-confirmed. They did not have DNA testing to confirm and growth and culture was not as commonplace. Either way you shake it out, you can argue it is so far on par, except that we still have 3 months left in the year. The key is that the incidence and prevalence has been quite a bit lower for the years previous, with prior peaks significantly lower than this one. If you look at the table in the report (Figure 2) you will see huge numbers in the 50′s, declining in the 60′s, and then staying quite low and steady until a gradual rise in the mid 90′s and then more and more over the last decade until this years peak. This is true for both prevalence AND incidence. Knowing that anti-vax starting up around the mid 90′s and gained steam at the turn of the century, this seems to fit the data – though of course at this point it seems correlated, though with just the data I have here I cannot prove causality.

    As for the claim that it is adults and illegal Mexicans who are the true causes of this epidemic, according the the CDC report, the demographics say otherwise. Overall the highest rate of incidence is in whites (10.3/100,000 – which is slightly above the median case rate per county). Also, the highest case rates are in children under 18, with infants less than 1 year bearing the brunt of it. The vast majority of these infants are less than 6 months and therefore have not been vaccinated. However, if you look at age groups that SHOULD be vaccinated, the second highest is children aged 7-9 (34/100,000). Considering that DTaP is good for 10 years, and you would have your first shot at 6-12 months, these children should be covered by the vaccine – IF they got it. Additionally, as you can see from Figure 4, incidence declines with age. Past 18, the incidence rate drops to 3.5 and down, indicating that it is not adults that are overdo for boosters that are the crux of this problem.

    The highest incidence and hospitalization (and deaths) are from Hispanics. This is true indeed, but once again, this is from children less than 6 months of age (89% of cases). We can speculate all we want about why this may be and there are a variety of plausible reasons. However, the data seem to indicate that while Hispanic infants are suffering the most of lack of herd immunity, it is the white children from 7-9 years of age that are carrying around the bug.

    http://www.cdph.ca.gov/programs/immunize/Documents/PertussisReport9-21-2010.pdf

    I would thus argue that it is NOT illegal immigrants who are bringing the disease that is causing the problem. Even if they WERE bringing it, the white kids from 7-9 should NOT act as the largest reservoir in our population. Keep in mind, I am eschewing the number for infants <6 months since this is an unvaccinated population expected to be hit the hardest from a lack of herd immunity. If it were adults who needed their boosters that were unwittingly created a lack of herd immunity and the crux of the problem then we would expect their incidence rates to be at LEAST elevated – but they are exactly baseline and very low. Since the largest age group affected is thus exactly the age group that would most likely be a product of the anti-vax crowd, and the data of trends correlates with the anti-vax movement, I would stipulate that there is reason to believe a causal link between the two. While far from proven at this stage, the alternate hypothesis above clearly seem erroneous.

  54. nybgrus says:

    As an addendum: I am sure someone will take me to task for my assumption that the rate comparison would be a wash. But please, bear in mind that is a MINOR point. The rate comparison for the intervening 40 years is beyond clear and the comparison to 1958 is purely to state how long it has been since such numbers. 35 years of incidence rates in the 2-4/100,000 and now a rate of 10.9/100,000 is the key metric here.

  55. Watcher says:

    Dr. Lipson said that cyclical outbreaks occur, but generally not this large.

    Sid says that they do, but the last one was in ’58.

    I’m not sure how Sid’s original post and link discredits DOCTOR Lipson’s point …

  56. laursaurus says:

    Breastfeeding is best for digestion and all.
    The bottle-feeding trend didn’t become the status-quo until the baby boom. Back in the days of high infant mortality, all babies were breastfed. We didn’t just need vaccines because of the decline of breastfeeding. Babies were dying!

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