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Mumps

I write this post with a great deal of trepidation. The last time I perused the Medical Voices website I found nine questions that needed answering. So I answered them. One of the consequences of that blog entry was the promise that Medical Voices was poised to “tear my arguments to shreds.” Tear to shreds! Such a painful metaphor.

They specified that the shred tearing would be accomplished during a live debate, rather than a written response. While Dr. Gorski gave excellent reasons why such a debate is counterproductive, I am disinclined for more practical reasons. I am a slow thinker and a lousy debater and have never, ever, won a debate at home. If I cannot win pitted against my wife, what chance would I have against the combined might of the doctors and scientists at Medical Voices? My fragile psyche could not withstand the onslaught.

Still, there is much iron pyrite to be mined at Medical Voices and it may provide me for at least a years worth of entries. Please forgive me if I seem nervous or distracted. I have a Sword of Damocles hanging over my head and it may fall at any time. My writings may, without warning, be torn to pieces by the razor sharp logical sword of Medical Voices. Or maybe not. It is my understanding that Medical Voices will only answer with a debate, so maybe I am safe from total ego destruction.

This month, as I perused Medical Voices, I found it difficult to choose an article. So much opportunity and I have limited time to write. I finally decided on Why the New Mumps Outbreak Puts You At Risk by Robert J. Rowen, MD.

Mumps is a timely topic as, along with measles, it has returned thanks to the work of Dr. Wakefield. His fabrication of data to falsely suggest MMR causes autism has lead to a decrease in MMR use. In some areas of England 15% of the children were not vaccinated, levels that allow the virus to perpetuate in the community. The second ‘M’ in the MMR stands for mumps. While the measles outbreak has been getting all the press, England has been plagued with mumps as well, with over 3000 reported cases. Dr. Wakefield can be credited with over 5000 (mumps plus measles) sick children. I wonder how he can look at himself in the mirror.

Last year an 11-year-old child visited England. He was not vaccinated for religious reasons and, in addition to wonderful memories of a trip overseas, he brought home mumps. There have been over 1500 cases in New York and New Jersey as a result. Most of the disease has circulated in the unvaccinated religious community, but there have been cases in adjacent communities as well. Most of the cases of mumps in the non-religious have been in individuals that have received the MMR, although the cases in the community have been isolated while the disease is persisting in the unvaccinated religious community.

This is being touted as a failure of the MMR and an indictment of vaccination in general. What you should have instead is the real disease, get real immunity, and never worry about mumps again — or so argues Dr. Rowen.

Does real infection give better immunity? Maybe. What happened in olden times is kids would get mumps and develop antibodies to the infection. Then, since mumps was constantly circulating, they would be intermittently re-exposed to the virus and the immune system would get a nudge and produce more antibody. Constant exposure kept the antibody levels high. Natural infection may, with some infections, lead to higher antibody levels and a more sustained response, at a cost of the morbidity and mortality. Everything in medicine is a trade off.

Contrast with today: your only exposure to mumps is from the vaccine. Since you are not constantly re-exposed, your immune system has no reason to make antibody and antibody levels drift down over time. This is happening with chickenpox. Shingles is increasing in incidence in the elderly since people are no longer getting naturally boosted from re-exposure to chickenpox. As their antibodies wane over time, the chance of shingles goes up. Hence the need for the zoster vaccine booster in the elderly.

The recommendation to help abort the mumps outbreak is another dose of the MMR vaccine and the brisk response many kids have suggests an amnestic response: they have memory cells that recognize the mumps and respond to the vaccine antigens.

I think of the vaccine as a four-foot wall to keep out zombies. Maybe the odd zombie will jump the wall, but unlikely. Zombies are not typically coordinated enough. Getting the disease instead of the vaccine is building an eight-foot wall. It keeps out the zombies as well, but during the construction a few will fall off into the mouths of the waiting zombie hordes. Mumps is not without complications (orchitis and encephalitis being the most feared).

So with that as back ground, what does Robert J. Rowen have to say about mumps?

Did you have the mumps when you were a child? If so, it’s one of the best ways to avoid the mumps now that you’re older. If you didn’t have the mumps, you could be at serious risk for contracting the childhood disease — even if you’ve had the vaccine. As you may know, I’ve decried vaccines for decades. Why? They’re toxic (they inject poisonous additives into you), they deny children their needed usual infections to develop a robust immune system, and now there’s a third reason. Vaccines may not last a lifetime. And if they don’t, you could contract the disease as an adult. Think it won’t happen? Think again.

The “toxin gambit” has been covered at length on this blog. However, the immune system does not need ‘usual’ infections to build a robust immune system. As I have mentioned in the past, the immune system is not like a bicep that gets bigger and stronger as you use it. There are over 1300 common pathogens that can infect us and uncountable non-pathogens we can be exposed to. We get enough infections in life — the vaccine preventable illnesses are a drop in the infectious bucket and can be avoided with no detriment to immune function.

I have to admit, as an infectious disease specialist who only gets paid to take care of infections, I do like I doc who seems to be in favor of children getting mumps, measles, influenza, tetanus, pneumococcus, Haemophilus, hepatitis B, rubella, hepatitis A, polio, diphtheria, pertussis and meningococcus.

No one has ever suggested that the mumps vaccine is perfect or that the efficacy lasts forever.

The effectiveness of the mumps component of the MMR vaccine is lower than that of the measles and rubella components. Estimates of the effectiveness of the mumps vaccine have varied in previous studies, ranging from 73% to 91% after 1 dose and from 79% to 95% after 2 doses.

It is well known that antibody levels slowly decline over time but that patients will have a brisk increase in their antibodies if they get a booster dose. Natural infection may give a longer lived antibody response but not without the complications from the diseases.

Is this ignorance of the data or willful misrepresentation of the data? I hope the former, but I suspect the latter.

Last week, at least 1,521 people in New York and New Jersey developed mumps. About 85% of the victims had the usual two doses of the MMR vaccine. What have they gotten for it? So far, 55 cases of swollen and painful testicles, five cases of pancreatitis, two cases of meningitis, one case of temporary deafness, one case of Bell’s palsy, and one case of inflamed ovaries.

That is what you get from the natural mumps? Ouch. That is the trade off. Vaccines prevent disease with almost no morbidity or mortality but immunity may fade with time and, if herd immunity is not maintained, disease can spread.

Mumps is a relatively benign disease in kids. It is far more problematic in adults. One fear is damaged testicles leading to sterility, which is probably an overblown risk (and something most men over 65 don’t worry about too much). The other complications mentioned above are also well known.

According to the CDC, “The median age of patients is 15 years (range 3 months–90 years) and is similar in all areas with ongoing transmission except New Jersey, where the median age is 17 years. Sound like kids to me.

What is the risk? “Orchitis is the most common complication of mumps in post-pubertal men, affecting about 20%-30% of cases: 10%-30% are bilateral. Orchitis usually occurs 1-2 weeks after parotitis. Of affected testicles, 30%-50 % show a degree of testicular atrophy.”

And he fails to mention encephalitis. That is the horrible complication of mumps. It’s rare, but awful to have a child brain damaged by a preventable illness. In Finland:

The incidence of encephalitis was 8.3/100,000 child-years (range 19.8 in 1974 to 2.5 in 1985 and 1986). The organisms most commonly associated with encephalitis in children were mumps, measles, and varicella viruses, and Mycoplasma pneumoniae. After the start of the nationwide measles, parotitis, and rubella (MPR) vaccination programme in 1982 in Finland, encephalitides associated with these viruses seem to have totally vanished.

Totally vanished. No brain damaged kids from mumps or measles. If the low vaccination rates become the norm, maybe we will see mumps encephalitis again. I bet some anti-vaxers will say the brain damage was not from the infection but that it was from shaking the child.

Of course, the pundits’ reaction is to recommend a third vaccine. This will raise the risk of immune reactions. And it will fill you with toxic substances.

Half a CC of vaccine will fill you with toxins. Yet another person I do not want to be my bartender. I would order a pint and get drop of ale and be told the glass was full to the rim.

But why would you want a third vaccine? Vaccines may not give life-long immunity, as does the wild virus. Furthermore, lifelong immunity might be fostered by repeated exposure to the wild virus circulating every few years and giving your immune system a memory boost. With the wild virus largely removed, large swaths of the population might lose immunity over time and when re-exposed, develop disease or at least become spreading carriers.

I would get a third dose of vaccine to avoid mumps and all its complications. He evidently is advocating for the return to the 1800’s when everyone got mumps and a few died or had permanent severe neurological complications compared to a well vaccinated population where no one gets mumps or its complications. Odd advice. Of course he fails to mention that when vaccine rates were high, mumps was almost non-existent. I have seen one case in 25 years of practice, and that was last year. The solution to mumps is not to let it circulate freely in human populations, the solution is to go all smallpox on its butt and eradicate it with vaccinations.

Please note it is not the vaccinated who are the “spreading carriers” in the current outbreak, it is the unvaccinated population.

If you or a loved one does get mumps, measles, or even chicken pox, I recommend an immediate ozone treatment, ultraviolet blood irradiation therapy, or a high-dose vitamin C IV. It sure worked for the few cases of mumps I saw in Alaska.

Huh? I have never heard to the first two interventions.

What is blood irradiation therapy? Take 6 oz of blood, irradiate it with ultraviolet light and reinject it into the patient. Infections will go away in hours to minutes. In the pre-antibiotic era it was 50% effective in comatose patients (those about to die) and 98 to 100% effective in less severe infections. It is equally effective for viruses, bacteria and even Tb.

Ozone therapy is the slow infusion hydrogen peroxide with similar benefits and no side effects in thousands of patients treated with the modality in the 1940’s.

I am not making this up; it is not an attempt at over-the-top humor. It is what Robert J. Rowen says on You Tube.

He also says that the therapy works in part by killing the bacteria or virus in the blood and then reinjecting it into the body where the immune system will have a much more brisk response to the dead bacteria. He calls it an autovaccine. Really. This from the man who has “decried vaccines for decades.” I guess it depends on what the meaning of vaccine is.

I’ve said before, please know where your closest oxidative physician is. If you are exposed to a childhood disease and become symptomatic, oxidation or high dose IV vitamin C could bring a quick resolution without complications. I am against vaccination. I would much rather treat an acute infection than the awful complications of vaccines. This includes the flu vaccine.

Treat self-limited diseases with rare complications and you will always have good results. All the complications mentioned in the essay are from mumps and not the vaccine, yet he concludes that it is the vaccines that have the side effects and should be avoided and you should embrace natural mumps, or influenza, and risk all the complications. Another Bizarro world essay from Medical Voices.

Man. Am I ever going to be torn to shreds with this one. Maybe next time I will write on a safer topic.

Posted in: Science and Medicine, Vaccines

Leave a Comment (57) ↓

57 thoughts on “Mumps

  1. Saffron says:

    There are times when I read your blog, and all I can think at the end is: Marry me.

    Not literally.

    I loved this one.

  2. Th1Th2 says:

    “There are over 1300 common pathogens that can infect us and uncountable non-pathogens we can be exposed to. ”

    How did you know?

  3. Mark Crislip says:

    I added them up from the id textbook. See my post on the infection schedule for the math.

    http://www.sciencebasedmedicine.org/?p=289

    its a ballpark figure.

  4. Scott says:

    So, in order to not get the disease, I should… get the disease? Sure, my odds of getting the disease a second time may be higher with natural infection than getting it the first time with the vaccine, but my odds of getting it once are lower with the vaccine. My odds of getting it twice are lower with the vaccine. My odds of getting it three times…

    You get the picture. But somehow “Dr” Rowen doesn’t.

  5. Thanks for the clear explanation on why the vaccines lose efficiency over time. I’ve heard a couple different explanations and never quite got it

    Question: does vaccination with MMR sometimes give partial immunity? Meaning, do the vaccinated more often get a less severe form of the illness?

    My daughter was vaccinated for chicken pox, was exposed about a year later and got mildly sick and about 10 bumps which the doctor thought might be atypical chicken pox. I’ve heard this is not uncommon with chicken pox. Wondered about measles, mumps and rubella (actually, I don’t know much about rubella, except it’s not good during pregnancy.)

  6. Josie says:

    So…once upon a time in the 40′s and in the pre-antibiotic era blood irradiation and ozone treatment were considered legitimate treatments?

    Color me confused.

    Wouldn’t the irradiation of blood kill off immune cells that are supposed to be fighting the infection?

    And ozone (O3)is not the same thing at hydrogen peroxide (H2O2) so far as I know, I am just a dumb girl biologist after all. The little I know about those two things makes me prefer the virus if I had to choose:
    http://en.wikipedia.org/wiki/Ozone

    Also curious that the alt-med crowd seem to be all into acai and the anti-oxidant properties of so-called super foods….ozone is about as oxidating as you can get…

    and then there is Hydrogen Peroxide, everyone’s favorite component of rocket fuel and hair bleach
    http://en.wikipedia.org/wiki/Hydrogen_peroxide

    Wow. I am not a teacher, but every time I read about things like this I feel I might do well by teaching logic, critical though and basic reading comprehension to gradeschoolers. I mean really, O3 vs H2O2 vs H3 vs H2O….it’s all the same right?

  7. Th1Th2 says:

    Mark Crislip,

    “its a ballpark figure.”

    Means anything but science.

  8. Th1Th2 says:

    Scott,

    “So, in order to not get the disease, I should… get the disease? ”

    AKA vaccination.

  9. Happy Camper says:

    Oh Stuff It!

    Don’t feed the troll.

  10. Th1Th2 says:

    micheleinmichigan,

    “Question: does vaccination with MMR sometimes give partial immunity? Meaning, do the vaccinated more often get a less severe form of the illness?”

    In MMR, there’s neither protection nor immunity; there is acquired infection!

  11. DevoutCatalyst says:

    Another pec’r.

  12. oderb says:

    Dr. Crislip:

    It’s hardly surprising that you have not heard of UVBIT. I’m sure it’s not taught in medical school nor suggested by your pharma reps.

    Not that it would difficult to research. There are dozens of articles in medical journals -mostly from the 1930′s and 1940′s – showing the amazing efficacy of ultra violet blood irradiation.

    Check your medical library for the following as examples:

    Miley, George P. “Ultraviolet Blood Irradiation Therapy in Acute Pyrogenic Infections” American Journal of Surgery, 57, 493, 1942

    Miley, George P, “Recovery from Botulism Coma following Ultra Violet
    Blood Irradiation” Review of Gastroenterology, 13,17,1946

    Bayliss and Waites, “The synergistic killing of spores of Bacilus Subtilis by Hydogen Peroxide and Ultraviolet Light Radiation on Bacterial Spores.” Journal of Applied Bacteriology, 47, 263-269, Jan 2, 1979

    How do I know of this therapy? Simple. After having a life threatening case of c diff several years ago, i was determined to find an alternative to antibiotics as a means of dealing with bacterial infections that would not land me back in the hospital. And so i went to a doctor who offered these treatments, spoke to him at length about his clinical experience with hundreds of patients, spoke with some of his patients in the treatment room and then read the literature. I did my due diligence and was convinced this was for real.

    Twice since then I’ve had confirmed bacterial infections that went away with remarkable speed after one or more of these simple 20 minute treatments. I’m not writing to suggest that my experience is in any way proof of the efficacy of these modalities. Only to beg you to be open minded and yes, scientific in reviewing the literature that shows the overwhelming efficacy and safety of these treatments – and then having the grace and intellectual honesty to admit that maybe there is something to this approach.

    You’d become a hero to your patients were you to use UV and Ozone, as much as you’d become a pariah to your colleagues.

    Now I’ll wait for the snark and scorn that always results from any of my comments that challenge the conventional medical wisdom.

    Shoot away.

  13. Scott says:

    Typically something that hasn’t been published much on since the 40s and 50s didn’t get more publications because it didn’t pan out. Got anything recent?

  14. Maz says:

    Th1Th2,

    You don’t make any sense. A ballpark figure is used as an illustrative example. Your comparing narrative style and science. Why? At least make a valid criticism.

    oderb,

    I often get sick with a local infection or cold. Surprisingly, they tend to go away with remarkable speed once I get a few nights of decent sleep.

    My cure is safer and cheaper.

  15. BKsea says:

    I love when they ask the question “Did you have Mumps (or chicken pox or …) as a child and are you just fine today?” For some reason the dead and brain damaged kids never answer.

  16. Mark Crislip says:

    It is hard to find articles that old, the first abstract is not that impressive to someone who spends much of his professional time killing staph. I’ll keep looking as it would make for an intersting read.

    Efficacy of ultraviolet blood irradiation therapy in the control of staphylococcemias

    This article is not included in your organization’s subscription. However, you may be able to access this article under your organization’s agreement with Elsevier.

    George Miley M.D.

    Abstract
    There has been presented a report and analysis of sixteen cases of staphylococcemia given ultraviolet blood irradiation therapy as a method of controlling this type of acute pyogenic infection.

    The first seven staphylococcemic individuals treated by ultraviolet blood irradiation therapy failed to respond and died. Six of these seven received intensive sulfa drug therapy, whereas the seventh, whose Staphylococcemia arose from a bladder carcinoma and was complicated by atelectasis and empyema at the time of institution of ultraviolet blood irradiation therapy, received only blood irradiation and also died.

    The results of ultraviolet brood irradiation therapy in a second group of nine consecutive staphylococcemic individuals given blood irradiation was reported; all nine of these individuals recovered uneventfully; eight of the nine received no suIfa drugs whatsoever, and the ninth, forty-eight hours of sulfathiazole therapy one week before bIood culture became positive.

    In each of the sixteen cases reported one or more pure cuItures of pathogenic strains of either Staphylococcus aureus or StaphyIococcus albus were obtained from blood cuItures taken in tryptose phosphate broth.

    In fifteen of the sixteen cases there was present a profound toxemia at the time of institution of uItravioIet bIood irradiation therapy.

    Uterine diratation and curettage was performed in three individuaIs of Group Two, the recovery group, whiIe the blood culture in each of the three individuals was still positive. No untoward effects were observed to follow this radical procedure performed despite the presence of staphylococci in the bIood stream.

  17. Maz says:

    So alt-med people believe that firing ultraviolet radiation at your blood is a better/safer/more natural alternative to antibiotics?

    Don’t get me wrong, I’m fully aware that antibiotics are over prescribed — this doesn’t SEEM like the solution, though.

    Dr. Crislip, if you have the chance to look something over, will you tell us your thoughts on Phage Therapy? I always thought it was an interesting/clever concept (in a fight-fire-with-fire kind of way).

    http://en.wikipedia.org/wiki/Phage_therapy

  18. oderb says:

    Dr. Crislip,

    Several of the papers I looked at indicated that for some reason UV was ineffective when given in proximity to sulfa drugs, as the abstract indicates.

    Here are several other references:

    Miley, George and Jens Christensen, “Ultraviolet Blood Irradiation Therapy: Further Studies in Acute Infections” American Journal of Surgery, 73,486-493, 1947

    (same authors) ” Ultraviolet Blood Irradiation in Acute Virus Like Infections” Review of Gastroenterology, 15:271-277, 1948

    Rebbeck, E.W.” Ultraviolet Irradiation of Blood in the Treatment of
    Escherichia Coli Septicemia.” Archives of Physical Therapy, 24, 158-167, 1943

    I have another dozen or so references I’d be happy to post if you like.

  19. pmoran says:

    Oderb, if you rummage around journals of that vintage you will find any number of since-discarded “cures” for just about anything. Quality clinical research was rare in those days. Staph septicemia can also abruptly subside if a staph abscess is drains itself.

    It is also an intensely implausible treatment. Both UV radiation and ozone can certainly kill microorganisms on direct contact but treating a small amount of blood when there will be an infective focus constantly shedding more bugs to the blood stream looks futile.

    The “auto-vaccine” idea doesn’t wash well. The immune system will already be maximally stimulated to its capacity at the time, and Rowen himself himself argues that live bugs are better than the dead or mutated ones used in vaccines.

    I applaud your awareness that your own story is also not proof.

  20. Mark Crislip says:

    I have asked the librarian to pull the entire ourvre.

  21. oderb says:

    Dr Crislip:

    I appreciate your open mindedness and look forward to your observations after you’ve reviewed the studies.

  22. overshoot says:

    Trolls aside …

    1) I’ve had measles and mumps and there’s a presumption that as a result I have effective immunity. On the other hand, any presumptive immunity isn’t likely to have been challenged — or refreshed — for forty years or so. Has anyone done any research into how much residual immunity old fogies like us actually have?

    2) … which leads to the question of whether it would make sense to have adult boosters since the odds of widespread outbreaks, including adults, seem to be increasing.

  23. Mark Crislip says:

    1) Has anyone done any research into how much residual immunity old fogies like us actually have?

    http://content.nejm.org/cgi/content/full/357/19/1903#F1

    2) Dont know. In the hospital we measure antibody levels of new hires and boost if low.

  24. sheldon101 says:

    Mark, Mark, Mark. tsk..tsk..tsk.

    You write: “I wonder how he can look at himself in the mirror?”

    The answer is simple, he doesn’t see anything.

  25. BillyJoe says:

    I don’t get it.

    Injecting a vaccine is wrong.

    Putting a needle into a vein, extracting some blood, irradiating with UV light, and injecting that back into the body is not only okay but a really good idea!

    How do these minds work?

  26. Ken Hamer says:

    “Zombies are not typically coordinated enough.”

    You sure ’bout that?

    One look at the anti-vax crowd suggests otherwise to me.

  27. Ken Hamer says:

    “Zombies are not typically coordinated enough.”

    You sure ’bout that?

    One look at the anti-vax crowd suggests otherwise to me.

  28. cellculturequeen says:

    A question:
    It’s well known that mumps can cause infertility in boys and men. Has anything similar been reported for girls and women? If so, the disease may have come close to cutting off my familiy tree two generations ago (my grandmother’s blocked fallopian tubes were blamed on a mumps infection in her youth).

    It definitively gave my aunt a horrible case of encephalitis, while my mother was still recovering from polio.
    I wonder why we are such big fans of vaccines in this family.

  29. cellculturequeen says:

    That word was supposed to be “definitely”. Sorry, English is not my first language.

  30. The Blind Watchmaker says:

    Someone above seemed to suggest that the MMR vaccine induced infection like the natural viruses. It does not. The live viruses in the vaccine are attenuated and do not cause infection. They do induce immunity without infection. That is the entire point!

  31. BillyJoe says:

    The Blind Watchmaker,

    If you are not familiar with Thick&Thicker, may I suggest that you ignore him when he responds to your post. ;)

  32. BillyJoe says:

    …actually that was Thick&Thicker you were responding to. :D

  33. overshoot says:

    Someone above seemed to suggest that the MMR vaccine induced infection like the natural viruses. It does not.

    FSVO “like.” They’re live viruses and they do reproduce in the body — they’re just not pathogenic. Our commenter-with-an-odd-aspect-ratio is a crank who apparently believes that humoral immunity to antigens is the essence of disease, though, which is arrant nonsense. Since s/he doesn’t state that clearly it’s sometimes possible to get into long exchanges where you’re talking past each other without really understanding that thick&thin is posting from a totally alien universe.

  34. lillym says:

    The1Troll2′s argument goes like this — infants are innately immune to all disease and would never get a disease except that doctors and parents insist on giving vaccines.

    Granted s/he never says this as simply there’s lots of word salad with innate and naive thrown in there as well.

  35. lillym,

    It gets even better. “Infants are innately immune to all disease and would never get a disease except that doctors and parents insist on giving vaccines” … or exposing them to sick people.

    Really. Infants can’t get sick because they have all these protections. Their protections are only overcome by vaccination or by exposure to disease, for instance at a pox party.

  36. _Arthur says:

    That bunch of **** gloats that only 55 kids had swollen and painful testes, not to mention the pancreatitis cases, meningitis, deafness, palsy, inflammed ovaries,
    and they all infer it happened _only_ to the vaccined children (or adults), while nothing in the published information supports that contention.

    The serious cases could be distributed evenly (prorata) between the vax/unvax cases, or could be concentrated in the unvaccined patients (mostly kids), since the vaccine is know to offer partial protection even when it fails.

  37. TsuDhoNimh says:

    @Maz – The problem with phage therapy is that there are thousands of phages, each of which are specific for certain species and sub-species and even specific to the antigens on the bacteria’s cell wall.

    It’s not “fight fire with fire”, where any old match will do, the match has to be custom-tailored to the specific bacteria. By the time you get a custom-built incendiary device the patient stands a good chance of being dead.

    And then there are the endotoxins, substances inside the bacteria that are released when the cell dies and lyses. My memory is a bit fuzzy, because it was in a lecture decades ago, but the prof discussing phages and phage therapy mentioned early experiments with a phage against a pathogen that was smokingly effective … it rapidly destroyed vast numbers of bacteria. And the the patient would die of shock from the endotoxins.

    Same problem exists with some antibiotics: plague bacilli can be rapidly killed off by several antibiotics, but the amount of endotixin released will then promptly kill the patient. They use “bacteriostatic” antibiotics to slow the cell deaths down enough so the body can handle the endotoxins.

  38. anjou says:

    I had mumps before vaccine was available…permanently and totally deaf in my left ear as a result, eternally grateful that it wasn’t both ears…

    “Deafness. Mumps was a leading cause of acquired deafness before the advent of mumps vaccines but nevertheless hearing loss is rare (one in every 20,000 mumps cases). It is usually unilateral. The patient may not, in fact, have overt mumps. Deafness may improve with time but is usually permanent.”

    Having lived with the consequences of mumps for over fifty years, I too wonder how Wakefield can look himself in the mirror.

    Thank you for your post!

  39. GinaPera says:

    Wow Mark. You’re a regular Morris Fishbein.

    If you haven’t read Pope Brock’s excellent book Charlatan, I highly recommend it.

    You will learn, if you don’t know already (and you probably do), that what you’re up against is a long-running genotype in the American psyche. Plus, it’s a great read.

  40. Another Saturday night and I ain’t got no mu-umps
    I got some toxins cause I just got shots.
    Oh how I wished that someone had told me,
    That risking infertility, brain inflammation, hearing loss and pancreatitis is actually better for me
    I’m in an awful way.

    Can’t quite seem to make that fourth line fit.

  41. hippiehunter says:

    I have a young child and we live in an area where we have have a pertussis epidemic ( coincidently ) near a major antivaxx promoter of woo.
    These people are not simply concerned about vaccination they are promoting thier own alternative magic water and building straw men in order to try and sell it.
    The result is the death and untold suffering of infants and a lot of fear amongst parents.
    These woo liars cannot be stopped by reason alone, something else MUST be done to stop thier murderous propaganda.

  42. squirrelelite says:

    Good try, though, michelle.

    Some times it helps to just stretch it out a bit.

  43. BillyJoe says:

    If Tim Minchin can do it and get away with it, so can you Michele. :)

  44. Yup, just like Tim Minchin, I’ve got the same hair, only fair less talent. ;)

  45. Jann Bellamy says:

    michelleinmichigan:

    Your poetry is a lot better than their poetry! Check out “Ode to Madness” on Medical Voices: http://www.medicalvoices.org/vaccination/articles/ode-to-madness.html.

  46. Oh, ouch. William Carlos Williams she ain’t.

  47. tcw says:

    In my experience, I think it is the memory of polio that makes some people vaccinate. Once this collective memory is gone of iron lungs, then I am afraid of polio’s return.
    Since an ID doctor has only seen one case of mumps in 25 years, may I suggest a post on what primary care doctors should do on encountering confirmed or suspected cases of these rare, but potentially re-emergent diseases? Yeah, one could read the CDC or some other guidelines, but you can make it more interesting. What disease would it take to shut down the clinic, quarantine the staff, run around, and act like Charlton Heston?

  48. dt says:

    Mark,
    I think you have missed out a blockquote in your article (the bit about UV and ozone).

    Re: Staph septicemia improving in that UV study-

    I note the paper says the patients had either Staph aureus, or Staph albus.

    Staph albus is actually non-pathogenic (it has now be renamed Staph epidermidis) and it is quite possible that the reason some patients got better was that they had this infection rather than Staph aureus septicemia. Does the paper tell which patients had which infection? Perhaps the “recovery group” all had S. epidemidis?
    Enquiring minds wish to know.

  49. pmoran says:

    Good pickup, DT. I will be interested in Mark’s more up-to-date opinion, but in my day, (60s-90s) S Albus was regarded as having very low pathogenicity and probably a contaminant when found in blood cultures. It does suggest that at least some of Miley’s patients had another reason for their fever, and for their recovery.

    This is typical of the fatal flaws often found in very old studies as commonly dredged up to support “alternative” methods.

    Key point — the first truly randomised controlled trial was performed in 1948. RCTs have further evolved even further since then.

  50. Mark,

    Great post, as always, but I have 2 quibbles. With any luck, you’ll point out my errors, and the crow will be mine to eat.

    I was just responding to some anti-vaccination nonsense on Facebook today (http://www.facebook.com/topic.php?uid=394883877268&topic=13716), and like you I claimed that Wakefield was responsible for the increase in mumps in the UK (esp. 2004-2005).

    It appears that the CDC has a different opinion:

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5507a1.htm

    “The 2004–2005 mumps epidemic in the UK did not result from the decrease in MMR vaccination coverage in recent years, but rather from gaps in eligibility of certain cohorts, which has been evident during the epidemic by the age breakdown among patients with confirmed cases; mumps occurred predominantly in older teens and young adults, with the highest attack rate occurring in those born during 1983–1986 (3). Persons born before September 1987 generally were not eligible for any routine mumps vaccination, although some might have received 1 dose of MMR upon school entry as part of a catch-up campaign after October 1988 that targeted children who missed their measles vaccination. Persons born before 1982 are more likely to have been exposed to mumps infection when it was still a common childhood disease. Only 2.4% of confirmed cases in 2004 occurred in persons who would have been eligible for 2 doses of MMR routinely.”

    So I did the right thing, and retracted my claim. (Wakefield remains on my dinner party blacklist, however.)

    Did I back down too quickly? Is there another interpretation of the data retains him in the villain’s role when it comes to the past increase in mumps, or will we only see his real impact in the future?

    The second quibble has to do with the immunization status of the patients in the NY/NJ outbreak:

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5905a1.htm

    From that page, I get these two nuggets:

    “Of the 1,521 patients, 1,477 (97%) are members of the tradition-observant Jewish community. Of the 44 cases not associated with this religious community, 33 have been reported from New York City; seven from New Jersey; two from Orange County, New York; and two from Rockland County, New York. Many of these outside cases have occurred among persons who have reported regular contact with members of the affected community.”

    …and…

    “Vaccination status is known for 1,115 patients: 966 (91%) of 1,062 patients aged ≤18 years and 149 (33%) of 456 patients aged ≥19 years (Table). Of these patients, 976 (88%) had received at least 1 dose of mumps-containing vaccine before the outbreak, and 839 (75%) had received 2 doses. Among patients aged 7–18 years, the age group with the majority of cases and for whom 2 doses of MMR vaccine is recommended, 93% had received at least 1 dose, and 85% had received 2 doses.”

    Now, you didn’t actually say that most of the cases in the religious community were unvaccinated individuals, but that seemed to be the implication of “Most of the disease has circulated in the unvaccinated religious community, but there have been cases in adjacent communities as well.”

    That had always been my understanding of the outbreak, too. But if 1,477 out of 1,521 cases are from the religious community, and 976 patients (whose vaccination status is known, but their religious affiliation is unstated) had received at least 1 dose of MMR, that seems to refute the idea that most of the patients from the religious community were unvaccinated.

    At worst, it would seem that 545 out of 1,477 patients from the religious community, or about 38%, were unvaccinated. Granted, that’s really dismal, and they may well qualify to be classified as an unvaccinated community. But it’s not entirely (or even predominately) unvaccinated, which was the idea I had gleaned from previous reports, and which seemed to be echoed in your post.

    Like I said, it’s just a quibble.

    Keep up the great work!

  51. mtngrrl says:

    My whole family suffered from pertussis all winter- we are all vaccinated- acquired at their public school.. the outbreak wasn’t discovered for months- my children went to their pediatrician several times- but since they generally are so healthy- he didn’t believe they were sick!! As their mom- I knew- and I had it too!! Mine was aggravated by my asthma- and I thought I had a lingering case of bronchitis- as I try and avoid anti-biotics- I didn’t go to dr. until last week.

  52. Mark Crislip says:

    I had never run across the CDC analysis of the UK outbreak

  53. So what’s your analysis of it? Do we all need to send Wakefield a gift basket and a note of apology? (Regarding the 2004-2005 mumps outbreak, at least.)

  54. wales says:

    Regarding HMN’s comments, I too have been curious about the assumptions surrounding the UK mumps outbreaks (and US outbreaks). This link is educational. http://www.cdc.gov/ncidod/eid/13/1/12.htm

    “During 2004–2005, a major increase in reported and confirmed cases occurred in all regions of England and Wales. In 2005, >56,000 clinical cases were reported, most in patients 19–23 years of age. Of the confirmed cases, 2,500 possible cases from 11 states was reported in the United States. The reemergence of mumps in countries that had high levels of vaccine coverage for many years raises questions about the effectiveness of the mumps component of the MMR vaccine and the possible contribution of waning immunity. In early clinical trials, the efficacy of a single dose of mumps vaccine was >95%, but estimates of the effectiveness in field evaluations have been 62%–85%.”

  55. wales says:

    Somehow those two paragraphs merged. To clarify: “During 2004–2005, a major increase in reported and confirmed cases occurred in all regions of England and Wales. In 2005, over 56,000 clinical cases were reported, most in patients 19–23 years of age. Of the confirmed cases, less than 3% occurred in children eligible to have received 2 doses of MMR vaccine routinely (i.e., those born from 1993 through 1999).” (Mumps vaccine was not introduced in the UK until 1988, and a second dose was not introduced until 1996.)

    The CDC piece also states “During 2005–2006, a large outbreak of mumps involving >2,500 possible cases from 11 states was reported in the United States. The reemergence of mumps in countries that had high levels of vaccine coverage for many years raises questions about the effectiveness of the mumps component of the MMR vaccine and the possible contribution of waning immunity. In early clinical trials, the efficacy of a single dose of mumps vaccine was >95%, but estimates of the effectiveness in field evaluations have been 62%–85%.”

  56. Mark Crislip says:

    I will review in the near future and post a self serving reply.

  57. I know you have a lot of demands on your time, but have you had a chance yet to think about the CDC document’s editorial statement on the 2004-2005 mumps outbreak in the UK?

    I’ve been very critical of Wakefield in the quixotic exchange of comments I’m engaged in at:

    http://www.facebook.com/topic.php?uid=394883877268&topic=13716

    …and I’d pin the mumps outbreak on him too if I could. Unfortunately, I’m constrained by the CDC’s argument that it’s origins precede Wakefield’s work.

    I would really like to hear any thoughts you have on their data and reasoning.

    Thanks!

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